Decreasing Misdiagnoses of Urinary Tract Infections in a Pediatric Emergency Department.

Background And Objectives: Urinary tract infection (UTI) is a common diagnosis in the emergency department (ED), often resulting in empirical antibiotic treatment before culture results. Diagnosis of a UTI, particularly in children, can be challenging and misdiagnosis is common. The aim of this initiative was to decrease the misdiagnosis of uncomplicated pediatric UTIs by 50% while improving antimicrobial stewardship in the ED over 4 years.

Stable isotopic composition of perchlorate and nitrate accumulated in plants: Hydroponic experiments and field data.

Natural perchlorate (ClO) in soil and groundwater exhibits a wide range in stable isotopic compositions (δCl, δO, and ΔO), indicating that ClO may be formed through more than one pathway and/or undergoes post-depositional isotopic alteration. Plants are known to accumulate ClO, but little is known about their ability to alter its isotopic composition. We examined the potential for plants to alter the isotopic composition of ClO in hydroponic and field experiments conducted with snap beans (Phaseolus vulgaris L.

Phenotyping novel stay-green traits to capture genetic variation in senescence dynamics.

Stay-green plants retain green leaves longer after anthesis and can have improved yield, particularly under water limitation. As senescence is a dynamic process, genotypes with different senescence patterns may exhibit similar final normalised difference vegetative index (NDVI). By monitoring NDVI from as early as awn emergence to maturity, we demonstrate that analysing senescence dynamics improves insight into genotypic stay-green variation.

Rapid paediatric fluid resuscitation: a randomised controlled trial comparing the efficiency of two provider-endorsed manual paediatric fluid resuscitation techniques in a simulated setting.

Objectives: Manual techniques of intravascular fluid administration are commonly used during paediatric resuscitation, although it is unclear which technique is most efficient in the hands of typical healthcare providers. We compared the rate of fluid administration achieved with the disconnect-reconnect and push-pull manual syringe techniques for paediatric fluid resuscitation in a simulated setting.

Methods: This study utilised a randomised crossover trial design and enrolled 16 consenting healthcare provider participants from a Canadian paediatric tertiary care centre.

Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size.

Background: Goal-directed therapy guidelines for pediatric septic shock resuscitation recommend fluid delivery at speeds in excess of that possible through use of regular fluid infusion pumps. In our experience, syringes are commonly used by health care providers (HCPs) to achieve rapid fluid resuscitation in a pediatric fluid resuscitation scenario. At present, it is unclear which syringe size health care providers should use when performing fluid resuscitation to achieve maximal fluid resuscitation efficiency.

Study protocol for a randomised controlled trial comparing the efficiency of two provider-endorsed manual paediatric fluid resuscitation techniques.

Introduction: Paediatric shock is a life-threatening condition with many possible causes and a global impact. Current resuscitation guidelines require rapid fluid administration as a cornerstone of paediatric shock management. However, little evidence is available to inform clinicians how to most effectively perform rapid fluid administration where this is clinically required, resulting in suboptimal knowledge translation of current resuscitation guidelines into clinical practice.

Perchlorate in wet deposition across North America.

Natural perchlorate is believed to be of atmospheric origin, yet no systematic study has been conducted to evaluate perchlorate deposition rate and possible seasonal or spatial variations. This study evaluated perchlorate concentrations in weekly composite wet deposition samples acquired through the National Atmospheric Deposition Program from 26 sites across the continental United States, Alaska, and Puerto Rico for a 1-3 year period. Perchlorate concentrations varied from <5 ng/L to a high of 102 ng/L with a mean of 14.