The association of varying treatment thresholds of mepolizumab on asthma exacerbations in adults.

Asthma has a high healthcare burden globally, with up to 10% of the asthma population suffering from severe disease. Biologic agents are a newer class of asthma treatments for severe asthma, with good evidence for efficacy in clinical trials. Nevertheless, real-world studies of its impact on clinical outcomes are limited.

Benefits, harms, and costs of newborn genetic screening for hypertrophic cardiomyopathy: Estimates from the PreEMPT model.

Purpose: Population newborn genetic screening for hypertrophic cardiomyopathy (HCM) is feasible, however its benefits, harms, and cost-effectiveness are uncertain.

Methods: We developed a microsimulation model to simulate a US birth cohort of 3.7 million newborns.

Population-Based Newborn Screening for Germline TP53 Variants: Clinical Benefits, Cost-Effectiveness, and Value of Further Research.

Background: Identification of children and infants with Li-Fraumeni syndrome prompts tumor surveillance and allows potential early cancer detection. We assessed the clinical benefits and cost-effectiveness of population-wide newborn screening for TP53 variants (TP53-NBS).

Methods: We simulated the impact of TP53-NBS using data regarding TP53-associated pediatric cancers and pathogenic or likely pathogenic (P/LP) TP53 variants from Surveillance, Epidemiology, and End Results; ClinVar and gnomAD; and clinical studies.

Tick Paralysis Case Series: An 11-Year Institutional Case Series.

Objectives: The aims of the study were to identify and to describe cases of pediatric tick paralysis presenting to an emergency department in southern Louisiana during an 11-year period.

Methods: We conducted a retrospective chart review of patients aged 0 to 18 years with a diagnostic code of toxic effect of venom, tick-borne viral encephalitis, Guillain-Barré syndrome, acute infective polyneuritis, or abnormality of gait from July 2005 to June 2016. Data were collected on visit month, patient age, race and sex, tick's attachment site, location of tick removal, symptoms and length of symptoms, initial diagnosis, time to appropriate diagnosis, and hospital length of stay.

Characteristics of new adult users of mepolizumab with asthma in the USA.

Background: In the USA, over 25 million people have asthma; 5%-10% of cases are severe. Mepolizumab (Nucala) is an interleukin-5 antagonist monoclonal antibody; it was approved by the FDA in 2015 as add-on maintenance treatment of severe asthma for patients aged ≥12 years with an eosinophilic phenotype.

Objectives: (1) Describe baseline demographic and clinical characteristics of new US adult mepolizumab users 2015-2019, (2) describe asthma medication use in the 12 months preceding initiation of and concomitant with mepolizumab and (3) assess mepolizumab adherence, persistence and discontinuation patterns in 12 months postinitiation.

Association of Alopecia Areata With Attention-Deficit/Hyperactivity Disorder Stimulant Medication: A Case-Control Study.

Both psychiatric disorders and diverse medications used to treat them have been associated with alopecia. The objective of our study was to investigate the existence of an association between attention-deficit/hyperactivity disorder (ADHD) stimulant medication (ASM) and various types of alopecia. We conducted a retrospective case-control medical record review of patients between the ages of 6 and 18 years seen in dermatology clinics during a 10-year period.

Universal newborn genetic screening for pediatric cancer predisposition syndromes: model-based insights.

Purpose: Genetic testing for pediatric cancer predisposition syndromes (CPS) could augment newborn screening programs, but with uncertain benefits and costs.

Methods: We developed a simulation model to evaluate universal screening for a CPS panel. Cohorts of US newborns were simulated under universal screening versus usual care.

Using Multisource Feedback to Assess Resident Communication Skills: Adding a New Dimension to Milestone Data.

The Accreditation Council for Graduate Medical Education (ACGME) requires evaluation of residents' communication skills. These evaluations should involve assessments from a variety of persons with different perspectives and opportunities to observe resident behavior. Our objectives with this study were to determine if parents, nurses, and physicians significantly differed in their ratings of residents' communication skills; to ascertain the degree of association between these evaluations and ACGME milestone data; and to elicit feedback from residents about the specificity and usefulness of this type of evaluation compared to the evaluations they were typically provided.

Practitioner Engagement in Activities of the National Dental Practice-Based Research Network (PBRN): 7-Year Results.

Purpose: To 1) quantify practitioner activities of the National Dental Practice-Based Research Network (Network) for which Continuing Education (CE) credits were received (study training, videos, webinars, meetings, and symposia); 2) quantify practitioner coauthoring Network publications and presentations; and 3) test whether practitioner characteristics were associated with participation in these activities.

Methods: A retrospective analysis of 4361 practitioners who enrolled in the Network between April 12, 2012 and October 12, 2018.

Results: Overall, 59% (n = 2586) of practitioners earned CE credit from the Network; among these, 68% (n = 1757) from a video, 38% (n = 993) attended an annual Network meeting, 31% (n = 798) due to training for a Network clinical study, 9% (n = 226) attended a national symposium, and 7% (n = 170) participated in a Network webinar.

The Relationship Between Grit and Resilience in Emergency Medical Service Personnel.

