Publications by authors named "Wathen J"

This report describes the Pediatrics in Disasters (PEDS) course during a novel hybrid in-person and virtual format due to the coronavirus disease 2019 pandemic. International and local faculty collaborated on 2021 precourse revisions and course facilitation for multinational in-person and virtual students. Student and facilitator 2021 surveys and 2019 to 2021 student feedback reported overall satisfaction with the course while suggesting needed improvements to maximize international and virtual student participation.

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Background: Over the past decade, autism spectrum disorder (ASD) research has blossomed, and multiple clinical trials have tested potential interventions, with varying results and no clear demonstration of efficacy. Lack of clarity concerning appropriate biological mechanisms to target and lack of sensitive, objective tools to identify subgroups and measure symptom changes have hampered the efforts to develop treatments. A platform trial for proof-of-concept studies in ASD could help address these issues.

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Importance: Platform trial design allows the introduction of new interventions after the trial is initiated and offers efficiencies to clinical research. However, limited guidance exists on the economic resources required to establish and maintain platform trials.

Objective: To compare cost (US dollars) and time requirements of conducting a platform trial vs a series of conventional (nonplatform) trials using a real-life example.

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Background: Among those aged 5 years or younger, foreign bodies are the fourth most common pediatric exposure reported to the American Association of Poison Control Centers. Although the majority of ingested foreign bodies pass through the gastrointestinal tract without complication, those that do not spontaneously pass can lead to a number of serious complications, such as gastrointestinal obstruction or perforation, which can be complicated by bleeding from aortoesophageal fistula, secondary mediastinitis, peritonitis, esophageal or gastrointestinal fistula formation, and abscesses.

Case Report: We present the case of a 10-month-old child who presented with new-onset focal seizure in the setting of multiple brain abscesses, ultimately found to be due to esophageal perforation from a retained, metallic esophageal foreign body.

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Background: Ketamine is a well-studied and safe medication used for procedural sedation in the pediatric emergency department (ED). However, in our ED and urgent care (UC), we had higher rates of respiratory events receiving intervention (REs) than has been reported nationally.

Objective: A quality improvement (QI) project was initiated to address this problem with the following aim: during a 24-month period, we aimed to decrease REs during i.

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Fish are good indicators of aquatic environment pollution because of their capability to uptake pollutants contained in water. Therefore, accumulation of pharmaceutical compounds in freshwater and marine fish and other aquatic organisms has been studied extensively in the last decade. In this context, the present study investigates the occurrence of pharmaceutical compounds in wild fish from 25 polluted river sites in the USA, downstream from wastewater treatment plants (WWTPs).

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Background: Atomized intranasal midazolam is a common adjunct in pediatrics for procedural anxiolysis. There are no previous studies of validated anxiety scores with pharmacokinetic data to support optimal procedure timing.

Objectives: We describe the clinical and pharmacokinetic profile of atomized intranasal midazolam in children presenting for laceration repair.

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Randomizing patients among treatments with equal probabilities in clinical trials is the established method to obtain unbiased comparisons. In recent years, motivated by ethical considerations, many authors have proposed outcome adaptive randomization, wherein the randomization probabilities are unbalanced, based on interim data, to favor treatment arms having more favorable outcomes. While there has been substantial controversy regarding the merits and flaws of adaptive versus equal randomization, there has not yet been a systematic simulation study in the multi-arm setting.

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Background: Changes in the manner in which medications can be delivered can have significant effects on the quality of care in the acute care setting.

Objective: The objective of this study was to evaluate the change in three Institute of Medicine quality indicators (timeliness, safety, and effectiveness) in the pediatric emergency department (ED) after the introduction of the Mucosal Atomizer Device Nasal™ (MADn) for opioid analgesia.

Methods: This was a retrospective review of patients receiving opioid analgesia for certain conditions over a 5-year period.

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Article Synopsis
  • The study aimed to compare the adverse events and effectiveness of ketamine monotherapy (KM) and a combination of ketamine and propofol (CoKP) for procedural sedation in pediatric emergency patients aged 3 to 21 years.
  • A total of 183 patients were randomized, with results showing no significant difference in adverse events between the two groups, although nausea was more frequent in the KM group.
  • Efficacy and provider satisfaction favored KM, which achieved a 99% efficacy rate, compared to 90% for CoKP, suggesting that CoKP does not provide a distinct advantage over KM for pediatric procedural sedation.
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U.S. EPA conducted a national statistical survey of fish tissue contamination at 540 river sites (representing 82 954 river km) in 2008-2009, and analyzed samples for 50 persistent organic pollutants (POPs), including 21 PCB congeners, 8 PBDE congeners, and 21 organochlorine pesticides.

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Background: Dasatinib exhibited activity in preclinical models of sarcoma. The Sarcoma Alliance for Research through Collaboration (SARC) conducted a multicenter, phase 2 trial of dasatinib in patients with advanced sarcoma.

Methods: Patients received dasatinib twice daily.

