435 results on '"Truog P"'
Search Results
2. Transpyloric feeding is associated with adverse in-hospital outcomes in infants with severe bronchopulmonary dysplasia
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Levin, Jonathan C., Kielt, Matthew J., Hayden, Lystra P., Conroy, Sara, Truog, William E., Guaman, Milenka Cuevas, Abman, Steven H., Nelin, Leif D., Rosen, Rachel L., and Leeman, Kristen T.
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- 2024
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3. Initial Laparotomy Versus Peritoneal Drainage in Extremely Low Birthweight Infants With Surgical Necrotizing Enterocolitis or Isolated Intestinal Perforation: A Multicenter Randomized Clinical Trial.
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Blakely, Martin L, Tyson, Jon E, Lally, Kevin P, Hintz, Susan R, Eggleston, Barry, Stevenson, David K, Besner, Gail E, Das, Abhik, Ohls, Robin K, Truog, William E, Nelin, Leif D, Poindexter, Brenda B, Pedroza, Claudia, Walsh, Michele C, Stoll, Barbara J, Geller, Rachel, Kennedy, Kathleen A, Dimmitt, Reed A, Carlo, Waldemar A, Cotten, C Michael, Laptook, Abbot R, Van Meurs, Krisa P, Calkins, Kara L, Sokol, Gregory M, Sanchez, Pablo J, Wyckoff, Myra H, Patel, Ravi M, Frantz, Ivan D, Shankaran, Seetha, D'Angio, Carl T, Yoder, Bradley A, Bell, Edward F, Watterberg, Kristi L, Martin, Colin A, Harmon, Carroll M, Rice, Henry, Kurkchubasche, Arlet G, Sylvester, Karl, Dunn, James CY, Markel, Troy A, Diesen, Diana L, Bhatia, Amina M, Flake, Alan, Chwals, Walter J, Brown, Rebeccah, Bass, Kathryn D, St Peter, Shawn D, Shanti, Christina M, Pegoli, Walter, Skarda, David, Shilyansky, Joel, Lemon, David G, Mosquera, Ricardo A, Peralta-Carcelen, Myriam, Goldstein, Ricki F, Vohr, Betty R, Purdy, Isabell B, Hines, Abbey C, Maitre, Nathalie L, Heyne, Roy J, DeMauro, Sara B, McGowan, Elisabeth C, Yolton, Kimberly, Kilbride, Howard W, Natarajan, Girija, Yost, Kelley, Winter, Sarah, Colaizy, Tarah T, Laughon, Matthew M, Lakshminrusimha, Satyanarayana, and Higgins, Rosemary D
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Perinatal Period - Conditions Originating in Perinatal Period ,Clinical Research ,Infant Mortality ,Rare Diseases ,Digestive Diseases ,Preterm ,Low Birth Weight and Health of the Newborn ,Pediatric ,Clinical Trials and Supportive Activities ,Good Health and Well Being ,Drainage ,Enterocolitis ,Necrotizing ,Feasibility Studies ,Female ,Humans ,Infant ,Extremely Low Birth Weight ,Infant ,Newborn ,Infant ,Premature ,Infant ,Premature ,Diseases ,Intestinal Perforation ,Laparotomy ,Male ,Neurodevelopmental Disorders ,Survival Rate ,Treatment Outcome ,isolated intestinal perforation ,neonatal surgery ,premature infant ,randomized clinical trial ,surgical necrotizing enterocolitis ,Eunice Kennedy Shriver National Institute of Child Health ,Human Development Neonatal Research Network ,Medical and Health Sciences ,Surgery - Abstract
ObjectiveThe aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP).Summary background dataThe impact of initial laparotomy versus peritoneal drainage for NEC or IP on the rate of death or NDI in extremely low birth weight infants is unknown.MethodsWe conducted the largest feasible randomized trial in 20 US centers, comparing initial laparotomy versus peritoneal drainage. The primary outcome was a composite of death or NDI at 18 to 22 months corrected age, analyzed using prespecified frequentist and Bayesian approaches.ResultsOf 992 eligible infants, 310 were randomized and 96% had primary outcome assessed. Death or NDI occurred in 69% of infants in the laparotomy group versus 70% with drainage [adjusted relative risk (aRR) 1.0; 95% confidence interval (CI): 0.87-1.14]. A preplanned analysis identified an interaction between preoperative diagnosis and treatment group (P = 0.03). With a preoperative diagnosis of NEC, death or NDI occurred in 69% after laparotomy versus 85% with drainage (aRR 0.81; 95% CI: 0.64-1.04). The Bayesian posterior probability that laparotomy was beneficial (risk difference
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- 2021
4. Umbilical Cord Milking vs Delayed Cord Clamping and Associations with In-Hospital Outcomes among Extremely Premature Infants
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Kumbhat, Neha, Eggleston, Barry, Davis, Alexis S, DeMauro, Sara B, Van Meurs, Krisa P, Foglia, Elizabeth E, Lakshminrusimha, Satyan, Walsh, Michele C, Watterberg, Kristi L, Wyckoff, Myra H, Das, Abhik, Handley, Sara C, Network, Generic Database Subcommittee of the National Institute of Child Health and Human Development Neonatal Research, Polin, Richard A, Laptook, R, Keszler, Martin, Hensman, Angelita M, Vieira, Elisa, St. Pierre, Lucille, Hibbs, Anna Maria, Truog, William E, Pallotto, Eugenia K, Parimi, Prabhu S, Gauldin, Cheri, Holmes, Anne, Knutson, Allison, Gaetano, Lisa, Poindexter, Brenda B, Schibler, Kurt, Merhar, Stephanie L, Grisby, Cathy, Kirker, Kristin, Cotten, C Michael, Goldberg, Ronald N, Finkle, Joanne, Fisher, Kimberley A, Laughon, Matthew M, Bose, Carl L, Bernhardt, Janice, Bose, Gennie, Clark, Cindy, Kicklighter, Stephen D, Rhodes-Ryan, Ginger, White, Donna, Carlton, David P, Patel, Ravi M, Loggins, Yvonne, Mackie, Colleen, Bottcher, Diane I, Bremer, Andrew A, Higgins, Rosemary D, Archer, Stephanie Wilson, Sokol, Gregory M, Herron, Dianne E, Tyson, Jon E, Khan, Amir M, Kennedy, Kathleen A, Pedrozza, Claudia, Eason, Elizabeth, Stephens, Emily K, McDavid, Georgia E, Martin, Karen, Hall, Donna, Wright, Sharon L, Sánchez, Pablo J, Nelin, Leif D, Jadcherla, Sudarshan R, Luzader, Patricia, Clark, Erna, Gutentag, Julie, Park, Courtney, Shadd, Julie C, Stein, Melanie, Baugher, Hallie, McCool, Jacqueline, Gantz, Marie G, Bann, Carla M, Wallace, Dennis, Zaterka-Baxter, Kristin M, Gabrio, Jenna, Leblond, David, Auman, Jeanette O'Donnell, Stevenson, David K, Chock, Valerie Y, Ball, M Bethany, Proud, Melinda S, Reichert, Elizabeth N, Williams, R Jordan, Carlo, Waldemar A, Ambalavanan, Namasivayam, Collins, Monica V, Cosby, Shirley S, McNair, Tara, Devaskar, Uday, Garg, Meena, Chanlaw, Teresa, Geller, Rachel, Bell, Edward F, Colaizy, Tarah T, and Ellsbury, Dan L
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Paediatrics ,Biomedical and Clinical Sciences ,Prevention ,Preterm ,Low Birth Weight and Health of the Newborn ,Infant Mortality ,Clinical Research ,Neurosciences ,Cardiovascular ,Clinical Trials and Supportive Activities ,Perinatal Period - Conditions Originating in Perinatal Period ,Pediatric ,Reproductive health and childbirth ,Good Health and Well Being ,Cerebral Intraventricular Hemorrhage ,Constriction ,Female ,Gestational Age ,Hospital Mortality ,Humans ,Infant ,Extremely Premature ,Infant ,Newborn ,Male ,Retrospective Studies ,Umbilical Cord ,Generic Database Subcommittee of the National Institute of Child Health and Human Development Neonatal Research Network ,Neonatal Research Network ,intraventricular hemorrhage ,placental transfusion ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo compare in-hospital outcomes after umbilical cord milking vs delayed cord clamping among infants
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- 2021
5. How collaboration between bioethicists and neuroscientists can advance research
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Hyun, Insoo, Scharf-Deering, J. C., Sullivan, Sarah, Aach, John Dennis, Arlotta, Paola, Baum, Matthew L., Church, George M., Goldenberg, Aaron, Greely, Henry T., Khoshakhlagh, Parastoo, Kohman, Richie E., Lopes, Melissa, Lowenthal, Caroline, Lu, Aric, Ng, Alex H. M., Pasca, Sergiu P., Paulsen, Bruna, Pigoni, Martina, Scott, Christopher T., Silbersweig, David A., Skylar-Scott, Mark A., Truog, Robert D., and Lunshof, Jeantine E.
