Study Supports Rabies Immunoglobulin for Post-Exposure Prophylaxis in Kids

NEW YORK (Reuters Health) – In children with confirmed or suspected rabies, human rabies immunoglobulin (HRIG) appears to be an effective part of the post-exposure prophylactic (PEP) treatment, researchers say.

“We know the incidence of kids being exposed to animals that may transmit rabies is high,” Dr. Novinyo Amega of Kedrion Biopharma, in Fort Lee, New Jersey, told Reuters Health by email. “However, little data exist that can help clinicians better understand the safety profiles of the various HRIG products currently available.”

Dr. Amega and colleagues conducted a phase-4 prospective, single-arm clinical trial of KEDRAB, an HRIG distributed by Kedrion Biopharma and approved by the U.S. Food and Drug Administration (FDA) in 2017, in 30 patients under 17.

All participants had confirmed or suspected rabies exposure in which PEP was indicated. This included standard-of-care wound washing, passive immunization with HRIG, and induction of active immunity through initiation of the rabies vaccine series. No placebo group was used, as this would have been ethically unacceptable due to the high fatality rate of rabies, the researchers say.

Participants received 20 IU/kg of HRIG150 (150 IU/mL) infiltrated into the wound site or sites. Any remainder was injected intramuscularly, concomitantly with the first of a four-dose series of rabies vaccine. Rabies virus neutralizing antibody (RVNA) titers and tolerability were assessed on day 14 following administration of the last vaccine dose.

There were no serious adverse events, rabies infections, or deaths, the researchers report in Human Vaccines and Immunotherapeutics. Twelve participants experienced a total of 13 adverse events deemed related to the study treatment, but all were mild.

By day 14, RVNA levels had reached at least 0.5 IU/mL in all but two of the participants. However, say the investigators, testing was “not repeated subsequently; thus, it remains possible that the two subjects that did not attain the cutoff by day 14 seroconverted by day 30.”

The study results have been submitted to the FDA for review, Dr. Amega said, adding, “we are pleased to see that top-line results of this pediatric study support KEDRAB’s safety profile. Importantly, we believe that meeting the primary objective of this study could further differentiate KEDRAB from other currently available HRIGs in the U.S.”

Kamada Ltd, which manufactures KEDRAB, and Kedrion Biopharma funded the study. Most of the authors are employees of these companies.

SOURCE: Human Vaccines and Immunotherapeutics, online February 9, 2021.

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Oxford Launches COVID-19 Vaccine Study in Children

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Oxford University is starting a COVID-19 vaccine study with children and young adults between ages 6 and 17.

At Oxford and three partner sites in London, Southampton, and Bristol, the phase 2 clinical trial will test whether kids and teens have a good immune response to the AstraZeneca vaccine. Previous trials have shown that the shot is safe in children.

“While most children are relatively unaffected by coronavirus and are unlikely to become unwell with the infection, it is important to establish the safety and immune response to the vaccine in children and young people as some children may benefit from vaccination,” Andrew Pollard, PhD, the chief investigator for the trial and a professor of pediatric infection and immunity at Oxford, said in a statement.

The new trial will enroll 300 volunteers, with up to 240 receiving the vaccine. The control group will receive a meningitis vaccine, which is safe in children and produces similar side effects to the COVID-19 vaccine, such as a sore arm.

COVID-19 vaccine trials have included children over age 12, so this marks the youngest group to be tested so far. Pfizer, Moderna, and Janssen have announced plans to start trials in younger children this spring, according to The Washington Post. Widespread vaccination in children likely won’t occur until 2022, the newspaper reported.

The trial launched on Friday, and the first vaccinations are expected by the end of the month. Parents can visit Oxford’s COVID-19 Vaccine Trial website to sign their children up for the study.

“This study will play an important role in helping to protect children in the future,” Grace Li, a pediatric clinical research fellow for the Oxford Vaccine Group, said in the statement.

“We’ve already seen that the vaccine is safe and effective in adults, and our understanding of how children are affected by the coronavirus continues to evolve,” she said.

