Asymmetrical hybridization and environmental factors influence the spatial genetic structure of a killifish hybrid zone.

Hybridization offers insight into speciation and the forces that maintain barriers to reproduction, and hybrid zones provide excellent opportunities to test how environment shapes barriers to reproduction and hybrid fitness. A hybrid zone between the killifish, Fundulus heteroclitus and F. grandis, had been identified in northeastern Florida, although the spatial structure and parameters that affect the distribution of the two species remain unknown.

Impact of COVID-19 on the Diagnosis of Coarctation of the Aorta in Infants.

Newborns with coarctation of the aorta are a potentially vulnerable population whose diagnosis could have been impacted by the COVID-19 pandemic. The objectives of this study were to assess if there was delayed diagnosis of infants with coarctation and if they had higher acuity prior to repair after the start of the pandemic. The Pediatric Health Information Systems database was queried for patients less than three months of age who underwent surgical repair or palliation of coarctation of the aorta.

Reach, Adoption, Implementation, and Sustainability of the Mobile Health for Migrant Health (mHealth-4-Mhealth) Program: Nebraska, 2022‒2023.

Migrant families face challenges to health and well-being from COVID-19. We deployed Mobile Health for Migrant Health (mHealth-4-Mhealth) to migrant families, a household-based program with mHealth-assisted at-home testing and linkages to community resources. We assessed the reach, adoption, and implementation of the program among rural migrant families enrolled in the Title IC Nebraska Migrant Education Program from February 2022 to July 2023.

Disparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project.

Background: Interventions aimed to standardize care may impact racial and ethnic disparities. We evaluated the association of race and ethnicity with adherence to recommendations from the American Academy of Pediatrics' clinical practice guideline for febrile infants after a quality improvement (QI) intervention.

Methods: We conducted a cross-sectional study of infants aged 8 to 60 days enrolled in a QI collaborative of 99 hospitals.

Destabilized host-parasite dynamics in newly founded populations.

When species disperse into previously unoccupied habitats, new populations encounter unfamiliar species interactions such as altered parasite loads. Theory predicts that newly founded populations should exhibit destabilized eco-evolutionary fluctuations in infection rates and immune traits. However, to understand founder effects biologists typically rely on retrospective studies of range expansions, missing early-generation infection dynamics.

A National Quality Improvement Collaborative to Improve Antibiotic Use in Pediatric Infections.

Background: Nearly 25% of antibiotics prescribed to children are inappropriate or unnecessary, subjecting patients to avoidable adverse medication effects and cost.

Methods: We conducted a quality improvement initiative across 118 hospitals participating in the American Academy of Pediatrics Value in Inpatient Pediatrics Network 2020 to 2022. We aimed to increase the proportion of children receiving appropriate: (1) empirical, (2) definitive, and (3) duration of antibiotic therapy for community-acquired pneumonia, skin and soft tissue infections, and urinary tract infections to ≥85% by Jan 1, 2022.

Multicenter Quality Collaborative to Reduce Overuse of High-Flow Nasal Cannula in Bronchiolitis.

Background And Objectives: High-flow nasal cannula (HFNC) for bronchiolitis increased over the past decade without clear benefit. This quality improvement collaborative aimed to reduce HFNC initiation and treatment duration by 30% from baseline.

Methods: Participating hospitals either reduced HFNC initiation (Pause) or treatment duration (Holiday) in patients aged <24 months admitted for bronchiolitis.

Improving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative.

Objectives: We aimed to examine the impact of a quality improvement (QI) collaborative on adherence to specific recommendations within the American Academy of Pediatrics' Clinical Practice Guideline (CPG) for well-appearing febrile infants aged 8 to 60 days.

Methods: Concurrent with CPG release in August 2021, we initiated a QI collaborative involving 103 general and children's hospitals across the United States and Canada. We developed a multifaceted intervention bundle to improve adherence to CPG recommendations for 4 primary measures and 4 secondary measures, while tracking 5 balancing measures.

Adoption of Vaping Cessation Methods by US Adolescent E-Cigarette Users.

Background: A large number of adolescent e-cigarette users intend to quit vaping or have past-year quit attempts. However, it remains unknown which methods they use in their vaping cessation efforts.

Methods: We analyzed current (past 30-day) e-cigarette users who made ≥1 quit attempt in the past 12 months from the 2021 National Youth Tobacco Survey (NYTS) to examine the prevalence and associations of sociodemographic factors, vaping behaviors, and harm perception with the adoption of different vaping cessation methods.

Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2.

Importance: The prevalence of urinary tract infection (UTI), bacteremia, and bacterial meningitis in febrile infants with SARS-CoV-2 is largely unknown. Knowledge of the prevalence of these bacterial infections among febrile infants with SARS-CoV-2 can inform clinical decision-making.

Objective: To describe the prevalence of UTI, bacteremia, and bacterial meningitis among febrile infants aged 8 to 60 days with SARS-CoV-2 vs without SARS-CoV-2.

