A5031613696- Respiratory Support and Mechanisms
- Neonatal Respiratory Health Research
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Intensive Care Unit Cognitive Disorders
- Mechanical Circulatory Support Devices
- Family and Patient Care in Intensive Care Units
- Respiratory viral infections research
- Immune Response and Inflammation
- Renal function and acid-base balance
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Cardiac, Anesthesia and Surgical Outcomes
- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Congenital Diaphragmatic Hernia Studies
- Neuroscience of respiration and sleep
- Transplantation: Methods and Outcomes
- Childhood Cancer Survivors' Quality of Life
- Thermal Regulation in Medicine
- Airway Management and Intubation Techniques
- Pulmonary Hypertension Research and Treatments
- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- Congenital Heart Disease Studies
- Erythrocyte Function and Pathophysiology
University of Pennsylvania
2016-2025
Children's Hospital of Philadelphia
2016-2025
Philadelphia University
2016-2024
University of Southern California
2018-2023
Children's Hospital of Los Angeles
2017-2023
National Institutes of Health
2019-2020
William Penn University
2019
Southern California Clinical and Translational Science Institute
2018
Pennsylvania State University
2012-2017
Rutgers, The State University of New Jersey
2017
Abstract Background In animals with heteromorphic sex chromosomes, dosage compensation of sex-chromosome genes is thought to be critical for species survival. Diverse molecular mechanisms have evolved effectively balance the expressed dose X-linked between XX and XY animals, expression X autosomal genes. Dosage not understood in birds, which females (ZW) males (ZZ) differ number Z chromosomes. Results Using microarray analysis, we compared male:female ratio sets Z-linked two bird species,...
We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence topic areas that were not previously addressed.International consensus conference series involving 52 multidisciplinary international content experts PARDS four methodology from 15 countries, using methodology, implementation science.Not applicable.Patients with or...
We previously used high-density expression arrays to interrogate a genetic cross between strains C3H/HeJ and C57BL/6J observed thousands of differences in gene sexes. now report analyses the molecular basis these sex effects on networks. analyzed liver hormone-treated gonadectomized mice as well XX male XY female mice. Differences resulted large part from acute gonadal hormones acting adulthood, chromosomes, apart hormones, were modest. also determined whether there are organization networks...
The integration of expression profiling with linkage analysis has increasingly been used to identify genes underlying complex phenotypes. effects gender on the regulation many physiological traits are well documented; however, "genetical genomic" analyses have not yet addressed degree which their conclusions affected by sex. We constructed and densely genotyped a large F2 intercross derived from inbred mouse strains C57BL/6J C3H/HeJ an apolipoprotein E null (ApoE-/-) background. This...
The ARDS Network (ARDSNet) used a positive end-expiratory pressure (PEEP)/FiO2 model in many studies. In general, pediatric intensivists use less PEEP and higher FiO2 than this model.To evaluate whether children managed with lower recommended by the ARDSNet PEEP/FiO2 had mortality.This was multicenter, retrospective analysis of patients acute respiratory distress syndrome (PARDS) without formal protocol. Four distinct datasets were combined for analysis. We extracted time-matched values,...
Although all definitions of acute respiratory distress syndrome use some measure hypoxemia, neither the Berlin definition nor recently proposed pediatric-specific by Pediatric Acute Lung Injury Consensus Conference utilizing oxygenation index specify which PaO2/FIO2 or best categorizes lung injury. We aimed to identify variables associated with mortality and ventilator-free days at 28 in a large cohort children syndrome.Prospective, observational, single-center study.Tertiary care,...
Diaphragm atrophy is associated with delayed weaning from mechanical ventilation and increased mortality in critically ill adults. We sought to test for the presence of diaphragm children acute respiratory failure.Prospective, observational study.Single-center tertiary noncardiac PICU a children's hospital.Invasively ventilated failure.Diaphragm thickness at end-expiration end-inspiration were serially measured by ultrasound 56 patients (median age, 17 mo; interquartile range, 5.5-52), first...