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- 2022
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6. Initiation and Withdrawal of Invasive Ventilation for Patients with Amyotrophic Lateral Sclerosis: A Narrative Literature Review
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Reina Ozeki-Hayashi, Eisuke Nakazawa, Robert Truog, and Akira Akabayashi
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amyotrophic lateral sclerosis ,narrative literature review ,invasive ventilation with tracheostomy ,ethics ,withdrawal ,Science - Abstract
Decisions regarding invasive ventilation with tracheostomy (TIV) in patients with amyotrophic lateral sclerosis (ALS) involve serious ethical issues. Cultural differences in the attitudes of patients, caregivers, and physicians toward TIV initiation and withdrawal decisions have been analyzed based on a narrative review approach, comparing the situation between Japan and the U.S. Three main issues were identified regarding the implementation of TIV. The first is the lack of Advance Care Planning. Second, some patients may choose TIV based on the wishes of their physicians or caregivers, even if the patients themselves do not want TIV in the Japanese context. Third is the influence of patient associations, which advocate for the protection of patients’ rights. Next, this study identifies the following issues related to TIV discontinuation. The main concern here is cultural differences in legislation and ethical intuitions regarding the discontinuation of TIV. The treatment guidelines for patients with ALS advise physicians to reassure patients that TIV can be withdrawn at any point. However, TIV withdrawal is not explicitly discussed in Japan. Moreover, Japanese ALS treatment guidelines state that ventilation withdrawal is currently impossible, due to a lack of legal support. Most Japanese physicians have told patients that they are not allowed to stop ventilation via such a request. Unlike in the U.S., withholding and withdrawing ventilators are not ethically equivalent in Japan. In conclusion, the decision-making process regarding TIV is difficult, not only for the patients and caregivers, but also for physicians. Even if patients are legally entitled to refuse unwanted treatment, there have been cases in which Japanese physicians have felt an ethical dilemma in stopping TIV for patients with ALS. However, few studies have investigated in detail why physicians oppose the patient’s right to discontinue TIV in Japan.
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- 2022
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7. Genetic variation in CRHR1 is associated with short-term respiratory response to corticosteroids in preterm infants at risk for bronchopulmonary dysplasia
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Lewis, Tamorah, Truog, William, Norberg, Mike, Ballard, Philip L, and Torgerson, Dara
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Paediatrics ,Biomedical and Clinical Sciences ,Neonatal Respiratory Distress ,Preterm ,Low Birth Weight and Health of the Newborn ,Clinical Research ,Prevention ,Genetics ,Lung ,Pediatric ,Perinatal Period - Conditions Originating in Perinatal Period ,Infant Mortality ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Respiratory ,Good Health and Well Being ,Adrenal Cortex Hormones ,Bronchopulmonary Dysplasia ,Dexamethasone ,Female ,Genetic Markers ,Genotype ,Glucocorticoids ,Humans ,Hydrocortisone ,Infant ,Newborn ,Infant ,Premature ,Introns ,Male ,Multivariate Analysis ,Pharmacogenetics ,Phenotype ,Polymorphism ,Single Nucleotide ,Receptors ,Corticotropin-Releasing Hormone ,Risk ,Surface-Active Agents ,TOLSURF Study Group ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Pediatrics - Abstract
BackgroundBronchopulmonary dysplasia (BPD) is an orphan disease and advances in prevention and treatment are lacking. The clinical efficacy of systemic corticosteroid therapy to reduce the severity of lung disease and BPD is highly variable. Our objective was to assess whether candidate SNPs in corticosteroid metabolism and response genes are associated with short-term phenotypic response to systemic corticosteroids in infants at high risk for BPD.MethodsPharmacogenetic analysis of data from a large randomized controlled trial (TOLSURF) in infants treated with dexamethasone or hydrocortisone using multivariate linear regression. The primary outcome was a change in respiratory severity score (RSS, mean airway pressure x FiO2) at day 7 of corticosteroid treatment.Resultsrs7225082 in the intron of CRHR1 is significantly associated with the magnitude of decrease in RSS 7 days after starting treatment with systemic corticosteroid (meta-analysis P = 2.8 × 10-4). Each T allele at rs7225082 is associated with a smaller absolute change in RSS at day 7, i.e., less response to systemic corticosteroids.ConclusionsGenetic variability is associated with corticosteroid responsiveness with regard to respiratory status in preterm infants. Identification of genetic markers of corticosteroid responsiveness may allow for therapeutic individualization, with the goal of optimizing the risk-to-benefit ratio for an individual child.
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- 2019
8. Surfactant status and respiratory outcome in premature infants receiving late surfactant treatment
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Ballard, Philip L, Keller, Roberta L, Truog, William E, Chapin, Cheryl, Horneman, Hart, Segal, Mark R, Ballard, Roberta A, and Tolsurf Investigators
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Paediatrics ,Biomedical and Clinical Sciences ,Infant Mortality ,Preterm ,Low Birth Weight and Health of the Newborn ,Perinatal Period - Conditions Originating in Perinatal Period ,Pediatric ,Clinical Research ,Lung ,Neonatal Respiratory Distress ,Birth Weight ,Bronchopulmonary Dysplasia ,Drug Administration Schedule ,Female ,Humans ,Infant ,Infant ,Newborn ,Infant ,Premature ,Infant ,Premature ,Diseases ,Male ,Phospholipids ,Pulmonary Surfactant-Associated Protein B ,Pulmonary Surfactants ,Respiration ,Tolsurf Investigators ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Pediatrics - Abstract
BackgroundMany premature infants with respiratory failure are deficient in surfactant, but the relationship to occurrence of bronchopulmonary dysplasia (BPD) is uncertain.MethodsTracheal aspirates were collected from 209 treated and control infants enrolled at 7-14 days in the Trial of Late Surfactant. The content of phospholipid, surfactant protein B, and total protein were determined in large aggregate (active) surfactant.ResultsAt 24 h, surfactant treatment transiently increased surfactant protein B content (70%, p
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- 2019
9. Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants.
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Speer, Allison L., Lally, Kevin P., Pedroza, Claudia, Yuxin Zhang, Poindexter, Brenda B., Chwals, Walter J., Hintz, Susan R., Besner, Gail E., Stevenson, David K., Ohls, Robin K., Truog, William E., Stoll, Barbara J., Rysavy, Matthew A., Das, Abhik, Tyson, Jon E., and Blakely, Martin L.
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Objective: We aimed to determine the incidence of growth failure in infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) and whether initial laparotomy versus peritoneal drainage (PD) impacted the likelihood of growth failure. Summary Background Data: Infants with surgical NEC and SIP have high mortality, and most have neurodevelopmental impairment and poor growth. Existing literature on growth outcomes for these infants is limited. Methods: This is a preplanned secondary study of the Necrotizing Enterocolitis Surgery Trial dataset. The primary outcome was growth failure (Z-score for weight < -2.0) at 18 to 22 months. We used logistic regression, including diagnosis and treatment, as covariates. Secondary outcomes were analyzed using the Fisher exact or Pearson χ² test for categorical variables and the Wilcoxon rank sum test or one-way ANOVA for continuous variables. Results: Among 217 survivors, 207 infants (95%) had primary outcome data. Growth failure at 18 to 22 months occurred in 24/50 (48%) of NEC infants versus 65/157 (42%) SIP (P=0.4). The mean weight-for-age Z-score at 18 to 22 months in NEC infants was -2.05±0.99 versus -1.84±1.09 SIP (P= 0.2), and the predicted mean weight-for-age Z-score SIP (Beta -0.27; 95% CI: -0.53, -0.01; P=0.041). Median declines in weight-for-age Z-score between birth and 18 to 22 months were significant in all infants but most severe (>2) in NEC infants (P=0.2). Conclusions: This first ever prospective study of growth outcomes in infants with surgical NEC or SIP demonstrates that growth failure is very common, especially in infants with NEC, and persists at 18-22 months. [ABSTRACT FROM AUTHOR]
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- 2024
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10. The Effects of Moral Distress on Resilience in Pediatric Emergency Department Nurses.
