Perspectives of Health Care Personnel on the Benefits of Bronchiolitis Interventions.

Objectives: Many interventions in bronchiolitis are low-value or poorly studied. Inpatient bronchiolitis management is multidisciplinary, with varying degrees of registered nurse (RN) and respiratory therapist (RT) autonomy. Understanding the perceived benefit of interventions for frontline health care personnel may facilitate deimplementation efforts.

Experiences of Parental Presence in the Induction of Anesthesia in a Canadian Tertiary Pediatric Hospital: A Cross-Sectional Study.

Background Parental presence at induction of anesthesia remains controversial and has been reported to provide mixed results. As such, parental presence at induction of anesthesia is not practiced routinely everywhere. There are currently limited data describing the practice of parental presence at induction of anesthesia or the experiences and perceptions of parents in Canada.

Thermostability and in vivo performance of AAV9 in a film matrix.

Background: Adeno-associated virus (AAV) vectors are stored and shipped frozen which poses logistic and economic barriers for global access to these therapeutics. To address this issue, we developed a method to stabilize AAV serotype 9 (AAV9) in a film matrix that can be stored at ambient temperature and administered by systemic injection.

Methods: AAV9 expressing the luciferase transgene was mixed with formulations, poured into molds and films dried under aseptic conditions.

Exercise-Induced Urticaria: A Rare Case Report.

Exercise is an important part of a healthy lifestyle. However, there is a subset of the population who are allergic to exercise. Exercise-induced urticaria is a rare clinical condition, which, as the name suggests, manifests as flushing, pruritus, and hives following physical exercise.

Evaluation of intermolecular interactions required for thermostability of a recombinant adenovirus within a film matrix.

Thermostability of vaccines and biologic drugs are key to increasing global access to a variety of life-saving agents. In this report, we characterize interactions between a novel zwitterionic surfactant and adenovirus serotype 5 which allow the virus to remain stable at room temperature in a thin film matrix. Complexity of the adenovirus capsid and the polydispersity of the surfactant required use of a variety of techniques to achieve this goal.

Multiple anatomic sites of infarction in a pediatric patient with M. pneumoniae infection, a case report.

Background: Although M. pneumoniae (M. pneumoniae) infections have been associated with various extrapulmonary manifestations, there have been very few documented cases of thrombotic events in pediatrics, and none to our knowledge with such extensive involvement as the patient described here.

Decreasing Hospital Observation Time for Febrile Infants.

Background: Febrile infants aged 0 to 60 days are often hospitalized for a 36-to-48 hour observation period to rule out invasive bacterial infections (IBI). Evidence suggests that monitoring blood and cerebrospinal fluid (CSF) cultures for 24 hours may be appropriate for most infants. We aimed to decrease the average culture observation time (COT) from 38 to 30 hours among hospitalized infants 0 to 60 days old over 12 months.

Increasing Physician Reporting of Diagnostic Learning Opportunities.

Background: An estimated 10% of Americans experience a diagnostic error annually, yet little is known about pediatric diagnostic errors. Physician reporting is a promising method for identifying diagnostic errors. However, our pediatric hospital medicine (PHM) division had only 1 diagnostic-related safety report in the preceding 4 years.

Satellite images and machine learning can identify remote communities to facilitate access to health services.

Objective: Community health systems operating in remote areas require accurate information about where people live to efficiently provide services across large regions. We sought to determine whether a machine learning analyses of satellite imagery can be used to map remote communities to facilitate service delivery and planning.

Materials And Methods: We developed a method for mapping communities using a deep learning approach that excels at detecting objects within images.

Assessment of Risk of Harm Associated With Intensive Blood Pressure Management Among Patients With Hypertension Who Smoke: A Secondary Analysis of the Systolic Blood Pressure Intervention Trial.

Importance: The randomized Systolic Blood Pressure Intervention Trial (SPRINT) showed that lowering systolic blood pressure targets for adults with hypertension reduces cardiovascular morbidity and mortality in general. However, whether the overall benefit from intensive blood pressure control masks important heterogeneity in risk is unknown.

Objective: To test the hypothesis that the overall benefit observed in SPRINT masked important heterogeneity in risk from intensive blood pressure control.

An independent evaluation of plutonium body burdens in populations near Los Alamos Laboratory using human autopsy data.

In the mid-1940s, the United States began producing atomic weapon components at the Los Alamos National Laboratory (LANL). In an attempt to better understand historical exposure to nearby residents, this study evaluates plutonium activity in human tissue relative to residential location and length of time at residence. Data on plutonium activity in the lung, vertebrae, and liver of nearby residents were obtained during autopsies as a part of the Los Alamos Tissue Program.

Airborne concentrations of metals and total dust during solid catalyst loading and unloading operations at a petroleum refinery.

Workers handle catalysts extensively at petroleum refineries throughout the world each year; however, little information is available regarding the airborne concentrations and plausible exposures during this type of work. In this paper, we evaluated the airborne concentrations of 15 metals and total dust generated during solid catalyst loading and unloading operations at one of the largest petroleum refineries in the world using historical industrial hygiene samples collected between 1989 and 2006. The total dust and metals, which included aluminum, cadmium, chromium, cobalt, copper, iron, lead, manganese, molybdenum, nickel, platinum, silicon, silver, vanadium, and zinc, were evaluated in relation to the handling of four different types of solid catalysts associated with three major types of catalytic processes.

An independent review and prioritization of past radionuclide and chemical releases from the Los Alamos National Laboratory--implications for future dose reconstruction studies.

From 1999 through 2010, a team of scientists and engineers systematically reviewed approximately eight million classified and unclassified documents at Los Alamos National Laboratory (LANL) that describe historical off-site releases of radionuclides and chemicals in order to determine the extent to which a full-scale dose reconstruction for releases is warranted and/or feasible. As a part of this effort, a relative ranking of historical airborne and waterborne radionuclide releases from LANL was established using priority index (PI) values that were calculated from estimated annual quantities released and the maximum allowable effluent concentrations according to The U.S.

Lead testing wipes contain measurable background levels of lead.

Lead is registered under the California Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65) as both a carcinogen and a reproductive hazard. As part of the process to determine if consumer products satisfy Proposition 65 with respect to lead, various wipe sampling strategies have been utilized. Four commonly used wipe materials (cotton gauze, cotton balls, ashless filter paper, and Ghost Wipes) were tested for background lead levels.