Abstract Background There is on-going controversy regarding the potential for increased respiratory effort to generate patient self-inflicted lung injury (P-SILI) in spontaneously breathing patients with COVID-19 acute hypoxaemic failure. However, direct clinical evidence linking inspiratory scarce. We adapted a computational simulator of cardiopulmonary pathophysiology quantify mechanical forces that could lead P-SILI at different levels effort. In accordance recent data, parameters were...
OBJECTIVES: In 2015, the Pediatric Acute Lung Injury Consensus Conference (PALICC) provided first pediatric-specific definitions for acute respiratory distress syndrome (pediatric [PARDS]). These have since been operationalized in cohort and interventional PARDS studies. As substantial data accrued we an opportunity to assess construct validity utility of initial PALICC definitions. Therefore, Second (PALICC-2) brought together multiple experts aimed identify summarize relevant evidence...
OBJECTIVES: To characterize immunocompromised-associated pediatric acute respiratory distress syndrome (I-PARDS) and contrast it to PARDS. DESIGN: This is a secondary analysis of the 2016–2017 PARDS incidence epidemiology (PARDIE) study, prospective observational, cross-sectional study children with SETTING: Dataset 145 PICUs across 27 countries. PATIENTS: During 10 nonconsecutive weeks (from May 2016 June 2017), data about immunocompromising conditions (ICCs, defined as malignancy,...
The epidemiology, management, and outcomes of acute respiratory distress syndrome (ARDS) differ between children adults, with lower mortality rates in despite comparable severity hypoxemia. However, the relationship age is unclear.
Mechanical ventilation with high tidal volumes has been associated pulmonary alveolar flooding. Understanding the mechanisms underlying cyclic stretch-induced increases in epithelial permeability may be important designing preventive measures for acute lung injury. In this work, we assessed whether stretch leads to generation of reactive oxygen species type I-like cells, which increase monolayer via activation NF-κB and extracellular signal-regulated kinase (ERK). We cyclically stretched rat...
Objectives: Investigations of acute respiratory distress syndrome in adults suggest hypoxemia is an uncommon cause death. However, the epidemiology death pediatric not well characterized. We aimed to describe cause, mode, and timing nonsurvivors. hypothesized that most deaths would be due nonpulmonary factors, rather than hypoxemia. Design: Retrospective, decedent-only analysis. Setting: Two large, academic PICUs. Patients: Nonsurvivors with syndrome. Interventions: None. Measurements Main...
Physiologic dead space is associated with mortality in acute respiratory distress syndrome, but its measurement cumbersome. Alveolar fraction relies on the difference between arterial and end-tidal carbon dioxide (alveolar = (PaCO2 - PetCO2) / PaCO2). We aimed to assess relationship alveolar a cohort of children meeting criteria for syndrome (both Berlin 2012 American-European Consensus Conference 1994 lung injury) pediatric (as defined by Pediatric Acute Lung Injury 2015).Secondary analysis...
Objectives: Pediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist trial design. We aimed develop and validate mortality prediction models for patients pediatric syndrome. Design: Leveraging additional data collection from preplanned ancillary study (Version 1) the multinational Acute Respiratory Distress Incidence Epidemiology study, we identified predictors mortality. Separate were built entire Version 1 cohort, cohort...
Importance While disparities in consent rates for research have been reported multiple adult and pediatric settings, limited data informing enrollment intensive care unit (PICU) are available. Acute settings such as the PICU present unique challenges study enrollment, given highly stressful emotional environment caregivers time-sensitive nature of studies. Objective To determine whether race ethnicity, language, religion, Social Deprivation Index (SDI) were associated with disparate approach...
Abstract Background Viral lower respiratory tract infections (LRTI) are a leading cause of child mortality worldwide. Improved understanding local and systemic host immune responses to severe viral LRTI could reveal insights into pathophysiology, lead novel host-based diagnostic tests, inform personalized treatment. To date, no studies have yet employed proteomics simultaneously characterize the airway proteome in pediatric LRTI. Figure 1 Methods We used SomaScan® assess relative expression...