An assessment of information needs and workflows for emergency service providers and caregivers of children with medical complexity.

Background: The goal of Project Austin, an initiative to improve emergency care for rural children who are medically complex (CMC), is to provide an Emergency Information Form (EIF) to their parents/caregivers, to local Emergency Medical Services, and Emergency Departments. EIFs are standard forms recommended by the American Academy of Pediatrics that provide pre-planned rapid response instructions, including medical conditions, medications, and care recommendations, for emergency providers. Our objective is to describe the workflows and perceived utility of the provided emergency information forms (EIFs) in the acute medical management of CMC.

Multicenter Study of High-Flow Nasal Cannula Initiation and Duration of Use in Bronchiolitis.

Background And Objectives: There is a paucity of multicenter data on rates of high flow nasal cannula (HFNC) usage in bronchiolitis in the United States, largely because of the absence of standardized coding, with HFNC often subsumed into the larger category of noninvasive mechanical ventilation.

Methods: We examined HFNC utilization in patients with bronchiolitis from a sample of hospitals participating in a national bronchiolitis quality improvement collaborative. Medical records of patients aged <2 years admitted November 2019 to March 2020 were reviewed and hospital-specific bronchiolitis policies were collected.

Antibiotic use in nonintubated children with bronchiolitis in the intensive care unit.

Introduction: Antibiotic use may shorten mechanical ventilation duration and length of stay for patients with bronchiolitis that require intubation. The goals of this study were to describe antibiotic use in previously healthy children with bronchiolitis admitted to the intensive care unit (ICU) for noninvasive respiratory support and to describe associations of early antibiotic use with clinical outcomes.

Methods: The Pediatric Health Information Systems database was queried for children <2 years of age without significant comorbidities admitted to the ICU for bronchiolitis.

Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic.

Objectives: Our objective was to describe the prevalence of urinary tract infection (UTI) and invasive bacterial infection (IBI) in febrile infants during the coronavirus disease 2019 pandemic.

Methods: We conducted a multicenter cross-sectional study that included 97 hospitals in the United States and Canada. We included full-term, well-appearing infants 8 to 60 days old with a temperature of ≥38°C and an emergency department visit or hospitalization at a participating site between November 1, 2020 and March 31, 2022.

Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUp): study protocol for a randomized, controlled trial.

Background: Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19.

Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUP): a randomized, controlled trial.

Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19.

Is implementation of a hospital pathway for high-flow nasal cannula initiation and weaning associated with reduced high-flow duration in bronchiolitis?

Background: High-flow nasal cannula (HFNC) therapy is widely used for children with bronchiolitis, but its optimal role remains uncertain. Our institution created and later revised a clinical pathway guiding HFNC initiation and weaning.

Methods: A retrospective review of 1690 bronchiolitis encounters was conducted.

Impact of Healthcare Disparities on Time to Surgery for Pediatric Urologic Patients.

Introduction Healthcare disparities are differences in health outcomes reflecting social inequalities. We aim to identify healthcare disparities in pediatric urologic patients by analyzing the time from surgical scheduling to completion of procedure at a single center and identify variables associated with increased time to surgery. Materials and methods We reviewed all patients aged 0-18 years who underwent surgery with one of three pediatric urologists at our institution from January 1, 2018, to December 31, 2019.

Inhaled Corticosteroid Exposure in Hospitalized Infants with Bronchopulmonary Dysplasia.

Objective: The objective of this paper was to determine inhaled corticosteroid (IC) use in infants with bronchopulmonary dysplasia (BPD), define the interhospital variation of IC administration to infants with BPD, and compare clinical, demographic, and hospital factors associated with IC use.

Study Design: Using the Pediatric Health Information System database, a retrospective multicenter cohort of 4,551 infants born at <32 weeks of gestation with developing BPD was studied. The clinical, demographic, and hospital characteristics of infants exposed and not exposed to ICs were compared.

Quality Improvement of Primary Care Provider Communication on Hospital Discharge.

Background And Objectives: Effective communication between inpatient and primary care providers (PCPs) is important for safe transition of care for hospitalized patients. In 2017, communication with PCPs was prioritized for the pediatric hospital medicine division. Our primary aim was to improve documented attempted communication with PCPs within 72 hours of discharge from 41% to at least 60% by January 1, 2018, and maintain this performance through 2019.

Prevalence of Invasive Bacterial Infections in Well-Appearing, Febrile Infants.

Background And Objectives: Data on invasive bacterial infection (IBI), defined as bacteremia and/or bacterial meningitis, in febrile infants aged <60 days old primarily derive from smaller, dated studies conducted at large, university-affiliated medical centers. Our objective with the current study was to determine current prevalence and epidemiology of IBI from a contemporary, national cohort of well-appearing, febrile infants at university-affiliated and community-based hospitals.

Patients And Methods: Retrospective review of well-appearing, febrile infants aged 7 to 60 days was performed across 31 community-based and 44 university-affiliated centers from September 2015 to December 2017.