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1. Continuous, Subject-Specific Attribute Control in T2I Models by Identifying Semantic Directions

Author

Baumann, Stefan Andreas, Krause, Felix, Neumayr, Michael, Stracke, Nick, Hu, Vincent Tao, and Ommer, Björn

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Artificial Intelligence, Computer Science - Machine Learning
Abstract

In recent years, advances in text-to-image (T2I) diffusion models have substantially elevated the quality of their generated images. However, achieving fine-grained control over attributes remains a challenge due to the limitations of natural language prompts (such as no continuous set of intermediate descriptions existing between ``person'' and ``old person''). Even though many methods were introduced that augment the model or generation process to enable such control, methods that do not require a fixed reference image are limited to either enabling global fine-grained attribute expression control or coarse attribute expression control localized to specific subjects, not both simultaneously. We show that there exist directions in the commonly used token-level CLIP text embeddings that enable fine-grained subject-specific control of high-level attributes in text-to-image models. Based on this observation, we introduce one efficient optimization-free and one robust optimization-based method to identify these directions for specific attributes from contrastive text prompts. We demonstrate that these directions can be used to augment the prompt text input with fine-grained control over attributes of specific subjects in a compositional manner (control over multiple attributes of a single subject) without having to adapt the diffusion model. Project page: https://compvis.github.io/attribute-control. Code is available at https://github.com/CompVis/attribute-control., Comment: Project page: https://compvis.github.io/attribute-control

Published
2024

3. Factors associated with successful liberation from continuous renal replacement therapy in children and young adults: analysis of the worldwide exploration of renal replacement outcomes collaborative in Kidney Disease Registry

Author

Stenson, Erin K., Alhamoud, Issa, Alobaidi, Rashid, Bottari, Gabriella, Fernandez, Sarah, Fuhrman, Dana Y., Guzzi, Francesco, Haga, Taiki, Kaddourah, Ahmad, Marinari, Eleonora, Mohamed, Tahagod, Morgan, Catherine, Mottes, Theresa, Neumayr, Tara, Ollberding, Nicholas J., Raggi, Valeria, Ricci, Zaccaria, See, Emily, Stanski, Natalja L., Zang, Huaiyu, Zangla, Emily, and Gist, Katja M.

Published
2024
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4. A multilevel mHealth intervention boosts adherence to hydroxyurea in individuals with sickle cell disease

Author

Hankins, Jane S, Brambilla, Donald, Potter, Michael B, Kutlar, Abdullah, Gibson, Robert, King, Allison A, Baumann, Ana A, Melvin, Cathy, Gordeuk, Victor R, Hsu, Lewis L, Nwosu, Chinonyelum, Porter, Jerlym S, Alberts, Nicole M, Badawy, Sherif M, Simon, Jena, Glassberg, Jeffrey A, Lottenberg, Richard, DiMartino, Lisa, Jacobs, Sara, Fernandez, Maria E, Bosworth, Hayden B, Klesges, Lisa M, Shah, Nirmish, Hodges, Jason, Carroll, Yvonne, Klesges, Lisa, Khan, Hamda, Smeltzer, Matthew, Gurney, James, Porter, Jerlym, Alberts, Nicole, French, Reginald, Badawy, Sherif, DeBaun, Michael, Kang, Guolian, Estepp, Jeremie, Wang, Winfred, Owens, Curtis, Debon, Margaret, Osarogiagbon, Ray, Nelson, Marquita, Treadwell, Marsha, Vichinsky, Elliott, Wun, Ted, Potter, Michael, Hessler, Danielle, Hagar, Ward, Marsh, Anne, Neumayr, Lynne, Kanter, Julie, Phillips, Shannon, Adams, Robert, Mueller, Martina, Abrams, Tina, Davia, Nathalia, Tanabe, Paula, Bosworth, Hayden, Jackson, George, Johnson, Fred, Richesson, Rachel, Prvu-Bettger, Janet, King, Allison, Baumann, Ana, Calhoun, Cecilia, Snyder, Angie, Fernandez, Maria, Richardson, Lynne D, Glassberg, Jeffrey, Genes, Nicholas G, Loo, George T, Shapiro, Jason S, Souffront, Kimberly, Clesca, Cindy, Linton, Elizabeth, Ryan, Gery, Kroner, Barbara L, Hendershot, Tabitha, Battestilli, Whitney, Cox, Lisa, Preiss, Liliana, Pugh, Norma, Li, Sophie, VonLehmden, Annie, Smith, Sharon M, Tonkins, William P, Peters-Lawrence, Marlene, Boyce, Cheryl, Barfield, Whitney, and Thompson, Alexis

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Services, Clinical Trials and Supportive Activities, Chronic Pain, Pain Research, Hematology, Sickle Cell Disease, Clinical Research, Rare Diseases, Management of diseases and conditions, 7.1 Individual care needs, Good Health and Well Being, Adult, Female, Humans, Male, Anemia, Sickle Cell, Hydroxyurea, Medication Adherence, Pain, Telemedicine, Cardiovascular medicine and haematology
Abstract

Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU Toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval. We enrolled 293 patients (51% male; median age 27.5 years, 86.8% HbSS/HbSβ0-thalassemia). The mean change in PDC among 235 evaluable subjects increased (39.7% to 56.0%; P < 0.001) and sustained (39.7% to 51.4%, P < 0.001). Mean HbF increased (10.95% to 12.78%; P = 0.03). Self-reported pain frequency reduced (3.54 to 3.35 events/year; P = 0.041). InCharge Health was used ≥1 day by 199 of 235 participants (84.7% implementation; median usage: 17% study days; IQR: 4.8-45.8%). For individuals with ≥1 baseline admission for pain, admissions per 24 weeks declined from baseline through 24 weeks (1.97 to 1.48 events/patient, P = 0.0045) and weeks 25-36 (1.25 events/patient, P = 0.0015). PDC increased with app use (P < 0.001), with the greatest effect in those with private insurance (P = 0.0078), older subjects (P = 0.033), and those with lower pain interference (P = 0.0012). Of the 89 providers (49 hematologists, 36 advanced care providers, 4 unreported), only 11.2% used HU Toolbox ≥1/month on average. This use did not affect change in PDC. Tailoring mHealth solutions to address barriers to hydroxyurea adherence can potentially improve adherence and provide clinical benefits. A definitive randomized study is warranted. This trial was registered at www.clinicaltrials.gov as #NCT04080167.

Published
2023

5. Suspected Acute Pulmonary Coccidioidomycosis in Traveler Returning to Switzerland from Peru

Author

Andreas Neumayr, Volker Rickerts, Sina Ackermann, Felipe Castelblanco, Esther Kuenzli, Ana Durovic, and Carlos Seas

Subjects
coccidioidomycosis, coccidioides, Valley Fever, fungi, fungal, mycosis, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

We report a suspected case of acute pulmonary coccidioidomycosis contracted in Peru, where the disease is not known to occur, in a patient from Switzerland. Although not confirmed by direct diagnostic testing, the clinical manifestations and serologic testing results of this case are highly suggestive of coccidioidomycosis.

