Boston Children's Hospital

Developmental differences in platelet P-selectin expression modulate neonatal monocyte inflammatory responses

Neonatal and adult platelets are functionally different, with neonatal platelets being comparatively hypo-reactive to multiple platelet agonists. When transfused, neonates receive platelets from adult donors, resulting in a cellular developmental mismatch. Platelets are key regul...

Genetically Predicted Circulating Lipid Traits and Risk of Primary Open-Angle Glaucoma: A Mendelian Randomization Study

Background: Observational studies examining the relationship between serum lipids and primary open-angle glaucoma (POAG) have yielded inconsistent findings, limiting causal inference. Mendelian randomization (MR) offers a robust approach to evaluate causality by leveraging geneti...

Pediatric Hospital Medicine FTEs and Staffing Models

Appropriate physician staffing is essential to providing safe, high-quality care for hospitalized children. Many challenges exist in achieving optimal staffing, including financial constraints, coverage of off-hour shifts, recruitment shortages, and building models that promote s...

Diagnosis-related handoffs for inter-facility transfers to the pediatric intensive care unit

OBJECTIVES: Inter-facility transfers to the pediatric intensive care unit (PICU) increase the risk of patient harm from communication breakdowns. We previously developed I-PASS-to-PICU, a structured inter-facility handoff program to improve information exchange during these trans...

Hyperoxia and neurologic complications in pediatric veno-arterial extracorporeal membrane oxygenation: a retrospective ELSO registry study

Hyperoxia can contribute to neurologic injury through oxidative injury and platelet activation leading to microvascular thrombosis in critical illness. We aimed to determine if hyperoxia exposure during ECMO is associated with increased neurologic complications. Secondarily, we a...

Patterns of care for single ventricle infants in a home monitoring programme

Abstract Introduction: The advanced practice registered nurse-led home monitoring programme has served as an early warning system for the fragile population of single ventricle infants discharged home between their staged interventions. However, patterns of care by the home monit...

Time to diagnosis of acute kidney injury and its predictors among outborn neonates in India: a competing-risk analysis of tele-ICU network data (2022–2024)

Background There is limited data on neonatal acute kidney injury (AKI) from resource-constrained settings. In this study, we describe time to AKI diagnosis and its predictors among neonates born outside the treating hospital (outborn) in India, accounting for competing events lik...

Five-Year Cost-Effectiveness Analysis of Endoscopic Third Ventriculostomy With Choroid Plexus Cauterization Versus Ventriculoperitoneal Shunting in Postinfectious Hydrocephalus in a Low-Income Setting

BACKGROUND AND OBJECTIVES: For over 2 decades, an emerging body of data has established endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) as a viable option in the treatment of postinfectious hydrocephalus (PIH) in low-resource settings with similar out...

Spread and Sustainability of an Antimicrobial Stewardship Initiative Within a Pediatric Network

BACKGROUND: Projects employing performance feedback with education have been used to improve antimicrobial prescribing practices, but improvements may not be sustainable after the active intervention. We sought to determine whether ongoing clinical decision support (CDS) could su...

High-grade astrocytoma with piloid features: a clinical and genomic analysis of prognostic factors using a large cohort

BACKGROUND: High-grade astrocytoma with piloid features (HGAP) is a recently defined tumor type that is not well-understood. Prognostic factors of clinical outcomes are not well-established. METHODS: Methylation profiling was performed on tumor samples, many at the National Cance...

The Heart of the Matter — Transforming Congenital Heart Disease Care through Patient-Reported Outcomes

Patients with congenital heart disease (CHD) face substantial challenges in managing their chronic illness. Common and often unmet needs include neurocognitive challenges, mental health conditions, multiorgan disease, school and work impairment, and financial constraints. To impr...

Longitudinal predictors of internalizing and externalizing behaviors in autism: Examining relationships with ritualistic behavior and social diagnostic features

Abstract Autistic youth commonly experience co-occurring mental health conditions. Core autism features have been linked to internalizing and externalizing symptoms, yet longitudinal pathways remain unclear. This study examined how ritualistic and social diagnostic features predi...

Serum Chloride Trajectories and Acute Kidney Injury in Children With Diabetic Ketoacidosis

OBJECTIVES: To characterize serum chloride (Cl) burden during diabetic ketoacidosis (DKA), examine associations between Cl metrics and creatinine-defined acute kidney injury (CDAKI) and hospital length of stay (LOS), and to assess the relationship between initial beta-hydroxybuty...

Short‐Term Changes in General and Central Adiposity and Subsequent Cardiometabolic Risk in Japanese Adults Undergoing Routine Health Screening

ABSTRACT Objective Annual health screening provides repeated measurements of body mass index (BMI) and waist‐based indices, but the implications of short‐term changes in general and central adiposity for cardiometabolic risk remain unclear. We examined whether 1‐year changes in B...

Conference Goals And Learning Preferences Among Attendees at A National Surgical Meeting

Objective This study evaluated differences in conference goals and preferred learning modalities across demographic groups at a national surgical conference. Design An optional online survey collected demographic information (gender, practice type, role, years in independent prac...

Gait Speed in Spinal Muscular Atrophy: A Key Vital Sign Linked to Strength and Fatigability

ABSTRACT Introduction/Aims Gait Speed (GS), a valid and reliable indicator of function and health in multiple populations, has not been explored in spinal muscular atrophy (SMA). The purpose of this study was to characterize GS and gait speed reserves (GSR), and explore associati...

Clinical trial barriers in neurostimulation for pediatric drug‐resistant epilepsy

Abstract Objective The NeuroPace responsive neurostimulation (RNS) System effectively treats focal drug‐resistant epilepsy (DRE) in adults but lacks pediatric regulatory approval. Despite effective off‐label pediatric use, systemic device‐trial challenges have impeded label expan...

Actuation of CRP activating region 3 by formylation modulates the Vibrio cholerae response to oxidative DNA damage

The cyclic AMP receptor protein or CRP is a global regulator of bacterial metabolism. CRP activates transcription of genes required for utilization of alternative carbon sources in response to the second messenger cAMP, which is synthesized in the setting of glucose scarcity. Tra...

Late Endocrine and Organ Toxicities After Treosulfan‐Based Conditioning in Pediatric Hematopoietic Cell Transplantation: A Systematic Review

Treosulfan is an alkylating agent indicated as a conditioning agent for allogeneic hematopoietic cell transplantation (HCT), with an established favorable acute toxicity profile; however, its long-term sequelae remain incompletely characterized. This review aims to characterize t...

Parent–Clinician Communication and End‐of‐Life Preparation in Pediatric Oncology: An Explanatory Sequential Mixed‐Methods Study

PURPOSE: Parental preparedness for their child's end of life (EOL) may lessen perceived suffering and prolonged grief. Although clear communication may support parental preparedness, the specific communication components that influence this process remain poorly understood. This...