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A Clinical Mathematical Model Estimating Postoperative Urine Output In Children Underwent Cardiopulmonary Bypass For Congenital Heart Surgery, Orkun Baloglu, Shawn D. Ryan, Ali M. Onder, David Rosen, Charles J. Mullett, Daniel S. Munther

Journal of Pediatric Intensive Care

Objectives: To build a proof of concept clinical mathematical model estimating postoperative urine output (UOP) utilizing pre-operative, intra-operative and immediate postoperative variables in children underwent cardiopulmonary bypass (CPB) for congenital heart surgery. Methods: Single-center, retrospective cohort study in a university-affiliated children’s hospital. Patients younger than 21 years old who underwent CPB for congenital heart surgery and were postoperatively admitted to West Virginia University Children’s Hospital`s pediatric intensive care unit (PICU) between September 1, 2007, and June 31, 2013 were included in the study. Body surface area, CPB duration, first measured hematocrit, serum pH, central venous pressure and vasoactive-inotropic score in …

Practice Variability And Unplanned Extubation Rates Across Pediatric Intensive Care Units, Krista Wollny, Amy Metcalfe, Karen Benzies, Simon J. Parsons, Tolulope Sajobi, Deborah Mcneil

Journal of Pediatric Intensive Care

Objectives The purpose of this study was to describe the care of intubated patients in pediatric critical care. Acknowledging there are several perceived factors that contribute to unplanned extubations, a secondary objective was to describe how practice variation may relate to observed differences in unplanned extubation rates. Methods A survey about practices related to the care of intubated patients was distributed to all PICUs participating in the Virtual Pediatrics System (VPS, LLC). Unplanned extubation rates for 2019-2020 were obtained from VPS. Univariate and bivariate analyses were performed to describe the responses, with unplanned extubation rates calculated as means. The text …

Development And Optimization Of A Remote Pediatric Cardiac Critical Care Bootcamp Using Telesimulation, Felina Mille, Amy Romer, Tarif A. Choudhury, Adrian D. Zurca, Stacie B. Peddy, Keith Widmeier, Marjorie Hamburger, Venkat Shankar

Journal of Pediatric Intensive Care

Objectives: We developed a novel cardiac critical care bootcamp consisting of didactic, small-group and simulation sessions. The bootcamp was remote due to the COVID-19 pandemic and included telesimulation. We aimed to assess learners’ reactions to the bootcamp and their perception of telesimulation. Methods: Paired anonymous surveys were administered before and after participation. Surveys assessed participants’ comfort in independently managing cardiac critical care scenarios, perceptions of telesimulation, barriers to its effectiveness, and specific feedback on course components. Results: Forty-three fellows from 10 institutions joined the bootcamp over two years. 38 pre- and 28 post-course surveys were completed. The course was rated …

The Association Of Teamwork And Adverse Tracheal Intubation–Associated Events (Tiaes) In Advanced Airway Management In The Pediatric Icu, John F. Jennings, Sholeen Nett, Rachel Umoren, Robert Murray, Aaron Kessel, Natalie Napolitano, Michelle Adu-Darko, Katherine Biagas, Philipp Jung, Debra Spear, Simon Parsons, Ryan Breuer, Keith Meyer, Matthew Malone, Asha Shenoi, Anthony Lee, Palen Mallory, Awni Al-Subu, Keiko Tarquinio, Lily Glater, Megan Toal, Jan Hau Lee, Matthew Pinto, Lee Polikoff, Erin Own, Iris Toedt-Pingel, Mioko Kasagi, Laurence Ducharme-Crevier, Makoto Motomura, Masafumi Gima, Serena Kelly, Josep Panisello, Gabrielle Nuthall, Kelsey Gladen, Justine Shults, Vinay Nadkarni, Akira Nishisaki

Journal of Pediatric Intensive Care

Background: Tracheal intubation in critically ill children is a life-saving, but high-risk procedure that involves multiple team members with diverse clinical skills. We aim to examine the association between the provider-reported teamwork rating and the occurrence of adverse tracheal intubation–associated events (TIAEs). Methods: A retrospective analysis of prospectively collected data from 45 pediatric intensive care units (PICUs) in the National Emergency Airway Registry for Children (NEAR4KIDS) database from January 2013 to March 2018 was performed. A composite teamwork score was generated using the average of each of five (7-point Likert scale) domains in the teamwork assessment tool. Poor teamwork was …