Published
2024
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8. Pediatric AKI in the real world: changing outcomes through education and advocacy—a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference

Author

Mottes, Theresa, Menon, Shina, Conroy, Andrea, Jetton, Jennifer, Dolan, Kristin, Arikan, Ayse Akcan, Basu, Rajit K., Goldstein, Stuart L., Symons, Jordan M., Alobaidi, Rashid, Askenazi, David J., Bagshaw, Sean M., Barhight, Matthew, Barreto, Erin, Bayrakci, Benan, Ray, II, O. N. Bignall, Bjornstad, Erica, Brophy, Patrick, Charlton, Jennifer, Chanchlani, Rahul, Conroy, Andrea L., Deep, Akash, Devarajan, Prasad, Fuhrman, Dana, Gist, Katja M., Gorga, Stephen M., Greenberg, Jason H., Hasson, Denise, Heydari, Emma, Iyengar, Arpana, Krawczeski, Catherine, Meigs, Leslie, Morgan, Catherine, Morgan, Jolyn, Neumayr, Tara, Ricci, Zaccaria, Selewski, David T., Soranno, Danielle, Stanski, Natalja, Starr, Michelle, Sutherland, Scott M., Symons, Jordan, Tavares, Marcelo, Vega, Molly, Zappitelli, Michael, Ronco, Claudio, Mehta, Ravindra L., Kellum, John, and Ostermann, Marlies

Published
2024
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10. Mask, Stitch, and Re-Sample: Enhancing Robustness and Generalizability in Anomaly Detection through Automatic Diffusion Models

Author

Bercea, Cosmin I., Neumayr, Michael, Rueckert, Daniel, and Schnabel, Julia A.

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Artificial Intelligence, Electrical Engineering and Systems Science - Image and Video Processing
Abstract

The introduction of diffusion models in anomaly detection has paved the way for more effective and accurate image reconstruction in pathologies. However, the current limitations in controlling noise granularity hinder diffusion models' ability to generalize across diverse anomaly types and compromise the restoration of healthy tissues. To overcome these challenges, we propose AutoDDPM, a novel approach that enhances the robustness of diffusion models. AutoDDPM utilizes diffusion models to generate initial likelihood maps of potential anomalies and seamlessly integrates them with the original image. Through joint noised distribution re-sampling, AutoDDPM achieves harmonization and in-painting effects. Our study demonstrates the efficacy of AutoDDPM in replacing anomalous regions while preserving healthy tissues, considerably surpassing diffusion models' limitations. It also contributes valuable insights and analysis on the limitations of current diffusion models, promoting robust and interpretable anomaly detection in medical imaging - an essential aspect of building autonomous clinical decision systems with higher interpretability.

Published
2023

11. Towards new realities: implications of personalized online layers in our daily lives

Author

Herder Eelco, Stojko Laura, Strecker Jannis, Neumayr Thomas, Yigitbas Enes, and Augstein Mirjam

Subjects
personalization, recommendation, adaptation, hci, realities, Communication. Mass media, P87-96, Electronic computers. Computer science, QA75.5-76.95
Abstract

We are currently in a period of upheaval, as many new technologies are emerging that open up new possibilities to shape our everyday lives. Particularly, within the field of Personalized Human-Computer Interaction we observe high potential, but also challenges. In this article, we explore how an increasing amount of online services and tools not only further facilitates our lives, but also shapes our lives and how we perceive our environments. For this purpose, we adopt the metaphor of personalized ‘online layers’ and show how these layers are and will be interwoven with the lives that we live in the ‘human layer’ of the real world.

Published
2024
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12. An evaluation of the outcomes associated with peritoneal catheter use in neonates undergoing cardiac surgery: A multicenter studyCentral MessagePerspective

Author

David M. Kwiatkowski, MD, MS, Jeffrey A. Alten, MD, Kenneth E. Mah, MD, David T. Selewski, MD, Tia T. Raymond, MD, MBA, Natasha S. Afonso, MD, MPH, Joshua J. Blinder, MD, Matthew T. Coghill, MD, David S. Cooper, MD, MPH, Joshua D. Koch, MD, Catherine D. Krawczeski, MD, David L.S. Morales, MD, Tara M. Neumayr, MD, A.K.M. Fazlur Rahman, PhD, Garrett Reichle, MS, Sarah Tabbutt, MD, PhD, Tennille N. Webb, MD, Santiago Borasino, MD, Huaiyu Zang, David Winlaw, MD, David Bailly, DO, Stuart Goldstein, MD, Katja Gist, DO, Katie L. Brandewie, MD, Priya N. Bhat, MD, John W. Diddle, MD, Muhammad Ghbeis, MD, Parthak Prodhan, MD, Xiomara Garcia, MD, Shannon Ramer, Mindy Albertson, Zahidee Rodriquez, MD, Mary Lukacs, Michael Gaies, MD, Joshua Freytag, Amanda Sammons, Hideat Abraha, John Butcher, Dominic Zanaboni, MD, Joan Sanchez de Toledo, MD, PhD, Yuliya A. Domnina, MD, Lucas Saenz, MD, Tracy Baust, Jane Kluck, RN, Jun Sasaki, MD, Aanish Raees, MD, Erika R. O'Neil, MD, Javier J. Lasa, MD, Patrick A. Phillips, Kristal M. Hock, Kevin Valentine, MD, Sachin Tadphale, MBBS, Jason R. Buckley, MD, Luke Schroeder, MD, Shanelle Clarke, MD, Wenying Zhang, MD, Andrew Smith, MD, Mohammed Absi, MD, David J. Askenazi, MD, David J. Askenazi, Parthak Prodhan, Xiomara Garcia, Shanelle Clarke, Zahidee Rodriquez, Muhammad Ghbeis, Jun Sasaki, Katie L. Brandewie, Katja Gist, Michael Gaies, Aanish Raees, Dominic Zanaboni, Joan Sanchez de Toledo, Yuliya A. Domnina, Lucas Saenz, John W. Diddle, Jane Kluck, Linda Duncan, Rebecca A. Bertrandt, Lisa J. Sosa, Priya N. Bhat, Erika R. O’Neal, Javier J. Lasa, Kevin Valentine, Jason R. Buckley, Luke Schroeder, Tammy Doman, Suzanne Viers, Wenying Zhang, Andrew H. Smith, Sachin Tadphale, Mohammed Absi, and David K. Bailly