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Sexton, Jessica R., Truog, Amy W., Kelly-Weeder, Susan, and Loftin, Collette
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Moral distress is widespread in health care, and nurses working in high-pressure environments, such as emergency departments, experience stress at high rates. Understanding how moral distress affects pediatric emergency nursing care is essential to moderate its negative impacts. Increased resilience has been promoted as a tool to mitigate moral distress. The purpose of this study, conducted prior to the pandemic, was to examine patterns of moral distress and the impact of moral distress on resilience among pediatric emergency nurses. A cross-sectional exploratory study of pediatric emergency nurses was performed. Moral Distress Scale-Revised (Pediatric) and Connor-Davidson Resilience Scale 25© scores were collected and calculated. Exploratory factor analysis with principal components was used to identify patterns of moral distress that impact resilience. Four distinct patterns of moral distress that impact resilience were identified: (1) incompetent practice, (2) incongruent truth-telling, (3) potentially inappropriate care, and (4) discordant health care teams. Our study was the first to identify 4 patterns of moral distress in pediatric emergency nurses. As a result, actions to promote resilience include: (1) supporting competent practice, (2) upholding appropriate truth-telling, (3) recognizing and addressing potentially inappropriate care, and (4) building concordant health care teams and systems. This pre-pandemic data provides a foundational understanding of the relationship between moral distress and resilience in pediatric emergency nurses. Identifying factors of moral distress that impact resilience has significant implications for pediatric emergency nursing, including the development of future initiatives, education, and research. [ABSTRACT FROM AUTHOR]
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- 2024
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11. A comparison of newer classifications of bronchopulmonary dysplasia: findings from the Children’s Hospitals Neonatal Consortium Severe BPD Group
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Vyas-Read, Shilpa, Logan, J. Wells, Cuna, Alain C., Machry, Joana, Leeman, Kristin T., Rose, Rebecca S., Mikhael, Michel, Wymore, Erica, Ibrahim, John W., DiGeronimo, Robert J., Yallapragada, Sushmita, Haberman, Beth E., Padula, Michael A., Porta, Nicolas F., Murthy, Karna, Nelin, Leif D., Coghill, Carl H., Zaniletti, Isabella, Savani, Rashmin C., Truog, William, Engle, William A., and Lagatta, Joanne M.
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- 2022
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12. Qualitative indications for tracheostomy and chronic mechanical ventilation in patients with severe bronchopulmonary dysplasia
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Yallapragada, Sushmita, Savani, Rashmin C., Mūnoz-Blanco, Sara, Lagatta, Joanne M., Truog, William E., Porta, Nicolas F. M., Nelin, Leif D., Zhang, Huayan, Vyas-Read, Shilpa, DiGeronimo, Robert, Natarajan, Girija, Wymore, Erica, Haberman, Beth, Machry, Joana, Potoka, Karin, and Murthy, Karna
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- 2021
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13. Building Capacity for a Global Genome Editing Observatory: Institutional Design
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Saha, Krishanu, Hurlbut, J Benjamin, Jasanoff, Sheila, Ahmed, Aziza, Appiah, Anthony, Bartholet, Elizabeth, Baylis, Françoise, Bennett, Gaymon, Church, George, Cohen, I Glenn, Daley, George, Finneran, Kevin, Hurlbut, William, Jaenisch, Rudolf, Lwoff, Laurence, Kimes, John Paul, Mills, Peter, Moses, Jacob, Park, Buhm Soon, Parens, Erik, Salzman, Rachel, Saxena, Abha, Simmet, Hilton, Simoncelli, Tania, Snead, O Carter, Rajan, Kaushik Sunder, Truog, Robert D, Williams, Patricia, and Woopen, Christiane
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Human Genome ,Genetics ,Capacity Building ,Gene Editing ,Global Health ,Humans ,CRISPR ,bioethics ,ethics ,genome editing ,science and technology studies ,science policy ,Biological Sciences ,Engineering ,Technology ,Biotechnology - Abstract
A new infrastructure is urgently needed at the global level to facilitate exchange on key issues concerning genome editing. We advocate the establishment of a global observatory to serve as a center for international, interdisciplinary, and cosmopolitan reflection. This article is the second of a two-part series.
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- 2018
14. Building Capacity for a Global Genome Editing Observatory: Conceptual Challenges
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Hurlbut, J Benjamin, Jasanoff, Sheila, Saha, Krishanu, Ahmed, Aziza, Appiah, Anthony, Bartholet, Elizabeth, Baylis, Françoise, Bennett, Gaymon, Church, George, Cohen, I Glenn, Daley, George, Finneran, Kevin, Hurlbut, William, Jaenisch, Rudolf, Lwoff, Laurence, Kimes, John Paul, Mills, Peter, Moses, Jacob, Park, Buhm Soon, Parens, Erik, Salzman, Rachel, Saxena, Abha, Simmet, Hilton, Simoncelli, Tania, Snead, O Carter, Rajan, Kaushik Sunder, Truog, Robert D, Williams, Patricia, and Woopen, Christiane
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Genetics ,Human Genome ,Bioethical Issues ,Gene Editing ,Humans ,CRISPR ,bioethics ,ethics ,gene editing ,science and technology studies ,science policy ,Biological Sciences ,Engineering ,Technology ,Biotechnology - Abstract
A new infrastructure is urgently needed at the global level to facilitate exchange on key issues concerning genome editing. We advocate the establishment of a global observatory to serve as a center for international, interdisciplinary, and cosmopolitan reflection. This article is the first of a two-part series.
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- 2018
15. Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial
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Wai, Katherine C, Hibbs, Anna M, Steurer, Martina A, Black, Dennis M, Asselin, Jeanette M, Eichenwald, Eric C, Ballard, Philip L, Ballard, Roberta A, Keller, Roberta L, Group, Trial of Late Surfactant Study, Strong, Suzanne Hamilton, Immamura-Ching, Jill, Orfanos-Villalobos, Margaret, Williams, Cassandra, Durand, David J, Merrill, Jeffrey D, Horton, Dolia, Pacello, Loretta, Willard, April, Truog, William E, Gauldin, Cheryl, Holmes, Anne, Johnson, Patrice, Meinert, Kerrie, Reynolds, Anne Marie, Lucie, Janine, Conway, Patrick, Sacilowski, Michael, Leadersdorff, Michael, Orbank, Pam, Wynn, Karen, Steinhorn, Robin H, deUngria, Maria, Khan, Janine Yasmin, Hamann, Karin, Schau, Molly, Hopkins, Brad, Jenson, James, Garcia, Carmen, Parekh, Aruna, Shariff, Jila, McGovern, Rose, Adelman, Jeff, Combs, Adrienne, Tjersland, Mary, Mayock, Dennis E, Howland, Elizabeth, Walker, Susan, Longoria, Jim, Meo, Holly, Khan, Amir, McDavid, Georgia, Burson, Katrina, Hinojosa, Richard, Johnson, Christopher, Martin, Karen, Martin, Sarah, Rogers, Shawna, Wright, Sharon, Hudak, Mark L, Barnette, Kimberly, Kellum, Amanda, Burcke, Michelle, Hayes, Christie, Chadwick, Stephanie, Howard, Danielle, Kennedy, Carla, Prince, Renee, Helderman, Jennifer, O'Shea, T Michael, Stefanescu, Beatrice, Warden, Kelly, Brown, Patty, Griffin, Jennifer, Conley, Laura, Bendel, Catherine M, Georgieff, Michael, Davern, Bridget, Mills, Marla, Ritter, Sharon, Wagner, Carol, Ryan, Rita M, Fanning, Deanna, Roberson, Jimmy, Mammel, Mark C, Lampland, Andrea, Meyers, Pat, Brey, Angela, Bendel-Stenzel, Ellen M, Mulrooney, Neil, Worwa, Cathy, Dixon, Pam, Ebert, Gerald, Hejl, Cathy, Maxwell, Molly, McCullough, Kristin, Dhanireddy, Ramasubbareddy, Abiad, Mohammed T El, Talati, Ajay, and Dempsey, Sheila
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Paediatrics ,Reproductive Medicine ,Biomedical and Clinical Sciences ,Asthma ,Prevention ,Preterm ,Low Birth Weight and Health of the Newborn ,Lung ,Behavioral and Social Science ,Clinical Research ,Nutrition ,Pediatric ,Perinatal Period - Conditions Originating in Perinatal Period ,Women's Health ,Clinical Trials and Supportive Activities ,Minority Health ,Black or African American ,Child ,Preschool ,Female ,Humans ,Infant ,Infant ,Extremely Premature ,Infant ,Newborn ,Infant ,Premature ,Diseases ,Male ,Mothers ,Respiration ,Artificial ,Respiratory Sounds ,Risk Factors ,Trial of Late Surfactant (TOLSURF) Study Group ,asthma ,prematurity ,socioeconomic factors ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship.Study designWe assessed persistent wheezing illness determined at 18-24 months corrected (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis.ResultsOf 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing illness. After adjustment for gestational age, birth weight, and sex, infants of black mothers had increased odds of persistent wheeze compared with infants of nonblack mothers (OR = 2.9, 95% CI 1.9, 4.5). Only bronchopulmonary dysplasia, breast milk diet, and public insurance status were identified as mediators. In this model, the direct effect of race accounted for 69% of the relationship between maternal race and persistent wheeze, whereas breast milk diet, public insurance status, and bronchopulmonary dysplasia accounted for 8%, 12%, and 10%, respectively.ConclusionsAmong former high-risk extremely low gestational age newborns, infants of black mothers have increased odds of developing persistent wheeze. A substantial proportion of this effect is directly accounted for by race, which may reflect unmeasured environmental influences, and acquired and innate biological differences.Trial registrationClinicalTrials.gov: NCT01022580.
