Collaboration to Reduce Sudden Unexpected Infant Death With Child Fatality Review and Outreach.

Sudden unexpected infant death (SUID) is the leading cause of postneonatal infant mortality in the United States, with disproportionately high rates in Baltimore City and Baltimore County in Maryland. This Advocacy Case Study describes the collaboration between the City and County Child Fatality Review teams to decrease infant mortality. B'more for Healthy Babies, formed in 2009 by the Bureau of Maternal Child Health in Baltimore City with the goal of reducing infant mortality through policy change, service improvements, community mobilization, and behavior change has had a sustained effort to respond to SUID.

Characteristics and Geographic Variation in Sudden Unexpected Infant Deaths in the District of Columbia.

Sleep-related infant death is a major cause of infant mortality in the United States. In the District of Columbia, infant mortality varies widely among regions (2 to 14 per 1000 live births). The study objectives were to analyze the patient characteristics and related variables to sudden unexpected infant deaths at 2 pediatric emergency department (ED) sites and the geographic patterns of infant deaths and their relationship to social vulnerability.

Liquid Nicotine, E-Cigarettes, and Vaping: Information for the Pediatric Emergency Medicine Provider.

E-cigarettes, or electronic cigarettes, are electronic nicotine delivery systems that are marketed as a healthier alternative to tobacco cigarettes. There has been an exponential increase in their use among youth since their introduction to the United States market in 2007. With increased use and popularity, there has been an increase in calls to poison control centers regarding liquid nicotine toxicity in children and adolescents.

Variations in Safe Sleep Practices and Beliefs: Knowledge is not Enough.

Objectives: Sleep-related infant deaths in the District of Columbia (DC) varies, with rates in certain geographical areas three times higher than DC and seven times higher than the national average. We sought to understand differences in infant sleep knowledge, beliefs, and practices between families in high-risk infant mortality and low-risk infant mortality areas in DC.

Methods: Caregivers of infants presenting to the emergency department were surveyed.

Association of Ventilation during Initial Trauma Resuscitation for Traumatic Brain Injury and Post-Traumatic Outcomes: A Systematic Review.

Objectives: In the absence of evidence of acute cerebral herniation, normal ventilation is recommended for patients with traumatic brain injury (TBI). Despite this recommendation, ventilation strategies vary during the initial management of patients with TBI and may impact outcome. The goal of this systematic review was to define the best evidence-based practice of ventilation management during the initial resuscitation period.

Triple threat: New presentation with diabetic ketoacidosis, COVID-19, and cardiac arrhythmias.

Patients with diabetes have increased susceptibility to infection with Severe acute respiratory syndrome-coronavirus 2 and increased morbidity and mortality from Coronavirus disease 2019 (COVID-19) infection. Mortality from COVID-19 is sometimes caused by cardiac arrhythmias. Electrolyte disturbances in patients with diabetic ketoacidosis (DKA) can increase the risk of cardiac arrhythmias.

So much nuance: A qualitative analysis of parental perspectives on child passenger safety.

Objective: To explore barriers and facilitators to optimal child restraint system (CRS) use for diverse parents of newborn infants and to obtain input from parents on the use of technology-assisted remote car seat checks as tools for promoting optimal CRS use.

Methods: Parents were recruited using purposive sampling. Interviews were conducted with English- or Spanish-speaking parents with a full term newborn and regular access to a car.

The Joys and Frustrations of Breastfeeding and Rooming-In Among Mothers With Opioid Use Disorder: A Qualitative Study.

Objectives: To investigate perspectives of mothers with opioid use disorder regarding breastfeeding and rooming-in during the birth hospitalization and identify facilitators and barriers.

Methods: We conducted in-depth qualitative interviews with 25 mothers with opioid use disorder 1-12 weeks after delivery. Grounded theory analysis was used until thematic saturation was reached.

Impact of Parental Presence at Infants' Bedside on Neonatal Abstinence Syndrome.

Background: Despite increased incidence of neonatal abstinence syndrome (NAS) over the past decade, minimal data exist on benefits of parental presence at the bedside on NAS outcomes.

Objective: To examine the association between rates of parental presence and NAS outcomes.

Methods: This was a retrospective, single-center cohort study of infants treated pharmacologically for NAS using a rooming-in model of care.

Dyslipidemia and its association with meibomian gland dysfunction.

Abnormal serum lipid levels significantly increase the risk for cardiovascular disease. Furthermore, abnormal compositions of cholesterol in glandular secretions have been hypothesized as an etiology for meibomian gland dysfunction, yet this relationship has not been well studied in clinical settings. The primary purpose of this study was to determine if there is an association between dyslipidemia and meibomian gland dysfunction (MGD).

Relocation consequences on an ophthalmology consultation service from an inpatient to outpatient facility.

