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"Dawson, Emily C"
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Push and pull
\"Describes the forces of push and pull using everyday objects such as strollers and wagons. Includes experiments\"-- Provided by publisher.
Book
Bridging the Gap: Critical Care Insights for Everyday Pediatric Practice
Whether you are the first point of contact in clinic for a new diagnosis of diabetes or you receive news that one of your patients is hospitalized in the intensive care unit (ICU) due to a firearm injury, we as pediatricians and pediatric subspecialists need to have a solid knowledge of the management of these children who are critically ill in order to find our role in helping to optimize their return to health. While prevention and critical care medicine may seem at odds, our third article, “Firearm Injury Prevention From a Pediatric Critical Care Perspective,” by Dr. Laura Bricklin, Dr. Kellie S. Snooks, Dr. Elizabeth H. Mack, Dr. Rebecca Bell, Kassondra Little, and Dr. Deanna M. Behrens, argues that the entire medical home and health care community can intervene at various times throughout a patient's life to try to alter the risk and optimize the outcome once a firearm injury occurs. [...]a critical threat to the field of pediatrics is not only found in its patients who are sickest but also in the lack of wellness of its physicians and providers.
Journal Article
Town leaders
\"Describes common community helpers that a child might see around town. Includes visual literacy activity\"--Provided by publisher.
Book
Is Repeat Head Computed Tomography Necessary in Children Admitted with Mild Head Injury and Normal Neurological Exam?
Background: Children admitted following mild head injury (MHI) often undergo repeat head computed tomography (HCT) to identify progression of injury, although there is little evidence to support this practice. Methods: From January 2007 to December 2009, we retrospectively reviewed the medical records of patients aged 2 months to 18 years admitted with a diagnosis of MHI to a Level I Pediatric Trauma Center. Data including Glasgow Coma Scale, loss of consciousness, length of stay (LOS), and number and results of HCTs were analyzed. Results: A total of 507 patients were admitted with MHI and normal neurological exam; 389 had a normal and 118 had an abnormal initial HCT. The median LOS in the normal HCT group was 17.68 h (5.47-109.68) and in the abnormal HCT group 36.63 h (10.15-192.40). The median number of HCTs in the normal HCT group was 1 (1-2) and in the abnormal HCT group 2 (1-5). Conclusions: Children admitted with MHI, abnormal initial HCT and normal neurological exam had longer LOS and more HCTs compared with children with normal initial HCTs. No patient in either group had any change in their management based on HCT. Therefore, repeat HCT may be unnecessary for patients with MHI and normal neurological exam.
Journal Article
Where animals live
Describes different continents where animals live and how they live where they can find food.
Book
A 16-Year-Old Male with Dizziness, Parasthesias, and Ataxia
A 16-year-old African-American male with no past medical history presented with gait instability and somnolence. He had intermittent neurological complaints during the prior 4 months, including dizziness, left arm paresthesias, decreased hearing, and inability to control his hands. After an initial diagnosis of vertigo, his symptoms progressed, leading to reevaluation and a second emergency department head computed tomography (CT) scan, which revealed a large area of hypodensity in the cerebellum. Repeat head CT on arrival to the intensive care unit showed a large, left cerebellar hemispheric stroke. This case study discusses the findings of the patient’s cerebral angiogram, the diagnosis of fibromuscular dysplasia, and the aggressive treatment that likely prevented further devastating strokes in the brainstem, thalamus, and occipital lobe. This case serves as a reminder that strokes are not just an adult disease and that classic presentations can occur even in unconventional patients.
Journal Article
Summer and winter
\"Compares and contrasts summer and winter in different climates around the world. Includes comprehension activity\"--Provided by publisher.
Book
Non-genetic determinants of malignant clonal fitness at single-cell resolution
All cancers emerge after a period of clonal selection and subsequent clonal expansion. Although the evolutionary principles imparted by genetic intratumour heterogeneity are becoming increasingly clear
1
, little is known about the non-genetic mechanisms that contribute to intratumour heterogeneity and malignant clonal fitness
2
. Here, using single-cell profiling and lineage tracing (SPLINTR)—an expressed barcoding strategy—we trace isogenic clones in three clinically relevant mouse models of acute myeloid leukaemia. We find that malignant clonal dominance is a cell-intrinsic and heritable property that is facilitated by the repression of antigen presentation and increased expression of the secretory leukocyte peptidase inhibitor gene (
Slpi
), which we genetically validate as a regulator of acute myeloid leukaemia. Increased transcriptional heterogeneity is a feature that enables clonal fitness in diverse tissues and immune microenvironments and in the context of clonal competition between genetically distinct clones. Similar to haematopoietic stem cells
3
, leukaemia stem cells (LSCs) display heritable clone-intrinsic properties of high, and low clonal output that contribute to the overall tumour mass. We demonstrate that LSC clonal output dictates sensitivity to chemotherapy and, although high- and low-output clones adapt differently to therapeutic pressure, they coordinately emerge from minimal residual disease with increased expression of the LSC program. Together, these data provide fundamental insights into the non-genetic transcriptional processes that underpin malignant clonal fitness and may inform future therapeutic strategies.
Non-genetic malignant clonal dominance is a cell-intrinsic and heritable property that underpins clonal output and response to therapy in cancer.
Journal Article
Animal clothing
\"Compares different animal coverings such as shells, feathers, fur, and scales. Includes comprehension activity\"--Provided by publisher.
Book
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection.
This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation.
This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047).
Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery.
National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Journal Article