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Child brain tumors can be classified by advanced imaging and AI

Child brain tumors can be classified by advanced imaging and AI

Diffusion weighted imaging and machine learning can successfully classify the diagnosis and characteristics of common types of pediatric brain tumors a UK-based multi-center study, including WMG at the University of Warwick has found. This means that the tumor can be characterized and treated more efficiently.

The largest cause of death from cancer in children are brain tumors in a particular part of the brain, called the posterior fossa. However, within this area, there are three main types of brain tumor, and being able to characterize them quickly and efficiently can be challenging.

Currently, a qualitative assessment of MRI by radiologists is used; however, overlapping radiological characteristics can make it difficult to distinguish which type of tumor it is, without the confirmation of biopsy. In the paper, “Classification of pediatric brain tumors by diffusion weighted imaging and machine learning,” published in the journal Scientific reports, led by the University of Birmingham including researchers from WMG, University of Warwick. The study found that tumor diagnostic classification can be improved by using non-invasive diffusion weighted imaging, when combined with machine learning (AI).

Diffusion weighted imaging involves the use of specific advanced MRI sequences, as well as software that generates images from the resulting data that uses the diffusion of water molecules to generate contrast in MR image. One can then extract an Apparent Diffusion Coefficient (ADC) map, analyzed values of which can be used to tell you more about the tumor.

The study involved 117 patients from five primary treatment centers across the UK with scans from twelve different hospitals on a total of eighteen different scanners, the images from them were then analyzed and region of interests were drawn by both an experienced radiologist and an expert scientist in pediatric neuroimaging. Values from the analysis of Apparent Diffusion Coeffcient maps from these images’ regions have been fed to AI algorithms to successfully discriminate the three most common types of pediatric posterior fossa brain tumors, non-invasively.

Professor Theo Arvanitis, director of the Institute of Digital Health at WMG, University of Warwick and one of the authors of the study explains:

“Using AI and advance Magnetic Resonance imaging characteristics, such as Apparent Diffusion Coefficient (ADC) values from diffusion weighted images, can potentially help distinguish, in a non-invasive way, between the main three different types of pediatric tumors in the posterior fossa, the area of the brain where such tumors are most commonly found in children.

“If this advanced imaging technique, combined with AI technology, can be routinely enrolled into hospitals it means that childhood brain tumors can be characterized and classified more efficiently, and in turn means that treatments can be pursued in a quicker manner with favorable outcomes for children suffering from the disease.”

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Explaining to your child why behavior is wrong may not always work


Parents know the scenario all too well: their child misbehaves and it comes time for discipline.

Research conducted globally shows that spanking is not the best option. But verbal reasoning, which explains why the behavior is wrong, may not always have the intended positive effect if the parent is loud and abrupt, according to a new University of Michigan study.

The findings indicate both positive and negative outcomes that could have lasting consequences on children’s emotional development. Verbal reasoning was associated with higher levels of getting along with others, but also with increased aggression and higher levels of distraction.

“Positive discipline doesn’t always seem to have all that many positive benefits,” said Andrew Grogan-Kaylor, professor of social work and lead author of the study published in the latest issue of International Journal of Behavioral Development.

“It’s more likely that the long-term investments that parents make in children, such as spending time with them, letting them know they are loved and listening to them, have more positive effects than nonviolent discipline. This has yet to be thoroughly researched in a global context.”

Research has continually shown that spanking leads to negative child outcomes, such as aggression and distraction, regardless of the context in which children are disciplined, including country, race and ethnicity, and neighborhood.

In the new study, researchers at U-M’s Ann Arbor and Flint campuses analyzed different forms of punishment associated with children’s behaviors in a global sample of nearly 216,000 families from 62 countries. The data came from the United Nations Children’s Fund Multiple Indicator Cluster Surveys.

The results confirmed that spanking was not associated with children getting along with their counterparts. It also led to increased aggression and distraction. For nonviolent discipline, which involved verbal reasoning and taking away privileges, mixed outcomes occurred, Grogan-Kaylor said.

