Ear to the ground! socioeconomic status, environmental stress, and the neural substrate of selective attention.

We reanalyzed data originally published by Berman and Friedman (1995), who recorded event related potentials (ERPs) while children and adults with low, medium, and high socioeconomic status (SES) detected oddball auditory targets (tones and consonant-vowel sequences) among distractors. The ERP differential measuring how much attention was allocated to the targets vs. distractors increased significantly with SES, independently of age.

Systems-based Strategies Improve Positive Screening Fecal Immunochemical Testing Follow-up and Reduce Time to Diagnostic Colonoscopy.

Introduction: Fecal immunochemical testing (FIT) is the most commonly used colorectal cancer (CRC) screening tool worldwide and accounts for 10% of all CRC screening in the United States. Potential vulnerabilities for patients enrolled to facilities within the military health system have recently come to light requiring reassessment of best practices. We studied the impact of a process improvement initiative designed to improve the safety and quality of care for patients after a positive screening FIT given previously published reports of poor organization performance.

Colon Cancer Metastatic to the Pancreas Presenting as of Diabetic Ketoacidosis.

Most of the malignant pancreatic lesions are primary pancreatic tumors with only a small percentage due to metastases. Pancreatic malignancies often present with symptoms such as jaundice and weight loss. Less commonly, new-onset diabetes mellitus has been seen in the setting of pancreatic adenocarcinomas.

The COVID-19 Serology Studies Workshop: Recommendations and Challenges.

The development, validation, and appropriate application of serological assays to detect antibodies to SARS-CoV-2 are essential to determining seroprevalence of this virus in the United States and globally and in guiding government leadership and the private sector on back-to-work policies. An interagency working group of the US Department of Health and Human Services convened a virtual workshop to identify knowledge gaps and key outstanding scientific issues and to develop strategies to fill them. Key outcomes of the workshop included recommendations for (1) advancing serology assays as a tool to better understand SARS-CoV-2 infection and (2) conducting crucial serology field studies to advance an understanding of immunity to SARS-CoV-2, leading to protection and duration of protection, including the correlation between serological test results and risk of reinfection.

Implementation of the US Department of Health and Human Services Zika Specimen Repository and Its Effect on Zika Diagnostic Test Development, 2016.

This study describes the efforts and outcomes associated with the establishment of a clinical sample repository during the 2016 Zika virus epidemic. To overcome the challenge of limited access to clinical samples to support diagnostic test development, multiple US Department of Health and Human Services (HHS) agencies formed a partnership to create the HHS Zika Specimen Repository. In 2016-2017, the Biomedical Advanced Research and Development Authority and the Centers for Disease Control and Prevention collected patient specimens (4420 convalescent sera aliquots from 100 donors and 7171 plasma aliquots from 239 donors), confirmed Zika virus test results, assembled 1 panel for molecular testing (n = 25 sets) and 7 panels for serologic testing (n = 92), and distributed the panels to test developers.

Automation of the I-PASS Tool to Improve Transitions of Care.

Introduction: Errors in communication during handoffs are a significant source of medical error and put patients at risk. The I-PASS system was designed to systematically communicate information to the oncoming healthcare provider and has been shown to decrease the risk of communication errors. The objective of this observational quality improvement study was to determine whether the addition of a partially automated, electronic handoff tool would further decrease errors in communication during transitions of care for inpatient medical teams.

The Adult with Post-operative Congenital Heart Disease: a Systematic Echocardiographic Approach.

Purpose Of Review: This article attempts to review some of the commonly seen repaired congenital heart defects in the adult population (ACHD), with a focus on important echocardiographic findings that may assist a practitioner in recognizing and managing this group of patients.

Recent Findings: The prevalence of ACHD population is increasing, and currently, there are over 1 million adults with congenital heart disease. At the current time, the total number of ACHD patients exceeds the total number of pediatric patients with CHD.

Mapping of the US Domestic Influenza Virologic Surveillance Landscape.