Subjects
acute kidney injury, fluid overload, neonatal cardiac surgery, peritoneal catheter, peritoneal dialysis, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: The study objective was to determine if intraoperative peritoneal catheter placement is associated with improved outcomes in neonates undergoing high-risk cardiac surgery with cardiopulmonary bypass. Methods: This propensity score–matched retrospective study used data from 22 academic pediatric cardiac intensive care units. Consecutive neonates undergoing Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery category 3 to 5 cardiac surgery with cardiopulmonary bypass at centers participating in the NEonatal and Pediatric Heart Renal Outcomes Network collaborative were studied to determine the association of the use of an intraoperative placed peritoneal catheter for dialysis or passive drainage with clinical outcomes, including the duration of mechanical ventilation. Results: Among 1490 eligible neonates in the NEonatal and Pediatric Heart Renal Outcomes Network dataset, a propensity-matched analysis was used to compare 395 patients with peritoneal catheter placement with 628 patients without peritoneal catheter placement. Time to extubation and most clinical outcomes were similar. Postoperative length of stay was 5 days longer in the peritoneal catheter placement cohort (17 vs 22 days, P = .001). There was a 50% higher incidence of moderate to severe acute kidney injury in the no-peritoneal catheter cohort (12% vs 18%, P = .02). Subgroup analyses between specific treatments and in highest risk patients yielded similar associations. Conclusions: This study does not demonstrate improved outcomes among neonates with placement of a peritoneal catheter during cardiac surgery. Outcomes were similar apart from longer hospital stay in the peritoneal catheter cohort. The no-peritoneal catheter cohort had a 50% higher incidence of moderate to severe acute kidney injury (12% vs 18%). This analysis does not support indiscriminate peritoneal catheter use, although it may support the utility for postoperative fluid removal among neonates at risk for acute kidney injury. A multicenter controlled trial may better elucidate peritoneal catheter effects.

Published
2024
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15. Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)

Author

Menon, Shina, Krallman, Kelli A, Arikan, Ayse A, Fuhrman, Dana Y, Gorga, Stephen M, Mottes, Theresa, Ollberding, Nicholas, Ricci, Zaccaria, Stanski, Natalja L, Selewski, David T, Soranno, Danielle E, Zappitelli, Michael, Zang, Huaiyu, Gist, Katja M, Investigators, WE-ROCK, Ahern, Emily, Arikan, Ayse Akcan, Alhamoud, Issa, Alobaidi, Rashid, Anton-Martin, Pilar, Balani, Shanthi S, Barhight, Matthew, Basalely, Abby, Bigelow, Amee M, Bottari, Gabriella, Cappoli, Andrea, Ciccia, Eileen A, Collins, Michaela, Colosimo, Denise, Cortina, Gerard, Damian, Mihaela A, De la Mata Navazo, Sara, DeAbreu, Gabrielle, Deep, Akash, Ding, Kathy L, Dolan, Kristin J, Lafever, Sarah N Fernandez, Gelbart, Ben, Guzzi, Francesco, Guzzo, Isabella, Haga, Taiki, Harvey, Elizabeth, Hasson, Denise C, Hill-Horowitz, Taylor, Inthavong, Haleigh, Joseph, Catherine, Kaddourah, Ahmad, Kakajiwala, Aadil, Kessel, Aaron D, Korn, Sarah, Kwiatkowski, David M, Lee, Jasmine, Lequier, Laurance, Kia, Tina Madani, Mah, Kenneth E, Marinari, Eleonora, Martin, Susan D, Mohamed, Tahagod H, Morgan, Catherine, Mottes, Theresa A, Muff-Luett, Melissa A, Namachivayam, Siva, Neumayr, Tara M, Nhan, Jennifer, O'Rourke, Abigail, Ollberding, Nicholas J, Pinto, Matthew G, Qutob, Dua, Raggi, Valeria, Reynaud, Stephanie, Rumlow, Zachary A, Lozano, María J Santiago, See, Emily, Serpe, Carmela, Serratore, Alyssa, Shah, Ananya, Shih, Weiwen V, Shin, H Stella, Slagle, Cara L, Solomon, Sonia, Srivastava, Rachana, Starr, Michelle C, Stenson, Erin K, Strong, Amy E, Taylor, Susan A, Thadani, Sameer V, Uber, Amanda M, Van Wyk, Brynna, Webb, Tennille N, and Zangla, Emily E

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Trials and Supportive Activities, Pediatric, Prevention, Kidney Disease, Clinical Research, Renal and urogenital, Good Health and Well Being, WE-ROCK Investigators, WE-ROCK, acute kidney injury, continuous renal replacement therapy, database, fluid overload, pediatric, Biomedical and clinical sciences, Health sciences
Abstract

IntroductionContinuous renal replacement therapy (CRRT) is used for the symptomatic management of acute kidney injury (AKI) and fluid overload (FO). Contemporary reports on pediatric CRRT are small and single center in design. Large international studies evaluating CRRT practice and outcomes are lacking. Herein, we describe the design of a multinational collaborative.MethodsThe Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) is an international collaborative of pediatric specialists whose mission is to improve short- and long-term outcomes of children treated with CRRT. The aims of this multicenter retrospective study are to describe the epidemiology, liberation patterns, association of fluid balance and timing of CRRT initiation, and CRRT prescription with outcomes.ResultsWe included children (n = 996, 0-25 years) admitted to an intensive care unit (ICU) and treated with CRRT for AKI or FO at 32 centers (in 7 countries) from 2018 to 2021. Demographics and clinical characteristics before CRRT initiation, during the first 7 days of both CRRT, and liberation were collected. Outcomes include the following: (i) major adverse kidney events at 90 days (mortality, dialysis dependence, and persistent kidney dysfunction), and (ii) functional outcomes (functional stats scale).ConclusionThe retrospective WE-ROCK study represents the largest international registry of children receiving CRRT for AKI or FO. It will serve as a broad and invaluable resource for the field of pediatric critical care nephrology that will improve our understanding of practice heterogeneity and the association of CRRT with clinical and patient-centered outcomes. This will generate preliminary data for future interventional trials in this area.

Published
2023

16. The Association Between Vasopressin and Adverse Kidney Outcomes in Children and Young Adults Requiring Vasopressors on Continuous Renal Replacement Therapy

