Direct-to-participant recruitment of mothers and infants: A strategic approach during challenging pandemic times.

Under traditional circumstances, most clinical trials rely on in-person operations to identify, recruit, and enroll study participants and to complete study-related visits. During unusual circumstances, such as the COVID-19 pandemic, the typical clinical trial model is challenged and forced to explore alternative approaches to implementing study recruitment, participant enrollment, and data collection strategies. One such alternative is a direct-to-participant approach which leverages electronic resources and relevant technological devices (, smart phones) available to researchers and patients.

Low Rate of Spontaneous Closure in Premature Infants Discharged with a Patent Ductus Arteriosus: A Multicenter Prospective Study.

Objectives: To assess the rate of spontaneous closure and the incidence of adverse events in infants discharged home with a patent ductus arteriosus.

Study Design: In a prospective multicenter study, we enrolled 201 premature infants (gestational age of 23-32 weeks at birth) discharged home with a persistently patent ductus arteriosus (PDA) and followed their PDA status at 6-month intervals through 18 months of age. The primary study outcome was the rate and timing of spontaneous ductal closure.

Placental Transfusion, Timing of Plastic Wrap or Bag Placement, and Preterm Neonates.

Objective: Compare delivery room practices and outcomes of infants born at less than 32 weeks' gestation or less than 1,500 g who have plastic wrap/bag placement simultaneously during placental transfusion to those receiving plastic wrap/bag placement sequentially following placental transfusion.

Study Design: Retrospective analysis of data from a multisite quality improvement initiative to refine stabilization procedures pertaining to placental transfusion and thermoregulation using a plastic wrap/bag. Delivery room practices and outcome data in 590 total cases receiving placental transfusion were controlled for propensity score matching and hospital of birth.

The pediatric airway: Historical concepts, new findings, and what matters.

New observations from novel imaging techniques regarding the anatomy, dimensions, and shape of the pediatric airway have emerged and provide insight for potential changes in the clinical management of the airway in infants and children. These new findings are challenging the historical concepts of a funnel-shaped upper airway with the cricoid ring as the narrowest dimension. Although these tenets have been accepted and used to guide clinical practice in airway management, there are limited clinical investigations in children to support the validity of these concepts.

Tracheobronchial angles in children: Three-dimensional computed tomography-based measurements.

Background: Studies have shown significant variation in the tracheobronchial angles in pediatric-aged patients. The current study revisits tracheobronchial angle measurements in children using accurate computed tomography-based 3-dimensional images to add clarity to the understanding of tracheobronchial angles. The primary objective of the current study was to measure the right and left bronchial angle take off from the trachea using 3-dimensional computed tomography-based images of the air column in the tracheobronchial tree.

Increased indomethacin dosing for persistent patent ductus arteriosus in preterm infants: a multicenter, randomized, controlled trial.

Objective: We conducted a multicenter, randomized, controlled trial to determine whether higher doses of indomethacin would improve the rate of patent ductus arteriosus (PDA) closure.

Study Design: Infants (<28 weeks gestation) who received a conventional, prophylactic 3-dose course of indomethacin were eligible if they had continued evidence of persistent ductus patency on an echocardiogram obtained before the third prophylactic indomethacin dose. Infants (n = 105) were randomized to receive an extended 3-day course of either low-dose (0.

Neonatology has always been a bargain--even when we weren't very good at it!

Objective: We wondered whether Neonatal Intensive Care Unit resources for Extremely Low Birth Weight infants have always been disproportionately devoted to survivors, even when ELBW infants were very likely to die.

Methods: We documented survival and length of stay (LOS) for 2354 ELBW infants (BW 450-1000 g) admitted to the NICU at the University of Chicago between 1978 and 2003. NICU bed-days were a proxy for medical expenses.

New variability in cerebrovascular anatomy determines severity of hippocampal injury following forebrain ischemia in the Mongolian gerbil.

Transient bilateral carotid artery occlusion in the Mongolian gerbil is a widely used model of forebrain ischemia due to species-specific absence of communicating arteries between the middle and posterior cerebral arteries. We have found that transient carotid occlusion induces a wide variation in histological injury of the hippocampus, suggesting that Mongolian gerbils currently available in the US have anomalous connections between the vertebral and carotid circulations. We subjected Mongolian gerbils from Harlan Sprague-Dawley and Charles River Laboratories to 5 min of bilateral carotid occlusion under continuous striatal temperature control and assessed hippocampal injury histologically 5 or 14 days later.