A5004653163- Respiratory Support and Mechanisms
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Emergency and Acute Care Studies
- Intensive Care Unit Cognitive Disorders
- Clinical Reasoning and Diagnostic Skills
- Airway Management and Intubation Techniques
- Bone fractures and treatments
- Attention Deficit Hyperactivity Disorder
- Healthcare Policy and Management
- Genetics and Neurodevelopmental Disorders
- Respiratory viral infections research
- Epilepsy research and treatment
- Artificial Intelligence in Healthcare and Education
- Child and Adolescent Health
- Hemodynamic Monitoring and Therapy
- Ultrasound in Clinical Applications
- Hip and Femur Fractures
- Children's Physical and Motor Development
- Heterotopic Ossification and Related Conditions
- Hospital Admissions and Outcomes
- COVID-19 diagnosis using AI
- Genomics and Rare Diseases
- Pneumothorax, Barotrauma, Emphysema
- Autoimmune Neurological Disorders and Treatments
Children's Hospital of Philadelphia
2018-2025
University of Pennsylvania
2012-2025
Academic Pediatric Association
2022
Weatherford College
2022
Hospital of the University of Pennsylvania
2013-2014
Columbia University
2011
University of Illinois Chicago, Rockford campus
2009
University of Louisville
1997
Smith & Nephew (United States)
1997
Neurogenic heterotopic ossification (NHO) is a disorder of aberrant bone formation affecting one in five patients sustaining spinal cord injury or traumatic brain injury. Ectopic forms around joints characteristic patterns, causing pain and limiting movement especially the hip elbow. Clinical sequelae neurogenic include urinary tract infection, pressure injuries, pneumonia poor hygiene, making early diagnosis treatment clinically compelling. However, remains difficult with more investigation...
Objectives: We aimed to determine the frequency and variables associated with low femoral central venous catheter (fCVC) tip position. also examined association between position symptomatic thromboembolism (VTE). Design: Retrospective cohort from two PICUs. Setting: Quaternary academic children’s hospitals, 2016–2021. Patients: Children (age <18 yr) in PICU who underwent temporary fCVC placement. Interventions: None. Measurements Main Results: Low occurs when is inferior fifth lumbar...
To determine if hyperinflammatory and hypoinflammatory pediatric acute respiratory distress syndrome (PARDS) subphenotypes defined using serum biomarkers can be determined solely from electronic health record (EHR) data machine learning. Retrospective, exploratory analysis 2014 to 2022. Single-center quaternary care PICU. Two temporally distinct cohorts of PARDS patients, 2014-2019 2019-2022. None. Patients in the derivation cohort (n = 333) were assigned or latent class analysis. A learning...
Many efforts to design introductory "cultural competence" courses for medical students rely on an information delivery (competence) paradigm, which can exoticize patients while obscuring social context, culture, and power structures. Other approaches foster a general open-minded orientation, remain nebulous without clear grounding principles. Medical educators are increasingly recognizing the limitations of both calling strategies that reenvision cultural competence training. Successfully...
Abstract Objective Literature on the genotypic spectrum of Infantile Epileptic Spasms Syndrome (IESS) in children is scarce developing countries. This multicentre collaboration evaluated and phenotypic landscape genetic IESS Indian children. Methods Between January 2021 June 2022, this cross‐sectional study was conducted at six centers India. Children with genetically confirmed IESS, without definite structural‐genetic structural‐metabolic etiology, were recruited underwent detailed...
US critical access hospitals play an integral role in rural healthcare. Accreditation may be helpful assuring that these provide high-quality care. To determine whether quality measures used the Centers for Medicare and Medicaid Services Hospital Compare database differed based on Joint Commission of Healthcare Organizations accreditation status. Cross-sectional with t-test statistics computed weighted data to ascertain statistically significant differences (P ≤ 0.01). Differences between...
A low-cost resource approach to ADHD therapy would be a practical treating children in developing countries. Research has shown that is prevalent all areas of the world, and yet treatment for more impoverished countries still lacking. The taken was combine yoga meditation combined with multimodal behavioral program ageing 6 11. kept low cost by using trained high school volunteers integrating within public school. After weeks program, 90.5% showed improvement as measured their performance...