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- 2018
16. Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants
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Bajaj, Monika, Natarajan, Girija, Shankaran, Seetha, Wyckoff, Myra, Laptook, R, Bell, Edward F, Stoll, Barbara J, Carlo, Waldemar A, Vohr, Betty R, Saha, Shampa, Van Meurs, Krisa P, Sanchez, Pablo J, D'Angio, Carl T, Higgins, Rosemary D, Das, Abhik, Newman, Nancy, Walsh, Michele C, Network, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research, Polin, Richard A, Keszler, Martin, Hensman, Angelita M, Vieira, Elisa, Hibbs, Anna Marie, Siner, Bonnie S, Truog, William E, Pallotto, Eugenia K, Kilbride, Howard W, Gauldin, Cheri, Holmes, Anne, Johnson, Kathy, Poindexter, Brenda B, Schibler, Kurt, Kallapur, Suhas G, Grisby, Cathy, Alexander, Barbara, Fischer, Estelle E, Jackson, Lenora, Kirker, Kristin, Jennings, Jennifer, Wuertz, Sandra, Muthig, Greg, Cotten, C Michael, Goldberg, Ronald N, Finkle, Joanne, Fisher, Kimberley A, Laughon, Matthew M, Bose, Carl L, Bernhardt, Janice, Clark, Cindy, Carlton, David P, Hale, Ellen C, Loggins, Yvonne, Bottcher, Diane I, Archer, Stephanie Wilson, Sokol, Greg, Herron, Dianne E, Nelin, Leif D, Jadcherla, Sudarshan R, Luzader, Patricia, Parikh, Nehal A, Nist, Marliese Dion, Fuller, Jennifer, Gutentag, Julie, Jones, Marissa E, McGregor, Sarah, Rodgers, Elizabeth, Ulloa, Jodi A, Wolfe, Tara, Wallace, Dennis, Zaterka-Baxter, Kristin M, Crawford, Margaret, Gabrio, Jenna, Kandefer, Sarah, Auman, Jeanette O'Donnell, Stevenson, David K, Ball, M Bethany, Proud, Melinda S, Ambalavanan, Namasivayam, Collins, Monica V, Cosby, Shirley S, Devaskar, Uday, Garg, Meena, Chanlaw, Teresa, Geller, Rachel, Colaizy, Tarah T, Ellsbury, Dan L, Brumbaugh, Jane E, Johnson, Karen J, Campbell, Donia B, Walker, Jacky R, Watterberg, Kristi L, Ohls, Robin K, Lacy, Conra Backstrom, Beauman, Sandy Sundquist, Hartenberger, Carol, Schmidt, Barbara, Kirpalani, Haresh, DeMauro, Sara B, Cook, Noah, and Chaudhary, Aasma S
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Paediatrics ,Biomedical and Clinical Sciences ,Preterm ,Low Birth Weight and Health of the Newborn ,Pediatric ,Perinatal Period - Conditions Originating in Perinatal Period ,Infant Mortality ,Lung ,Clinical Research ,Reproductive health and childbirth ,Good Health and Well Being ,Cardiopulmonary Resuscitation ,Continuous Positive Airway Pressure ,Delivery Rooms ,Female ,Humans ,Infant ,Newborn ,Infant ,Premature ,Infant ,Small for Gestational Age ,Intubation ,Intratracheal ,Male ,Outcome Assessment ,Health Care ,Oxygen Inhalation Therapy ,Prospective Studies ,Registries ,Risk Factors ,Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network ,CPR ,delivery room ,endotracheal intubation ,moderate Preterm ,oxygen ,resuscitation ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectivesTo describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants.Study designThis was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use. The association of antepartum and intrapartum risk factors and discharge outcomes with the intensity of resuscitation was evaluated.ResultsOf 7014 included infants, 1684 (24.0%) received routine care and no additional resuscitation, 2279 (32.5%) received oxygen or continuous positive airway pressure, 1831 (26.1%) received bag and mask ventilation, 1034 (14.7%) underwent endotracheal intubation, and 186 (2.7%) received cardiopulmonary resuscitation. Among the antepartum and intrapartum factors, increasing GA, any exposure to antenatal steroids and prolonged rupture of membranes decreased the likelihood of receipt of all levels of resuscitation. Infants who were small for GA (SGA) had increased risk of delivery room resuscitation. Among the neonatal outcomes, respiratory support at 28 days, days to full oral feeds and length of stay were significantly associated with the intensity of delivery room resuscitation. Higher intensity of resuscitation was associated with increased risk of mortality.ConclusionsThe majority of MPT infants receive some level of delivery room resuscitation. Increased intensity of delivery room interventions was associated with prolonged respiratory and nutritional support, increased mortality, and a longer length of stay.
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- 2018
17. Admission Temperature and Associated Mortality and Morbidity among Moderately and Extremely Preterm Infants
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Laptook, R, Bell, Edward F, Shankaran, Seetha, Boghossian, Nansi S, Wyckoff, Myra H, Kandefer, Sarah, Walsh, Michele, Saha, Shampa, Higgins, Rosemary, Network, Generic and Moderate Preterm Subcommittees of the NICHD Neonatal Research, Polin, Richard A, Keszler, Martin, Vohr, Betty R, Hensman, Angelita M, Vieira, Elisa, Little, Emilee, Fanaroff, Avroy A, Hibbs, Anna Marie, Newman, Nancy S, Siner, Bonnie S, Truog, William E, Pallotto, Eugenia K, Kilbride, Howard W, Gauldin, Cheri, Holmes, Anne, Johnson, Kathy, Schibler, Kurt, Kallapur, Suhas G, Grisby, Cathy, Alexander, Barbara, Fischer, Estelle E, Jackson, Lenora, Kirker, Kristin, Jennings, Jennifer, Wuertz, Sandra, Muthig, Greg, Donovan, Edward F, Hessling, Jody, Mersmann, Marcia Worley, Mincey, Holly L, Cotten, C Michael, Goldberg, Ronald N, Finkle, Joanne, Fisher, Kimberley A, Auten, Kathy J, Laughon, Matthew M, Bose, Carl L, Bernhardt, Janice, Clark, Cindy, Stoll, Barbara J, Carlton, David P, Hale, Ellen C, Loggins, Yvonne, Bottcher, Diane I, Archer, Stephanie Wilson, Wright, Linda L, McClure, Elizabeth M, Poindexter, Brenda B, Sokol, Gregory M, Herron, Dianne E, Lemons, James A, Appel, Diana D, Miller, Lucy C, Sanchez, Pablo J, Nelin, Leif D, Jadcherla, Sudarshan R, Luzader, Patricia, Parikh, Nehal A, Nist, Marliese Dion, Fuller, Jennifer, Gutentag, Julie, Jones, Marissa E, McGregor, Sarah, Rodgers, Elizabeth, Ulloa, Jodi A, Wolfe, Tara, Das, Abhik, Wallace, Dennis, Poole, W Kenneth, Zaterka-Baxter, Kristin M, Crawford, Margaret, Gabrio, Jenna, Auman, Jeanette O'Donnell, Huitema, Carolyn Petrie, Hastings, Betty K, Van Meurs, Krisa P, Stevenson, David K, Ball, M Bethany, Proud, Melinda S, Carlo, Waldemar A, Ambalavanan, Namasivayam, Collins, Monica V, Cosby, Shirley S, Devaskar, Uday, Garg, Meena, Chanlaw, Teresa, Geller, Rachel, Colaizy, Tarah T, Ellsbury, Dan L, and Brumbaugh, Jane E
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Paediatrics ,Biomedical and Clinical Sciences ,Perinatal Period - Conditions Originating in Perinatal Period ,Infant Mortality ,Pediatric ,Clinical Research ,Preterm ,Low Birth Weight and Health of the Newborn ,Reproductive health and childbirth ,Good Health and Well Being ,Body Temperature ,Female ,Fever ,Hospital Mortality ,Humans ,Hypothermia ,Infant ,Extremely Premature ,Infant ,Newborn ,Infant ,Premature ,Diseases ,Intensive Care Units ,Neonatal ,Logistic Models ,Male ,Patient Admission ,Risk Factors ,United States ,Generic and Moderate Preterm Subcommittees of the NICHD Neonatal Research Network ,hyperthermia ,hypothermia ,prematurity ,survival ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo evaluate the temperature distribution among moderately preterm (MPT, 29-33 weeks) and extremely preterm (EPT, 37.5°C (4.2% vs 6.2%). For EPT infants in 2012-2013 compared with 2002-2003, the percentage of temperatures between 36.5°C and 37.5°C more than doubled and the percentage of temperatures >37.5°C more than tripled. Admission temperature was inversely associated with in-hospital mortality.ConclusionsLow and high admission temperatures are more frequent among EPT than MPT infants. Compared with a decade earlier, fewer EPT infants experience low admission temperatures but more have elevated temperatures. In spite of a change in distribution of NICU admission temperature, an inverse association between temperature and mortality risk persists.
