Impact of COVID-19 pandemic on traumatic brain injury emergency department visits, interfacility transfer and mortality in the United States, 2016-2020: a cross-sectional study.

Objective: The aim of this study was to determine how the COVID-19 pandemic affected patient demographics, injury mechanisms, interhospital transfers and mortality of patients with traumatic brain injuries (TBIs) treated in US emergency departments (EDs).

Design: This cross-sectional study analysed 2016-2020 Nationwide Emergency Department Sample (NEDS) data.

Setting: US EDs contained in the NEDS.

Perspectives of Caregivers on Children Boarding With Mental Health Conditions.

Objective: Addressing the acute mental healthcare needs of children is a national crisis. Despite the ongoing crisis, there are limited prior studies that capture caregiver perspectives on acute pediatric mental healthcare, notably in a general emergency department (ED) in a rural state. Based on these knowledge gaps, our objective was to assess caregiver opinions and perspectives of acute management for children boarding with mental health conditions.

Postconcussive Symptoms After Early Childhood Concussion.

Importance: Research on postconcussive symptoms (PCS) following early childhood concussion has been hindered by a lack of measures suitable for this age group, resulting in a limited understanding of their evolution in young children.

Objective: To document PCS in the first 3 months after early childhood concussion using a developmentally appropriate measure.

Design, Setting, And Participants: This cohort study used data collected at 3 Canadian and 1 US urban pediatric emergency departments (EDs) and 8 Canadian daycares from December 2018 to December 2022 as part of the Kids' Outcomes and Long-Term Abilities (KOALA) project, a prospective, multicenter, longitudinal cohort study.

Pilot study using machine learning to improve estimation of physical abuse prevalence.

Background: International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes have been shown to underestimate physical abuse prevalence. Machine learning models are capable of efficiently processing a wide variety of data and may provide better estimates of abuse.

Objective: To achieve proof of concept applying machine learning to identify codes associated with abuse.

Anxiety and Depression Among Pediatric Emergency Nurses and Physicians During the Coronavirus Disease 2019 Pandemic.

Introduction: To determine anxiety and depression levels among pediatric acute care nurses and physicians before and after vaccine implementation during the coronavirus disease 2019 pandemic.

Methods: Prospective cross-sectional study of emergency medicine and urgent care providers at a metropolitan quaternary pediatric emergency department, including 2 satellite emergency departments and 7 urgent care sites. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-2.

Dissolved gases in the deep North Atlantic track ocean ventilation processes.

Gas exchange between the atmosphere and ocean interior profoundly impacts global climate and biogeochemistry. However, our understanding of the relevant physical processes remains limited by a scarcity of direct observations. Dissolved noble gases in the deep ocean are powerful tracers of physical air-sea interaction due to their chemical and biological inertness, yet their isotope ratios have remained underexplored.

Emergency department visits for mild traumatic brain injury in early childhood.

Background: Brain injury during early childhood may disrupt key periods of neurodevelopment. Most research regarding mild traumatic brain injury (mTBI) has focused on school-age children. We sought to characterize the incidence and healthcare utilization for mTBI in young children presenting to U.

Diagnosis codes dramatically underestimate the burden of abuse.

Background: International Classification of Diseases (ICD) billing codes are not well-suited to estimate physical abuse prevalence among hospitalized patients and may be even less accurate in emergency departments (EDs). The Centers for Disease Control and Prevention (CDC) has recently published a child abuse and neglect syndromic surveillance definition to more accurately examine national abuse trends among ED visits.

Objective: To retrospectively apply the CDC syndromic definition to a population of physically abused children and determine its sensitivity for abuse in an ED and at hospital discharge.

Brief Report: A Pilot Study Examining the Effects of PEERS® for Adolescents Telehealth for Autistic Adolescents.

The COVID-19 pandemic sparked a worldwide transition to providing online services overnight, highlighting the urgent need for empirically supported telehealth interventions. The current study examined the effects of PEERS® for Adolescents Telehealth, an adaptation from the original social skills intervention developed for in-person provision, among 22 autistic adolescents and their caregivers. To evaluate the intervention, caregivers completed questionnaires assessing core autistic features and frequency of get-togethers.

Enrollment with and without exception from informed consent in a pilot trial of tranexamic acid in children with hemorrhagic injuries.

Background: Federal exception from informed consent (EFIC) procedures allow studies to enroll patients with time-sensitive, life-threatening conditions when written consent is not feasible. Our objective was to compare enrollment rates with and without EFIC in a trial of tranexamic acid (TXA) for children with hemorrhagic injuries.

