The Cognitive and Linguistic Scale (CALS) was developed to serially monitor cognitive recovery of children and young people after severe acquired brain injury (ABI), during inpatient rehabilitation. The CALS can be used to derive Cognitive Ability Estimates (CAE) which are Rasch-propertied (unidimensional, interval-scale) and therefore may be ideally applied for use in research including within the context of clinical trials. Here, we used established statistical distribution-based and expert consensus-based methods to estimate the Minimal Clinically Important Difference (MCID) for CAE derived from the CALS.
View Article and Find Full Text PDFBackground: Autoimmune encephalitis (AE) can present as first-episode psychosis (FEP) in children. An FEP diagnostic algorithm has been proposed, but how this algorithm applies to children is unknown. We assess the FEP diagnostic algorithm in children with FEP.
View Article and Find Full Text PDFTraumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates.
View Article and Find Full Text PDFHealth profession educators readily identify with the goal of fostering healthcare providers who are critical thinkers focused on quality patient care. In the following paper, we aim to delve into critical thinking at the team level and help educators begin the process of creating a shared mental model focusing on cognition to identify gaps and opportunities for growth in their trainees. We will distinguish between microcognition (an individual's own critical thinking process in a controlled environment), macrocognition (critical thinking process in a real-world environment), and team cognition (the interaction and relationship among team members to augment macrocognition).
View Article and Find Full Text PDFObjective: To understand how methylphenidate (MPH) is used in youth with traumatic brain injury (TBI) during inpatient pediatric rehabilitation.
Setting: Inpatient pediatric rehabilitation.
Participants: In total, 234 children with TBI; 62 of whom received MPH and 172 who did not.
Background: Firearm-related injuries (FRI) are an increasing cause of death and injury in children. The etiology for this rise is multifactorial and includes socioeconomic factors. Despite its prevalence and documented increase over COVID-19, there is a paucity of research on disparities and the influence of social determinants of health (SDH) in pediatric FRI.
View Article and Find Full Text PDFIntroduction: Social determinants of health (SDH) are factors that may impact outcomes following pediatric traumatic brain injuries (TBI). The purpose of this study was to investigate the relationship between race and functional outcomes in a diverse pediatric population. We further explored how this association may be modified by SDH factors, including insurance status, social vulnerability, and child opportunity.
View Article and Find Full Text PDFBackground: Simulation has been shown to be an effective teaching strategy for increasing nursing students' knowledge and empathy toward individuals with low income. Virtual simulation is effective in teaching critical thinking, situational awareness, and empathy.
Method: This mixed-method study examined three virtual poverty simulation programs.
Traumatic brain injury (TBI) is a serious public health concern impacting millions of children and adolescents each year. Experiencing a brain injury during key critical periods of brain development can affect the normal formation of brain networks that are responsible for a range of complex neurocognitive outcomes. In addition, there are multiple pre- and postinjury factors that influence the trajectory of recovery and outcomes.
View Article and Find Full Text PDFBlood based traumatic brain injury (TBI) biomarkers offer additional diagnostic, therapeutic, and prognostic utility. While adult studies are robust, the pediatric population is less well studied. We sought to determine whether plasma osteopontin (OPN) and S100B alone or in combination predict mortality, head Computed tomography (CT) findings, as well as 6-month functional outcomes after TBI in children.
View Article and Find Full Text PDFObjective: People living with diabetes mellitus (DM) and chronic kidney disease can have difficulty attending multiple appointments to receive DM care. We developed and studied the utility of a DM outreach program to offer in the hemodialysis (HD) unit.
Methods: We conducted a quality improvement project in a satellite HD unit in London, Ontario, Canada, between August 1, 2019, and July 31, 2022.
Pharma 4.0 is a digital evolution of the pharmaceutical industry that automates scientists' traditional workflows with the implementation of modern technologies like cloud pipelines, artificial intelligence, robotic platforms, and augmented reality. Lab data capture (LDC) is an essential strategy for initiating Pharma 4.
