Elicitation of expert prior opinion to design the BARJDM trial in juvenile dermatomyositis.

Objectives: To elicit and quantify expert opinion concerning the relative merits of two treatments for a rare inflammatory disease: Juvenile dermatomyositis (JDM). The formal expression of expert opinion reported in this paper will be used in a Bayesian analysis of a forthcoming randomised controlled trial known as BARJDM (baricitinib for juvenile dermatomyositis).

Methods: A Bayesian prior elicitation meeting was convened, following a previously described methodological template.

The prescription and monitoring of conventional synthetic disease-modifying anti-rheumatic drugs: British Society for Rheumatology guideline scope.

This guideline will provide up-to-date, evidence-based recommendations on the safe use of non-biologic DMARDs, also called conventional synthetic DMARDs (csDMARD), across the full spectrum of autoimmune rheumatic diseases. The guideline will update the guideline published in 2017 and will be expanded to include people of all ages. Updated information on the monitoring of DMARDs and vaccinations will be included.

Completeness of reporting and outcome switching in trials published in Indian journals from 2017 to 2019: A cross-sectional study.

Context: Randomized controlled trials (RCTs) are among the cornerstones for generation of high-quality clinical evidence. However, incomplete or biased reporting of trials can hamper the process of review of trials and their results. Outcome switching, intentional, or otherwise leads to biased reporting and can result in false inferences.

Why is a paediatric respiratory specialist integral to the paediatric rheumatology clinic?

Systemic connective tissue diseases (CTDs) are characterised by the presence of autoantibodies and multiorgan involvement. Although CTDs are rare in children, they are associated with pulmonary complications, which have a high morbidity and mortality rate. The exact pathophysiology remains unclear.

SAFEST: Use of a Rubric to Teach Safety Reporting to Pediatric House Officers.

Background: Among the many modalities of error detection in academic pediatric hospitals, patient safety reporting is an important component, particularly for unexpected events. Residents recognize the importance of reporting but cite some barriers to doing so. A rubric was developed to guide resident reporting and streamline information gathering in patient safety reports.

Surface modification induced enhanced CO sorption in cucurbit[6]uril, an organic porous material.

The CO adsorption properties of an organic macrocycle, cucurbit[6]uril (CB[6]), have been evaluated through experimental and theoretical studies. Quantum mechanical calculations show that CB[6] is capable of adsorbing the CO molecule selectively within its cavity relative to nitrogen. Adsorption experiments at 298 K and at 1 bar pressure gave a CO adsorption value of 1.

Variability in Threshold for Medication Error Reporting Between Physicians, Nurses, Pharmacists, and Families.

Background: Voluntary medication error reporting is an imperfect resource used to improve the quality of medication administration. It requires judgment by front-line staff to determine how to report enough to identify opportunities to improve patients' safety but not jeopardize that safety by creating a culture of "report fatigue."

Objective: This study aims to provide information on interpretability of medication error and the variability between the subgroups of caregivers in the hospital setting.

Anti-HMGCR Autoantibodies in Juvenile Idiopathic Inflammatory Myopathies Identify a Rare but Clinically Important Subset of Patients.

Objective: We aimed to establish the prevalence and clinical associations of anti-HMG-CoA-reductase (anti-HMGCR) in a large UK cohort with juvenile myositis.

Methods: There were 381 patients investigated for anti-HMGCR using ELISA.

Results: Anti-HMGCR autoantibodies were detected in 4 patients (1%).

Role of precursors on the photophysical properties of carbon nitride and its application for antibiotic degradation.

In this paper, we provide a comprehensive evaluation of graphitic carbon nitride (CN) powders derived from the four different precursors melamine, cyanamide, thiourea, and urea for the photocatalytic degradation of tetracycline (TC) antibiotic under sunlight irradiation. The powders were synthesized by employing the conventional thermal decomposition method. The synthesized powders were examined using different characterization tools for evaluating the photophysical properties.

TEMPO-Oxidized Nanocellulose Fiber-Directed Stable Aqueous Suspension of Plasmonic Flower-like Silver Nanoconstructs for Ultra-Trace Detection of Analytes.

The synthesis of shape-tuned silver (Ag) nanostructures with high plasmon characteristics has become of significant importance in in vitro diagnostic applications. Herein, we report a simple aqueous synthetic route using 2,2,6,6-tetramethylpiperidine-1-oxyl-oxidized nanocellulose fibers (T-NCFs) and trisodium citrate (TSC) that results in anisotropically grown flower-like Ag nanoconstructs (AgNFs). A detailed investigation of the concentration and sequence of the addition of reactants in the formation of these anisotropic Ag structures is presented.

Hydrophobic and Metallophobic Surfaces: Highly Stable Non-wetting Inorganic Surfaces Based on Lanthanum Phosphate Nanorods.

Metal oxides, in general, are known to exhibit significant wettability towards water molecules because of the high feasibility of synergetic hydrogen-bonding interactions possible at the solid-water interface. Here we show that the nano sized phosphates of rare earth materials (Rare Earth Phosphates, REPs), LaPO4 in particular, exhibit without any chemical modification, unique combination of intrinsic properties including remarkable hydrophobicity that could be retained even after exposure to extreme temperatures and harsh hydrothermal conditions. Transparent nanocoatings of LaPO4 as well as mixture of other REPs on glass surfaces are shown to display notable hydrophobicity with water contact angle (WCA) value of 120° while sintered and polished monoliths manifested WCA greater than 105°.

