Safe Sleep Knowledge and Use of Provided Cribs in a Crib Delivery Program

Introduction. Risk of infant sleep-related death can be reducedthrough safe sleep practices. Barriers to infant safe sleep have beenmitigated through education and crib distribution, however, previousstudies have not explored whether distributed cribs are put to use. Methods. In a rural Michigan county, the Great Start Sleep Initiativesupplied cribs and education shortly after infant birth to familieswith high-risk of infant mortality, as assessed through comprehensiveinterviews with families by program staff. Participant knowledgewas evaluated using structured pre- and post-assessments beforeand after education. Further, a home visit was conducted to evaluatethe infant’s sleeping environment. Data from the program, collectedbetween January 2012 and December 2014, were evaluated. Results. Cribs and concomitant education were delivered to 75caregivers. Knowledge of safe sleep practices increased significantlyat follow-up with 67 caregivers (89%) affirming back positioning,68 (91%) endorsing removal of unsafe items or soft objects, suchas blankets, from the sleeping area, and 42 (56%) renouncing bedsharing.At the home visit, 74 caregivers (99%) were using a crib toput their infant down to sleep, 70 (93%) were using the providedcrib, and 67 (89%) had no unsafe items in the child’s sleeping area. Conclusion. Providing education to high-risk mothersresulted in improved safe sleep knowledge and providedcribs are used in these homes. KS J Med 2017;10(3):59-61

Intention to Read to Newborns Following a Brief Reading Promotion Intervention among Low-Income Pregnant Women

Introduction. Reading to children can increase word knowledge andsuccess in school. The American Academy of Pediatrics recommendsbeginning reading at birth. However, children from low-incomefamilies are exposed to less words, including reading exposure, thanchildren from high-income families.Methods.xPregnant women attending a community prenatal educationprogram targeted at high-risk and low-income populationswere recruited into this study. Participants completed a pre-survey,engaged with a brief educational intervention, then completed amatched post-survey. Surveys assessed perceived benefits, intendedbehaviors, and self-efficacy regarding reading to their child.Results. Of 61 eligible participants, 54 (89%) completed the study.Participants reported being Black (33%), White (30%), Hispanic(28%), and other race (9%). Average gestational age at enrollmentwas 27 weeks (range 13 to 38 weeks). The average age of respondentswas 26 years (SD = 7.2); 46% reported being pregnant for the firsttime. Following the intervention, no change in knowledge regardingbenefits of reading was observed, however, baseline knowledge washigh (58% - 94%). At post-test, significantly more women reported itwas important to start reading to their child at birth (83% vs 56%; p< 0.001) and that they planned to start reading to their child at birth(70% vs 50%; p = 0.001).Conclusions. A brief educational intervention showed promise inincreasing pregnant women’s intentions to read to their children andshould be considered in conjunction with other reading promotionprograms. Follow-up to assess actual reading behavior is needed.Kans J Med 2019;12(2):50-52

Safe Sleep Practices of Kansas Birthing Hospitals

Introduction. Sleep-related death is tied with congenital anomaliesas the leading cause of infant mortality in Kansas, and externalrisk factors are present in 83% of these deaths. Hospitals can impactcaregiver intentions to follow risk-reduction strategies. This projectassessed the current practices and policies of Kansas hospitals withregard to safe sleep. Methods. A cross-sectional survey of existing safe sleep practicesand policies in Kansas hospitals was performed. Hospitals were categorizedbased on reported delivery volume and data were comparedacross hospital sizes. Results. Thirty-one of 73 (42%) contacted hospitals responded. Individualsurvey respondents represented various hospital departmentsincluding newborn/well-baby (68%), neonatal intensive care unit(3%) and other non-nursery departments or administration (29%).Fifty-eight percent of respondents reported staff were trained oninfant safe sleep; 44% of these held trainings annually. High volumehospitals tended to have more annual training than low or mid volumebirth hospitals. Thirty-nine percent reported a safe sleep policy,though most of these (67%) reported never auditing compliance. Thetop barrier to safe sleep education, regardless of delivery volume, wasconflicting patient and family member beliefs. Conclusions. Hospital promotion of infant safe sleep is being conductedin Kansas to varying degrees. High and mid volume birthhospitals may need to work more on formal auditing of safe sleeppractices, while low volume hospitals may need more staff training.Low volume hospitals also may benefit from access to additional caregivereducation materials. Finally, it is important to note hospitalsshould not be solely responsible for safe sleep education.KS J Med 2018;11(1):1-4

Kansas Provider Report of Adolescent Vaccinations in Their Practice

Introduction. Kansas falls consistently below average for adolescentvaccination of meningococcal (MCV), human papillomavirus(HPV), and influenza. Methods. For this study, the members of Kansas Chapter of theAmerican Academy of Pediatrics were emailed a confidential electronicsurvey soliciting their impressions of vaccination in theirpractice. Results. Of 137 providers emailed, 61 (45%) completed the survey.Thirteen providers were excluded as they did not see/vaccinate adolescentsor did not complete the survey. Tetanus, diphtheria, pertussis(Tdap), and MCV vaccines were most commonly up to date with31 (65%) and 20 (42%) respondents reporting greater than 90%immunization rates, respectively. HPV (n = 42, 89%) and influenza(n = 40, 83%) vaccines had refusal rates greater than 25% in mostclinics. Most practices (n = 44, 92%) used internal electronic medicalrecords to track vaccinations, although 29 practices (60%) utilizedthe state immunization information system. Providers requestedvaccine-specific patient education tools, positive media coverage,staffing support, and best-practices workshops to support vaccinationefforts. Conclusion. Kansas providers may not be optimizing availableresources to enhance these rates, such as Web IZ tracking and immunizationreminders. Patient education supplies, specific to HPV andInfluenza vaccination, potentially could increase vaccination rates.KS J Med 2017;10(4):84-87