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- 2018
18. Barriers to enrollment in a randomized controlled trial of hydrocortisone for cardiovascular insufficiency in term and late preterm newborn infants
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Watterberg, KL, Fernandez, E, Walsh, MC, Truog, WE, Stoll, BJ, Sokol, GM, Kennedy, KA, Fraga, MV, Beauman, SS, Carper, B, Das, A, Duncan, AF, Buss, WF, Gauldin, C, Lacy, CB, Sanchez, PJ, Chawla, S, Lakshminrusimha, S, Cotten, CM, Van Meurs, KP, Poindexter, BB, Bell, EF, Carlo, WA, Devaskar, U, Wyckoff, MH, and Higgins, RD
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Preterm ,Low Birth Weight and Health of the Newborn ,Clinical Research ,Infant Mortality ,Clinical Trials and Supportive Activities ,Perinatal Period - Conditions Originating in Perinatal Period ,Pediatric ,Reproductive health and childbirth ,Good Health and Well Being ,Cardiotonic Agents ,Critical Illness ,Double-Blind Method ,Early Termination of Clinical Trials ,Heart Defects ,Congenital ,Heart Failure ,Humans ,Hydrocortisone ,Infant ,Newborn ,Infant ,Premature ,Informed Consent ,Neurodevelopmental Disorders ,Patient Selection ,Clinical Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns.Study designThe original study was a multicenter RCT. Eligibility: ⩾34 weeks' gestation,
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- 2017
19. A multidisciplinary chronic lung disease team in a neonatal intensive care unit is associated with increased survival to discharge of infants with tracheostomy
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Hansen, Taylor P., Noel-MacDonnell, Janelle, Kuckelman, Sara, Norberg, Michael, Truog, William, and Manimtim, Winston
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- 2021
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20. Neurally adjusted ventilatory assist in neonates with congenital diaphragmatic hernia
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Kurland, Yonatan, Gurung, Kamal, Pallotto, Eugenia K., Manimtim, Winston, Feldman, Keith, Staggs, Vincent S., and Truog, William
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- 2021
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21. Effectiveness and safety of repeat dexamethasone for bronchopulmonary dysplasia
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Cuna, Alain, Quiqley, Anastasia, Varghese, Kevin, Ciccolari-Micaldi, Greta, Oliveros, Christian, Cheng, An-Lin, Norberg, Michael, and Truog, William E.
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- 2021
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22. Invasive mechanical ventilation at 36 weeks post-menstrual age, adverse outcomes with a comparison of recent definitions of bronchopulmonary dysplasia
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Guaman, Milenka Cuevas, Pishevar, Nikou, Abman, Steven H., Keszler, Martin, Truog, William E., Panitch, Howard, and Nelin, Leif D.
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- 2021
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23. The Randomized, Controlled Trial of Late Surfactant: Effects on Respiratory Outcomes at 1-Year Corrected Age
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Keller, Roberta L, Eichenwald, Eric C, Hibbs, Anna Maria, Rogers, Elizabeth E, Wai, Katherine C, Black, Dennis M, Ballard, Philip L, Asselin, Jeanette M, Truog, William E, Merrill, Jeffrey D, Mammel, Mark C, Steinhorn, Robin H, Ryan, Rita M, Durand, David J, Bendel, Catherine M, Bendel-Stenzel, Ellen M, Courtney, Sherry E, Dhanireddy, Ramasubbareddy, Hudak, Mark L, Koch, Frances R, Mayock, Dennis E, McKay, Victor J, Helderman, Jennifer, Porta, Nicolas F, Wadhawan, Rajan, Palermo, Lisa, Ballard, Roberta A, and Group, TOLSURF Study
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Paediatrics ,Biomedical and Clinical Sciences ,Preterm ,Low Birth Weight and Health of the Newborn ,Pediatric ,Perinatal Period - Conditions Originating in Perinatal Period ,Lung ,Clinical Research ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,Reproductive health and childbirth ,Administration ,Inhalation ,Age Factors ,Bronchopulmonary Dysplasia ,Confidence Intervals ,Dose-Response Relationship ,Drug ,Double-Blind Method ,Drug Administration Schedule ,Female ,Follow-Up Studies ,Gestational Age ,Humans ,Infant ,Infant ,Extremely Low Birth Weight ,Infant ,Newborn ,Male ,Nitric Oxide ,Pulmonary Surfactants ,Respiration ,Artificial ,Respiratory Distress Syndrome ,Newborn ,Risk Assessment ,Survival Rate ,Time Factors ,TOLSURF Study Group ,bronchopulmonary dysplasia ,prematurity ,pulmonary morbidity ,wheeze ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo determine the effects of late surfactant on respiratory outcomes determined at 1-year corrected age in the Trial of Late Surfactant (TOLSURF), which randomized newborns of extremely low gestational age (≤28 weeks' gestational age) ventilated at 7-14 days to late surfactant and inhaled nitric oxide vs inhaled nitric oxide-alone (control).Study designCaregivers were surveyed in a double-blinded manner at 3, 6, 9, and 12 months' corrected age to collect information on respiratory resource use (infant medication use, home support, and hospitalization). Infants were classified for composite outcomes of pulmonary morbidity (no PM, determined in infants with no reported respiratory resource use) and persistent PM (determined in infants with any resource use in ≥3 surveys).ResultsInfants (n = 450, late surfactant n = 217, control n = 233) were 25.3 ± 1.2 weeks' gestation and 713 ± 164 g at birth. In the late surfactant group, fewer infants received home respiratory support than in the control group (35.8% vs 52.9%, relative benefit [RB] 1.28 [95% CI 1.07-1.55]). There was no benefit of late surfactant for No PM vs PM (RB 1.27; 95% CI 0.89-1.81) or no persistent PM vs persistent PM (RB 1.01; 95% CI 0.87-1.17). After adjustment for imbalances in baseline characteristics, relative benefit of late surfactant treatment increased: RB 1.40 (95% CI 0.89-1.80) for no PM and RB 1.24 (95% CI 1.08-1.42) for no persistent PM.ConclusionTreatment of newborns of extremely low gestational age with late surfactant in combination with inhaled nitric oxide decreased use of home respiratory support and may decrease persistent pulmonary morbidity.Trial registrationClinicalTrials.gov: NCT01022580.
