Pediatric Meningeal Diseases: What Radiologists Need to Know.

Evaluating altered mental status and suspected meningeal disorders in children often begins with imaging, typically before a lumbar puncture. The challenge is that meningeal enhancement is a common finding across a range of pathologies, making diagnosis complex. This review proposes a categorization of meningeal diseases based on their predominant imaging characteristics.

SHAPE: A visual computing pipeline for interactive landmarking of 3D photograms and patient reporting for assessing craniosynostosis.

3D photogrammetry is a cost-effective, non-invasive imaging modality that does not require the use of ionizing radiation or sedation. Therefore, it is specifically valuable in pediatrics and is used to support the diagnosis and longitudinal study of craniofacial developmental pathologies such as craniosynostosis - the premature fusion of one or more cranial sutures resulting in local cranial growth restrictions and cranial malformations. Analysis of 3D photogrammetry requires the identification of craniofacial landmarks to segment the head surface and compute metrics to quantify anomalies.

Hypothesis generation for rare and undiagnosed diseases through clustering and classifying time-versioned biological ontologies.

Rare diseases affect 1-in-10 people in the United States and despite increased genetic testing, up to half never receive a diagnosis. Even when using advanced genome sequencing platforms to discover variants, if there is no connection between the variants found in the patient's genome and their phenotypes in the literature, then the patient will remain undiagnosed. When a direct variant-phenotype connection is not known, putting a patient's information in the larger context of phenotype relationships and protein-protein interactions may provide an opportunity to find an indirect explanation.

Real-world effectiveness and causal mediation study of BNT162b2 on long COVID risks in children and adolescents.

Background: The impact of pre-infection vaccination on the risk of long COVID remains unclear in the pediatric population. We aim to assess the effectiveness of BNT162b2 on long COVID risks with various strains of the SARS-CoV-2 virus in children and adolescents, using comparative effectiveness methods. We further explore if such pre-infection vaccination can mitigate the risk of long COVID beyond its established protective benefits against SARS-CoV-2 infection using causal mediation analysis.

Characteristics and management of eosinophilic esophagitis in Australasian children: a decade of experience.

Background: The frequency of EoE has been increasing in Northern Hemisphere cohorts, yet there is a scarcity of data in our region. Regional climatic factors, and lifestyle habits may influence the presentation of EoE, and appropriate management is crucial to prevent complications. WIth this is mind we undertook the first comprehensive multisite study of EoE in Australasian children.

Navigating the complex care landscape: Addressing challenges and advancing adult care frameworks for individuals with cerebral palsy.

Despite cerebral palsy (CP) being the most common motor disability in childhood, there are more adults living with CP than children. The necessitates a systematic approach to the care of adults with CP. This perspective piece presents the complex nature of a lifespan approach to the care of a childhood-onset disability.

Testosterone Effects on Short-Term Physical, Hormonal, and Neurodevelopmental Outcomes in Infants with 47,XXY/Klinefelter Syndrome: The TESTO Randomized Controlled Trial.

Context: 47,XXY/Klinefelter syndrome (XXY) is associated with impaired testicular function and differences in physical growth, metabolism, and neurodevelopment. Clinical features of XXY may be attributable to inadequate testosterone during the mini-puberty period of infancy.

Objective: We tested the hypothesis that exogenous testosterone treatment positively effects short-term physical, hormonal, and neurodevelopmental outcomes in infants with XXY.

Opioid prescribing patterns and the effect of chronic kidney disease in pediatric urology population: A retrospective cohort analysis.

Background: Significant efforts have been undertaken to decrease opioid prescribing, but there is little research into patient-specific factors presenting as barriers in the pediatric surgical population. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be a safe and effective alternative to opioids for pain control, however, concerns about their impact on renal function limit their use in patients with chronic kidney disease (CKD). Data is limited on the interplay of CKD on opioid prescribing.

Healthcare, educational, and vocational transitions in young adults with pediatric-onset disabilities: Associations with social determinants of health.

Objective: We aim to describe healthcare, vocational, and educational transitions in young adults with pediatric-onset disabilities and to examine the associations with social determinants of health and depressive symptoms.

Design: This cross-sectional study used multinomial and binary logistic regression to examine the associations of sociodemographic factors and depressive symptoms with healthcare, educational, and vocational transitions.

Setting: Participants were recruited from outpatient specialty clinics in a Rehabilitation Medicine department at a quaternary academic children's hospital.

International workshop: what is needed to ensure outcome measures for Rett syndrome are fit-for-purpose for clinical trials? June 7, 2023, Nashville, USA.

Introduction: The clinical, research and advocacy communities for Rett syndrome are striving to achieve clinical trial readiness, including having fit-for-purpose clinical outcome assessments. This study aimed to (1) describe psychometric properties of clinical outcome assessment for Rett syndrome and (2) identify what is needed to ensure that fit-for-purpose clinical outcome assessments are available for clinical trials.

Methods: Clinical outcome assessments for the top 10 priority domains identified in the Voice of the Patient Report for Rett syndrome were compiled and available psychometric data were extracted.

Evolving Food Allergy Clinical Trials to Become More Patient-Centered.

