Advances in the diagnosis of pediatric arterial ischemic stroke - imaging and beyond.

Introduction: Arterial ischemic stroke (AIS) represents a significant cause of neurological morbidity and mortality in the pediatric population, with reported mortality rates ranging from 2% to 9%. The growing evidence supporting the efficacy and safety of reperfusion therapies in pediatric AIS underscores the critical importance of timely and accurate diagnosis. There are many barriers to achieving this, including a lack of clinical recognition and diagnostic imaging delays.

Development and Adaptive Function in Individuals With -Related Disorders.

Background And Objectives: Developmental impairment is common in individuals with -related disorders, although descriptions are limited. We aimed to determine trajectories and outcomes of development and adaptive function.

Methods: This was a mixed retrospective cross-sectional study of individuals from an international Natural History Study, who had neurologic/neurodevelopmental disorders due to an variant.

Agreement between face-to-face and photograph and video assessments in children with Bell's palsy: secondary analysis of a randomised controlled trial.

Objective: Bell's palsy is a sudden unilateral weakness of the facial muscles due to idiopathic lower motor neuron palsy of cranial nerve VII. We set out to determine the level of agreement in the severity of facial palsy based on the House-Brackmann scale between face-to-face assessment by clinicians, and independent clinician assessment of photographs and videos.

Design: Secondary analysis of children enrolled in a triple blind, randomised controlled trial assessing recovery rates following steroid treatment versus placebo for Bell's palsy who had photographs and videos recorded initially and at subsequent reviews.

Probabilistic emotion and sentiment modelling of patient-reported experiences.

Patient feedback is necessary to assess the extent to which healthcare delivery aligns with public needs and expectations. Surveys provide structured feedback that is readily analysed; however, they are costly, infrequent, and constrained by predefined questions, limiting a comprehensive understanding of patient experience. In contrast, the unstructured nature of online reviews and social-media posts can reveal unique insights into patient perspectives, yet that very lack of structure presents a challenge for analysis.

Factors Influencing Long-Term Outcomes in Childhood Arterial Ischemic Stroke.

Background: Childhood arterial ischemic stroke (AIS) is associated with substantial long-term morbidity. This study aims to describe factors associated with recurrence, mortality, and neurological disability.

Methods: Australian children with radiologically confirmed AIS were enrolled prospectively to the Royal Children's Hospital stroke registry from 2003 to 2017.

Examination of pediatric hemorrhagic stroke incidence: A systematic review and meta-analysis.

Background: Pediatric hemorrhagic stroke (HS) poses a significant burden. We aimed to examine the incidence rate of pediatric hemorrhagic stroke globally.

Method: This systematic review and meta-analysis searched Medline via Ovid, Embase, EBCOHOST, Scopus and Google Scholar up to 6 March 2024 for observational studies included pediatrics' incidence rate of hemorrhagic stroke (PROSPERO: CRD42022312643).

Neural mechanisms driving speech and language recovery following childhood stroke: a scoping review.

Purpose: This scoping review aimed to inform future research priorities by collating evidence on neural correlates of speech and language recovery following childhood stroke.

Methods: Neuroimaging, motor speech, or language outcomes following childhood stroke (28 days to 18 years age) in the subacute to chronic community stages (care occurring after acute medical management, including inpatient and outpatient rehabilitation, and community-based programs) were identified and extracted from Medline, Embase, PsycInfo, and Clinical databases.

Results: Of the 3990 studies screened, 11 met the inclusion criteria.

Revealing patient-reported experiences in healthcare from social media using thedesign-acquire-process-model-analyse-visualise framework.

Understanding patient experience in healthcare is increasingly important and desired by medical professionals in a patient-centred care approach. Healthcare discourse on social media presents an opportunity to gain a unique perspective on patient-reported experiences, complementing traditional survey data. These social media reports often appear as first-hand accounts of patients' journeys through the healthcare system, whose details extend beyond the confines of structured surveys and at a far larger scale than focus groups.

Facial Function in Bell Palsy in a Cohort of Children Randomized to Prednisolone or Placebo 12 Months After Diagnosis.

Background: Information on the medium-term recovery of children with Bell palsy or acute idiopathic lower motor neuron facial paralysis is limited.

Methods: We followed up children aged 6 months to <18 years with Bell palsy for 12 months after completion of a randomized trial on the use of prednisolone. We assessed facial function using the clinician-administered House-Brackmann scale and the modified parent-administered House-Brackmann scale.

Distinct manifestations and potential mechanisms of seizures due to cortical versus white matter injury in children.

Purpose: To study seizure manifestations and outcomes in children with cortical versus white matter injury, differences potentially explaining variability of epilepsy in children with cerebral palsy.

Methods: In this population-based retrospective cohort study, MRIs of children with cerebral palsy due to ischemia or haemorrhage were classified according to presence or absence of cortical injury. MRI findings were then correlated with history of neonatal seizures, seizures during childhood, epilepsy syndromes, and seizure outcomes.

Pain in children with Bell's palsy: secondary analysis of a randomised controlled trial.

Objective: To describe the prevalence and severity of pain experienced by children with Bell's palsy over the first 6 months of illness and its association with the severity of facial paralysis.

Methods: This was a secondary analysis of data obtained in a phase III, triple-blinded, randomised, placebo-controlled trial of prednisolone for the treatment of Bell's palsy in children aged 6 months to <18 years conducted between 13 October 2015 and 23 August 2020 in Australia and New Zealand. Children were recruited within 72 hours of symptom onset and pain was assessed using a child-rated visual analogue scale (VAS), a child-rated Faces Pain Score-Revised (FPS-R) and/or a parent-rated VAS at baseline, and at 1, 3 and 6 months until recovered, and are reported combined across treatment groups.