Influenza virologic surveillance is critical each season for tracking influenza circulation, following trends in antiviral drug resistance, detecting novel influenza infections in humans, and selecting viruses for use in annual seasonal vaccine production. We developed a framework and process map for characterizing the landscape of US influenza virologic surveillance into 5 tiers of influenza testing: outpatient settings (tier 1), inpatient settings and commercial laboratories (tier 2), state public health laboratories (tier 3), National Influenza Reference Center laboratories (tier 4), and Centers for Disease Control and Prevention laboratories (tier 5). During the 2015-16 season, the numbers of influenza tests directly contributing to virologic surveillance were 804,000 in tiers 1 and 2; 78,000 in tier 3; 2,800 in tier 4; and 3,400 in tier 5.

Measuring laboratory-based influenza surveillance capacity: development of the 'International Influenza Laboratory Capacity Review' Tool.

Objectives: The 2005 International Health Regulations (IHR 2005) emphasized the importance of laboratory capacity to detect emerging diseases including novel influenza viruses. To support IHR 2005 requirements and the need to enhance influenza laboratory surveillance capacity, the Association of Public Health Laboratories (APHL) and the Centers for Disease Control and Prevention (CDC) Influenza Division developed the International Influenza Laboratory Capacity Review (Tool).

Study Design: Data from 37 assessments were reviewed and analyzed to verify that the quantitative analysis results accurately depicted a laboratory's capacity and capabilities.

Tetralogy of Fallot with complete DiGeorge syndrome: report of a case and a review of the literature.

Complete DiGeorge syndrome (CDGS) has a severe T-cell immunodeficiency and is fatal without thymus or bone marrow transplantation. Associated congenital heart disease (CHD) further complicates the clinical management. We report an infant with tetralogy of Fallot, confluent and hypoplastic pulmonary arteries, right aortic arch, and aberrant left subclavian artery.

Left recurrent laryngeal nerve palsy secondary to left pulmonary artery stent in a child.

We report a 10-year-old girl who developed persistent hoarseness after stent placement for the treatment of left pulmonary artery stenosis. Laryngoscopy performed 21 months after stent placement revealed left vocal cord paralysis, presumed secondary to compression of the left recurrent laryngeal nerve by the stent. Pediatric cardiologists should be reminded of this possible rare complication after stent placement.

Pooling nasopharyngeal/throat swab specimens to increase testing capacity for influenza viruses by PCR.

Real-time PCR methodology can be applied to rapidly and accurately detect influenza viruses. During times of surge testing or enhanced pandemic surveillance, public health laboratories (PHLs) may experience overwhelming demand for testing, even while the prevalence of positive specimens remains low. To improve laboratory capacity and testing efficiency during surges, we evaluated whether nasopharyngeal (NP)/throat swab specimens can be pooled and tested for the presence of the 2009 H1N1 influenza virus without a reduction in sensitivity.

Detecting 2009 pandemic influenza A (H1N1) virus infection: availability of diagnostic testing led to rapid pandemic response.

Diagnostic tests for detecting emerging influenza virus strains with pandemic potential are critical for directing global influenza prevention and control activities. In 2008, the Centers for Disease Control and Prevention received US Food and Drug Administration approval for a highly sensitive influenza polymerase chain reaction (PCR) assay. Devices were deployed to public health laboratories in the United States and globally.

Differential West Nile fever ascertainment in the United States: a multilevel analysis.

We evaluated the completeness of West Nile fever (WNF) surveillance within the U.S. public health system.

Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study.

Background: Decision making in the care of pediatric patients with congenital and acquired heart disease remains reliant on detailed measurements of cardiac structures using 2-dimensional echocardiography. Calculated z scores are often used to normalize these measurements to the patient's body size. Existing normal data in the literature are limited by small sample size, small numbers of measured cardiac structures, and inadequate data for the calculation of z scores.

Sildenafil use in a symptomatic neonate with severe Ebstein's anomaly of the tricuspid valve.

Ebstein's anomaly (EA) is associated with poor outcome in symptomatic neonates. Management typically includes prostaglandins or surgical creation of a Blalock-Taussig shunt. Right ventricular afterload reduction may help by improving the forward flow across the pulmonary valve.