Complications Of Peripheral Arterial Access In Preterm And Term Neonates: A Systematic Review, Yangmyung Ma, Ahmed Salem, Andrea Jester

Journal of Pediatric Intensive Care

Aims: To provide a comprehensive review of vascular complications secondary to peripheral arterial catheterisation in preterm and term neonates. Methods: The systematic review consisted of searching PubMed, Scopus, Google Scholar, Cochrane Database of Systematic Reviews and references of journals using pre-trialled MeSH terms and articles. Results: Eight studies were included for full text analysis from 2369 initial articles: 6 retrospective reviews and 2 prospective studies. The rate of complication was 8.6% and all complications were ischemic in nature. Complications most often occurred in neonates with pulmonary/cardiac comorbidities and lower gestational ages. No association was found for weight and sex of …

Outcomes Of Pediatric Patients With Sepsis Managed On Extracorporeal Membrane Oxygenation: An Analysis Of The Elso Registry, Adrian Holloway, Jason Custer, Ripal Patel, Peta Alexander, Peter Rycus, Cortney Foster, Dayanand Bagdure, Angelina June, Vladimir Michtcherkin, William Blackwelder, Carissa Baker-Smith, Adnan Bhutta

Journal of Pediatric Intensive Care

Objective: Extracorporeal Membrane Oxygenation (ECMO) support is increasingly used for refractory septic shock. There is lack of data on the outcomes of children requiring ECMO support for refractory septic shock. Our study objective was to describe the variables associated with survival, risk factors for mortality and outcomes of children requiring ECMO support for refractory shock. Materials and Methods: Retrospective registry study of 340 international centers contributing data to the ELSO Registry, analyzing children <18 years who received ECMO with septic shock, severe sepsis, sepsis, SIRS, toxic shock syndrome, shock associated with infection and septicemia from any organism from 1990 to 2015. Outcomes were analyzed by categorizing the data into survivors and non-survivors. Logistic regression models were used to describe the association of dependent variable and multiple independent variables. Results: A total of 1928 patients were identified which met the inclusion criteria. 744 (38.5%) of the cohort survived. Survivors in this cohort tend to have longer duration of ECMO (230 hrs vs 201 hrs, p =0.005) and shorter time from intubation to ECMO cannulation (87 hrs vs 116 hrs, p =0.0033) when compared to non-survivors. Survivors were also noted to have higher pH, higher serum bicarbonate, higher saturations, and higher systolic, diastolic, and mean arterial pressures compared to non-survivors. Conclusions: These results suggest that early initiation of ECMO therapy for refractory sepsis is associated with better patient outcomes. ECMO is unlikely to recover patients once circulatory and metabolic collapse has developed.

Postoperative Inhaled Nitric Oxide Use And Early Outcomes After Fontan Surgery Completion, Kamalvir Gill, Estefania Rivera, Nicolas Ortiz Flores, Amro Alashi, Anthony Rossi, Jun Sasaki

Journal of Pediatric Intensive Care

A considerable number of patients after the Fontan operation require prolonged hospitalization due to significant perioperative morbidities. The early postoperative morbidity can be attributed to elevated pulmonary vascular resistance. We hypothesized that the postoperative outcomes would improve with the routine use of inhaled nitric oxide (iNO) to decrease pulmonary vascular resistance. From January 2015 to November 2017 (Group 1), 37 patients underwent Fontan operation, and from December 2017 to December 2019 (Group 2), 34 patients underwent Fontan operation. All patients in Group 2 received iNO in the immediate perioperative period as part of a standardized postoperative pathway. There was no …

Decompressive Craniectomy In Pediatric Traumatic Brain Injury: A Retrospective Cohort Study, Wan Xin Yew, Jan Hau Lee, Hongxing Dang, Sharon Yin Yee Low, Dianna Sri Dewi, Shu-Ling Chong

