Sepsis Mortality in Hospitalized Children With Cancer Is Associated With Lack of a Screening Tool.

Objective: Sepsis is associated with significant morbidity and mortality in pediatric hematology, oncology, and transplant (PHOT) patients. This study characterized PHOT patients who developed hospital-onset sepsis more than 12 hours after admission and identified risk factors for 30-day sepsis-attributable (SA) mortality.

Patients And Methods: We analyzed an existing multicenter database of sepsis collected prospectively over 5 years (2017-2021) as part of the Improving Pediatric Sepsis Outcomes Collaborative.

Symptom Documentation in Unstructured Palliative Care Notes of Children and Adolescents With Cancer.

Context: Children and adolescents with cancer experiencing complex symptoms can benefit from subspeciality palliative care. However, standardized methods of symptom documentation by pediatric palliative care teams are lacking. Understanding current approaches to symptom documentation will inform next steps to optimize symptom support.

Prevention and Management of Infectious Complications in Pediatric Patients With Cancer: A Survey Assessment of Current Practices Across Children's Oncology Group Institutions.

Introduction: While clinical practice guidelines (CPGs) for pediatric oncology infection prophylaxis and management exist, few data describe actual management occurring at pediatric oncology centers.

Methods: An electronic survey querying infection management practices in nontransplant pediatric oncology patients was iteratively created by the Children's Oncology Group (COG) Cancer Control and Supportive Care Infectious Diseases Subcommittee and sent to leaders at all COG institutions, limiting each site to one response to represent their institution.

Results: The response rate was 57% (129/227 institutions).

The epidemiology of pediatric oncology and hematopoietic cell transplant admissions to U.S. intensive care units from 2001-2019.

Children with cancer or hematopoietic cell transplant (HCT) frequently require ICU care. We conducted a retrospective cohort study using Healthcare Cost and Utilization Project's State Inpatient Databases from 21 U.S.

Co-production of a novel intervention targeting obesity-related barriers to mammographic screening participation.

Introduction: Women with obesity are less likely to participate in mammographic screening and more likely to develop post-menopausal breast cancer. We describe the co-production of a novel training intervention for breast screening staff, targeting obesity-related barriers to participating in a population-based mammographic screening.

Methods: A Stakeholder Consultant Group (SCG) was established to guide the co-production process.

Case Ascertainment in Pediatric Heart Failure Using International Classification of Disease Clinical Modification (ICD-CM) Codes.

Most epidemiological studies in pediatric heart failure (HF) use administrative database sources, defining patient cohorts by presence of a single HF ICD code. However, the ability of ICD codes to identify true HF patients is unknown in pediatrics. Here we describe the accuracy of HF ICD-10-CM code search algorithms, in identifying pediatric patients with HF from electronic data sources.

Multiplexed gastrointestinal PCR panels for the evaluation of diarrhea in patients with acute leukemia.

Objective: To better delineate multiplexed gastrointestinal polymerase chain reaction (PCR) panel (MGPP) diagnostic and therapeutic stewardship for patients undergoing treatment for acute leukemia including indications and benefits of testing, optimal timing, and interpretation of results.

Study Design: We retrieved all MGPP ordered on 662 consecutive patients admitted with newly diagnosed acute leukemia between June 2015 and May 2024.

Setting: Regional referral center for acute leukemia.

Case Ascertainment in Pediatric Heart Failure Using International Classification of Disease Clinical Modification (ICD-CM) Codes.

Background: Most epidemiological studies in pediatric heart failure (HF) use administrative database sources, defining patient cohorts by presence of a single HF ICD code. However, the ability of ICD codes to identify true HF patients is unknown in pediatrics. Here we describe the accuracy of HF ICD-10-CM code search algorithms, in identifying pediatric patients with HF from electronic data sources.

Factors Influencing Length of Care in Physical Therapy After Pediatric and Adolescent Concussion.

Context: Social determinants of health including insurance type, income, race, and ethnicity have been shown to influence the utilization of physical therapy and recovery after an orthopedic injury. The influence of social determinants of health on the utilization of physical therapy and recovery from concussion is not well understood.

Design: Prospective observational registry study in a specialty concussion program.

Enhancer AAV toolbox for accessing and perturbing striatal cell types and circuits.

We present an enhancer AAV toolbox for accessing and perturbing striatal cell types and circuits. Best-in-class vectors were curated for accessing major striatal neuron populations including medium spiny neurons (MSNs), direct and indirect pathway MSNs, as well as Sst-Chodl, Pvalb-Pthlh, and cholinergic interneurons. Specificity was evaluated by multiple modes of molecular validation, three different routes of virus delivery, and with diverse transgene cargos.

Validation of the Japanese version of the Patient Health Questionnaire-4 (PHQ-4-J) to screen for depression and anxiety.