Maternal Knowledge, Attitudes, and Practices Concerning Interpregnancy Interval

Introduction. Few studies have examined maternal intentions andpractices related to interpregnancy interval (IPI). IPI less than 18months has been linked to increased preterm birth and infant mortality.This manuscript reports on a cross-sectional survey of mothersconducted to understand maternal knowledge, attitudes, and practiceof IPI in Sedgwick County, Kansas. Methods. New and expectant mothers and mothers of neonatalinfant care unit (NICU) graduates (n = 125) were surveyed regardingthe issues surrounding IPI. Front desk staff handed out self-administeredsurveys, which were returned to a nurse upon completion.NICU participants were emailed a link to the survey hosted on SurveyMonkey®. Results. Fewer than 30% of mothers reported previously receivinginformation about IPI from any source. When asked about risks associatedwith IPI, women frequently (n = 58, 45%) identified increasedrisk for birth outcomes with no known association with short IPI.Findings regarding maternal attitudes surrounding optimal IPI weremixed with many mothers defining ideal IPI as less than 18 months(n = 52, 42%), while broadly reporting they believed that a woman’sbody needs time to heal between pregnancies. Respondents from theNICU sample generally reported shorter optimal IPI values than theother participants. When IPI was estimated from participants’ pastpregnancies, half of IPIs were less than 18 months. Mothers reportedthey favored healthcare providers as a source for IPI education. Faceto-face discussions or printed materials were the preferred modes ofeducation. Conclusions. Women were aware of the need for spacing betweenpregnancies, however, that knowledge was unassociated with pastbehavior. These findings should be taken into consideration whenformulating future interventions. Kans J Med 2018;11(4):86-90

The Relationship of Personality Style and Attention Deficit Hyperactivity Disorder in Children

Introduction. This study was to identify personality correlates ofchildren with a diagnosis of Attention Deficit Hyperactive Disorder(ADHD). The Jungian Personality Type dimensions primarilyconsidered were Sensing/Intuiting and Perceiving/Judging.A Sensing child is likely to be very present-centered. A Perceivingchild tends to be curious and resist order and structure. Methods. Children attending a general pediatric clinic with a diagnosisof ADHD were eligible to participate. Enrolled childrenwere administered the Murphy-Meisgeier Type Indicator forChildren. Binomial tests were performed comparing Perceivingand Sensing personality components to accepted population rates. Results. Participants (n = 117) were predominantly male(78%) with a median age of 10 years. The Sensing trait (72%)was more prevalent than expected, though prevalence for thePerceiving trait (44%) did not differ from population rates. Conclusions. Personality types occasioned with the diagnosisof ADHD could be useful in establishing/normalizingtreatment regimens and approaches to assist thesechildren and their families better. KS J Med 2017;10(2):26-29

Analysis of sexual phenotype and prezygotic fertility in natural populations of Fucus spiralis, F. vesiculosus (Fucaceae, Phaeophyceae) and their putative hybrids

In the genus Fucus, the character dioecy/hermaphroditism has undergone multiple state changes and hybridization is possible between taxa with contrasting mating systems, e.g. between the dioecious Fucus vesiculosus and the hermaphrodite F. spiralis. In the context of mating system evolution, we evaluated the potential consequences of hybridization by studying the variation in sexual phenotype and prezygotic fertility. Firstly, as a result of hybridization between the two sexual systems, gender variation may arise depending on the relative importance of genes with large versus small phenotypic effects. We thus qualitatively examined the extent of gender variation within and among individual hybrids in comparison with both parental species. Secondly, if hybridization breaks up co-adapted gene complexes, hybrid fertility may be reduced in comparison with both parental species. Therefore, we also quantified male and female prezygotic fertility in parental species and their hybrids in order to test for reduction in hybrid fitness. A total of 89 sexually mature individuals (20 F. spiralis, 40 F. vesiculosus, 10 hermaphrodite hybrids and 19 dioecious hybrids) were sampled in two geographically distant regions (France and Portugal) and six conceptacles per individual were observed. Within-individual variation was very restricted qualitatively – only one hybrid carried a conceptacle with a different sexual phenotype from the five others – as well as quantitatively. This suggests a simple genetic system for sex determination involving a few genes with major effects. In addition, analyses showed no significant decrease in hybrid fertility compared with parental species. Moreover, hybrids exhibited all sexual phenotypes, suggesting several generations of hybridization and backcrossing and, therefore, that hybrids are reproductively successful. Finally, the occurrence of sterile paraphyses in female and hermaphrodite individuals was interpreted as a relic of male function and suggests that, as in higher plants, evolution from hermaphroditism to dioecy may be the most parsimonious pathway

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment