A5053412842- Prenatal Substance Exposure Effects
- Neuroscience of respiration and sleep
- Meta-analysis and systematic reviews
- Maternal Mental Health During Pregnancy and Postpartum
- Respiratory Support and Mechanisms
- Traumatic Brain Injury and Neurovascular Disturbances
- Health Systems, Economic Evaluations, Quality of Life
- Pregnancy and preeclampsia studies
- Health Sciences Research and Education
- Assisted Reproductive Technology and Twin Pregnancy
- Ethics in Clinical Research
- Neonatal Health and Biochemistry
- Statistical Methods in Clinical Trials
- Non-Invasive Vital Sign Monitoring
- Metabolism and Genetic Disorders
- Food Security and Health in Diverse Populations
- Child Nutrition and Water Access
- Bayesian Methods and Mixture Models
- Pharmaceutical studies and practices
- Preterm Birth and Chorioamnionitis
- Congenital Heart Disease Studies
- Alcoholism and Thiamine Deficiency
- Pregnancy-related medical research
- Ectopic Pregnancy Diagnosis and Management
- Primary Care and Health Outcomes
University of Arkansas for Medical Sciences
2016-2025
Arkansas Children's Hospital
2015-2019
Although clinicians have traditionally used the Finnegan Neonatal Abstinence Scoring Tool to assess severity of neonatal opioid withdrawal, a newer function-based approach - Eat, Sleep, Console care is increasing in use. Whether new can safely reduce time until infants are medically ready for discharge when it applied broadly across diverse sites unknown.In this cluster-randomized, controlled trial at 26 U.S. hospitals, we enrolled with withdrawal syndrome who had been born 36 weeks'...
Importance The function-based eat, sleep, console (ESC) care approach substantially reduces the proportion of infants who receive pharmacologic treatment for neonatal opioid withdrawal syndrome (NOWS). This reduction has led to concerns increased postnatal exposure in treatment. However, effect ESC on hospital outcomes pharmacologically treated NOWS is currently unknown. Objective To evaluate differences and total length stay (LOS) managed with vs usual Finnegan tool. Design, Setting,...
Variation in pediatric medical care is common and contributes to differences patient outcomes. Site-to-site variation the characteristics of infants with neonatal opioid withdrawal syndrome (NOWS) has yet be quantified. Our objective was describe site-to-site maternal-infant characteristics, infant management, outcomes for NOWS.
Objective To evaluate whether the association between maternal periconceptional use of selective serotonin reuptake inhibitors (SSRIs) and increased risk congenital heart defects in offspring is modified by or infant genetic variants folate, homocysteine, transsulfuration pathways.Design Population based study. DNA from mothers, fathers, infants was genotyped with an Illumina GoldenGate custom single nucleotide polymorphism panel. A hybrid design on a log linear model used to calculate...
Importance Infants with neonatal opioid withdrawal syndrome (NOWS) cared for the Eat, Sleep, Console (ESC) care approach receive less pharmacologic treatment and have shorter hospital stays compared to usual Finnegan Neonatal Abstinence Scoring Tool, but effects of these approaches on feeding weight are unknown. Objective To evaluate practices trajectories in infants ESC vs care. Design, Setting, Participants ESC-NOW is a cluster randomized trial NOWS born at 36 weeks’ gestation or later 26...
Abstract Background Studies have shown that data collection by medical record abstraction (MRA) is a significant source of error in clinical research studies relying on secondary use data. Yet, the quality collected using MRA seldom assessed. We employed novel, theory-based framework for assurance and control MRA. The objective this work to determine potential impact formalized training continuous (QC) processes over time. Methods conducted retrospective analysis QC during cross-sectional...
OBJECTIVES: The incidence of neonatal opioid withdrawal syndrome (NOWS) has increased fivefold over the last 10 years. Standardized NOWS care protocols have revealed many improved patient outcomes. Our objective for this study is to describe results a clinical practice survey management practices designed inform future studies in diagnosis and NOWS. METHODS: A cross-sectional was administered medical unit directors at 32 Institutional Development Award States Pediatric Clinical Trial Network...