Objective: We aimed to validate the Japanese version of the Patient Health Questionnaire-4 (PHQ-4-J). People in Japan, especially healthcare workers (HCWs) suffer from high rates of mental health symptoms. The PHQ-4 is an established ultra-brief mental health measure used in various settings, populations and languages.

Influence of acute mild winter conditions on the productivity of feedlot cattle: An Australian perspective.

The impact of cold stress on feedlot cattle has received limited investigation in temperate climates. However, cold stress has been found to impact cattle welfare and production in temperate climatic conditions, where ambient temperature (T), precipitation, relative humidity (RH), wind speed (WS) and solar radiation (SR) all influencing apparent temperature. While there are many indices to quantify cold stress in cattle, there are limited indices that directly relate to cattle and account for all the interactions between climatic variables.

Pediatric Epilepsy Genetic Testing Results and Long-term Seizure Freedom.

To determine whether there is a correlation of genetic diagnosis/result with long-term seizure freedom in pediatric epilepsy patients. This was a prospective and retrospective cohort study of children with epilepsy referred for genetic testing at a single center. The primary outcomes were presence and type of genetic diagnosis (pathogenic, benign, or variant of uncertain significance) and patient epilepsy status (seizure free, treatment failure, uncertain).

Comorbidity of concussion and depression alters brain functional connectivity in collegiate student-athletes.

Depression and concussion are highly prevalent neuropsychological disorders that often occur simultaneously. However, due to the high degree of symptom overlap between the two events, including but not limited to headache, sleep disturbances, appetite changes, fatigue, and difficulty concentrating, they may be treated in isolation. Thus, clinical awareness of additive symptom load may be missed.

Familial autoimmunity and risk of developing immune thrombocytopenia and Evans syndrome.

Background: Immune thrombocytopenia (ITP) and Evans syndrome (ES) are manifestations of immune dysregulation. Genetic variants in immune-related genes have been identified in patients with ITP and especially ES. We aimed to explore familial autoimmunity in patients with ITP and ES to understand possible contributions to chronicity.

SHIELD: Skull-shaped hemispheric implants enabling large-scale electrophysiology datasets in the mouse brain.

To understand the neural basis of behavior, it is essential to measure spiking dynamics across many interacting brain regions. Although new technologies, such as Neuropixels probes, facilitate multi-regional recordings, significant surgical and procedural hurdles remain for these experiments to achieve their full potential. Here, we describe skull-shaped hemispheric implants enabling large-scale electrophysiology datasets (SHIELD).

Pediatric Digit Replantation: A Nationwide Analysis of Failure Rate, Complications, and Potential Factors Affecting Failure.

Purpose: Function and cosmesis may be improved by replantation following digital amputation in pediatric patients. However, accurate failure and complication rate estimates may be limited as most pertinent studies reflect single center/surgeon experience and therefore are limited by small sample sizes. The primary aim of this study was to assess the rate of failure (amputation) following pediatric digital replantation.

Time to diagnosis among young patients with cancer.

Background: Sociodemographic and clinical factors associated with diagnostic delays in pediatric, adolescent, and young adult cancers are poorly understood.

Methods: Using the Optum Labs Data Warehouse's de-identified claims data for commercial health plan enrollees, we identified children (0-14 years) and adolescents/young adults (AYAs) (15-39 years) diagnosed with one of 10 common cancers from 2001 to 2017, who were continuously enrolled for 6 months preceding diagnosis. Time to diagnosis was calculated as days between first medical encounter with possible cancer symptoms and cancer diagnosis date.

Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis.

Importance: Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and within 3 hours for sepsis without shock. Limited studies exist identifying a specific time past which delays in antibiotic administration are associated with worse outcomes.

Objective: To determine a time point for antibiotic administration that is associated with increased risk of mortality among pediatric patients with sepsis.

COVID-19 infection in children, adolescents, and young adults with Down syndrome and hematologic malignancies.

Introduction: Children, adolescents, and young adults (CAYAs) with Down syndrome (DS) and hematologic malignancies are particularly vulnerable to infections and related complications. There are limited data regarding COVID-19 infections in this group. We aimed to understand the clinical course of COVID-19 in this population.

Co-design of an intervention to optimize mammographic screening participation in women with obesity and/or physical disabilities.

Background: Mammographic breast screening/rescreening rates are suboptimal for women with obesity and/or physical disabilities. This study describes development of an intervention framework targeting obesity- and disability-related barriers to improve participation.

Methods: Mixed methods combined a systematic review with first-person perspectives to optimise screening engagement among women with obesity and/or physical disabilities.

Household income and health-related quality of life in children receiving treatment for acute myeloid leukemia: Potential impact of selection bias in health equity research.

Objective: Examine the influence of household income on health-related quality of life (HRQOL) among children with newly diagnosed acute myeloid leukemia (AML).

Design: Secondary analysis of data prospectively collected from pediatric patients receiving treatment for AML at 14 hospitals across the United States.

Exposure: Household income was self-reported on a demographic survey.