Methods: We conducted a four-center randomized controlled pilot and feasibility trial evaluating TXA in children with severe hemorrhagic brain and/or torso injuries.

The COVID-19 Elective for Pediatric Residents: Learning About Systems-Based Practice During a Pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has prompted pediatric residency programs to adjust the delivery of educational curricula and to update content relevant to the pandemic.

Objective: In this descriptive paper, we present how we rapidly developed and implemented a COVID-19 pandemic elective for pediatric residents.

Methods: This curriculum was established at a single tertiary care children's hospital in June 2020.

The role of loneliness as a mediator between autism features and mental health among autistic young adults.

Autistic adults commonly experience mental health concerns including social anxiety and depression, which can have negative effects on their quality of life. It is not completely clear, however, why rates of mental health concerns are so high. Some evidence suggests that social connectedness might play a key role.

Children's Mental Health Emergency Department Visits: 2007-2016.

Background And Objectives: Emergency department (ED) visits for children seeking mental health care have increased. Few studies have examined national patterns and characteristics of EDs that these children present to. In data from the National Pediatric Readiness Project, it is reported that less than half of EDs are prepared to treat children.

General Pediatricians' Performance of Accreditation Agency's Recommended Procedures: A Complementary Analysis Using Administrative Data and the Knowledge Translation Model.

Introduction: The Accreditation Council for Graduate Medical Education provided guidelines, in 2013, regarding 13 clinical procedures pediatric residents should learn. Previous studies show that, when asked, general pediatricians (GPeds) self-report performing these procedures infrequently. When examined using the knowledge translation model, this low procedural performance frequency, especially by GPeds, may indicate a problem within the primary care landscape.

Development of transfusion guidelines for injured children using a Modified Delphi Consensus Process.

Background: There is wide variability of transfusion practices for children with hemorrhagic injuries across trauma centers. We are planning a multicenter, randomized clinical trial evaluating tranexamic acid in children with hemorrhage. Standardization of transfusion practices across sites is important to minimize confounding.

A Psychometric Analysis of the Social Anxiety Scale for Adolescents Among Youth With Autism Spectrum Disorder: Caregiver-Adolescent Agreement, Factor Structure, and Validity.

Social anxiety is common among adolescents with autism spectrum disorder (ASD). An ongoing challenge for both research and clinical practice in ASD is the assessment of anxious symptomatology. Despite its widespread use in samples of youth with ASD, the Social Anxiety Scale for Adolescents (SAS-A) has not received psychometric evaluation within this population; thus, the validity of its use in research and clinical practice for ASD remains unclear.

A Comparison of National Pediatric Procedures Training Guidelines With Actual Clinical Practice in Ohio.

Background: The Accreditation Council for Graduate Medical Education (ACGME) and Pediatrics Review Committee (RC) recommends the clinical procedures residents should master during their training. These guidelines may be partially based on consensus opinion or tradition rather than actual need. The literature defining which procedures general pediatricians actually perform in practice is limited.

Off-label Medication Prescribing Patterns in Pediatrics: An Update.

Objectives: To describe the frequency of off-label drug use in 2014 as defined by the Food and Drug Administration (FDA)-approved age ranges in patients ≤18 years of age, to determine the rate of off-label drug use in 2014 by drug classification, and to compare current off-label medication usage rates with historical rates.

Methods: This is a retrospective cohort study of an administrative database containing inpatient resource use data from January 1, 2014, to December 31, 2014. Patients ≤18 years of age receiving 1 of 76 selected commonly prescribed medications are included.

Management of Adult Patients in the Pediatric Emergency Department.

Adult patients often present to the pediatric emergency department (ED) for treatment of a wide variety of diseases. However, pediatric emergency medicine physicians are primarily trained to provide specialized care for children. Studies have shown that the number of adult patients presenting to pediatric EDs has increased significantly since the introduction of the Emergency Medicine Transfer and Active Labor Act in 1986.

Traumatic injury clinical trial evaluating tranexamic acid in children (TIC-TOC): study protocol for a pilot randomized controlled trial.

Background: Trauma is the leading cause of morbidity and mortality in children in the United States. The antifibrinolytic drug tranexamic acid (TXA) improves survival in adults with traumatic hemorrhage, however, the drug has not been evaluated in a clinical trial in severely injured children. We designed the Traumatic Injury Clinical Trial Evaluating Tranexamic Acid in Children (TIC-TOC) trial to evaluate the feasibility of conducting a confirmatory clinical trial that evaluates the effects of TXA in children with severe trauma and hemorrhagic injuries.