Journal of Pediatric Intensive Care

Introduction: Decompressive craniectomy in children with traumatic brain injury (TBI) and refractory raised intracranial pressure (ICP) remains controversial. We aimed to describe the clinical and operative characteristics of children with moderate to severe TBI who underwent decompressive craniectomy, and compare outcomes with those who received medical therapy. Methods: We performed a retrospective observational cohort study on children < 16 years old with moderate to severe TBI (Glasgow Coma Scale, GCS ≤ 13 who underwent DC in 2 pediatric centers in Singapore and China between 2014 and 2017, and compared their outcomes to children who underwent medical treatment, among participating centers of the Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN). We defined poor functional outcomes as moderate, severe disability, vegetative or comatose state, or mortality, using the Pediatric Cerebral Performance Category scale. We performed multivariable logistic regression to identify predictors for poor functional outcomes. Results: We analyzed 18 children who underwent DC with 214 who had medical therapy. A greater proportion of children with DC (14, 77.8%) experienced poor functional outcomes, compared to those with medical therapy (87, 41.2%, p=0.003). Children who underwent DC had fewer median 14-day ICU-free days (2.5 days, interquartile range, IQR 0.0 – 5.8 vs 8.0, IQR 0.0 – 11.0, p=0.033), median 28-day hospital-free days (0 days, IQR 0.0-3.5 vs 11.0, IQR 0.0 – 21.0, p=0.002) and 14-day mechanical ventilation-free days (6.5 days, IQR 0.0 – 12.3 vs 11.0, IQR 3.0 – 14.0, p=0.011). After accounting for age, sex, GCS, cerebral edema, uncal herniation, nonaccidental injury (NAI) and need for intubation, there was no significant association between decompressive craniectomy and poor functional outcomes (aOR 1.59, 95% CI 0.35 – 7.24, p = 0.548). Conclusions: Children with DC had severe injuries, prolonged hospital and ICU stays. Future studies are needed to understand the effectiveness of DC on children with TBI.

Performance Of The Mean, Highest, And Admission Day Pediatric Sequential Organ Failure Assessment (Psofa) Scores As Outcome Predictors In A Pediatric Intensive Care Unit: A Prospective Observational Study, Debasis Maity, Moumita Samanta, Sandipan Sen, Tapan Kumar Sinha Mahapatra, Asim Kumar Mallick

Journal of Pediatric Intensive Care

Objectives: The Pediatric Sequential Organ Failure Assessment score (pSOFA) has been recently validated from its adult version having included the six clinical and biochemical parameters of organ dysfunction (respiratory, coagulation, cardiovascular, neurological, hepatic, and renal) and adapting age-adjusted cutoffs. Our goal was to find out which among the pSOFA scores (recorded on admission, highest score, and the mean score i.e., pSOFA1, pSOFAh, and pSOFAm respectively) performed better to predict mortality among the patients admitted in our pediatric intensive care unit (PICU). Methods: This prospective observational study was conducted on 104 patients (1 month to 12 years of age) admitted in …

Metabolic Abnormalities In Association With Clinical Neonatal Seizures In An Indian Tertiary Care Center, Ramesh Bhat. Y., Sandeep Pd

Journal of Pediatric Intensive Care

Background: Metabolic disturbances frequently occur in neonatal seizures either as an underlying cause or as an associated abnormality. A prompt recognition of metabolic abnormalities and early therapy are necessary to avoid poor neurological outcome. Methods: Neonates with clinical seizures were enrolled in the study. Diagnostic evaluation included complete blood count, sepsis screen, and estimation of blood glucose, serum sodium, calcium and magnesium before instituting any specific treatment. Metabolic abnormalities, were considered as isolated when hypoxic-ischemic encephalopathy (HIE), sepsis, intracranial hemorrhage and polycythemia were ruled out. Results: Among 80 newborns with clinical seizures, one metabolic abnormality was detected in 46 (57.5%). …

The Historiography Of The National Movement In Tunisia Between The Official, The Militant, And The Academic, Aamira Aaliya Seghir

Basamat

No abstract provided.

Geography Between Social And Human Sciences: New Developments Of Globalization, Mostapha Nachoui

Basamat

No abstract provided.

Geomorphology From Geological Time To Lived Time: Application To The Doukkala-Abda Region., Mohamed Mohyieddine

Basamat

No abstract provided.

Towards The Professionalization Of Press Relations Between The Public Administration And Journalists In Morocco, Rachida Bouzidi

Basamat

No abstract provided.

The Sacred King And The Profane King: The Case Of Louis Xiv, Anouar Marzouki

Basamat

No abstract provided.

Time And Pause In Spontaneous Speech, Lahcen Ouasmi

Basamat

No abstract provided.

The Metaphoric Structuring Of Time In Moroccan Arabic, Khalid Berrada

Basamat

No abstract provided.

Imagination And Time Against The Tearing Of The Social Fabric, Abdelbaki Belfakih

Basamat

No abstract provided.