The current FDA paradigm may not fully capture important patient-centered outcomes or measure a primary outcome that is truly meaningful to patients. Patient reported outcome measures (PROMs) are standardized tools measuring the patient's experience in food allergy clinical trials, which can help support shared decision-making (SDM) and further our understanding of treatment impact. Food allergy PROMs include quality of life (QoL), health state utility (HSU), severity, and self-efficacy measures.

Creative Arts Therapy Reduces Psychological Distress in Non-Patient-Facing Healthcare Workers.

Objective: To assess the feasibility, acceptability, and efficacy of a 12-week in-person Creative Arts Therapy intervention in reducing psychological distress and burnout symptoms in non-patient-facing healthcare workers.

Background: Burnout and psychological distress among non-patient-facing healthcare workers are significant and understudied problems in healthcare systems.

Methods: Non-patient-facing healthcare workers with burnout symptoms were randomly assigned to one of four Creative Arts Therapy modalities (art, music, creative writing, or dance/movement) or a control group.

Children Requiring 3 or More Days of Invasive Ventilation: Secondary Analysis of Post-Discharge Change in Caregiver Employment.

Objectives: To describe frequency of, and risk factors, for change in caregiver employment among critically ill children with acute respiratory failure.

Design: Preplanned secondary analysis of prospective cohort dataset, 2018-2021.

Setting: Quaternary Children's Hospital PICU.

Caregiver worry about COVID-19 as a predictor of social mitigation behaviours and SARS-CoV-2 infection in a 12-city U.S. surveillance study of households with children.

Objective: Understanding compliance with COVID-19 mitigation recommendations is critical for informing efforts to contain future infectious disease outbreaks. This study tested the hypothesis that higher levels of worry about COVID-19 illness among household caregivers would predict lower (a) levels of overall and discretionary social exposure activities and (b) rates of household SARS-CoV-2 infections.

Methods: Data were drawn from a surveillance study of households with children ( = 1913) recruited from 12 U.

Neighborhood Disadvantage and Injury Mechanism, Severity, and Outcomes in Pediatric Trauma.

Background: Traumatic injuries remain the leading cause of death in children aged 1-14. Previous research demonstrates a link between lower socioeconomic status (SES) and higher pediatric injury morbidity and mortality. There is scant research exploring the relationship between neighborhood disadvantage and pediatric trauma.

Use of Right Ventricular Free-Wall Strain in a Multivariable Estimate of Right Ventricular-Arterial Coupling in Pediatric Pulmonary Arterial Hypertension.

Background: Right ventricular-arterial coupling (RVAC) describes the relationship between right ventricular contractility and pulmonary vascular afterload. Noninvasive surrogates for RVAC using echocardiographic estimates of right ventricular function, such as tricuspid annular plane systolic excursion (TAPSE), have been shown to correlate with invasively measured RVAC and predict clinical outcomes in pediatric pulmonary arterial hypertension. However, given the limitations of TAPSE at accurately estimating right ventricular function in children, we hypothesized that a multivariable estimate of RVAC using right ventricular free-wall longitudinal strain (RVFW-LS) may perform better than those utilizing TAPSE at predicting clinical outcomes.

Machine Learning-Based Prediction Model for ICU Mortality After Continuous Renal Replacement Therapy Initiation in Children.

Background: Continuous renal replacement therapy (CRRT) is the favored renal replacement therapy in critically ill patients. Predicting clinical outcomes for CRRT patients is difficult due to population heterogeneity, varying clinical practices, and limited sample sizes.

Objective: We aimed to predict survival to ICUs and hospital discharge in children and young adults receiving CRRT using machine learning (ML) techniques.

Staff and caregivers' perceptions of digital storytelling to increase influenza vaccine confidence in an urban safety-net healthcare system.

Background: Myriad risk factors contribute to pediatric influenza vaccination disparities. Digital stories are compelling accounts of lived experience that have been useful in health promotion, especially in minoritized communities. Little is known about how they are perceived as a behavioral intervention to improve influenza vaccination confidence in safety-net healthcare systems.

Bedside transfontanelle drain placement reduces the need for operative intervention in infants with subdural fluid collections.

Objective: Subdural fluid collection is a common neurosurgical condition in the pediatric population. Patients requiring surgical intervention have historically been managed with subdural drains, subdural-subgaleal shunting, subdural-peritoneal shunting, and mini-craniotomies. An alternative procedure for patients with an open anterior fontanelle is bedside transfontanelle drainage.

Synchrotron-Based Phase-Contrast Micro-CT Combined With Histology to Decipher Differences Between Hereditary and Sporadic Pediatric Pulmonary Veno-Occlusive Disease.

Pulmonary veno-occlusive disease (PVOD) is a lethal variant of pulmonary hypertension. The degree of pulmonary arterial involvement varies. Here, we compare two PVOD patients who were transplanted at 8 years of age, whereof one is a homozygous mutation carrier.

Cost-effectiveness of oral immunotherapy for egg allergy according to age of therapy commencement.

Background: Egg oral immunotherapy can induce desensitization or remission of egg allergy in children.

Objective: To determine the cost-effectiveness of OIT for raw egg allergy in school-aged children compared to egg avoidance, and the most cost-effective age at which to commence treatment.

Methods: A decision-analytic Markov model estimated the health and cost outcomes of 1000 children aged four years with egg allergy, comparing different ages of OIT commencement (from ages 4-12, inclusive) versus ongoing egg avoidance.