Variation and Drivers of Costs for Emergency Department Visits Among Children in 8 States.

Objective: To describe variation in costs for emergency department (ED) visits among children and to assess hospital and regional factors associated with costs.

Methods: Cross-sectional study of all ED encounters among children under 18 years in 8 states from 2014 to 2018. The primary outcome was each hospital's mean inflation-adjusted ED costs.

Characteristics and Outcomes of Culture-Positive and Culture-Negative Pediatric Sepsis.

Objectives: To compare the outcomes of pediatric severe sepsis and septic shock among patients with culture-positive and culture-negative sepsis and to determine if there are differentiating markers of disease severity between these 2 populations during their initial presentation and emergency department (ED) stay.

Study Design: Retrospective cohort study of patients ≤21 years of age who presented to the ED of a single children's hospital with severe sepsis or septic shock from June 1, 2017 to June 5, 2019.

Results: There were 235 patients who met criteria for severe sepsis or septic shock.

Changes Made to Orders Placed by Overnight Admitting Residents on Teaching Rounds the Next Day.

Objectives: Increased focus on health care quality and safety has generally led to additional resident supervision by attending physicians. At our children's hospital, residents place orders overnight that are not explicitly reviewed by attending physicians until morning rounds. We aimed to categorize the types of orders that are added or discontinued on morning rounds the morning after admission to a resident team and to understand the rationale for these order additions and discontinuations.

Utility of specific laboratory biomarkers to predict severe sepsis in pediatric patients with SIRS.

Objective: To identify the association between readily available laboratory biomarkers and the development of severe sepsis in children presenting to the emergency department (ED) with systemic inflammatory response syndrome (SIRS).

Methods: In this retrospective cohort study, ED patient encounters from June 2018 to June 2019 that triggered an automated sepsis alert based on SIRS criteria were analyzed. Encounters were included if the patient had any of the following laboratory tests sent within 6 h of ED arrival: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lactic acid, and procalcitonin.

Outcomes of Patients with Sepsis in a Pediatric Emergency Department after Automated Sepsis Screening.

Objective: To determine the effect of an automated sepsis screening tool on treatment and outcomes of severe sepsis in a pediatric emergency department (ED).

Study Design: Retrospective cohort study of encounters of patients with severe sepsis in a pediatric ED with a high volume of pediatric sepsis cases over a 2-year period. The automated sepsis screening algorithm replaced a manual screen 1 year into the study.

Comparison of Manual and Automated Sepsis Screening Tools in a Pediatric Emergency Department.

Objectives: To compare the performance and test characteristics of an automated sepsis screening tool with that of a manual sepsis screen in patients presenting to a pediatric emergency department (ED).

Methods: We conducted a retrospective cohort study of encounters in a pediatric ED over a 2-year period. The automated sepsis screening algorithm replaced the manual sepsis screen 1 year into the study.

Clinical Effects of Pediatric Clonidine Exposure: A Retrospective Cohort Study at a Single Tertiary Care Center.

Background: Pediatric clonidine ingestions frequently result in emergency department visits and admission for cardiac monitoring. Detailed information on the clinical course and specifically time of vital sign abnormalities of these patients is lacking.

Objective: The objective of this study was to provide descriptive analysis of the rates and times to vital sign abnormalities, treatment, disposition, and outcomes in a single-center cohort of pediatric patients with report of clonidine poisoning.

Applying Cognitive Learning Strategies to Enhance Learning and Retention in Clinical Teaching Settings.

Introduction: Cognitive learning strategies are strategies that improve a learner's ability to process information more deeply, transfer and apply information to new situations, and result in enhanced and better-retained learning.

Methods: We developed an interactive workshop for a national conference of pediatric educators to teach five cognitive learning strategies. The specific strategies were (1) spaced retrieval practice, (2) interleaving, (3) elaboration, (4) generation, and (5) reflection.

Identification and characterization of T reg-like cells in zebrafish.

Regulatory T (T reg) cells are a specialized sublineage of T lymphocytes that suppress autoreactive T cells. Functional studies of T reg cells in vitro have defined multiple suppression mechanisms, and studies of T reg-deficient humans and mice have made clear the important role that these cells play in preventing autoimmunity. However, many questions remain about how T reg cells act in vivo.