<h3>BACKGROUND:</h3> High electrode temperature during transcutaneous monitoring is associated with skin burns in extremely premature infants. We evaluated the accuracy and precision of CO<sub>2</sub> O<sub>2</sub> measurements using lower temperatures below 42°C. <h3>METHODS:</h3> enrolled 20 neonates. Two monitors were placed simultaneously on each neonate, one maintained at 42°C other randomized to 38, 39, 40, 41, Arterial blood was collected twice temperature. <h3>RESULTS:</h3> At time...
In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. certain aerosols are ineffective due to their inadequate ventilation. Bilevel (BiPAP) in acute asthmatics can be effective treatment. BiPAP works by unloading fatigued muscles,...
Children with asthma and obesity are more likely to have lower vitamin D levels, but the optimal replacement dose is unknown in this population. The objective of study identifying a children obesity-related that safely achieves serum levels ≥ 40 ng/mL. This prospective multisite randomized controlled trial recruited children/adolescents body mass index 85% for age/sex. Part 1 (dose finding), evaluated 4 oral regimens 16 weeks identify achieved 2 compared calculated from part (50,000 IU...
Abstract Background: Studies have shown that data collection by medical record abstraction (MRA) is a significant source of error in clinical studies. Yet, the quality collected using MRA seldom assessed. We employed novel, theory-based framework for assurance and control MRA. The objective this work to determine effects formalized training continuous (QC) processes on over time. Methods: conducted retrospective analysis QC during cross-sectional review mother-infant dyads with Neonatal...
Medical record abstraction (MRA) is a commonly used method for data collection in clinical research, but prone to error, and the influence of quality control (QC) measures seldom inconsistently assessed during course study. We employed novel, standardized MRA-QC framework as part an ongoing observational study effort MRA error rates. In order assess effectiveness our framework, we compared rates against traditional studies that had not reported using formalized methods. Thus, objective this...
To predict pharmacotherapy for NOWS based on factors available shortly after birth. A multi-center, retrospective study of 1377 opioid exposed newborns between 2016 and 2017 dichotomized pharmacologic treatment (N = 665 treated, N 712 not treated) was conducted. multilevel mixed-effect logistic regression model that considered cluster effect from sites determined significant maternal newborn associated with pharmacotherapy, which were combined in a nomogram to probability infants at each...
Medical record abstraction (MRA) is a commonly used method for data collection in clinical research, but prone to error, and the influence of quality control (QC) measures seldom inconsistently assessed during course study. We employed novel, standardized MRA-QC framework as part an ongoing observational study effort MRA error rates. In order assess effectiveness our framework, we compared rates against traditional studies that had not reported using formalized methods. Thus, objective this...
Suspected cerebral edema diabetic ketoacidosis (SCEDKA) is more common than perceived with symptoms including altered mentation, headache vomiting, depressed Glasgow coma scale (GCS), abnormal motor or verbal responses, combativeness, and neurological depression. has been associated initial (DKA) presentation at start of DKA therapy.Cerebral oximetry (bihemispheric regional oxygen saturation [rcSO2] blood volume index [CBVI]) can detect increased intracranial pressure (ICP)-induced...
This study introduces the concept of Food Acquisition Stress (FAS), stress associated with food acquisition among those who do not necessarily screen positive for insecurity.. used an exploratory sequential mixed methods approach a sample predominantly early childhood educators to develop 7-item tool measuring current and retrospective FAS. Using this tool, we identified that 61% individuals had FAS did meet criteria insecurity. Capturing FAS, even categorized as secure, has potential...
Small number of clusters combined with cluster level heterogeneity poses a great challenge for the data analysis. We have published weighted Jackknife approach to address this issue applying means as basic estimators. The current study proposes new version delete-one-cluster analytic framework, which employs Ordinary Least Squares or Generalized estimators fundamentals. Algorithms computing estimated variances also been derived. Wald test statistics can be further obtained, and statistical...