Parental Perceptions of Early Childhood In-Home Research with Monitoring: A Qualitative Study.

Objective: To explore perceptions, concerns, and enthusiasm from a diverse group of parents regarding early childhood research that involves home monitoring technologies for collecting environmental exposure data.

Study Design: A diverse group of new and expecting parents participated in semi-structured interviews. A single interviewer conducted all sessions and introduced a hypothetical longitudinal early childhood research study, which included novel home monitoring approaches: 1) wearable devices, 2) audio monitoring, and 3) environmental sampling.

High-Risk Infant Developmental Outcome Is Associated with Medical Complexity and Neighborhood Opportunity.

Objective: To assess how medical complexity and neighborhood opportunity jointly affect cognitive, motor, and language Bayley's Scales of Infant Development. Secondary objectives involved identifying the factors contributing to developmental disparities across diverse racial and ethnic groups.

Study Design: Electronic health records from a Southern California high-risk infant follow-up clinic were analyzed for 440 infants from 2014 through 2023 who had either had neonatal intensive care unit stays, prematurity, very low birthweight, or developmental delay risk.

Alternative antibiotic selections during the 2022 amoxicillin shortage in the US.

This study of seven pediatric hospitals identified that the amoxicillin shortage in 2022 resulted in a decline in amoxicillin suspension prescribing by 30.8% with increases in use of amoxicillin non-suspension (+7.9) and broad-spectrum antibiotics.

Leukocyte-lymphatic intersections during cardiac inflammation.

Advances in genetic, pharmacologic, and sequencing technology have led to new insight into the role of lymphatics in health and disease. This includes fundamental aspects of the crosstalk between immune cells with cardiac lymphatics. At the interface between leukocytes and lymphatic endothelial cells, myeloid populations are sources of lymphatic growth factors during inflammation.

Classification of Human Ovarian Follicle Morphology: Recommendations of the NICHD-Sponsored Ovarian Nomenclature Workshop.

Objective: To develop a consensus on histologic human ovarian follicle staging nomenclature, provide guidelines for follicle density calculation, and assess changes due to fixation to enhance communication among clinicians and ovarian biology researchers in order to gain a deeper understanding of human fertility.

Methods: Beginning in March 2021, the Ovarian Nomenclature Workshop's Follicle Classification Working Subgroup was organized by the Pediatric and Adolescent Gynecology program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Results: The Follicle Working Subgroup recommends consolidation and expansion of the current classification systems to include six stages of normal preantral follicles, five stages of normal antral follicles, as well as categories of corpus lutea, abnormal preantral follicles, abnormal antral follicles, and other distinct follicle types.

Upadacitinib is associated with clinical response and steroid-free remission for children and adolescents with inflammatory bowel disease.

Objective: Upadacitinib, an oral Janus kinase inhibitor (JAKi), is approved for inflammatory bowel disease (IBD) in adults. As on-label use will face significant delay in pediatrics, a real-world understanding of safety and efficacy in children is critical.

Methods: This is a single-center retrospective cohort of pediatric subjects (ages 9-20 years) with a diagnosis of IBD initiated on upadacitinib.

Ethical Issues Faced by Data Monitoring Committees: Results from an Exploratory Qualitative Study.

To protect research participants and ensure scientific integrity in clinical trials, independent data monitoring committees (DMCs, also known as data and safety monitoring boards) increasingly oversee randomized clinical trials and recommend modifying or stopping research. Little is known about the ethical issues DMCs face. We conducted semistructured interviews of DMC members using a qualitative description approach with low-inference interpretation.

Adherence to Pediatric Screening.

Background: Preventive screenings in children encourage maintenance of optimal cardiovascular health, but gaps may exist between recommendations and clinical practice. We evaluated adherence to pediatric guidelines for universal age-based and risk-based screening for body mass index, blood pressure, lipids, and blood glucose.

Methods And Results: We used 2010 to 2018 ambulatory visit data from children aged 2 to 12 years within CAPRICORN (Chicago Area Patient-Centered Outcomes Research Network), an electronic health record network in Chicago.

Navigating ethical and legal challenges in the HEALthy Brain and Child Development Study: Lessons learned from the ethics, law, policy working group.

The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. The HBCD study has faced several ethical and legal challenges due to its goal of enrolling pregnant people (including those with substance use disorder) and their newborns. Challenges not fully anticipated at the outset emerged from the rapidly changing legal landscape around reproductive rights in the United States.

Tumor volume features predict survival outcomes for patients diagnosed with diffuse intrinsic pontine glioma.

Background: Diffuse intrinsic pontine glioma (DIPG) is a fatal childhood central nervous system tumor. Diagnosis and monitoring of tumor response to therapy is based on magnetic resonance imaging (MRI). MRI-based analyses of tumor volume and appearance may aid in the prediction of patient overall survival (OS).

How Child Health Financing and Payment Mitigate and Perpetuate Structural Racism.

Health financing for children and youth comes mainly from commercial sources (especially, a parent's employer-sponsored insurance) and public sources (especially, Medicaid and Children's Health Insurance Plan [CHIP]). These 2 sources serve populations that differ in race and ethnicity. This inherent segregation perpetuates a system of disparities in health and health care.

Expansion of Medicaid Coverage of Continuous Glucose Monitor Reduces Health Disparity in Children and Young Adults With Type 1 Diabetes.

Background: Continuous glucose monitor (CGM) usage improves glycemia in people with type 1 diabetes (PWD) and is accepted as the standard of care. The CGM utilization is lower in patients with public insurance and minorized ethnicities. In 2022, California Medicaid reduced its barriers to obtaining CGM coverage for PWD.

Comparison of Neighborhood Disadvantage Indices on Emergency Medical Services Interventions and Outcomes for Pediatric Out-of-Hospital Emergencies.

Objective: Measures of neighborhood disadvantage demonstrate correlations to health outcomes in children. We compared differing indices of neighborhood disadvantage with emergency medical services (EMS) interventions in children.

Methods: We performed a retrospective study of EMS encounters for children (<18 years) from approximately 2000 US EMS agencies between 2021 and 2022.

Managing Patients With COVID-19 in Armenia Using a Remote Monitoring System: Descriptive Study.

Background: The COVID-19 pandemic has imposed immense stress on global health care systems, especially in low- and middle-income countries (LMICs). Armenia, a middle-income country in the Caucasus region, contended with the pandemic and a concurrent war, resulting in significant demand on its already strained health care infrastructure. The COVID@home program was a multi-institution, international collaboration to address critical hospital bed shortages by implementing a home-based oxygen therapy and remote monitoring program.

Clinician Perspectives on Decision Support and AI-based Decision Support in a Pediatric ED.

Background: Clinical decision support (CDS) systems offer the potential to improve pediatric care through enhanced test ordering, prescribing, and standardization of care. Its augmentation with artificial intelligence (AI-CDS) may help address current limitations with CDS implementation regarding alarm fatigue and accuracy of recommendations. We sought to evaluate strengths and perceptions of CDS, with a focus on AI-CDS, through semistructured interviews of clinician partners.

GCN2 kinase activation mediates pulmonary vascular remodeling and pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH) is characterized by progressive increase of pulmonary vascular resistance and remodeling that result in right heart failure. Recessive mutations of EIF2AK4 gene (encoding general control nonderepressible 2 kinase, GCN2) are linked to heritable pulmonary veno-occlusive disease (PVOD) in patients but rarely in patients with PAH. The role of GCN2 kinase activation in the pathogenesis of PAH remains unclear.