Author

Denise C. Hasson, MD, Katja M. Gist, DO, MSc, JangDong Seo, PhD, Erin K. Stenson, MD, Aaron Kessel, MD, MS, Taiki Haga, MD, MSc, Sara LaFever, MD, PhD, Maria Jose Santiago, MD, PhD, Matthew Barhight, MD, MS, David Selewski, MD, MSCR, Zaccaria Ricci, MD, Nicholas J. Ollberding, PhD, Natalja L. Stanski, MD, on behalf of the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) Collaborative, Emily Ahern, CPNP, DNP, Ayse Akcan Arikan, MD, Issa Alhamoud, MD, Rashid Alobaidi, MD, MSc, Pilar Anton-Martin, MD, PhD, Shanthi S. Balani, MD, Abby Basalely, MD, MS, Amee M. Bigelow, MD, MS, Gabriella Bottari, MD, Andrea Cappoli, MD, Eileen A. Ciccia, MD, Michaela Collins, BA, Denise Colosimo, MD, Gerard Cortina, MD, Mihaela A. Damian, MD, MPH, Sara De la Mata Navazo, MD, Gabrielle DeAbreu, MD, Akash Deep, MD, Kathy L. Ding, BS, Kristin J. Dolan, MD, Sarah N. Fernandez Lafever, MD, PhD, Dana Y. Fuhrman, DO, MS, Ben Gelbart, MBBS, Stephen M. Gorga, MD, MSc, Francesco Guzzi, MD, Isabella Guzzo, MD, Taiki Haga, MD, Elizabeth Harvey, MD, Taylor Hill-Horowitz, BS, Haleigh Inthavong, BS, MS, Catherine Joseph, MD, Ahmad Kaddourah, MD, MS, Aadil Kakajiwala, MD, MSCI, Aaron D. Kessel, MD, MS, Sarah Korn, DO, Kelli A. Krallman, BSN, MS, David M. Kwiatkowski, MD, Msc, Jasmine Lee, MSc, Laurance Lequier, MD, Tina Madani Kia, BS, Kenneth E. Mah, MD, MS, Eleonora Marinari, MD, Susan D. Martin, MD, Shina Menon, MD, Tahagod H. Mohamed, MD, Catherine Morgan, MD, MSc, Theresa A. Mottes, APRN, Melissa A. Muff-Luett, MD, Siva Namachivayam, MBBS, Tara M. Neumayr, MD, Jennifer Nhan Md, MS, Abigail O’Rourke, MD, Matthew G. Pinto, MD, Dua Qutob, MD, Valeria Raggi, MD, Stephanie Reynaud, MD, Zachary A. Rumlow, DO, María J. Santiago Lozano, MD, PhD, Emily See, MBBS, David T. Selewski, MD, MSCR, Carmela Serpe, MSc, PhD, Alyssa Serratore, RN, MsC, Ananya Shah, BS, Weiwen V. Shih, MD, H. Stella Shin, MD, Cara L. Slagle, MD, Sonia Solomon, DO, Danielle E. Soranno, MD, Rachana Srivastava, MD, Michelle C. Starr, MD, MPH, Amy E. Strong, MD, MSCE, Susan A. Taylor, MSc, Sameer V. Thadani, MD, Amanda M. Uber, DO, Brynna Van Wyk, ARNP, MSN, Tennille N. Webb, MD, MSPH, Huaiyu Zang, PhD, Emily E. Zangla, DO, Michael Zappitelli, MD, MSc, T. Christine, E. Alvarez, MHI, RN, Elizabeth Bixler, BS, Erica Blender Brown, MA, CRA, Cheryl L. Brown, BS, Ambra Burrell, BA, Anwesh Dash, BS, Jennifer L. Ehrlich, RN, MHA, Simrandeep Farma, HBSc, Kim Gahring, RN, BSN, CCRN, Barbara Gales, RN, Madison R. Hilgenkamp, Sonal Jain, MS, Kate Kanwar, BA, MS, Jennifer Lusk, BSN, RN, CCRN, Christopher J. Meyer, BA AA, Katherine Plomaritas, BSN, RN, Joshua Porter, BS, Jessica Potts, BSN, RN, Alyssa Serratore, BNurs, GDipNP(PIC), RN, MsC, Elizabeth Schneider, BS, Vidushi Sinha, BS, P. J. Strack, RN, BSN, CCRN, Sue Taylor, RN, Katherine Twombley, MD, Brynna Van Wyk, MSN, ARNP, CPNP, Samantha Wallace, MS, Janet Wang, BS, Megan Woods, BS, Marcia Zinger, RN, and Alison Zong, BS

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

OBJECTIVES:. Continuous renal replacement therapy (CRRT) and shock are both associated with high morbidity and mortality in the ICU. Adult data suggest renoprotective effects of vasopressin vs. catecholamines (norepinephrine and epinephrine). We aimed to determine whether vasopressin use during CRRT was associated with improved kidney outcomes in children and young adults. DESIGN:. Secondary analysis of Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK), a multicenter, retrospective cohort study. SETTING:. Neonatal, cardiac, PICUs at 34 centers internationally from January 1, 2015, to December 31, 2021. PATIENTS/SUBJECTS:. Patients younger than 25 years receiving CRRT for acute kidney injury and/or fluid overload and requiring vasopressors. Patients receiving vasopressin were compared with patients receiving only norepinephrine/epinephrine. The impact of timing of vasopressin relative to CRRT start was assessed by categorizing patients as: early (on or before day 0), intermediate (days 1–2), and late (days 3–7). INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 1016 patients, 665 (65%) required vasopressors in the first week of CRRT. Of 665, 248 (37%) received vasopressin, 473 (71%) experienced Major Adverse Kidney Events at 90 days (MAKE-90) (death, renal replacement therapy dependence, and/or > 125% increase in serum creatinine from baseline 90 days from CRRT initiation), and 195 (29%) liberated from CRRT on the first attempt within 28 days. Receipt of vasopressin was associated with higher odds of MAKE-90 (adjusted odds ratio [aOR], 1.80; 95% CI, 1.20–2.71; p = 0.005) but not liberation success. In the vasopressin group, intermediate/late initiation was associated with higher odds of MAKE-90 (aOR, 2.67; 95% CI, 1.17–6.11; p = 0.02) compared with early initiation. CONCLUSIONS:. Nearly two-thirds of children and young adults receiving CRRT required vasopressors, including over one-third who received vasopressin. Receipt of vasopressin was associated with more MAKE-90, although earlier initiation in those who received it appears beneficial. Prospective studies are needed to understand the appropriate timing, dose, and subpopulation for use of vasopressin.

Published
2024
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18. Remote Collaboration Between Sighted and Non-Sighted People in Mixed-Ability Teams

Author

Kaschnig, Francesca, Neumayr, Thomas, Augstein, Mirjam, Hartmanis, Juris, Founding Editor, van Leeuwen, Jan, Series Editor, Hutchison, David, Editorial Board Member, Kanade, Takeo, Editorial Board Member, Kittler, Josef, Editorial Board Member, Kleinberg, Jon M., Editorial Board Member, Kobsa, Alfred, Series Editor, Mattern, Friedemann, Editorial Board Member, Mitchell, John C., Editorial Board Member, Naor, Moni, Editorial Board Member, Nierstrasz, Oscar, Series Editor, Pandu Rangan, C., Editorial Board Member, Sudan, Madhu, Series Editor, Terzopoulos, Demetri, Editorial Board Member, Tygar, Doug, Editorial Board Member, Weikum, Gerhard, Series Editor, Vardi, Moshe Y, Series Editor, Goos, Gerhard, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Woeginger, Gerhard, Editorial Board Member, Miesenberger, Klaus, editor, Peňáz, Petr, editor, and Kobayashi, Makoto, editor

Published
2024
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19. Human Taenia martis Neurocysticercosis, Switzerland

Author

Steinsiepe, Valentin K., Ruf, Marie-Therese, Rossi, Marco, Fricker-Feer, Claudia, Kolenc, Danijela, Buser, Brigitte Suter, Concu, Maura, Neumayr, Andreas, and Schneider, Ulf C.

Subjects
Cysticercosis -- Case studies, Taeniasis -- Case studies, Health
Abstract

Neurocysticercosis is a zoonotic, parasitic, central nervous system infection almost exclusively caused by the larvae of Taenia solium, the pork tapeworm (1). In a few exceptional cases, neurocysticercosis in humans [...]