A Case Report Of Shwachman-Diamond Syndrome And Literature Review, Xinfeng Gao, Jizhong Wang

Journal of Pediatric Genetics

Shwachman–Diamond syndrome (SDS) is a rare autosomal recessive genetic disorder, with approximately 90% of cases caused by pathogenic variants in the SBDS gene. This report describes a case of SDS diagnosed during the management of acute appendicitis. The patient, a male aged two years and 11 months, was admitted for emergency surgery for acute appendicitis. Subsequent evaluation revealed pancreatic exocrine dysfunction, pancreatic steatosis, abnormal liver function, and a history of recurrent diarrhea and neutropenia. Next-generation sequencing identified compound heterozygous SBDS variants: NM_016038.2:c.183_184TA>CT (p.Lys62*) and NM_016038.2:c.258+2T>C. This case highlights the importance of considering SDS in children presenting with recurrent …

Fanconi-Bickel Syndrome With Variable Phenotypes: A Case Series Highlighting A Successful Pregnancy Outcome From A Tertiary Care Center In North India, Pragya Kafley, Varunvenkat M. Srinivasan, Chaitra Ravi, Sangeeta Das, Pooja Motwani, Kausik Mandal

Journal of Pediatric Genetics

Fanconi-Bickel syndrome (FBS) is a rare autosomal recessive disorder caused by biallelic mutations in the SLC2A2 gene, characterized by proximal renal tubular dysfunction, hepatomegaly, and growth failure. We report five patients from three unrelated families in North India, including a sibling trio with significant intrafamilial variability and one of the few documented successful pregnancies in an affected female. Genetic testing identified a recurrent nonsense variant c.1093C>T (p.Arg365Ter) in two families and a missense variant c.1330T>C (p.Trp444Arg) in the third. The phenotypic spectrum ranged from mild growth delay to severe skeletal involvement and poor therapeutic response. Our report underscores …

A Study Of Diagnostic Experience And Impacts Of Rare Disease Diagnosis In Children And Their Families: Insights From India, Nidhi Vijay, Ashok Gupta, Priyanshu Mathur, Megha Sharma

Journal of Pediatric Genetics

Objective: Many rare diseases are usually misdiagnosed or diagnosed late. Delays in diagnosis have led to delayed treatment, resulting in poor outcomes. This study aims to shed light on the Indian scenario and help formulate schemes for early diagnosis, management of rare diseases and to uncover the unmet needs of the families of children with rare diseases. Methods: The target population were families with a child (17 years or younger) with any rare disease coming to SPINPH, Jaipur. The first author met face-to-face with the parents and they were made to answer a questionnaire. The questionnaires were checked for completeness …

Tethered Spinal Cord And Urinary Tract Complications In Trisomy 18, Michael A. Phillipi, Ladawna Gievers, Jesse L. Winer, Casey Seideman, Amanda J.H. Kim

Journal of Pediatric Genetics

Background: Trisomy 18 is an aneuploidy that has historically been associated with early mortality However, recently parents of children with complex conditions are more often pursuing life-prolonging medical interventions. The increasing use of neonatal intensive care has led to longer lifespans in infants affected by trisomy 18, allowing for later complications to emerge. While many comorbidities have been reported in the literature, tethered cord has rarely been reported in this population. This study examines the potential relationship between trisomy 18, tethered spinal cord, and related urinary tract complications. Methods: A retrospective chart review of subjects admitted to a single quaternary …

Lesch-Nyhan Disease A Treatable Mimicker Of Dyskinetic Cerebral Palsy In Boys: Insights From An Indian Series Of Six Cases With Report Of Four Novel Variants, Vykuntaraju K. Gowda, Spoorthy Nelaji Karunakar, Varunvenkat M. Srinivasan, Viveka-Santhosh Reddy

Journal of Pediatric Genetics

Background: HPRT1-related disorders are X-linked metabolic disorders of the purine pathway caused due to mutations in the hypoxanthine-guanine phosphoribosyl transferase (HPRT1) gene and present with features of dyskinetic cerebral palsy, self-mutilation/behavioral abnormality, and hyperuricemia in variable severity. Objective: Describe the clinical characteristics and treatment outcome of a series of 6 children with Lesch-Nyhan disease. Methods: Retrospective chart review from September 2022 to July 2024 of six molecularly confirmed cases of Lesch-Nyhan disease from India. Results: A total of 6 boys are described here. The mean age of onset was since birth, the age of diagnosis was 2 years 7 months, …