Respiratory complications of the rheumatological diseases in childhood.

Pleuropulmonary manifestations of rheumatological diseases are rare in children but pose a significant risk to overall morbidity and mortality. We have reviewed the literature to provide an overview of the respiratory complications of the commonest rheumatological diseases to occur in children (juvenile systemic lupus erythematosus, scleroderma, juvenile dermatomyositis, mixed connective tissue disease, granulomatosis with polyangitis and juvenile idiopathic arthritis). Pulmonary function testing in these patients can be used to refine the differential diagnosis and establish disease severity, but also has a role in ongoing monitoring for respiratory complications.

Lemierre Syndrome Presenting as Acute Mastoiditis in a 2-Year-Old Girl with Congenital Dwarfism.

Lemierre syndrome is defined by septic thrombophlebitis of the internal jugular vein caused by Fusobacterium. Historically, these infections originate from the oropharynx and typically are seen in older children, adolescents and young adults. More recently, otogenic sources in younger children have been described with increasing frequency.

Bifunctional lanthanum phosphate substrates as novel adsorbents and biocatalyst supports for perchlorate removal.

Porous lanthanum phosphate substrates, obtained by an environmentally benign colloidal forming process employing methyl cellulose, are reported here as excellent adsorbents of perchlorate with >98% efficiency and with 100% reusability. Additionally, the effectiveness of such substrates as biocatalyst supports that facilitate biofilm formation of perchlorate reducing microbes (Serratia marcescens NIIST 5) is also demonstrated for the first time. The adsorption of perchlorate ions is attributed to the pore structure of lanthanum phosphate substrate and the microbial attachment is primarily ascribed to its intrinsic hydrophobic property.

Care of the complex chronically ill child by generalist pediatricians: lessons learned from pediatric palliative care.

Background And Objective: Parents of children with complex chronic conditions report fragmented care, unmet medical needs, and financial strain from health care costs. The aim of this study was to identify both prevalent themes discussed during pediatric palliative care consultation of patients with complex chronic conditions cared for by pediatric generalists and variation in consultation content by age and timing of consultation in disease course.

Methods: Forty randomly selected initial inpatient or outpatient consultation notes authored by the pediatric palliative care team at an academic, tertiary care children's hospital.

Long-term gain after team-based learning experience in a pediatric clerkship.

Background: Team-based learning (TBL) increases student engagement, value of teamwork, and performance on standardized evaluations.

Purpose: The authors implemented a 3rd-year pediatric TBL curriculum, evaluating its effect on satisfaction, engagement, value of teamwork, and short-term and long-term academic performance.

Method: Students evaluated the TBL curriculum and core lectures through satisfaction, engagement and value of team surveys.

Assessing the validity evidence of an objective structured assessment tool of technical skills for neonatal lumbar punctures.

Background: The lumbar puncture (LP) is a procedural competency deemed necessary by the Accreditation Council for Graduate Medical Education and the Emergency Medicine and Pediatric Residency Review Committees. The emergency department (ED) is a primary site for residents to be evaluated performing neonatal LPs. Current evaluation methods lack validity evidence as assessment tools.

Novel multifunctional titania-silica-lanthanum phosphate nanocomposite coatings through an all aqueous sol-gel process.

A novel nanocomposite coating containing titania, silica and lanthanum phosphate prepared through an all aqueous sol-gel route exhibits excellent self-cleaning ability arising from the synergistic effect of the constituents in the nanocomposite. A highly stable titania-silica-lanthanum phosphate nanocomposite sol having particle size in the range of 30-50 nm has been synthesized starting from a titanyl sulphate precursor, which was further used for the development of photocatalytically active composite coatings on glass. The coatings prepared by the dip coating technique as well as the nanocomposite powders are heat treated and characterized further for their morphology and multifunctionality.

Characterization of central venous catheter-associated deep venous thrombosis in infants.

Purpose: Deep venous thrombosis (DVT) is a frequent complication in infants with central venous catheters (CVCs). We performed this study to identify risk factors and risk-reduction strategies of CVC-associated DVT in infants.

Methods: Infants younger than 1 year who had a CVC placed at our center from 2005 to 2009 were reviewed.

Photocatalytic activity enhancement in doped titanium dioxide by crystal defects.

Visible light sensitive Fe(3+) and Ce(4+) co-doped nano TiO(2) photocatalyst has been prepared by a modified aqueous sol-gel method and the activity has been measured in terms of degradation of MB dye. Both dopants shifted the absorption profile of TiO(2) to the visible region and improved activity. Fe(3+) ions trapped the charge carriers due to the stable electronic configuration and improved their separation.

Clinical screening for Congenital heart disease at birth: a prospective study in a community hospital in Kerala.

Objective: To develop a clinical strategy for detection of Congenital heart disease (CHD) in the newborn through a combination of clinical signs and pulse oximetry.

Design: Prospective longitudinal study.

Setting: Community level hospital in the city of Kochi, Kerala.