The objective was to assess the efficacy of a one-year, peer-mediated interventional program consisting yoga, meditation and play therapy maintained by student volunteers in school India. population consisted 69 students between ages 6 11 years, previously identified as having attention deficit hyperactivity disorder (ADHD). A program, known Climb-Up, initially embedded twice weekly. Local high were then trained continue implement weekly over period one year. Improvements ADHD symptoms...
OBJECTIVES Emergency transfers (ETs), deterioration events with late recognition requiring ICU interventions within 1 hour of transfer, are associated adverse outcomes. We leveraged electronic health record (EHR) data to assess the association between ETs and also evaluated intervention timing (urgency) METHODS conducted a propensity-score-matched study hospitalized children transfer 2015 2019 at single institution. The primary exposure was ET, automatically classified using Epic Clarity...
IMPORTANCE: A recent study showed an association between high hospital-level noninvasive positive pressure ventilation (NIPPV) use and in-hospital cardiac arrest (IHCA) in children with bronchiolitis. OBJECTIVES: We aimed to determine if patient-level exposure NIPPV bronchiolitis was associated IHCA. DESIGN, SETTING AND PARTICIPANTS: Retrospective cohort at a single-center quaternary PICU North America including International Classification of Diseases primary or secondary diagnoses the...
Objectives: There is limited evidence on the impact of protocolized ventilator weaning in pediatric acute respiratory distress syndrome, despite utilization clinical trials and care. We aimed to determine whether shortens mechanical ventilation duration PICU length stay syndrome survivors. Design: Secondary analysis a prospective (Berlin definition) cohort from July 2011 June 2019 analyzed using interrupted time series pre- postimplementations ventilator-weaning pathway. compared invasive...
Residents play a key role in patient care at academic medical centers and have unique insights into safety improvement opportunities. At our institution, <1% of events were reported by resident trainees. The primary objective this quality (QI) initiative was to increase the monthly incidence event reporting pediatric residents 20% from baseline within 12 months.
The rapid progress of artificial intelligence (AI) and the adoption Large Language Models (LLMs) suggests that these technologies will transform healthcare in coming years. We present a primer on LLMs for clinicians, focusing OpenAI's Generative Pretrained Transformer-4 (GPT-4) model which powers ChatGPT as use-case, it has already seen record-breaking uptake usage. generates natural-sounding text based patterns observed from vast amounts training data. core strengths applications include...
A sheep study was performed to compare the in vivo performance of bone plates 316L stainless steel and a new titanium alloy, + 13% niobium zirconium (Ti-13Nb-13Zr), which had been subjected diffusion hardening treatment produce blue, wear resistant surface. Bone screws hardened Ti-13Nb-13Zr were implanted adult sheep, one group (with unosteotomized femurs) for 16 weeks, other osteotomized 8 weeks. At harvest, devices superior fixation strength, with greater screw torque out strength fewer...
Abstract Background Late recognition of in‐hospital deterioration is a source preventable harm. Emergency transfers (ET), when hospitalized patients require intensive care unit (ICU) interventions within 1 h ICU transfer, are proximal measure late associated with increased mortality and length stay (LOS). Objective To apply diagnostic process improvement frameworks to identify missed opportunities for in diagnosis (MOID) ETs evaluate their association outcomes. Design, Settings, Participants...
Inpatient rounding serves numerous roles. The American Academy of Pediatrics recommends a family-centered bedside model. Residents identified physical examination teaching during and satisfaction with rounds as areas for improvement. A resident group developed project utilizing quality improvement (QI) methodology to address these concerns. We aimed increase the frequency most or every day on single inpatient unit by 20% over 1 year, secondary goals percentage interns spending one hour more...
Proactive surveillance by a critical care outreach team (CCOT) can promote early recognition of deterioration in hospitalized patients but is uncommon pediatric rapid response systems (RRSs). After our children's hospital introduced CCOT 2019, we aimed to characterize implementation outcomes. We hypothesized that rounding would identify additional children at risk for deterioration.