Taming Psoriatic Inflammation: Targeting The Inos–Oxidative Stress–Necroptosis Axis For Precision Therapy, Tolulope Omotope Omolekan, Tithi Roy, Jean Christopher Chamcheu

Faculty Publications

Necroptosis is increasingly recognized as a central driver of psoriatic inflammation, promoting keratinocyte death and sustaining immune activation. Recent evidence shows that inducible nitric oxide synthase (iNOS) deficiency and exogenous nitric oxide (NO) supplementation ameliorate psoriasis-like dermatitis in mice by reducing oxidative stress and constraining necroptotic signaling. These findings identify iNOS-derived NO as both a mediator of reduction–oxidation (redox) imbalance and a key regulator of necroptosis, thereby advancing mechanistic insight into psoriatic pathogenesis. Importantly, they highlight the iNOS–oxidative stress–necroptosis axis as a translationally actionable therapeutic target. Modulating necroptotic cell death through NO-based interventions may restore epidermal homeostasis and improve clinical …

The Expansion Of Exposure Notification Software To Enhance Disease Surveillance And Ring Vaccination, Julia Felton

URGENT Matters

No abstract provided.

Global Spatiotemporal Multi-Criteria Analysis Of Coastal Risk: Current And Future Hot Spots And Clusters, Marco Bidoia, Carlo Giupponi

Fondazione Eni Enrico Mattei Working Papers

Coastal zones are among the environments most threatened by climate change. Although various efforts for global mapping and classification of coastal social and ecological systems have been undertaken, the ability to analyse and describe the spatial heterogeneity and multidimensionality of these phenomena remains limited. In the current study, we developed a methodological framework for assessing risk from extreme sea levels and examined its application at the global level. A multi-criteria analysis method was applied to the current scenario and to two future combinations of shared socioeconomic (SSP2 and 5) and representative concentration pathways (RCP4.5 and 8.5), accounting for risk attitudes. …

Clinical Outcomes Of Patients Hospitalized For Conventional Pacemaker Implantation With Protein-Energy Malnutrition, Phuuwadith Wattanachayakul, Pojsakorn Danpanichkul, Chalothorn Wannaphut, Hamza Tahir, John Malin, Thanathip Suenghataiphorn, Kanokphong Suparan, Aman Amanullah

Einstein Health Papers

INTRODUCTION: The impact of protein-energy malnutrition (PEM) on patients hospitalized for conventional pacemaker implantation remains poorly understood.

METHODS: We utilized the 2020 U.S. National Inpatient Sample (NIS) database to evaluate the impact of PEM on the in-hospital outcomes of patients who underwent conventional pacemaker implantation. Patients aged 18 and older were identified by ICD-10 CM and PCS codes. Multivariable survey logistic and linear regression analyses were employed to examine in-hospital outcomes, including in-patient mortality, system-based outcomes, and post-procedural complications.

RESULTS: A total of 108 020 patients were identified with 4315 (3.99%) diagnosed with PEM. The mean age of the cohort …

The Perception Of Fentanyl’S Harm, Rachel Antenucci

ETDs from 2020-2029

While drug overdose deaths have generally decreased in the past year, close to 60,000 overdoses involving opioids occurred in 2024. The opioid crisis has lasted over two decades and is now in the fourth wave. The fourth wave has been characterized by overdoses resulting from fentanyl adulteration in the drug supply and polysubstance overdoses involving fentanyl. The purpose of the current study is to compare the perceived harm of fentanyl to other drugs of abuse and identify differences in the perceived harm of fentanyl between groups of people who use substances. An online survey was conducted across 15 states in …

Strengthening The Use Of Sexual And Reproductive Health And Rights Evidence In Refugee And Humanitarian Settings, Baobab Research Programme Consortium

Humanitarian Task Force

This guide offers practical, experience-based direction for strengthening the uptake of sexual and reproductive health and rights (SRHR) evidence in refugee and humanitarian settings. Drawing on five years of Baobab’s work in Uganda and Ethiopia, it outlines principles for effective research uptake, including embedded partnerships, rigorous locally owned methods, stakeholder engagement, capacity development, adaptive communication, and continuous learning. The guide illustrates how these approaches enabled pioneering evidence generation—such as the first Humanitarian Violence Against Children Survey (VACS)—and informed service innovations, national policy reforms, and cross-country learning. It provides a replicable framework for translating SRHR research into action and system level …

Cover And Contents

Turkish Journal of Botany

No abstract provided.