Developing Health Management Competency for Digital Health Transformation: Protocol for a Qualitative Study.

Background: Globally, the health care system is experiencing a period of rapid and radical change. In response, innovative service models have been adopted for the delivery of high-quality care that require a health workforce with skills to support transformation and new ways of working.

Objective: The aim of this research protocol is to describe research that will contribute to developing the capability of health service managers in the digital health era and enabling digital transformation within the Australian health care environment.

A quantitative EEG index for the recognition of arterial ischemic stroke in children.

Objective: To describe and assess performance of the Correlate Of Injury to the Nervous system (COIN) index, a quantitative electroencephalography (EEG) metric designed to identify areas of cerebral dysfunction concerning for stroke.

Methods: Case-control study comparing continuous EEG data from children with acute ischemic stroke to children without stroke, with or without encephalopathy. COIN is calculated continuously and compares EEG power between cerebral hemispheres.

Association of Acute Infarct Topography With Development of Cerebral Palsy and Neurologic Impairment in Neonates With Stroke.

Background And Objectives: Research investigating neonatal arterial ischemic stroke (NAIS) outcomes have shown that combined cortical and basal ganglia infarction or involvement of the corticospinal tract predict cerebral palsy (CP). The research question was whether voxel-based lesion-symptom mapping (VLSM) on acute MRI can identify brain regions associated with CP and neurodevelopmental impairments in NAIS.

Methods: Newborns were recruited from prospective Australian and Swiss pediatric stroke registries.

Cost-effectiveness of Prednisolone to Treat Bell Palsy in Children: An Economic Evaluation Alongside a Randomized Controlled Trial.

Background And Objectives: Bell palsy is the third most frequent diagnosis in children with sudden-onset neurologic dysfunction. The cost-effectiveness of treating Bell palsy with prednisolone in children is unknown. We aimed to assess the cost-effectiveness of prednisolone in treating Bell palsy in children compared with placebo.

Agreement of Clinician-Administered and Modified Parent-Administered House-Brackmann Scales in Children with Bell's Palsy.

Objective: Currently there is no parent administered scale for facial nerve function in children. We set out to assess the agreement between a newly developed parent-administered modified version of the House-Brackmann (HB) scale and the standard clinician-administered HB scale in children with Bell's palsy.

Study Design: Secondary analysis of a triple-blind, randomized, placebo-controlled trial of corticosteroids to treat idiopathic facial paralysis (Bell's palsy) in children (6 months to <18 years).

The incidence of pediatric ischemic stroke: A systematic review and meta-analysis.

Background: Despite its importance in being among the top 10 causes of childhood death, there is limited data on the incidence of stroke in children and whether this has changed over time.

Aims: We performed a systematic review and meta-analysis to estimate the worldwide incidence rate of pediatric ischemic stroke, identify population differences, and assess trends in incidence.

Methods: We screened three databases (Medline, Embase, and Cumulative Index of Nursing and Allied Health Literature (CINAHL)) and a Google Search was performed up to October 2021.

Prednisolone or tetracosactide depot for infantile epileptic spasms syndrome? A prospective analysis of data embedded within two randomised controlled trials.

Objective: To report a prospectively planned analysis of two randomised controlled trials with embedded comparisons of prednisolone versus tetracosactide depot for the treatment of infantile epileptic spasms syndrome (IESS).

Methods: Individual patient data from patients randomly allocated to prednisolone or tetracosactide depot were analysed from two trials (UKISS, ICISS). The comparison was embedded within trials in which some patients also received vigabatrin but only patients receiving monotherapy with randomly allocated hormonal treatments are included in this analysis.

Building health service management workforce capacity in the era of health informatics and digital health - A scoping review.

Introduction: Health informatics and digital health, two rapidly growing disciplines, are becoming increasingly important to the sustainability of health service provision, highlighted especially through the COVID-19 pandemic. To maximise the benefits of the adoption and growth of health informatics and digital health, health service managers play a critical role in leading and managing the implementation and transformation of the system, both strategically and operationally, whilst still needing to manage 'business as usual'.

Objectives: The objectives of the paper are to present and discuss the findings from a scoping review identifying: 1) competencies required for health service managers leading the implementation and transformation of informatics and digital technology in the health sector; and 2) factors that are critical to building the management workforce capacity in the era of health informatics and digital health.

Neuroimaging in Pediatric Stroke.

Pediatric stroke is unfortunately not a rare condition. It is associated with severe disability and mortality because of the complexity of potential clinical manifestations, and the resulting delay in seeking care and in diagnosis. Neuroimaging plays an important role in the multidisciplinary response for pediatric stroke patients.

Making waves: The changing tide of cerebral palsy.

Cerebral palsy (CP) is a broad diagnosis unbound by aetiology and is based on a clinical examination demonstrating abnormalities of movement or posture. CP represents a static neurological condition, provided that neurodegenerative conditions, leukoencephalopathies and neuromuscular disorders are excluded. In paediatrics, the genetic conditions associated with CP are rapidly increasing, with primary and overlapping neurodevelopmental conditions perhaps better categorised by the predominant clinical feature such as CP, intellectual disability, autism spectrum disorder or epilepsy.

Efficacy of Prednisolone for Bell Palsy in Children: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial.

Background And Objectives: Corticosteroids are used to treat the early stages of idiopathic facial paralysis (Bell palsy) in children, but their effectiveness is uncertain. We set out to determine whether prednisolone improves the proportion of children with Bell palsy with complete recovery at 1 month.

Methods: We conducted a double-blind, placebo-controlled, randomized trial of prednisolone in children presenting to emergency departments with Bell palsy.