Verbal reasoning did promote one positive result: Children were more prosocial with others, especially in countries where this discipline was more common. Surprisingly, verbal reasoning also increased aggression, likely in cases when the parents used harsh tones and language, the study suggested.

“Verbal reasoning may have negative effects on children if it is not employed in a way that is developmentally appropriate for the child to understand why their behavior is inappropriate,” Grogan-Kaylor said.

Meanwhile, children did not get along with other children and showed higher levels of aggression and became distracted when parents took away privileges.

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Catelynn Lowell, Tyler Baltierra Would Consider Adoption for '1 More' Child

Keeping their options open. Catelynn Lowell and Tyler Baltierra wouldn’t be opposed to expanding their family through adoption.

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“We have discussed it,” the 16 and Pregnant alum, 28, exclusively told Us Weekly while promoting season 9 of Teen Mom OG. “Yeah, if we weren’t able to have one more, sure, [we’d adopt]. Most definitely. But who knows at this time?”

Lowell went on to tell Us that she and her husband, 29, “do want to have one more child and that will be [their] last child.” She added, “It’s just up to the universe right now. Whatever happens, will happen, I guess, in its own time. I don’t know when that will be.”

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The Michigan native first gave birth to daughter Carly, now 11, in 2009 and placed her for adoption. The preteen is still in touch with the MTV personalities and has met their daughters, Novalee, 6, and Vaeda, 23 months.

In December 2020, Lowell revealed that she had suffered a miscarriage. “I WAS Pregnant and excited to share it with all of you and I am heartbroken to reveal that I lost the baby,” she wrote via Instagram at the time. “I am sharing this to let you know you are not alone. We are all in this together and everyone experiences pain, loss, and the recovery from it. [I’m] still in the thick of dealing with this loss as it was recent and all the emotional trauma that follows such a loss in an already horrifically hard year.”

The Conquering Chaos author previously miscarried in 2017 and exclusively told Us that a pregnancy loss is “always going to be in the back of” her mind when she sees a positive test.

“It’s like, ‘Well, maybe I shouldn’t get so excited,’” she explained. “But I’m also not going to let it hold me back from what I know I want eventually. Having children and watching siblings together is one of the most amazing things we’re able to watch as a parent. It’s one of the most beautiful things in life to have children and raise them. So yeah … it’s sad and I feel those emotions, but I’m not going to let it hold me back from something really beautiful in the long run.”

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She advised other moms in the same situation to “really have a support system,” from a therapist to a group of friends.

Season 9 of Teen Mom OG premieres on MTV Tuesday, January 26, at 8 p.m. ET.

With reporting by Christina Garibaldi

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Pippa Middleton Is Expecting 2nd Child With James Matthews: Report

Pippa Middleton is pregnant! Duchess Kate‘s sister is expecting baby No. 2 with her husband, James Matthews, according to Page Six.

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The socialite, 37, became a mom in October 2018 when her son, Arthur, arrived. “James and Pippa have had a baby boy. He was born Monday 15th October at 1:58 p.m., weighing 8 lbs and 9 oz,” Pippa’s rep told Us Weekly at the time. “Everyone is delighted and mother and baby are doing well.”

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Another source told Us that “the Duke and Duchess of Cambridge, [Prince William and Kate], are thrilled for Pippa and James.”

During his first year, the little one regularly worked out with his mom. “Now that Arthur is 11 months old and more mobile, I have been trying to come up with different activities to do with him,” the new mom explained in a Waitrose Weekend column in September 2019. “I needed to find something more than just park walks in the pram. Our local baby gym has been a saving grace. It’s a big space full of fun, soft objects, playmats, stairs, balls, swings, mini trampolines and more to stimulate and physically engage babies and toddlers.”

Pippa added that Arthur was learning “movement, balance and strength” in the classes, as well as “building his confidence with each visit.”

