Inter-center variations in inpatient outcomes for infants with gastroschisis from the Children's Hospitals Neonatal Consortium.

Objective: To estimate inter-center variation (ICV) in hospital length of stay (LOS) and oral feeding at discharge among infants with gastroschisis.

Study Design: The Children's Hospitals Neonatal Consortium's (CHNC) database was used to identify hospitalized survivors with gastroschisis. Two outcomes were evaluated: LOS and discharge without tube feedings.

Implementation cost analysis of collaborative care for perinatal mental health in community health centers.

Background: Although costs are of key importance to clinic leadership when considering adoption of new programs, few studies examine real-world resource needs associated with implementing complex interventions for chronic conditions in primary care. This analysis sought to identify the costs necessary to implement the evidence-based collaborative care model (CoCM), an integrated behavioral health program for common mental disorders in primary care.

Methods: Ten federally qualified health centers (FQHCs) adopted CoCM as part of a larger national randomized trial evaluating implementation strategies for CoCM when adapted for perinatal mental health.

Liberation from Respiratory Support in Bronchopulmonary Dysplasia.

Objective: To estimate the association between the mode of respiratory support administered at 36 weeks' post-menstrual age (PMA) with time-to-liberation from respiratory support (LRS) in infants with grade 2/3 bronchopulmonary dysplasia (BPD).

Study Design: Daily respiratory support data were abstracted for infants born <32 weeks' gestation with grade 2/3 BPD enrolled in the Children's Hospitals Neonatal Database between 2017 and 2022. The main exposure was the mode of respiratory support received at 36 weeks' PMA: high flow nasal cannula >2 L/min (HFNC), continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV), or mechanical ventilation (MV).

Neonatal Risk Factors for Pulmonary Vein Stenosis in Infants Born Preterm with Severe Bronchopulmonary Dysplasia.

Objective: To evaluate associations between neonatal risk factors and pulmonary vein stenosis (PVS) among infants born preterm with severe bronchopulmonary dysplasia (sBPD).

Study Design: We performed a case-control study of infants born from 2010 to 2022 at <32 weeks' gestation with sBPD among 46 neonatal intensive care units in the Children's Hospitals Neonatal Consortium. Cases with PVS were matched to controls using epoch of diagnosis (2010-2016; 2017-2022) and hospital.

Fault in Our Genes: A Case of Pulmonary Thromboembolism in Young.

Methylenetetrahydrofolate reductase (MTHFR) enzyme is one of the key enzymes involved in the metabolism of folate. Mutations in this enzyme can lead to a procoagulant state. We present a case of a 20-year-old male with no known comorbidities, who presented with fever and hemoptysis and was diagnosed as a case of pulmonary embolism.

Continuous improvement of non-emergent neonatal intubations in a level IV NICU.

Objective: We sought to improve practices and outcomes related to non-emergent neonatal intubations in a level IV academic Neonatal Intensive Care Unit.

Study Design: A multidisciplinary team created guidelines for non-emergent neonatal intubations. In period 1, premedication practices were standardized.

Time to positivity of blood cultures in a level IV NICU varies based on organism category and population subgroups: is a 36-hour rule out safe?

Background: Time to positivity (TTP) of blood cultures and organism characteristics may be different in a Level IV NICU population.

Methods: Retrospective study of 309 Level IV NICU positive blood cultures between January 2012 to December 2018 describing TTP and organism characteristics.

Results: Median TTP [IQR] was 21.

Effect of Block Copolymer Self-Assembly on Phase Separation in Photopolymerizable Epoxy Blends.

Directing self-assembly of photopolymerizable systems is advantageous for controlling polymer nanostructure and material properties, but developing techniques for inducing ordered structure remains challenging. In this work, well-defined diblock or random copolymers were incorporated into cationic photopolymerizable epoxy systems to investigate the impact of copolymer architecture on self-assembly and phase separated nanostructures. Copolymers consisting of poly(hydroxyethyl acrylate)(butyl acrylate) were prepared using photoiniferter polymerization to control functional group placement and molecular weight/polydispersity.

A multicenter matched-cohort analysis of gastroschisis outcomes in infants born before 32 weeks gestation.

Objective: To examine neonatal outcomes of infants with gastroschisis born <32 weeks' gestation compared to matched infants without gastroschisis.

Study Design: Retrospective matched-cohort analysis of infants with gastroschisis born <32 weeks' gestation at Children's Hospitals Neonatal Consortium (CHNC) NICUs from 2010 to 2022 compared to gestational age-matched controls.

Results: The study included 119 infants with gastroschisis and 357 matched infants; 60% of infants born 29-32 weeks, 23% born 26-28 weeks, and 16% born < 25 weeks.