Published
2023

21. Characteristics and Outcomes of Children and Young Adults With Sepsis Requiring Continuous Renal Replacement Therapy: A Comparative Analysis From the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)*

Author

Stanski, Natalja L., Gist, Katja M., Hasson, Denise, Stenson, Erin K., Seo, JangDong, Ollberding, Nicholas J., Muff-Luett, Melissa, Cortina, Gerard, Alobaidi, Rashid, See, Emily, Kaddourah, Ahmad, Fuhrman, Dana Y., Ahern, Emily, Akcan Arikan, Ayse, Alhamoud, Issa, Alobaidi, Rashid, Anton-Martin, Pilar, Balani, Shanthi S., Barhight, Matthew, Basalely, Abby, Bigelow, Amee M., Bottari, Gabriella, Cappoli, Andrea, Ciccia, Eileen A., Collins, Michaela, Colosimo, Denise, Cortina, Gerard, Damian, Mihaela A., De la Mata Navazo, Sara, DeAbreu, Gabrielle, Deep, Akash, Ding, Kathy L., Dolan, Kristin J., Fernandez Lafever, Sarah N., Fuhrman, Dana Y., Gelbart, Ben, Gist, Katja M., Gorga, Stephen M., Guzzi, Francesco, Guzzo, Isabella, Haga, Taiki, Harvey, Elizabeth, Hasson, Denise C., Hill-Horowitz, Taylor, Inthavong, Haleigh, Joseph, Catherine, Kaddourah, Ahmad, Kakajiwala, Aadil, Kessel, Aaron D., Korn, Sarah, Krallman, Kelli A., Kwiatkowski, David M., Lee, Jasmine, Lequier, Laurance, Madani Kia, Tina, Mah, Kenneth E., Marinari, Eleonora, Martin, Susan D., Menon, Shina, Mohamed, Tahagod H., Morgan, Catherine, Mottes, Theresa A., Muff-Luett, Melissa A., Namachivayam, Siva, Neumayr, Tara M., Nhan, Jennifer, O’Rourke, Abigail, Ollberding, Nicholas J., Pinto, Matthew G., Qutob, Dua, Raggi, Valeria, Reynaud, Stephanie, Ricci, Zaccaria, Rumlow, Zachary A., Santiago Lozano, María J., See, Emily, Selewski, David T., Serpe, Carmela, Serratore, Alyssa, Shah, Ananya, Shih, Weiwen V., Stella Shin, H., Slagle, Cara L., Solomon, Sonia, Soranno, Danielle E., Srivastava, Rachana, Stanski, Natalja L., Starr, Michelle C., Stenson, Erin K., Strong, Amy E., Taylor, Susan A., Thadani, Sameer V., Uber, Amanda M., Van Wyk, Brynna, Webb, Tennille N., Zang, Huaiyu, Zangla, Emily E., Zappitelli, Michael, Alvarez, T. Christine E., Bixler, Elizabeth, Brown, Erica Blender, Brown, Cheryl L., Burrell, Ambra, Dash, Anwesh, Ehrlich, Jennifer L., Farma, Simrandeep, Gahring, Kim, Gales, Barbara, Hilgenkamp, Madison R., Jain, Sonal, Kanwar, Kate, Lusk, Jennifer, Meyer, Christopher J., Plomaritas, Katherine, Porter, Joshua, Potts, Jessica, Serratore, Alyssa, Schneider, Elizabeth, Sinha, Vidushi, Strack, P. J., Taylor, Sue, Twombley, Katherine, Van Wyk, Brynna, Wallace, Samantha, Wang, Janet, Woods, Megan, Zinger, Marcia, and Zong, Alison

Published
2024
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22. The Association Between Vasopressin and Adverse Kidney Outcomes in Children and Young Adults Requiring Vasopressors on Continuous Renal Replacement Therapy

Author

Hasson, Denise C., Gist, Katja M., Seo, JangDong, Stenson, Erin K., Kessel, Aaron, Haga, Taiki, LaFever, Sara, Santiago, Maria Jose, Barhight, Matthew, Selewski, David, Ricci, Zaccaria, Ollberding, Nicholas J., Stanski, Natalja L., Ahern, Emily, Akcan Arikan, Ayse, Alhamoud, Issa, Alobaidi, Rashid, Anton-Martin, Pilar, Balani, Shanthi S., Barhight, Matthew, Basalely, Abby, Bigelow, Amee M., Bottari, Gabriella, Cappoli, Andrea, Ciccia, Eileen A., Collins, Michaela, Colosimo, Denise, Cortina, Gerard, Damian, Mihaela A., De la Mata Navazo, Sara, DeAbreu, Gabrielle, Deep, Akash, Ding, Kathy L., Dolan, Kristin J., Fernandez Lafever, Sarah N., Fuhrman, Dana Y., Gelbart, Ben, Gist, Katja M., Gorga, Stephen M., Guzzi, Francesco, Guzzo, Isabella, Haga, Taiki, Harvey, Elizabeth, Hasson, Denise C., Hill-Horowitz, Taylor, Inthavong, Haleigh, Joseph, Catherine, Kaddourah, Ahmad, Kakajiwala, Aadil, Kessel, Aaron D., Korn, Sarah, Krallman, Kelli A., Kwiatkowski, David M., Lee, Jasmine, Lequier, Laurance, Madani Kia, Tina, Mah, Kenneth E., Marinari, Eleonora, Martin, Susan D., Menon, Shina, Mohamed, Tahagod H., Morgan, Catherine, Mottes, Theresa A., Muff-Luett, Melissa A., Namachivayam, Siva, Neumayr, Tara M., Nhan, Jennifer, O’Rourke, Abigail, Ollberding, Nicholas J., Pinto, Matthew G., Qutob, Dua, Raggi, Valeria, Reynaud, Stephanie, Ricci, Zaccaria, Rumlow, Zachary A., Santiago Lozano, María J., See, Emily, Selewski, David T., Serpe, Carmela, Serratore, Alyssa, Shah, Ananya, Shih, Weiwen V., Stella Shin, H., Slagle, Cara L., Solomon, Sonia, Soranno, Danielle E., Srivastava, Rachana, Stanski, Natalja L., Starr, Michelle C., Stenson, Erin K., Strong, Amy E., Taylor, Susan A., Thadani, Sameer V., Uber, Amanda M., Van Wyk, Brynna, Webb, Tennille N., Zang, Huaiyu, Zangla, Emily E., Zappitelli, Michael, Christine, T., Alvarez, E., Bixler, Elizabeth, Brown, Erica Blender, Brown, Cheryl L., Burrell, Ambra, Dash, Anwesh, Ehrlich, Jennifer L., Farma, Simrandeep, Gahring, Kim, Gales, Barbara, Hilgenkamp, Madison R., Jain, Sonal, Kanwar, Kate, Lusk, Jennifer, Meyer, Christopher J., Plomaritas, Katherine, Porter, Joshua, Potts, Jessica, Serratore, Alyssa, Schneider, Elizabeth, Sinha, Vidushi, Strack, P. J., Taylor, Sue, Twombley, Katherine, Van Wyk, Brynna, Wallace, Samantha, Wang, Janet, Woods, Megan, Zinger, Marcia, and Zong, Alison

Published
2024
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27. Human granulocytotropic anaplasmosis-A systematic review and analysis of the literature.