The infant also learned to swim in April 2019, the University of Edinburgh graduate revealed in her column. “Starting my son Arthur swimming at four months old has given him confidence and enjoyment in the water,” she wrote at the time. “He’s now six months old, and swimming is one of our favorite activities. The exercise helps guarantee sound daytime sleep, and the movement has improved his digestion.”

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Arthur has an “extremely close bond” with his grandma, Carole Middleton. The businesswoman, 65, is also “adored” by Kate, 38, and William’s three kids — Prince George, 7, Princess Charlotte, 5, and Prince Louis, 2.

“The kids love it in the countryside because they have so much freedom,” an insider exclusively told Us of the little ones’ time at grandma and grandpa Michael Middleton’s house.

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Molecular stress indicator not observed in survivors of child sexual abuse

Researchers and medical experts have long known that child sexual abuse has profoundly negative effects on the health of survivors; however, an international team of researchers was not able to find a link between the abuse and telomere length, considered an indicator of cellular aging and health.

Telomeres—molecular complexes that cap the ends of chromosomes—naturally decline in length as a person ages. But past research suggests that telomeres can shorten prematurely in response to stress, said Laura Etzel, a doctoral candidate in biobehavioral health at Penn State and lead author of the study. The researchers, who reported their findings in Psychoneuroendocrinology, available online now, hypothesized that signs of sexual abuse could show up in shortened lengths of a survivor’s telomeres.

“Essentially, when we look across different tissues, we find that in many cases shorter telomere lengths are associated with earlier onset aging-related phenotype and diseases. So, for example shorter telomere lengths in the blood or in the heart tissues are associated with earlier and more severe cardiovascular events,” said Etzel. “Contrary to our hypothesis, in this cohort, child sexual abuse in the mothers we studied was not associated with differences in telomere lengths at age 36.”

Because telomere length is often passed on to offspring, the researchers also checked the telomeres of the women’s children and did not find any association between the abuse and telomere length in the children either.

The results are already prompting the team to consider a few different routes for future research, particularly in addressing some of the limitations of the study, said Etzel. For example, she added that investigating the effects of variables—such as the differing impact of abuse severity, or the length of the abuse—may be critical, albeit difficult, next step in the research.

“It’s important to note that we found no evidence in this cohort of differential telomere lengths between women who were sexually abused as children and those who were not sexually abused as children,” she said. “Within both groups of women, however, we have women who were exposed to extreme poverty, to violence, to emotional abuse and physical abuse. So, we didn’t compare someone who reported no abuse with someone who only reported sexual abuse. In this research area, it’s difficult to tease apart those various forms of abuse because these types of abuse tend to manifest together.”

She added that because there was a 20-year gap between when the abuse occurred and when the measurement of the telomeres, there is a possibility that other influences negated the effects of the sexual abuse in the telomeres.

Telomere science is complex, said Etzel and the researchers conducted several checks to verify their findings. For example, they examined telomeres drawn from multiple tissues. Finding similar results in different tissues diminishes the likelihood that the results could be due to mainly random effects, according to the team.

“In the mothers, specifically, we had enough participants to do a cross-tissue look at it, so we included telomeres from their buccal tissue—the inside of their cheek—as well as their leukocytes—or blood—and we found a strong correlation between those two tissues, as well, ” said Etzel.

Although the findings ran counter to what the researchers originally hypothesized, studies like this are important for better understanding the long-term effects of childhood abuse, neglect and other forms of adversity, said Jennie Noll, professor of Human Development and Family Studies, Penn State and director of the Child Maltreatment Solutions Network. Noll is the principal investigator of the Female Growth and Development Study, the study from which the data for this work are drawn.

“Longitudinal, intergenerational cohort studies are extremely rare yet necessary to a nuanced understanding of the transmission of the effects of early life adversities across generations,” said Noll. “This analysis is not only important in adding to the literature on intergenerational continuity, but is also an important null finding regarding the impact of early life stress on telomere length later in adulthood.”

Noll is also an affiliate of Penn State’s Institute for Computational and Data Sciences.

According to Idan Shalev, associate professor of biobehavioral health, Penn State, telomere science is an emerging field that holds great promise for understanding how psychological and environmental exposures influence health and aging over the life course.