- Published
- 2017
24. Pharmacometabolomics Profiling of Preterm Infants Validates Patterns of Metabolism Associated With Response to Dexamethasone Treatment for Bronchopulmonary Dysplasia
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Bradley Stockard, Cheri Gauldin, William Truog, and Tamorah Lewis
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pharmacometabolomics ,neonatology ,pulmonology ,dexamethasone ,pharmacology ,Pediatrics ,RJ1-570 - Abstract
Bronchopulmonary dysplasia (BPD) is one of the most common health complications of premature birth. Corticosteroids are commonly used for treatment of BPD, but their use is challenging due to variability in treatment response. Previous pharmacometabolomics study has established patterns of metabolite levels with response to dexamethasone. We obtained additional patient samples for metabolomics analysis to find associations between the metabolome and dexamethasone response in a validation cohort. A total of 14 infants provided 15 plasma and 12 urine samples. The measure of treatment response was the calculated change in respiratory severity score (deltaRSS) from pre-to-post treatment. Each metabolite was assessed with paired analysis of pre and post-treatment samples using Wilcoxon signed rank test. Correlation analysis was conducted between deltaRSS and pre-to-post change in metabolite level. Paired association analysis identified 20 plasma and 26 urine metabolites with significant level difference comparing pre to post treatment samples (p < 0.05). 4 plasma and 4 urine metabolites were also significant in the original study. Pre-to-post treatment change in metabolite analysis identified 4 plasma and 8 urine metabolites significantly associated with deltaRSS (p < 0.05). Change in urine citrulline levels showed a similar correlation pattern with deltaRSS in the first study, with increasing level associated with improved drug response. These results help validate the first major findings from pharmacometabolomics of BPD including key metabolites within the urea cycle and trans-4-hydroxyproline as a potential marker for lung injury. Ultimately, this study furthers our understanding of the mechanisms of steroid response in BPD patients and helps to design future targeted metabolomics studies in this patient population.
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- 2022
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25. Early Cumulative Supplemental Oxygen Predicts Bronchopulmonary Dysplasia in High Risk Extremely Low Gestational Age Newborns
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Wai, Katherine C, Kohn, Michael A, Ballard, Roberta A, Truog, William E, Black, Dennis M, Asselin, Jeanette M, Ballard, Philip L, Rogers, Elizabeth E, Keller, Roberta L, and Group, Trial of Late Surfactant Study
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Paediatrics ,Biomedical and Clinical Sciences ,Neonatal Respiratory Distress ,Clinical Research ,Pediatric ,Lung ,Preterm ,Low Birth Weight and Health of the Newborn ,Perinatal Period - Conditions Originating in Perinatal Period ,Prevention ,Bronchopulmonary Dysplasia ,Female ,Gestational Age ,Humans ,Infant ,Extremely Low Birth Weight ,Infant ,Newborn ,Infant ,Premature ,Male ,Oxygen Inhalation Therapy ,Prospective Studies ,ROC Curve ,Risk ,Survival Rate ,Trial of Late Surfactant (TOLSURF) Study Group ,inhaled nitric oxide ,mechanical ventilation ,oxidative stress ,prematurity ,surfactant ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo assess the prognostic accuracy of early cumulative supplemental oxygen (CSO) exposure for prediction of bronchopulmonary dysplasia (BPD) or death, and to evaluate the independent association of CSO with BPD or death.Study designWe performed a secondary analysis of the Trial of Late Surfactant, which enrolled 511 infants born at ≤28 weeks gestational age who were mechanically ventilated at 7-14 days of life. Our primary outcome was BPD or death at 36 weeks postmenstrual age, as determined by a physiological oxygen/flow challenge. Average daily supplemental oxygen (fraction of inspired oxygen - 0.21) was calculated. CSO was calculated as the sum of the average daily supplemental oxygen over time periods of interest up to 28 days of age. Area under the receiver operating curve (AUROC) values were generated to evaluate the accuracy of CSO for prediction of BPD or death. The independent relationship between CSO and BPD or death was assessed in multivariate modeling, while adjusting for mean airway pressure.ResultsIn the study infants, mean gestational age at birth was 25.2 ± 1.2 weeks and mean birth weight was 700 ± 165 g. The AUROC value for CSO at 14 days was significantly better than that at earlier time points for outcome prediction (OR, 0.70; 95% CI, 0.65-0.74); it did not increase with the addition of later data. In multivariate modeling, a CSO increase of 1 at 14 days increased the odds of BPD or death (OR, 1.7; 95% CI, 1.3-2.2; P
- Published
- 2016
26. Randomized Trial of Late Surfactant Treatment in Ventilated Preterm Infants Receiving Inhaled Nitric Oxide
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Ballard, Roberta A, Keller, Roberta L, Black, Dennis M, Ballard, Philip L, Merrill, Jeffrey D, Eichenwald, Eric C, Truog, William E, Mammel, Mark C, Steinhorn, Robin H, Rogers, Elizabeth E, Ryan, Rita M, Durand, David J, Asselin, Jeanette M, Bendel, Catherine M, Bendel-Stenzel, Ellen M, Courtney, Sherry E, Dhanireddy, Ramasubbareddy, Hudak, Mark L, Koch, Frances R, Mayock, Dennis E, McKay, Victor J, O'Shea, T Michael, Porta, Nicolas F, Wadhawan, Rajan, Palermo, Lisa, Strong, S Hamilton, Immamura-Ching, J, Orfanos-Villalobos, M, Williams, C, Horton, D, Pacello, L, Willard, A, Gauldin, C, Holmes, A, Johnson, P, Meinert, K, Reynolds, AM, Lucie, J, Conway, P, Sacilowski, ML, Leadersdorff, M, Orbank, P, Wynn, K, deUngria, M, Khan, J, Hamann, K, Schau, M, Hopkins, B, Jenson, J, Garcia, C, Shariff, J, McGovern, R, Adelman, J, Combs, A, Tjersland, M, Walker, S, Howland, E, Longoria, J, Meo, H, McDavid, G, Burson, K, Hinojosa, R, Johnson, C, Miller, K, Rogers, S, Wright, S, Barnette, K, Kellum, A, Burke, M, Hayes, C, Chadwick, S, Howard, D, Kennedy, C, Prince, R, Stefanescu, B, Helderman, J, Warden, K, Brown, P, Griffin, J, Conley, L, Georgieff, M, Davern, B, Mills, M, Ritter, S, Wagner, C, Fanning, D, Roberson, J, Lampland, A, Meyers, P, Brey, A, Worwa, C, Dixon, P, Ebert, G, Hejl, C, Maxwell, M, McCullough, K, Abiad, MT El, Talati, A, Dempsey, S, and Gammage, K
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Paediatrics ,Biomedical and Clinical Sciences ,Preterm ,Low Birth Weight and Health of the Newborn ,Lung ,Perinatal Period - Conditions Originating in Perinatal Period ,Pediatric ,Patient Safety ,Neonatal Respiratory Distress ,Clinical Trials and Supportive Activities ,Clinical Research ,Reproductive health and childbirth ,Administration ,Inhalation ,Bronchopulmonary Dysplasia ,Female ,Humans ,Infant ,Newborn ,Infant ,Premature ,Infant ,Premature ,Diseases ,Infant ,Very Low Birth Weight ,Male ,Nitric Oxide ,Pulmonary Surfactants ,Respiration ,Artificial ,Survival Rate ,United States ,TOLSURF Study Group ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveTo assess whether late surfactant treatment in extremely low gestational age (GA) newborn infants requiring ventilation at 7-14 days, who often have surfactant deficiency and dysfunction, safely improves survival without bronchopulmonary dysplasia (BPD).Study designExtremely low GA newborn infants (GA ≤28 0/7 weeks) who required mechanical ventilation at 7-14 days were enrolled in a randomized, masked controlled trial at 25 US centers. All infants received inhaled nitric oxide and either surfactant (calfactant/Infasurf) or sham instillation every 1-3 days to a maximum of 5 doses while intubated. The primary outcome was survival at 36 weeks postmenstrual age (PMA) without BPD, as evaluated by physiological oxygen/flow reduction.ResultsA total of 511 infants were enrolled between January 2010 and September 2013. There were no differences between the treated and control groups in mean birth weight (701 ± 164 g), GA (25.2 ± 1.2 weeks), percentage born at GA
- Published
- 2016
27. Pharmacometabolomics of Respiratory Phenotypic Response to Dexamethasone in Preterm Infants at Risk for Bronchopulmonary Dysplasia
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Tamorah Lewis, Prabhakar Chalise, Cheri Gauldin, and William Truog
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Therapeutics. Pharmacology ,RM1-950 ,Public aspects of medicine ,RA1-1270 - Abstract
A prospective cohort study was performed in preterm infants less than 32 weeks gestation at birth who were treated with dexamethasone for developing or established bronchopulmonary dysplasia (BPD). Respiratory phenotype (Respiratory Severity Score (RSS)), serum, and urine metabolomics were assessed before and after treatment. Ten infants provided nine matched serum and nine matched urine samples. There was a significant decrease in RSS with steroid treatment. Serum gluconic acid had the largest median fold change (140 times decreased, P = 0.008). In metabolite set enrichment analysis, in both serum and urine, the urea cycle, ammonia recycling, and malate‐aspartate shuttle pathways were most significantly enriched when comparing pretreatment and post‐treatment (P value