Author

Sophie Schudel, Larissa Gygax, Christian Kositz, Esther Kuenzli, and Andreas Neumayr

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Human granulocytotropic anaplasmosis (HGA) is a zoonotic tick-borne bacterial infection caused by Anaplasma phagocytophilum. While most cases are reported from North America, HGA has been recognized as an emerging disease in several regions of the world in recent decades. Most available data comes from case reports, case series and retrospective studies, while prospective studies and clinical trials are largely lacking. To obtain a clearer picture of the currently known epidemiologic distribution, clinical and paraclinical presentation, diagnostic aspects, complications, therapeutic aspects, and outcomes of HGA, we systematically reviewed the literature and analyzed and summarized the data. Cases of HGA are reported from all continents except from Antarctica. HGA primarily presents as an unspecific febrile illness (88.5% of the cases) often accompanied by thrombocytopenia (71.8% of the cases), abnormal liver injury tests (66.7% of the cases), and leukopenia (49.8% of the cases). Although we found complications reported in a total of 40.5% of the reviewed cases and severe and even life-threatening complications are not infrequent (e.g. acute renal failure 9.8%, multi organ failure 7.5%, ARDS 6.3%, a.o.), sequelae are rare (2.1% of the cases) and lethality is low (3.0% of the cases). Treatment with doxycycline shows a rapid response, with the fever subsiding in the majority of patients within one day of starting treatment. Unlike in human monocytotropic ehrlichiosis (HME), reports of opportunistic infections complicating HGA are rare. HGA during pregnancy does not appear to be associated with unfavorable outcomes. In addition, our analysis provides some evidence that HGA may differ in clinical aspects and laboratory characteristics in different regions of the world. Overall, the data analyzed indicates a non-negligible bias in reporting/publication, so a certain degree of caution is required when generalizing the data.

Published
2024
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29. Impact of an individualized pain plan to treat sickle cell disease vaso-occlusive episodes in the emergency department

Author

Hodges, Jason, Carroll, Yvonne, Smeltzer, Matthew, Nwosu, Chinonyelum, Gurney, James, Potter, Jerlym, Badawy, Sherif, Estepp, Jeremie, Treadwell, Marsha, Vichinsky, Elliott, Wun, Ted, Potter, Michael, Hessler, Danielle, Hagar, Ward, Marsh, Anne, Neumayr, Lynne, Melvin, Cathy, Kanter, Julie, Phillips, Shannon, Adams, Robert, Mueller, Martina, Davila, Caroline, Nirmish Shah, Sarah Bourne., Tanabe, Paula, Bosworth, Hayden, Jackson, George, Richesson, Rachel, Prvu-Bettger, Janet, Masese, Rita, DeMartino, Terri, Kutlar, Abdullah, Gibson, Robert, Snyder, Angela, Fernandez, Maria, Lyon, Matthew, Lottenberg, Richard, Lawrence, Raymona, Gollan, Sierra, Bowman, Latanya, Richardson, Lynne, Glassberg, Jeffrey, Simon, Jena, Loo, George T., Clesca, Cindy, Linton, Elizabeth, Ryan, Gery, Gordeuk, Victor, Hirschtick, Jana, Hsu, Lewis, Krishnan, Jerry, Wandersman, Abe, Colla, Joe, Erwin, Kim, Lamont, Andrea, Norell, Sarah, Saving, Kay, Nocek, Judith, King, Allison, Baumann, Ana, Calhoun, CeCe, Luo, Lingzi, James, Aimee, Abel, Regina, Varughese, Taniya, Kroner, Barbara, Rojas-Smith, Lucia, Hendershot, Tabitha, DiMartino, Lisa, Jacobs, Sara, Battestilli, Whitney, Brambilla, Don, Cox, Lisa, Preiss, Liliana, Pugh, Norma, Telfair, Joseph, Hassell, Kathryn, Thompson, Alexis, Tompkins, William, Smith, Sharon, Luksenberg, Harvey, Peters-Lawrence, Marlene, Boyce, Cheryl, Barfield, Whitney, Werner, Ellen, Siewny, Lauren, Melvin, Cathy L., Carpenter, Christopher R., Hankins, Jane S., Colla, Joseph S., Davila, Natalia, Masese, Rita V., McCuskee, Sarah, and Gollan, S. Siera

Published
2024
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30. Consensus definitions in imported human schistosomiasis: a GeoSentinel and TropNet Delphi study

Author

Tamarozzi, Francesca, Mazzi, Cristina, Antinori, Spinello, Arsuaga, Marta, Becker, Sören L, Bottieau, Emmanuel, Camprubi-Ferrer, Daniel, Caumes, Eric, Duvignaud, Alexandre, Grobusch, Martin P, Jaureguiberry, Stephane, Jordan, Sabine, Mueller, Andreas, Neumayr, Andreas, Perez-Molina, Jose A, Salas-Coronas, Joaquin, Salvador, Fernando, Tomasoni, Lina R, van Hellemond, Jaap J, Vaughan, Stephen D, Wammes, Linda J, Zammarchi, Lorenzo, Buonfrate, Dora, Huits, Ralph, van Lieshout, Lisette, and Gobbi, Federico

Published
2024
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33. Human Taenia martis Neurocysticercosis, Switzerland

Author

Valentin K. Steinsiepe, Marie-Therese Ruf, Marco Rossi, Claudia Fricker-Feer, Danijela Kolenc, Brigitte Suter Buser, Maura Concu, Andreas Neumayr, and Ulf C. Schneider

Subjects
taenia, neurocysticercosis, parasites, tapeworms, parasitic diseases, central nervous system, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Neurocysticercosis is almost exclusively caused by Taenia solium tapeworms. We describe a case of neurocysticercosis in Switzerland caused by infection with Taenia martis, the marten tapeworm, and review all 5 published cases of human infection with the marten tapeworm. In epidemiologically nonplausible cases of neurocysticercosis, zoonotic spillover infections should be suspected.