Importance: This study shows that relocation of an academic ophthalmology residency program from an inpatient to an outpatient setting in western New York does not affect the consult volume but affects management patterns and follow-up rates.

Objective: To investigate the effects on the ophthalmology consultation service of an academic program with relocation from a Regional Level-1 Trauma center to an outpatient facility.

Design: Consultation notes from 3 years before and 3 years after the University at Buffalo's (UB) Department of Ophthalmology relocation from a Regional Level-1 Trauma center (Erie County Medical Center) to an outpatient facility (Ross Eye Institute) were obtained from hospital electronic medical records and analyzed.

Infection control link nurse program: an interdisciplinary approach in targeting health care-acquired infection.

Background: We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting.

Methods: Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education.

The neuromagnetic response to spoken sentences: co-modulation of theta band amplitude and phase.

Speech elicits a phase-locked response in the auditory cortex that is dominated by theta (3-7 Hz) frequencies when observed via magnetoencephalography (MEG). This phase-locked response is potentially explained as new phase-locked activity superimposed on the ongoing theta oscillation or, alternatively, as phase-resetting of the ongoing oscillation. The conventional method used to distinguish between the two hypotheses is the comparison of post- to prestimulus amplitude for the phase-locked frequency across a set of trials.

The effect of imaging on the clinical management of breast pain.

Background: Breast pain is a common complaint to primary care and breast specialists. Literature recommends imaging to provide reassurance of benign etiology. The effect of imaging on reassurance and subsequent healthcare utilization has not been described.

The addition of internists to a breast health program.

With the increases in complexity of care for breast health concerns, there is a growing need for efficient and effective clinical evaluation, especially for vulnerable populations at risk for poor outcomes. The Breast Health Center at Boston Medical Center is a multidisciplinary program, with internists providing care alongside breast surgeons, radiologists, and patient navigators. Using a triage system previously shown to have high provider and patient satisfaction, and the ability to provide timely care, patients are assigned to either a breast surgeon or internist.

Defining natural history: assessment of the ability of college students to aid in characterizing clinical progression of Niemann-Pick disease, type C.

Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies.

Discrimination of speech stimuli based on neuronal response phase patterns depends on acoustics but not comprehension.

Speech stimuli give rise to neural activity in the listener that can be observed as waveforms using magnetoencephalography. Although waveforms vary greatly from trial to trial due to activity unrelated to the stimulus, it has been demonstrated that spoken sentences can be discriminated based on theta-band (3-7 Hz) phase patterns in single-trial response waveforms. Furthermore, manipulations of the speech signal envelope and fine structure that reduced intelligibility were found to produce correlated reductions in discrimination performance, suggesting a relationship between theta-band phase patterns and speech comprehension.

Hemispheric asymmetry in mid and long latency neuromagnetic responses to single clicks.

We examine lateralization in the evoked magnetic field response to a click stimulus, observing that lateralization effects previously demonstrated for tones, noise, frequency modulated sweeps and certain syllables are also observed for (acoustically simpler) clicks. These effects include a difference in the peak latency of the M100 component of the evoked field waveform such that the peak consistently appears earlier in the right hemisphere, as well as rightward lateralization of field amplitude during the rise of the M100 component. Our review of previous findings on M100 lateralization, taken together with our data on the click-evoked response, leads to the hypothesis that these lateralization effects are elicited by stimuli containing a sharp sound energy onset or acoustic transition rather than specific types of stimuli.

Atherosclerosis and teen eating study.

Background: Low-density lipoprotein, high-density lipoprotein, serum triglyceride concentrations, blood pressure, obesity, and blood glucose are all known to contribute to risk for development of atherosclerosis. Research demonstrates that dietary modifications, which reduce saturated fat intake, impact the likelihood of development of atherosclerosis.

Objective: The Atherosclerosis and Teen Eating Study was designed to determine whether a short-term health educational program, complemented by availability of alternative low-fat school lunches, could result in favorable changes to healthier eating patterns.

A theory of the visual system biology underlying development of spatial frequency lateralization.

The spatial frequency hypothesis contends that performance differences between the hemispheres on various visuospatial tasks are attributable to lateralized processing of the spatial frequency content of visual stimuli. Hellige has proposed that such lateralization could arise during infant development from the earlier maturation of the right hemisphere combined with the increasing sensitivity of the visual system to high spatial frequencies. This proposal is intuitively appealing but lacks an explicit theory with respect to the underlying visual system biology.

The effects of multi-task learning and time-varying hemispheric asymmetry on lateralisation in a neural network model.

While various functional and cognitive capabilities appear to differ in both degree and direction of lateralisation, the factors underlying these differences are poorly understood. It is hypothesised that time-varying asymmetry in plasticity between homologous regions in the cerebral hemispheres, coupled with asynchronous development of capabilities, may account for the lateralisation differences in two ways. First, the lateralisation of an earlier acquired behaviour may influence the lateralisation of a later developing behaviour.