Palliative Care Outcomes for Critically ill Children After Rapid Whole Genome Sequencing.

Objectives: Clinical utility of rapid whole genome sequencing (rWGS) has been reported in 30-70% of pediatric ICU patients who receive a molecular diagnosis. Rapid molecular diagnostic techniques have been increasingly integrated into critical care, yet the influence of genetic test results on palliative care related decision making is largely unknown. This study evaluates palliative care related outcomes after rWGS.

Effect of end-of-life care education on perceived self-efficacy of the pediatric respiratory therapist.

Background: End-of-life care (EoLC) is difficult for respiratory therapists (RTs), causing struggles with providing EoLC and grief during and after the death.

Objective: The objective of the study was to determine if EoLC education can increase RTs' perception of knowledge of EoLC, respiratory therapy as a valuable EoLC service, comfort providing EoLC, and knowledge of ways to deal with grief.

Methods: One hundred and thirty pediatric RTs completed a 1 h EoLC education session.

Empowering Pediatric Palliative Homecare Patients and Caregivers with Symptom Management Plans.

Pediatric palliative home-based care has been shown to improve symptoms, quality of life, and coordination of care. Despite these successes, hospital utilization in our own palliative home-based care population remained high as some caregivers lacked confidence to manage symptoms at home and had difficulty in recalling or accessing "sick care plans." Our team developed the Symptom Management Plan (SMP), a multi-system "sick care plan," as a quality improvement project with the aim of improving caregiver confidence to manage symptoms at home.

Retrospective Pediatric Telepalliative Care Experience.

Rady Children's Hospital (RCH) offers an outpatient pediatric palliative clinic that began offering telepalliative care in 2016. This study describes demographics of parents receiving pediatric telepalliative care, patient/family satisfaction with telepalliative care, and patient/family perspectives. Retrospective electronic medical record chart review (2016-2020) of telepalliative patients at RCH (San Diego, USA), including satisfaction surveys.

Rapid Whole Genome Sequencing Has Clinical Utility in Children in the PICU.

Objectives: Genetic disorders are a leading contributor to mortality in the neonatal ICU and PICU in the United States. Although individually rare, there are over 6,200 single-gene diseases, which may preclude a genetic diagnosis prior to ICU admission. Rapid whole genome sequencing is an emerging method of diagnosing genetic conditions in time to affect ICU management of neonates; however, its clinical utility has yet to be adequately demonstrated in critically ill children.

Confidence with and Barriers to Serious Illness Communication: A National Survey of Hospitalists.

Objective: To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication.

Background: Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described.

Methods: Web-based survey, conducted in May 2016.

Interactive Palliative and End-of-Life Care Modules for Pediatric Residents.

. There is a need for increased palliative care training during pediatric residency. .

Apparent life-threatening event admissions and gastroesophageal reflux disease: the value of hospitalization.

Background: No standard management plan for infants with an apparent life-threatening event (ALTE) currently exists. These infants are routinely hospitalized. Benefits of hospitalization of ALTE patients with gastroesophageal reflux disease (GERD) need definition.

Planar chiral organoborane Lewis acids derived from naphthylferrocene.

Enantiomerically pure metalated 2-(1-naphthyl)ferrocene (NpFc) derivatives NpFcM (M=SnMe(3), HgCl) were prepared and characterized by multinuclear NMR and UV/Vis spectroscopy, cyclic voltammetry, and elemental analysis. Optical rotation measurements were performed and the absolute configuration of the new planar chiral ferrocene species was confirmed by single-crystal X-ray diffraction analysis. The mercuriated species NpFcHgCl proved suitable as a reagent for the preparation of the chiral organoborane Lewis acid NpFcBCl(2), which can in turn be converted to other ferrocenylboranes by replacement of Cl with nucleophiles.

Binary stacks of [CuC6F5]4 with arenes.

Formation of the first binary stacks of an intact organocopper aggregate with the arenes naphthalene and 2,2'-bithiophene is reported; crystallographic data suggest that the supramolecular assembly process is supported by Cu-pi, Cu-S, and perfluoroarene-arene pi-interactions.

Examination of the mixed-valence state of the doubly boron-bridged diferrocene cation [(FeCp)2{mu-C10H6(BPh)2}]+.

A series of mixed-valent (MV) complexes [(FeCp)2(mu-C10H6(BPh)2)]+X ([1+]X; X=I 5, PF6, SbF6, B(C6F5)4) were prepared by oxidation of diboradiferrocene [(FeCp)2(mu-C10H6(BPh)2)] (1) with I 2, AgPF6, and AgSbF6, respectively, and through anion exchange of the I 5(-) salt with [Li(Et2O)x][B(C6F5)4] in the case of X=B(C6F5)4. The MV state of the cation was investigated in solution by multinuclear NMR spectroscopy, CV, and UV/Vis-NIR absorption spectroscopy, and in the solid state by IR spectroscopy, single-crystal X-ray crystallography, and Mössbauer spectroscopy. The cyclic voltammogram of 1 shows two distinct redox waves with a large redox splitting of Delta E=510 mV in CH2Cl2 and the NIR spectrum for the mono-oxidized species displays an intervalence charge-transfer band at around 1500 to 1700 nm depending on the specific counterion present.

Simultaneous fluoride binding to ferrocene-based heteronuclear bidentate Lewis acids.

A series of micro2-fluoro-bridged heteronuclear bidentate Lewis acid complexes [K(18-crown-6)THF]+ [Fc(BMeF)(SnMe2Cl)F]- (1-2F), [K(18-crown-6)THF]+ [Fc(BMeF)(SnMe2F)F]- (1-3F), [K(18-crown-6)THF]+ [Fc(BMePh)(SnMe2Cl)F]- (2-F), and [K(18-crown-6)THF]+ [Fc(BMePh)(SnMe2F)F]- (2-2F) (Fc=1,2-ferrocenediyl) was prepared. Compounds 2-F and 2-2F were obtained as a mixture of diastereomers, which arise due to the generation of a stereocenter at boron in addition to their inherent planar chirality. All compounds have been studied in the solid state by single-crystal X-ray diffraction analysis and by multinuclear NMR spectroscopy in solution.