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- 2019
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28. Inhaled Nitric Oxide Increases Urinary Nitric Oxide Metabolites and Cyclic Guanosine Monophosphate in Premature Infants: Relationship to Pulmonary Outcome
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Ballard, Philip L, Keller, Roberta L, Black, Dennis M, Durand, David J, Merrill, Jeffrey D, Eichenwald, Eric C, Truog, William E, Mammel, Mark C, Steinhorn, Robin, Ryan, Rita M, Courtney, Sherry E, Horneman, Hart, and Ballard, Roberta A
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Paediatrics ,Biomedical and Clinical Sciences ,Perinatal Period - Conditions Originating in Perinatal Period ,Infant Mortality ,Pediatric ,Preterm ,Low Birth Weight and Health of the Newborn ,Neonatal Respiratory Distress ,Lung ,Clinical Research ,Respiratory ,Good Health and Well Being ,Administration ,Inhalation ,Biomarkers ,Bronchopulmonary Dysplasia ,Creatinine ,Cyclic GMP ,Dose-Response Relationship ,Drug ,Female ,Humans ,Infant ,Newborn ,Infant ,Premature ,Infant ,Premature ,Diseases ,Male ,Nitric Oxide ,Regression Analysis ,Respiration ,Artificial ,nitric oxide ,cyclic GMP ,bronchopulmonary dysplasia ,premature ,urine ,Investigators of TOLSURF Pilot and TOLSURF ,Clinical Sciences ,Paediatrics and Reproductive Medicine ,Obstetrics & Reproductive Medicine ,Reproductive medicine ,Midwifery - Abstract
ObjectiveInhaled nitric oxide (iNO) has been tested to prevent bronchopulmonary dysplasia (BPD) in premature infants, however, the role of cyclic guanosine monophosphate (cGMP) is not known. We hypothesized that levels of NO metabolites (NOx) and cGMP in urine, as a noninvasive source for biospecimen collection, would reflect the dose of iNO and relate to pulmonary outcome.Study designStudies were performed on 125 infants who required mechanical ventilation at 7 to 14 days and received 24 days of iNO at 20-2 ppm. A control group of 19 infants did not receive iNO.ResultsIn NO-treated infants there was a dose-dependent increase of both NOx and cGMP per creatinine (maximal 3.1- and 2-fold, respectively, at 10-20 ppm iNO) compared with off iNO. NOx and cGMP concentrations at both 2 ppm and off iNO were inversely related to severity of lung disease during the 1st month, and the NOx levels were lower in infants who died or developed BPD at term. NOx was higher in Caucasian compared with other infants at all iNO doses.ConclusionUrinary NOx and cGMP are biomarkers of endogenous NO production and lung uptake of iNO, and some levels reflect the severity of lung disease. These results support a role of the NO-cGMP pathway in lung development.
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- 2015
29. Effect of Depth and Duration of Cooling on Deaths in the NICU Among Neonates With Hypoxic Ischemic Encephalopathy: A Randomized Clinical Trial
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Shankaran, Seetha, Laptook, Abbot R, Pappas, Athina, McDonald, Scott A, Das, Abhik, Tyson, Jon E, Poindexter, Brenda B, Schibler, Kurt, Bell, Edward F, Heyne, Roy J, Pedroza, Claudia, Bara, Rebecca, Van Meurs, Krisa P, Grisby, Cathy, Huitema, Carolyn M Petrie, Garg, Meena, Ehrenkranz, Richard A, Shepherd, Edward G, Chalak, Lina F, Hamrick, Shannon EG, Khan, Amir M, Reynolds, Anne Marie, Laughon, Matthew M, Truog, William E, Dysart, Kevin C, Carlo, Waldemar A, Walsh, Michele C, Watterberg, Kristi L, and Higgins, Rosemary D
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Paediatrics ,Biomedical and Clinical Sciences ,Clinical Research ,Perinatal Period - Conditions Originating in Perinatal Period ,Clinical Trials and Supportive Activities ,Pediatric ,Infant Mortality ,Reproductive health and childbirth ,Acidosis ,Arrhythmias ,Cardiac ,Developmental Disabilities ,Female ,Hemorrhage ,Humans ,Hypothermia ,Induced ,Hypoxia-Ischemia ,Brain ,Infant ,Infant ,Newborn ,Intensive Care Units ,Neonatal ,Male ,Survival Analysis ,Temperature ,Thrombosis ,Time Factors ,Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
ImportanceHypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models.ObjectiveTo determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy.Design, setting, and participantsA randomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013.InterventionsNeonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours.Main outcomes and measuresThe primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours' vs 120 hours' duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes).ResultsThe NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92-2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69-2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07-0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%.Conclusions and relevanceAmong neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials.Trial registrationclinicaltrials.gov Identifier: NCT01192776.
- Published
- 2014
30. Pharmacoepidemiology of Drug Exposure in Intubated and Non-Intubated Preterm Infants With Severe Bronchopulmonary Dysplasia
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T. Lewis, W. Truog, L. Nelin, N. Napolitano, R. L. McKinney, and and on behalf of The BPD Collaborative
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neonate ,bronchopulmonary dysplasia ,epidemiology - descriptive ,diuretic ,inhaled steroid ,bronchodilator ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: Infants with severe bronchopulmonary dysplasia (BPD) are commonly treated with off-label drugs due to lack of approved therapies. To prioritize drugs for rigorous efficacy and safety testing, it is important to describe exposure patterns in this population.Objective: Our objective was to compare rates of drug exposure between preterm infants with severe bronchopulmonary dysplasia based on respiratory support status at or beyond 36 weeks post-menstrual age.Methods: A cross-sectional cohort study was performed on October 29, 2019. Preterm infants with severe BPD were eligible and details of respiratory support and drug therapy were recorded. Wilcoxon paired signed rank test was used to compare continuous variables between the invasive and non-invasive groups. Fisher’s exact test was used to compare binary variables by respiratory support status.Results: 187 infants were eligible for the study at 16 sites. Diuretics were the drug class that most subjects were receiving on the day of study comprising 54% of the entire cohort, followed by inhaled steroids (47%) and short-acting bronchodilators (42%). Infants who were invasively ventilated (verses on non-invasive support) were significantly more likely to be receiving diuretics (p 0.013), short-acting bronchodilators (p < 0.01), long-acting bronchodilators (p < 0.01), systemic steroids (p < 0.01), systemic pulmonary hypertension drugs (p < 0.01), and inhaled nitric oxide (p < 0.01).Conclusion: Infant with severe BPD, especially those who remain on invasive ventilation at 36 weeks, are routinely exposed to multiple drug classes despite insufficient pharmacokinetic, safety, and efficacy evaluations. This study helps prioritize sub-populations, drugs and drug classes for future study.
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- 2021
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31. Late administration of surfactant replacement therapy increases surfactant protein-B content: a randomized pilot study.
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Merrill, Jeffrey, Steinhorn, Robin, Eichenwald, Eric, Durand, David, Ryan, Rita, Truog, William, Courtney, Sherry, Ballard, Philip, Keller, Roberta, Black, Dennis, and Ballard, Roberta
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Humans ,Infant ,Newborn ,Infant ,Premature ,Pilot Projects ,Pulmonary Surfactant-Associated Protein B ,Pulmonary Surfactants - Abstract
BACKGROUND: Surfactant dysfunction may contribute to the development of bronchopulmonary dysplasia (BPD) in persistently ventilated preterm infants. We conducted a multicenter randomized, blinded, pilot study to assess the safety and efficacy of late administration of doses of a surfactant protein-B (SP-B)-containing surfactant (calfactant) in combination with prolonged inhaled nitric oxide (iNO) in infants ≤1,000 g birth weight (BW). METHODS: We randomized 85 preterm infants ventilated at 7-14 d after birth to receive either late administration of surfactant (up to 5 doses) plus prolonged iNO or iNO alone. Large aggregate surfactant was isolated from daily tracheal aspirates (TAs) for measurement of SP-B content, total protein, and phospholipid (PL). RESULTS: Late administration of surfactant had minimal acute adverse effects. Clinical status as well as surfactant recovery and SP-B content in tracheal aspirate were transiently improved as compared to the controls; these effects waned after 1 d. The change in SP-B content with surfactant dosing was positively correlated with SP-B levels during treatment (r = 0.50, P = 0.02). CONCLUSION: Low SP-B values increased with calfactant administration, but the relationship of this response to SP-B levels suggests that degradation is a contributing mechanism for SP-B deficiency and surfactant dysfunction. We conclude that late therapy with surfactant in combination with iNO is safe and transiently increases surfactant SP-B content, possibly leading to improved short- and long-term respiratory outcomes.