View Article and Find Full Text PDFBACKGROUNDTyphoid fever is caused by the Gram-negative bacterium Salmonella enterica serovar Typhi and poses a substantial public health burden worldwide. Vaccines have been developed based on the surface Vi-capsular polysaccharide of S. Typhi; these include a plain-polysaccharide-based vaccine, ViPS, and a glycoconjugate vaccine, ViTT.
View Article and Find Full Text PDFQ fever is a highly infectious zoonosis caused by the Gram-negative bacterium Coxiella burnetii. The worldwide distribution of Q fever suggests a need for vaccines that are more efficacious, affordable, and does not induce severe adverse reactions in vaccine recipients with pre-existing immunity against Q fever. Potential Q fever vaccine antigens include lipopolysaccharide (LPS) and several C.
View Article and Find Full Text PDFObjectives: Anti-NMDA receptor autoimmune encephalitis (NMDARE) is a common pediatric encephalitis, resulting in neuropsychiatric symptoms. Predicting severity and course is challenging, with objective cognitive assessments lacking in NMDARE, especially in children. The CASE (Clinical Assessment Scale in Autoimmune Encephalitis) measures severity in autoimmune encephalitis.
View Article and Find Full Text PDFBackground: Nirmatrelvir/ritonavir was approved for use in high-risk outpatients with coronavirus disease 2019 (COVID-19). However, patients with severe CKD were excluded from the phase 3 trial, and the drug is not recommended for those with GFR <30 ml/min per 1.73 m 2 .
View Article and Find Full Text PDFAn increasing number of neuropsychologists are evaluating children with congenital heart disease (CHD). When conceptualizing results, the provider must consider medical risks such as abnormal neuroimaging and comorbidities, along with social risks such as socioeconomic status. The aim of the current study was to examine the influence of parent income and education on IQ and achievement across race groups in adolescents with CHD, while also accounting for medical risk (e.
View Article and Find Full Text PDFBackground The neutrophil-to-lymphocyte ratio (NLR) may predict poor outcomes in adult anti-NMDAR encephalitis (NMDARE). The association of NLR with outcomes in pediatric NMDARE was examined. Methods Pediatric NMDARE patients (N = 36) were retrospectively studied.
View Article and Find Full Text PDFSchool underachievement is a persistent problem in the United States. Direct-to-student, computer-delivered growth-mindset interventions have shown promise as a way to improve achievement for students at risk of failing in school; however, these interventions benefit only students who happen to be in classrooms that support growth-mindset beliefs. Here, we tested a teacher-delivered growth-mindset intervention for U.
View Article and Find Full Text PDFThe clinical development of the meningococcal vaccine, 4CMenB, included 2 doses in vaccine-naïve adolescents, which was considered unlikely to be cost-effective for implementation. Theoretically, priming with 4CMenB in early childhood might drive strong immune responses after only a single booster dose in adolescents and reduce programmatic costs. To address this question, children over 11 years old who took part in previous trials involving the administration of 3-5 doses of 4CMenB at infant/preschool age from 2006 were recruited into a post licensure single-centre trial, and were divided into two groups: those who received their last dose at 12 months old (infant group) and those who received their last dose at 3 years old (infant + preschool group).
View Article and Find Full Text PDFBackground: Electrographic characteristics (extreme delta brush, posterior dominant rhythm and slow waves) may predict outcomes in anti-NMDA receptor encephalitis (NMDARE). However, whether changes in EEG sleep architecture predict outcomes are unknown. We examine electrophysiological characteristics including sleep architecture in a pediatric NMDARE population and correlate with outcomes at one year.
View Article and Find Full Text PDFThis study sought to evaluate the candidacy of plasma osteopontin (OPN) as a biomarker of COVID-19 severity and multisystem inflammatory condition in children (MIS-C) in children. A retrospective analysis of 26 children (0-21 years of age) admitted to Children's Healthcare of Atlanta with a diagnosis of COVID-19 between March 17 and May 26, 2020 was undertaken. The patients were classified into three categories based on COVID-19 severity levels: asymptomatic or minimally symptomatic (control population, admitted for other non-COVID-19 conditions), mild/moderate, and severe COVID-19.
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