Published
2023
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34. Caries Detection and Classification in Photographs Using an Artificial Intelligence-Based Model—An External Validation Study

Author

Elisabeth Frenkel, Julia Neumayr, Julia Schwarzmaier, Andreas Kessler, Nour Ammar, Falk Schwendicke, Jan Kühnisch, and Helena Dujic

Subjects
dental caries, diagnosis, validation study, artificial intelligence, deep learning, Medicine (General), R5-920
Abstract

Objective: This ex vivo diagnostic study aimed to externally validate a freely accessible AI-based model for caries detection, classification, localisation and segmentation using an independent image dataset. It was hypothesised that there would be no difference in diagnostic performance compared to previously published internal validation data. Methods: For the independent dataset, 718 dental images representing different stages of carious (n = 535) and noncarious teeth (n = 183) were retrieved from the internet. All photographs were evaluated by the dental team (reference standard) and the AI-based model (test method). Diagnostic performance was statistically determined using cross-tabulations to calculate accuracy (ACC), sensitivity (SE), specificity (SP) and area under the curve (AUC). Results: An overall ACC of 92.0% was achieved for caries detection, with an ACC of 85.5–95.6%, SE of 42.9–93.3%, SP of 82.1–99.4% and AUC of 0.702–0.909 for the classification of caries. Furthermore, 97.0% of the cases were accurately localised. Fully and partially correct segmentation was achieved in 52.9% and 44.1% of the cases, respectively. Conclusions: The validated AI-based model showed promising diagnostic performance in detecting and classifying caries using an independent image dataset. Future studies are needed to investigate the validity, reliability and practicability of AI-based models using dental photographs from different image sources and/or patient groups.

Published
2024
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37. What was Hybrid? A Systematic Review of Hybrid Collaboration and Meetings Research

Author

Neumayr, Thomas, Saatci, Banu, Rintel, Sean, Klokmose, Clemens Nylandsted, and Augstein, Mirjam

Subjects
Computer Science - Human-Computer Interaction
Abstract

Interest in hybrid collaboration and meetings (HCM), where several co-located participants engage in coordinated work with remote participants, is gaining unprecedented momentum after the rapid shift in working from home due to the COVID-19 pandemic. However, while the interest is new, researchers have been exploring HCM phenomena for decades, albeit dispersed across diverse research traditions, using different terms, definitions, and frameworks. In this article, we present a systematic literature review of the contexts and tools of HCM in the ACM Digital Library. We obtained approximately 1,200 results, which were narrowed down to 62 key articles. We report on the terms, citations, venues, authors, domains, study types, and data of these publications and present a taxonomic overview based on their reported hybrid settings' actual characteristics. We discuss why the SLR resulted in a relatively small number of publications, and then as a corollary, discuss how some excluded high-profile publications flesh out the SLR findings to provide important additional concepts. The SLR itself covers the ACM until November 2019, so our discussion also includes relevant 2020 and 2021 publications. The end result is a baseline that researchers and designers can use in shaping the post-COVID-19 future of HCM systems.

Published
2021

38. An evaluation of the outcomes associated with peritoneal catheter use in neonates undergoing cardiac surgery: A multicenter study

Author

Zang, Huaiyu, Winlaw, David, Bailly, David, Goldstein, Stuart, Gist, Katja, Brandewie, Katie L., Bhat, Priya N., Diddle, John W., Ghbeis, Muhammad, Prodhan, Parthak, Garcia, Xiomara, Ramer, Shannon, Albertson, Mindy, Rodriquez, Zahidee, Lukacs, Mary, Gaies, Michael, Freytag, Joshua, Sammons, Amanda, Abraha, Hideat, Butcher, John, Zanaboni, Dominic, Sanchez de Toledo, Joan, Domnina, Yuliya A., Saenz, Lucas, Baust, Tracy, Kluck, Jane, Sasaki, Jun, Raees, Aanish, O'Neil, Erika R., Lasa, Javier J., Phillips, Patrick A., Hock, Kristal M., Valentine, Kevin, Tadphale, Sachin, Buckley, Jason R., Schroeder, Luke, Clarke, Shanelle, Zhang, Wenying, Smith, Andrew, Absi, Mohammed, Askenazi, David J., Duncan, Linda, Bertrandt, Rebecca A., Sosa, Lisa J., O’Neal, Erika R., Doman, Tammy, Viers, Suzanne, Smith, Andrew H., Bailly, David K., Kwiatkowski, David M., Alten, Jeffrey A., Mah, Kenneth E., Selewski, David T., Raymond, Tia T., Afonso, Natasha S., Blinder, Joshua J., Coghill, Matthew T., Cooper, David S., Koch, Joshua D., Krawczeski, Catherine D., Morales, David L.S., Neumayr, Tara M., Rahman, A.K.M. Fazlur, Reichle, Garrett, Tabbutt, Sarah, Webb, Tennille N., and Borasino, Santiago

Published
2024
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39. Cardiac cystic echinococcosis-A systematic review and analysis of the literature.

Author

Simone Bumann, Esther Kuenzli, Raffaella Lissandrin, Enrico Brunetti, Sam Goblirsch, Lars Henning, Francesca Tamarozzi, and Andreas Neumayr

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.

Published
2024
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40. Cardiac Surgery-Associated Acute Kidney Injury in Neonates Undergoing the Norwood Operation: Retrospective Analysis of the Multicenter Neonatal and Pediatric Heart and Renal Outcomes Network Dataset, 2015–2018

Author

Bertrandt, Rebecca A., Gist, Katja, Hasson, Denise, Zang, Huaiyu, Reichle, Garrett, Krawczeski, Catherine, Winlaw, David, Bailly, David, Goldstein, Stuart, Selewski, David, Alten, Jeffrey, Brandewie, Katie L., Diddle, John W., Ghbeis, Muhammad, Mah, Kenneth E., Neumayr, Tara M., Raymond, Tia T., Prodhan, Parthak, Garcia, Xiomara, Ramer, Shannon, Albertson, Mindy, Cooper, David, Rodriquez, Zahidee, Lukacs, Mary, Gaies, Michael, Sammons, Amanda, Sanchez de Toledo, Joan, Domnina, Yuliya A., Saenz, Lucas, Baust, Tracy, Kluck, Jane, Koch, Joshua D., Sasaki, Jun, Raees, Aanish, Afonso, Natasha S., O’Neal, Erika R., Lasa, Javier J., Phillips, Patrick A., Hock, Kristal, Borasino, Santiago, Kwiatkowski, David M., Blinder, Joshua, Valentine, Kevin M., Tadphale, Sachin D., Buckley, Jason R., Clarke, Shanelle A., Zhang, Wenying, Smith, Andrew, Absi, Mohammed, and Askenazi, David J.