“The results of this study were surprising to us, but it also shows that more work is needed to understand the context of specific exposures and other factors that may influence telomere biology,” said Shalev. “This study also adds important information to what degree telomere length is correlated between different cells in the body and between mothers and children. This is a theme that our lab continues to investigate together with other leaders in the field as part of the Telomere Research Network.”

This investigation used data from the Female Growth and Development Study, which began in 1987. Female subjects with substantiated sexual abuse were referred to the study by Child Protective Services (CPS) agencies in the Washington, D.C., metropolitan area. Control subjects were recruited from the same communities.

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'Bachelor' Baby! Britt Nilsson Gives Birth to 1st Child With Jeremy Byrne

Welcome to Bachelor Nation! Britt Nilsson and her husband, Jeremy Byrne, welcomed their first child, a baby girl, on Tuesday, June 23.

The former reality star announced her daughter’s arrival on Friday, June 26, sharing a series of photos and posts on Instagram. “Hello! My Name is Noa Ellis Joy Byrne and I was born June 23 at 5:52 am, 9lb and 21 inches long!! 👑👑👑🥳🥳🥳🥰🥰🥰💕💕💕,” Nilsson wrote.

The Michigan native revealed that Noa has multiple meanings. In Hebrew she said it means “movement” or “motion,” while in Japanese it means “my love” or “from love.”

💕👑💕 squooooshhhyyy I love you more than words could ever say. And yes I’m probably gonna post a lot of pictures 🥳🥳🥳🌷🌷💃💃💃 I can’t help it! 😭😭😭😭💋💋

A post shared byBritt Karolina Byrne (@brittkarolinabyrne) on

The new mom continued: “In Hawaiian it means ‘freedom’ or ‘sea of freedom.’ In Arabic it means ‘higher’ and ‘genius.’ To us, it means the cutest little squishy warrior princess angel nugget ever born on this earth. It’s also a biblical story in Numbers about 5 daughters asking Moses for their fathers’ inheritance and God blessing their request before that was even remotely happening in society. Get it girl! So basically we love it for all the reasons!”

Nilsson added that Ellis means, “Yahweh is God” or “My God is Jehovah” or “The Lord is my God” and “JOY means JOY.”

The Bachelor alum, 33, announced in December 2019 that she was pregnant. “Swipe to see who’s inside!!!!” Nilsson captioned her Instagram reveal at the time. “First pic is me at 14 weeks, second is baby Byrne at 10 weeks. I can’t believe our little boobah is zootin all around so much with their little legs and arms, makes me cry!! Can’t wait to keep watching you grow, I already love you so much!”

Two months later, she and Byrne, shared the sex of their baby-to-be with the help of a confetti cannon.

The couple, who wed in September 2017 in Vista, California, were traveling to Taiwan ahead of their little one’s arrival when their home burned down in March. “Just know we are safe, happy, and good and are seeing more than ever that Father God is a wonderful protector, counselor, comforter!” Nilsson wrote alongside Instagram footage following the fire. “And even though I’ve cried a LOT the past weeks, I’ve also felt more LIFE and POWER than when everything is just easy.”

The former model and Bryne started dating in 2016 following her split from Bachelorette alum Brady Toops. While Nilsson came close to leading season 11 of the ABC show the previous year, Kaitlyn Bristowe received more votes for the role from male contestants.

In May 2017, Byrne got down on one knee. After going to Detroit, Michigan, to get Nilsson’s dad’s blessing, he proposed in their home surrounded by white candles and flower petals.

“WE ARE ENGAGED!!!!” his then-fiancée captioned her Instagram reveal. “I’m over the moon!!! The man of my dreams and the most godly, amazing, fun, life-giving, silly, intelligent, wonderful best friend I could ever ask for is my future husband!!!! I have been dreaming of this day forever!! Thank You Jesus!!! Wooo hooooo!!!!! I had no idea it was coming and it was the best day of my life! I love you forever Jeremy Byrne!!!”

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