Coenzyme Q10 Supplementation May Be Correlated With Resolution of New Daily Persistent Headache.

New daily persistent headache is a chronic, treatment-resistant primary headache disorder with limited guidance on effective management. Despite its significant impact on headache-related quality of life, few studies have identified targeted therapies that contribute to symptom resolution. This study aims to describe the outcomes of pediatric patients diagnosed with new daily persistent headache and assess associations between specific interventions and headache resolution.

Electroencephalogram Features Distinguish Cases of Cerebral Malaria Among Malawian Children With Fever and Coma.

Background: In febrile comatose patients living in malaria-endemic areas, overlapping symptoms and limited laboratory capacity make it difficult to distinguish parasitic, bacterial, and viral central nervous system infections. We evaluated electroencephalography (EEG) as a biomarker to differentiate the microbiologic etiology of pediatric febrile coma at a major referral center in Malawi.

Methods: This was a retrospective case-control study comparing EEG recordings of Malawian children with cerebral malaria to those with febrile coma of nonmalarial cause (bacterial meningitis, viral encephalitis, or unknown cause).

Examining Medical and Demographic Associations With the Diabetes Management Questionnaire Among Racially Minoritized Youth With Type 1 Diabetes.

PurposeThe purpose of this study was to examine demographic and diabetes-related factors with the Diabetes Management Questionnaire (DMQ) among racially minoritized youth with type 1 diabetes.MethodsA descriptive correlational study was employed. Youth and their caregivers were enrolled in a behavioral intervention to promote optimal continuous glucose monitoring (CGM) use along with completing the DMQ at baseline.

Screening for Caregiver Stress in an Urban Medical Home for Children with Medical Complexity: Results of a Pilot Study.

Background: Children with medical complexity (CMC), a subset of children with special healthcare needs, have chronic conditions affecting multiple organ systems, require medical technology, and account for a significant share of pediatric healthcare spending despite comprising only 1% of the population. Their families experience unique stressors, including financial strain and high rates of workforce attrition, suggesting medical inequity is an independent risk factor for health inequity. The role of universal caregiver stress screening using a validated tool within the outpatient primary care medical home for CMC youth has not been explored in the literature.

Polymorphism and Mechanical Behavior in Hot-Pressed 3D-Printed Polyamide Composite: Effects of Pressure and Temperature.

The aim of this work is to study the effect of high-temperature compaction (HTC) upon the polymorphism and the mechanical behavior of an additively manufactured (AM) carbon fiber-reinforced polyamide (PA6). Different pressure and temperature levels during HTC were tested to determine the overall effect on the mechanical behavior and material crystalline composition. Treated, carbon fiber-reinforced PA6 samples were analyzed using differential scanning calorimetry, X-ray diffraction, thermogravimetric analysis, scanning electron microscopy, and three-point bending testing.

Positive Pre-Transplant Respiratory Viral PCR is Associated With Increased Day 100 Transplant-Related Mortality in Pediatric HSCT Recipients.

Background: Hematopoietic stem cell transplant (HSCT) is a curative procedure for conditions requiring the replacement of bone marrow. Respiratory viral infections (RVI) in the lower respiratory tract (LRT) cause substantial morbidity and transplant-related mortality (TRM) in pediatric transplant recipients, but the impact of mild/asymptomatic RVI is unclear. Some studies have identified certain viral infections as high risk for posttransplant complications.

Maternal health outcomes in ornithine transcarbamylase deficiency: A comparative analysis of pregnancies in symptomatic and asymptomatic heterozygotes.

Introduction: Ornithine transcarbamylase deficiency (OTCD, MIM: 311250) is an X-linked disorder of ureagenesis caused by pathogenic variants in OTC (MIM: 300461). Due to varying X-inactivation patterns, female heterozygotes can range from asymptomatic to severe disease with recurrent hyperammonemia. There is a paucity of data regarding the safety of pregnancy in symptomatic versus asymptomatic OTC heterozygotes.

Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens.

Two-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of its components (macular whitening, retinal hemorrhages, and vessel color changes) with the total, circulating, or sequestered parasite load in children with CM.

Enriching Clinical Trials Enrolling Children With Cerebral Malaria Using Admission Demographics, Physical Examination and Point-of-care Testing Results.

Background: Multiple clinical trials evaluating therapies for cerebral malaria (CM) have failed to demonstrate improved outcomes. This may derive from inclusion of children at all risk levels, including those at low risk of mortality or neurologic morbidity, limiting power to detect significant differences between intervention arms. One solution is enrichment, enrolling clinical trial participants at higher risk of adverse outcomes.

Establishing Priorities for Epilepsy Care and Electroencephalogram Use in Low-Resource Settings.

We convened an electroencephalography and epilepsy think tank in Blantyre, Malawi, bringing together American pediatric neurologist clinical researchers and Malawian clinicians. We worked with the aim of improving care for children with seizures and epilepsy in southern Malawi. By sharing and discussing ideas, six United States-based researchers and six Malawian end users developed consensus for directions of both current and future clinical research activities.

Experiences of Parent Coaches in an Intervention for Parents of Young Children Newly Diagnosed with Type 1 Diabetes.

Objectives: This paper explores parent coaching experiences supporting parents of young children newly diagnosed with type 1 diabetes in a clinical trial.

Methods: In a trial for 157 parents, those in the intervention arm ( = 116) were paired with a parent coach (n = 37; Mage = 37.9 years, SD = 3.

Unraveling the Link: Seizure Characteristics and Ammonia Levels in Urea Cycle Disorder During Hyperammonemic Crises.

Background: This retrospective clinical study performed at a single clinical center aimed to identify the prevalence of seizures in individuals with urea cycle disorders (UCDs) with and without hyperammonemic (HA) crises. In addition, we sought to correlate the utility of biochemical markers and electroencephalography (EEG) in detecting subclinical seizures during HA.

Methods: Medical records of individuals with UCDs enrolled in Urea Cycle Disorders Consortium Longitudinal Study (UCDC-LS) (NCT00237315) at Children's National Hospital between 2006 and 2022 were reviewed for evidence of clinical and subclinical seizuress during HA crises, and initial biochemical levels concurrently.

Substances of health concern in home-distilled and commercial alcohols from Texas.

Objective: Poor distillation practices in the production of spirits have historically resulted in many instances of adverse health outcomes including death. Concern has focused on lead and copper contamination as well as unhealthy levels of methanol and glyphosate. This study assesses home-distilled and commercially distilled alcohols from Texas for these substances of concern, highlighting their potential risks to public health.

Meaningful Work, Career Fit, and Professional Well-Being of Pediatric Academicians in the United States.

Objective: Examine associations between time spent in academic activities perceived as meaningful and professional well-being among academic pediatrics faculty.

Methods: The sample comprised 248 full-time pediatric faculty (76% female, 81% white, non-Hispanic, 41% instructor or assistant professor) across the United States who completed an online survey in November 2019. Survey items included sociodemographic and professional characteristics, professional well-being measures (Stanford Professional Fulfillment Index; Maslach Burnout Inventory; Intention to Leave Academic Medicine), perceived meaningfulness of academic activities and assigned time to those activities.

ROUTE-T1D: A behavioral intervention to promote optimal continuous glucose monitor use among racially minoritized youth with type 1 diabetes: Design and development.

Background: Type 1 diabetes management is often challenging during adolescence, and many youth with type 1 diabetes struggle with sustained and optimal continuous glucose monitor (CGM) use. Due to racial oppression and racially discriminatory policies leading to inequitable access to quality healthcare and life necessities, racially minoritized youth are significantly less likely to use CGM.

Methods: ROUTE-T1D: Research on Optimizing the Use of Technology with Education is a pilot behavioral intervention designed to promote optimal CGM use among racially minoritized youth with type 1 diabetes.

Post hospital admission blood lactate measurements are associated with mortality but not neurologic morbidity in children with cerebral malaria.

Background: In children with cerebral malaria (CM) admission blood lactate has previously guided intravenous fluid therapy and been validated as a prognostic biomarker associated with death. The usefulness of post-admission measurements of blood lactate in children with CM is less clear. The strength of association between blood lactate and neurological sequelae in CM survivors, as well as the optimal duration of post-admission measurements of blood lactate to identify children at higher risk of adverse outcomes is unknown.

Loss to Hospital Follow-Up in Pediatric Cerebral Malaria Survivors: A Case-Control Study.

Children surviving central nervous system (CNS) infections are at high risk of neurological, behavioral, and cognitive sequalae. Early identification, characterization, and treatment of these sequelae may improve child and family health. In Africa, it is unclear if there are demographic or clinical factors that increase the risk of post-hospital loss to follow-up in children with CNS infections.

Health-related quality of life in a systematically assessed cohort of children and adults with urea cycle disorders.

Purpose: Individuals with urea cycle disorders (UCDs) may develop recurrent hyperammonemia, episodic encephalopathy, and neurological sequelae which can impact Health-related Quality of Life (HRQoL). To date, there have been no systematic studies of HRQoL in people with UCDs.

Methods: We reviewed HRQoL and clinical data for 190 children and 203 adults enrolled in a multicenter UCD natural history study.

Social support, resource utilization, and well-being: a survey of adolescent parents in Washington, DC.

Background: Adolescent parents experience worse health and socioeconomic outcomes compared to older parents. Little is known about the factors that can lead to better health and well-being among teen-headed families. A city-wide collaborative conducted a comprehensive well-being assessment of expectant and parenting teens in Washington, DC.

Temporal Trends of Blood Glucose in Children with Cerebral Malaria.

Hypoglycemia, defined as a blood glucose < 2.2 mmol/L, is associated with death in pediatric cerebral malaria (CM). The optimal duration of glucose monitoring in CM is unknown.

Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital.

Background: COVID-19 was declared a global pandemic in March 2020. Early reports were primarily in adults, and sickle cell disease (SCD) was classified as a risk factor for severe COVID-19 disease. However, there are a limited number of primarily multi-center studies reporting on the clinical course of pediatric patients with SCD and COVID-19.