Published
2024
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43. Continuous Kidney Replacement Therapy and Survival in Children and Young Adults: Findings From the Multinational WE-ROCK Collaborative

Author

Ahern, Emily, Arikan, Ayse Akcan, Alhamoud, Issa, Alobaidi, Rashid, Anton-Martin, Pilar, Barhight, Matthew, Basalely, Abby, Bigelow, Amee M., Bottari, Gabriella, Collins, Michaela, Colosimo, Denise, Cortina, Gerard, Damian, Mihaela A., Navazo, Sara de la Mata, DeAbreu, Gabrielle, Deep, Akash, Ding, Kathy L., Dolan, Kristin J., Fernandez Lafever, Sarah N., Fuhrman, Dana Y., Gelbart, Ben, Gorga, Stephen M., Guzzi, Francesco, Guzzo, Isabella, Haga, Taiki, Harvey, Elizabeth, Hasson, Denise C., Hill-Horowitz, Taylor, Inthavong, Haleigh, Kaddourah, Ahmad, Korn, Sarah, Krallman, Kelli A., Kwiatkowski, David M., Lee, Jasmine, Lequier, Laurance, Kia, Tina Madani, Mah, Kenneth E., Marinari, Eleonora, Martin, Susan D., Mohamed, Tahagod H., Morgan, Catherine, Mottes, Theresa A., Namachivayam, Siva, Neumayr, Tara M., Nhan, Jennifer, O’Rourke, Abigail, Qutob, Dua, Raggi, Valeria, Ricci, Zaccaria, Rumlow, Zachary A., See, Emily, Selewski, David T., Serpe, Carmela, Serratore, Alyssa, Shah, Ananya, Shin, H. Stella, Soranno, Danielle E., Stanski, Natalja L., Stenson, Erin K., Strong, Amy E., Taylor, Susan A., Thadani, Sameer V., Uber, Amanda M., Van Wyk, Brynna, Zangla, Emily E., Zappitelli, Michael, Starr, Michelle C., Gist, Katja M., Zang, Huaiyu, Ollberding, Nicholas J., Balani, Shanthi, Cappoli, Andrea, Ciccia, Eileen, Joseph, Catherine, Kakajiwala, Aadil, Kessel, Aaron, Muff-Luett, Melissa, Santiago Lozano, María J., Pinto, Matthew, Reynaud, Stephanie, Solomon, Sonia, Slagle, Cara, Srivastava, Rachana, Shih, Weiwen V., Webb, Tennille, and Menon, Shina

Published
2024
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44. Assessment of fluid balance after neonatal cardiac surgery: a description of intake/output vs. weight-based methods

Author

Neumayr, Tara M., Alten, Jeffrey A., Bailly, David K., Bhat, Priya N., Brandewie, Katie L., Diddle, J. Wesley, and Ghbeis, Muhammad

Subjects
Water-electrolyte balance (Physiology) -- Evaluation, Heart -- Surgery, Children -- Surgery, Osmoregulation -- Evaluation, Health
Abstract

Background Fluid overload associates with poor outcomes after neonatal cardiac surgery, but consensus does not exist for the most clinically relevant method of measuring fluid balance (FB). While weight change-based FB (FB-W) is standard in neonatal intensive care units, weighing infants after cardiac surgery may be challenging. We aimed to identify characteristics associated with obtaining weights and to understand how intake/output-based FB (FB-IO) and FB-W compare in the early postoperative period in this population. Methods Observational retrospective study of 2235 neonates undergoing cardiac surgery from 22 hospitals comprising the NEonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) database. Results Forty-five percent (n = 998) of patients were weighed on postoperative day (POD) 2, varying from 2 to 98% among centers. Odds of being weighed were lower for STAT categories 4 and 5 (OR 0.72; 95% CI 0.53-0.98), cardiopulmonary bypass (0.59; 0.42-0.83), delayed sternal closure (0.27; 0.19-0.38), prophylactic peritoneal dialysis use (0.58; 0.34-0.99), and mechanical ventilation on POD 2 (0.23; 0.16-0.33). Correlation between FB-IO and FB-W was weak for every POD 1-6 and within the entire cohort (correlation coefficient 0.15; 95% CI 0.12-0.17). FB-W measured higher than paired FB-IO (mean bias 12.5%; 95% CI 11.6-13.4%) with wide 95% limits of agreement (- 15.4-40.4%). Conclusions Weighing neonates early after cardiac surgery is uncommon, with significant practice variation among centers. Patients with increased severity of illness are less likely to be weighed. FB-W and FB-IO have weak correlation, and further study is needed to determine which cumulative FB metric most associates with adverse outcomes. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information., Author(s): Tara M. Neumayr [sup.1] , Jeffrey A. Alten [sup.2] , David K. Bailly [sup.3] , Priya N. Bhat [sup.4] , Katie L. Brandewie [sup.2] , J. Wesley Diddle [sup.5] [...]

Published
2023
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46. In vivo measurement of pediatric extracorporeal oxygenator insensible losses; a single center pilot study

Author

Tess L. Suttles, John Poe, Tara M. Neumayr, and Ahmed S. Said

Subjects
extracorporeal membrane oxygenation, intensive care units, pediatric, insensible losses, fluid overload, Pediatrics, RJ1-570
Abstract

IntroductionFluid overload on Extracorporeal Membrane Oxygenation (ECMO) is associated with worse outcomes. Previous in vitro studies have attempted to quantify oxygenator-related insensible losses, as failure to account for this fluid loss may lead to inaccurate fluid balance assessment and potentially harmful clinical management, such as unnecessary exposure to diuretics, slow continuous ultrafiltration (SCUF), or continuous kidney replacement therapy (CKRT). We performed a novel in vivo study to measure insensible fluid losses in pediatric ECMO patients.MethodsPediatric ECMO patients were approached over eleven months in the pediatric and cardiac intensive care units. The water content of the oxygenator inflow sweep gas and exhaust gas were calculated by measuring the ambient temperature and relative humidity at frequent intervals and various sweep flow.Results and discussionNine subjects were enrolled, generating 431 data points. The cohort had a median age of 11 years IQR [0.83, 13], weight of 23.2 kg IQR [6.48, 44.28], and body surface area of 0.815 m2 IQR [0.315, 1.3725]. Overall, the cohort had a median sweep of 2.5 L/min [0.9, 4], ECMO flow of 3.975 L/m2/min [0.75, 4.51], and a set ECMO temperature of 37 degrees Celsius [36.6, 37.2]. The calculated net water loss per L/min of sweep was 75.93 ml/day, regardless of oxygenator size or patient weight. There was a significant difference in median documented vs. calculated fluid balance incorporating the insensible fluid loss, irrespective of oxygenator size (pediatric oxygenator: 7.001 ml/kg/day [−12.37, 28.59] vs. −6.11 ml/kg/day [−17.44, 13.01], respectively, p = 0.005 and adult oxygenator: 14.36 ml/kg/day [1.54, 25.77] and 9.204 ml/kg/day [−1.28, 22.05], respectively, p =

Published
2024
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48. Multiple liver abscesses with isolation of streptococcus intermedius related to a pyogenic dental infection in an immuno-competent patient

Author

Neumayr A, Kubitz R, Bode JG, Bilk P, and Häussinger D

Subjects
Streptococcus intermedius, Streptococcus anginosus, liver abscess, dental infection, Medicine
Abstract

Abstract Introduction Streptococcus intermedius - a member of the Streptococcus anginosus group - is part of the normal microbial flora of the oral cavity. Despite being regarded as a harmless apathogenic commensal, Streptococcus intermedius has been described to cause abscesses in various locations of the body. Case Presentation We report the clinical case and course of treatment of a 18-year-old male patient presenting with multiple hepatic abscesses associated with an untreated pyogenic dental infection. Conclusion Streptococcus intermedius can cause liver abscesses emerging from dental infectious foci even in previously healthy patients without underlying innate or aquired immunodeficiency. The case illustrates the potential danger and underestimated risk associated with untreated dental infections.

Published
2010
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