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Background: In recent years, various outcome adaptive randomization (AR) methods have been used to conduct comparative clinical trials. Rather than randomizing patients equally between treatments, outcome AR uses the accumulating data to unbalance the randomization probabilities in favor of the treatment arm that currently is superior empirically. This is motivated by the idea that, on average, more patients in the trial will be given the treatment that is truly superior, so AR is ethically more desirable than equal randomization.

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The U.S. EPA conducted a national statistical survey of fish fillet tissue with a sample size of 541 sites on boatable rivers =>5th order in 2008-2009.

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Enhancements of the continuous-wave four-wave mixing conversion efficiency and bandwidth are accomplished through the application of plasma-assisted photoresist reflow to reduce the sidewall roughness of sub-square-micron-modal area waveguides. Nonlinear AlGaAs optical waveguides with a propagation loss of 0.56 dB/cm demonstrate continuous-wave four-wave mixing conversion efficiency of -7.

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We use pump-probe spectroscopy and continuous wave cross-phase and cross-amplitude modulation measurements to study the optical nonlinearity of a hydrogenated amorphous silicon (a-Si:H) nanowire waveguide, and we compare the results to those of a crystalline silicon waveguide of similar dimensions. The a-Si:H nanowire shows essentially zero instantaneous two-photon absorption, but it displays a strong, long-lived non-instantaneous nonlinearity that is both absorptive and refractive. Power scaling measurements show that this non-instantaneous nonlinearity in a-Si:H scales as a third-order nonlinearity, and the refractive component possesses the opposite sign to that expected for free-carrier dispersion.

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Perfluorinated compounds (PFCs) have recently received scientific and regulatory attention due to their broad environmental distribution, persistence, bioaccumulative potential, and toxicity. Studies suggest that fish consumption may be a source of human exposure to perfluorooctane sulfonate (PFOS) or long-chain perfluorocarboxylic acids. Most PFC fish tissue literature focuses on marine fish and waters outside of the United States (U.

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The findings of this evaluation document partial success for the PEDS training program to achieve its 3 aims. It will take several years for the dissemination of this program to reach a critical mass of pediatricians and other physicians in many LMICs. Obtaining stronger support from MOHs and other governmental agencies is necessary to achieve this goal.

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Adaptive designs are increasingly used in clinical trials. The Drug Information Association's Adaptive Design Scientific Working Group (ADSWG) works to foster collaboration among regulatory agencies, academia, and pharmaceutical and biotech companies to further the science of adaptive clinical development. The ADSWG Survey Subteam has collected data on the usage of adaptive designs in clinical research from multiple sources, including a recent ADSWG survey regarding the perception and usage of adaptive designs in academia and industry for studies between 2008 and 2011, as well as barriers to usage; a literature review examining publications of adaptive design methodology and usage between 2000 and 2011; and a trial registry review of adaptive design references from 1996 to 2011.

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Objective: To compare management of acute femur fractures in children who received a fascia iliaca compartment nerve block (FICNB) to those who received systemic intravenously administered analgesics in the pediatric emergency department. The comparison evaluated frequency of use, effectiveness, and associated adverse event profiles.

Methods: Study population was derived from a retrospective chart review of pediatric patients sustaining acute femur fractures between 2005 and 2009.

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We present a side-by-side comparison of the nonlinear behavior of four passive AlGaAs ridge waveguides where the bandgap energy of the core layers ranges from 1.60 to 1.79 eV.

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Background: Between 30% and 50% of women who have high-grade uterine leiomyosarcoma (uLMS) limited to the uterus at diagnosis remain progression-free at 2 years. Adjuvant pelvic radiation does not improve outcome. The objective of the current study was to determine the 2-year and 3-year progression-free survival (PFS) among a prospective cohort of women who received adjuvant gemcitabine plus docetaxel followed by doxorubicin.

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We describe a technique for accurately measuring the ratio between the imaginary and real parts of the third-order nonlinearity in optical waveguides. Unlike most other methods, it does not depend on precise knowledge of the coupling efficiencies, optical propagation loss, or optical pulse shape. We apply the method to characterize a silicon waveguide, a GaAs waveguide, and AlGaAs waveguides with different alloy concentrations.

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Objective: This study aimed to prospectively determine the etomidate dose associated with adequate sedation and few significant respiratory events for procedures of short duration in children.

Methods: This is a prospective cohort study in an urban pediatric emergency department of patients 4 to 18 years requiring sedation and analgesia for painful procedures of short duration. Patients received fentanyl 1 μg/kg followed by intravenously administered etomidate 0.

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Background: Gemcitabine and docetaxel have a broad spectrum of clinical activity in patients with carcinoma. The Sarcoma Alliance for Research Through Collaboration conducted a phase II trial of gemcitabine in combination with docetaxel in children and adults with recurrent Ewing sarcoma (EWS), osteosarcoma (OS), or unresectable or recurrent chondrosarcoma. The primary objective was to determine the objective response rate using response evaluation criteria in solid tumors (RECIST).

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