Emergency medical service (EMS) personnel are regularly exposed to traumatic incidents and experience higher rates of symptoms of posttraumatic stress disorder (PTSD) than the general population. Grit is a construct proposed to be associated with achievement, but it has demonstrated preliminary evidence of an association with resilience. The current study examined the relationship between grit and resilience among EMS workers.

Parent and Child Reports of Food Insecurity and Mental Health: Divergent Perspectives.

Background: Food insecurity-the inability to provide adequate food for at least one household member sometime during the year-is linked to negative physical and mental health outcomes. Child reports of experiences in other domains of life are only moderately related to parental proxy reports of the same experiences. The goal of our study was to assess the convergence of parent and child reports of food insecurity and several specific mental health symptoms.

Practitioner Participation in National Dental Practice-based Research Network (PBRN) Studies: 12-Year Results.

Purpose: This study examines practitioner participation over 12 years in the National Dental Practice-Based Research Network (PBRN) studies and practitioner meetings, average length of participation, and association of practitioner- and practice-level characteristics with participation. Little information exists about practitioners' long-term participation in PBRNs.

Methods: The network conducted a retrospective analysis of practitioner participation in 3 main network activities during 2005 to 2017.

An Atypical Case of Osteomyelitis and Hepatic Disease.

is a Gram-negative bacterium and the causative agent of cat scratch disease (CSD). Atypical presentations of that involve the musculoskeletal, hepatosplenic, cardiac, or neurologic systems are rare. In this case report, we describe a case of osteomyelitis involving bilateral iliac bones complicated by hepatic lesions in a 12-year-old immunocompetent female patient.

Integration of Mobile Devices to Facilitate Patient Care and Teaching During Family-Centered Rounds.

Objectives: The increasing prevalence of mobile devices in clinical settings has the potential to improve both patient care and education. The benefits are particularly promising in the context of family-centered rounds in inpatient pediatric settings. We aimed to increase mobile device usage by inpatient rounding teams by 50% in 6 months.

The impact of overdiagnosis on the selection of efficient lung cancer screening strategies.

The U.S. Preventive Services Task Force (USPSTF) recently updated their national lung screening guidelines and recommended low-dose computed tomography (LDCT) for lung cancer (LC) screening through age 80.

Combined Biomarker and Computed Tomography Screening Strategies for Lung Cancer: Projections of Health and Economic Tradeoffs in the US Population.

Background: Lung cancer screening with computed tomography (CT) of individuals who meet certain age and smoking history criteria is the current standard-of-care.

Methods: Using a published simulation model, we compared outcomes associated with seven biomarker+CT screening strategies to CT screening alone using CMS eligibility criteria. We assumed that the biomarker: had conditionally independent performance; was used for first-line screening in some, or all, individuals screened; and could be extended to CMS-ineligible smokers.

Cost Analysis of a Randomized Trial of Early Palliative Care in Patients with Metastatic Nonsmall-Cell Lung Cancer.

Background: Several trials have shown that integrated palliative and oncology care improves quality of life and mood in patients with advanced cancers. However, the degree to which early involvement of palliative care (PC) in the outpatient setting impacts the cost of care remains unknown.

Methods: Data for this secondary analysis came from a trial of 151 patients with metastatic nonsmall-cell lung cancer (NSCLC) who were randomized to early PC integrated with standard oncology care (SC) or SC alone.

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study.

Objective: While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence.

Setting: Computer-based simulation model.

Protocol to Clear Cervical Spine Injuries in Pediatric Trauma Patients.

In order to minimize the amount of ionizing radiation to which young trauma patients are subjected, a cervical spine clearance project was implemented. The aim was to increase the number of pediatric trauma patients clinically cleared and decrease the number of such patients undergoing cervical spine CT imaging when they met clinical clearance criteria. To accomplish the goals, a brief education program about the epidemiology of pediatric cervical spine injuries, radiation exposure risks, and safe and effective means available for cervical spine clearance to pediatric trauma providers was delivered.

Catalog and comparison of societal preferences (utilities) for lung cancer health states: results from the Cancer Care Outcomes Research and Surveillance (CanCORS) study.

Background: The EQ-5D and SF-6D are 2 health-related quality-of-life indexes that provide preference-weighted measures for use in cost-effectiveness analyses.

Methods: The National Cancer Institute's Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium included the EQ-5D and SF-12v2 in their survey of newly diagnosed lung cancer patients. Utilities were calculated from patient-provided scores for each domain of the EQ-5D or the SF-6D.

Personalizing annual lung cancer screening for patients with chronic obstructive pulmonary disease: A decision analysis.

Background: Lung cancer screening with annual chest computed tomography (CT) is recommended for current and former smokers with a ≥30-pack-year smoking history. Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of developing lung cancer and may benefit from screening at lower pack-year thresholds.

Methods: We used a previously validated simulation model to compare the health benefits of lung cancer screening in current and former smokers ages 55-80 with ≥30 pack-years with hypothetical programs using lower pack-year thresholds for individuals with COPD (≥20, ≥10, and ≥1 pack-years).