Separability Transitions in Topological States Induced by Local Decoherence.

We study states with intrinsic topological order subjected to local decoherence from the perspective of separability, i.e., whether a decohered mixed state can be expressed as an ensemble of short-range entangled pure states.

A clinical consensus guideline for nutrition in infants with congenital diaphragmatic hernia from birth through discharge.

Objective: To develop a consensus guideline to meet nutritional challenges faced by infants with congenital diaphragmatic hernia (CDH).

Study Design: The CDH Focus Group utilized a modified Delphi method to develop these clinical consensus guidelines (CCG). Topic leaders drafted recommendations after literature review and group discussion.

Association of organizational culture and climate with variation in the clinical outcomes of collaborative care for maternal depression in community health centers.

Background: Organizational factors may help explain variation in the effectiveness of evidence-based clinical innovations through implementation and sustainment. This study tested the relationship between organizational culture and climate and variation in clinical outcomes of the Collaborative Care Model (CoCM) for treatment of maternal depression implemented in community health centers.

Method: Organizational cultures and climates of 10 community health centers providing CoCM for depression among low-income women pregnant or parenting were assessed using the organizational social context (OSC) measure.

Coronary allograft vasculopathy in post-heart transplant patients: pathogenesis and role of cardiac computed tomography in diagnosis-a comprehensive review.

Coronary allograft vasculopathy, often known as cardiac allograft vasculopathy (CAV), is a substantial source of morbidity and mortality in people who have had heart transplants. Early detection and monitoring of CAV are crucial for improving outcomes in this population. Although cardiac computed tomography (CT) has emerged as a possible method for finding and evaluating CAV, invasive coronary angiography has long been thought of as the gold standard for recognizing CAV.

A Multicenter Collaborative to Improve Postoperative Pain Management in the NICU.

Objectives: This quality improvement initiative aimed to decrease unrelieved postoperative pain and improve family satisfaction with pain management.

Methods: NICUs within the Children's Hospitals Neonatal Consortium that care for infants with complex surgical problems participated in this collaborative. Each of these centers formed multidisciplinary teams to develop aims, interventions, and measurement strategies to test in multiple Plan-Do-Study-Act cycles.

Decreasing Percentage of Infants With Very Low 5-Minute Apgar Scores at a Safety-Net Level III NICU.

Objectives: Low 5-minute Apgar scores predict mortality and may be associated with poor neurologic outcomes. Our percentage of infants with low 5-minute Apgar scores was higher than the national average (2.4%).

A Prospective Comparison of Insertion Characteristics of Laryngeal Mask Airway (LMA) ProSeal® Using Rotation Techniques vs Standard Techniques in Adults Undergoing Elective Surgery.

Background: Airway management is the most essential skill in Anesthesiology and the inability to secure the airway is one of the most common reasons for anesthesia-related morbidity and mortality. This study aimed to evaluate and compare the insertion characteristics of laryngeal mask airway (LMA) ProSeal insertion using the standard introducer technique, 90-degree rotation technique, and 180-degree rotation technique in adult patients undergoing elective surgery.

Material And Method: This prospective, interventional, randomized, comparative study was carried out in the Department of Anesthesia and Intensive Care, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, after obtaining hospital ethical committee approval for 18 months of duration.

Variability for Age at Successful Extubation in Infants with Congenital Diaphragmatic Hernia.

Objective: The objective of this study was to characterize clinical factors associated with successful extubation in infants with congenital diaphragmatic hernia.

Study Design: Using the Children's Hospitals Neonatal Database, we identified infants with congenital diaphragmatic hernia from 2017 to 2020 at 32 centers. The main outcome was age in days at the time of successful extubation, defined as the patient remaining extubated for 7 consecutive days.

BLOSSoM: Improving Human Milk Provision in Preterm Infants Through Texting Support.

Unlabelled: Mother's own milk (MOM) reduces complications of preterm birth. Despite high initiation rates of expression, half of preterm infants do not receive MOM at discharge. Frequent outreach and a short message service (SMS) have improved MOM provision in term dyads.

Alignment Between Heart Rate Variability From Fitness Trackers and Perceived Stress: Perspectives From a Large-Scale In Situ Longitudinal Study of Information Workers.

Background: Stress can have adverse effects on health and well-being. Informed by laboratory findings that heart rate variability (HRV) decreases in response to an induced stress response, recent efforts to monitor perceived stress in the wild have focused on HRV measured using wearable devices. However, it is not clear that the well-established association between perceived stress and HRV replicates in naturalistic settings without explicit stress inductions and research-grade sensors.