- Published
- 2012
32. Late administration of surfactant replacement therapy increases surfactant protein-B content: A randomized pilot study
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Keller, Roberta, Black, Dennis, Ballard, Philip, Ballard, Roberta, Keller, RL, Merrill, JD, Black, DM, Steinhorn, RH, Eichenwald, EC, Durand, DJ, Ryan, RM, Truog, WE, Courtney, SE, and Ballard, PL
- Abstract
Background: Surfactant dysfunction may contribute to the development of bronchopulmonary dysplasia (BPD) in persistently ventilated preterm infants. We conducted a multicenter randomized, blinded, pilot study to assess the safety and efficacy of late admin
- Published
- 2012
33. Inhaled nitric oxide in premature infants: effect on tracheal aspirate and plasma nitric oxide metabolites
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Posencheg, MA, Gow, AJ, Truog, WE, Ballard, RA, Cnaan, A, Golombek, SG, and Ballard, PL
- Subjects
Paediatrics ,Biomedical and Clinical Sciences ,Preterm ,Low Birth Weight and Health of the Newborn ,Pediatric ,Clinical Trials and Supportive Activities ,Clinical Research ,Perinatal Period - Conditions Originating in Perinatal Period ,Lung ,Infant Mortality ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,Bronchopulmonary Dysplasia ,Gestational Age ,Humans ,Infant ,Newborn ,Infant ,Premature ,Nitrates ,Nitric Oxide ,Nitrites ,Respiratory Therapy ,Trachea ,nitrite ,bronchopulmonary dysplasia ,NO CLD trial ,NO CLD Investigators ,Clinical Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectiveInhaled nitric oxide (iNO) is a potential new therapy for prevention of bronchopulmonary dysplasia and brain injury in premature infants. This study examined dose-related effects of iNO on NO metabolites as evidence of NO delivery.Study designA subset of 102 premature infants in the NO CLD trial, receiving 24 days of iNO (20 p.p.m. decreasing to 2 p.p.m.) or placebo, were analyzed. Tracheal aspirate (TA) and plasma samples collected at enrollment and at intervals during study gas were analyzed for NO metabolites.ResultiNO treatment increased NO metabolites in TA at 20 and 10 p.p.m. (1.7- to 2.3-fold vs control) and in plasma at 20, 10, and 5 p.p.m. (1.6- to 2.3-fold). In post hoc analysis, treated infants with lower metabolite levels at entry had an improved clinical outcome.ConclusioniNO causes dose-related increases in NO metabolites in the circulation as well as lung fluid, as evidenced by TA analysis, showing NO delivery to these compartments.
- Published
- 2010
34. Exploring the Association of Male Sex With Adverse Outcomes in Severe Bronchopulmonary Dysplasia
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Hammond, J.D., Kielt, Matthew J., Conroy, Sara, Lingappan, Krithika, Austin, Eric D., Eldredge, Laurie C., Truog, William E., Abman, Steven H., Nelin, Leif D., and Guaman, Milenka Cuevas
- Abstract
Bronchopulmonary dysplasia (BPD) is a significant contributor to morbidity and death in infants who are born premature. Male sex is an independent risk factor for the development of BPD. However, whether male sex is associated with adverse outcomes that occur after formal diagnosis of severe BPD prior to hospital discharge remains unclear.
- Published
- 2024
- Full Text
- View/download PDF
35. The impact of neurally adjusted ventilatory assist mode on respiratory severity score and energy expenditure in infants: a randomized crossover trial
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Rosterman, J L, Pallotto, E K, Truog, W E, Escobar, H, Meinert, K A, Holmes, A, Dai, H, and Manimtim, W M
- Published
- 2018
- Full Text
- View/download PDF
36. Research involving the recently deceased: ethics questions that must be answered
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Parent, Brendan, Kates, Olivia S, Arap, Wadih, Caplan, Arthur, Childs, Brian, Dickert, Neal W, Homan, Mary, Kinlaw, Kathy, Lang, Ayannah, Latham, Stephen, Levan, Macey L, Truog, Robert D, Webb, Adam, Root Wolpe, Paul, and Pentz, Rebecca D
- Abstract
Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically.
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- 2024
- Full Text
- View/download PDF
37. Invasive mechanical ventilation at 36 weeks post-menstrual age, adverse outcomes with a comparison of recent definitions of bronchopulmonary dysplasia
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Guaman, Milenka Cuevas, Pishevar, Nikou, Abman, Steven H., Keszler, Martin, Truog, William E., Panitch, Howard, and Nelin, Leif D.
- Abstract
Objectives: To determine whether the need for invasive mechanical ventilation (iMV) at 36 weeks PMA in patients with severe bronchopulmonary dysplasia (sBPD) identifies those patients at highest risk for tracheostomy or gastrostomy, and to compare sBPD with recent definitions of BPD. Study design: Observational study from Jan 2015 to Sept 2019 using data from the BPD Collaborative Registry. Results: Five hundred and sixty-four patients with sBPD of whom 24% were on iMV at 36 weeks PMA. Those on iMV had significantly (p< 0.0001) increased risk for tracheostomy or gastrostomy. The overall mortality rate was 3% and the risk for mortality was substantially greater in those on iMV than in those on noninvasive support at 36 weeks PMA (RR 13.8, 95% CI 4.3–44.5, p< 0.0001). When applying the NICHD definition (2016) 44% had Grade III BPD. When applying the NRN definition, 6% had Grade 1 BPD, 70% had Grade 2 BPD, and 24% had Grade 3 BPD. Conclusions: Patients with sBPD who were on iMV at 36 weeks had a significantly greater risk of inhospital mortality and survivors had a significantly greater risk of undergoing tracheostomy and/or gastrostomy. The use of type 2 sBPD or Grade 3 BPD would enhance the ability to target future studies to those infants with sBPD at the highest risk of adverse long-term outcomes.
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- 2024
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- View/download PDF
38. Inter-center variation in death or tracheostomy placement in infants with severe bronchopulmonary dysplasia
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Murthy, K, Porta, N F M, Lagatta, J M, Zaniletti, I, Truog, W E, Grover, T R, Nelin, L D, and Savani, R C
- Published
- 2017
- Full Text
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39. A comparison of 7-day versus 10-day course of low-dose dexamethasone for chronically ventilated preterm infants
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Cuna, A, Govindarajan, S, Oschman, A, Dai, H, Brophy, K, Norberg, M, and Truog, W
- Published
- 2017
- Full Text
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40. Insights Before Flights: How Community Perceptions Can Make or Break Medical Drone Deliveries
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Susan Truog, Luciana Maxim, Charles Matemba, Carla Blauvelt, Hope Ngwira, Archimede Makaya, Susana Moreira, Emily Lawrence, Gabriella Ailstock, Andrea Weitz, Melissa West, and Olivier Defawe
- Subjects
medicines drone delivery ,healthcare logistics ,UAV for human health ,Motor vehicles. Aeronautics. Astronautics ,TL1-4050 - Abstract
Drones are increasingly used to transport health products, but life-saving interventions can be stalled if local community concerns and preferences are not assessed and addressed. In order to inform the introduction of drones in new contexts, this paper analyzed similarities and differences in community perceptions of medical delivery drones in Malawi, Mozambique, the Democratic Republic of the Congo (DRC) and the Dominican Republic (DR). Community perceptions were assessed using focus group discussions (FGDs) and key informant interviews (KIIs) conducted with stakeholders at the national level, at health facilities and in communities. Data were collected on respondents’ familiarity with drones, perceptions of benefits and risks of drones, advice on drone operations and recommendations on sharing information with the community. The comparative analysis found similar perceptions around the potential benefits of using drones, as well as important differences in the perceived risks of flying drones and culturally appropriate communication mechanisms based on the local context. Because community perceptions are heavily influenced by culture and local experiences, a similar assessment should be conducted before introducing drone activities in new areas and two-way feedback channels should be established once drone operations are established in an area. The extent to which a community understands and supports the use of drones to transport health products will ultimately play a critical role in the success or failure of the drone’s ability to bring life-saving products to those who need them.
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- 2020
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41. In support of mitochondrial replacement therapy
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Adashi, Eli Y., Caplan, Arthur L., Capron, Alexander, Chapman, Audrey R., Cho, Mildred, Clayton, Ellen Wright, Cohen, I. Glenn, Cook-Deegan, Robert, Faden, Ruth R., Friedmann, Theodore, Gostin, Lawrence O., Greely, Henry T., Johnston, Josephine, Juengst, Eric, King, Patricia A., Knowles, Lori P., Lyerly, Anne Drapkin, McGuire, Amy L., Moreno, Jonathan D., Rothenberg, Karen, Truog, Robert D., and Walters, LeRoy
- Published
- 2019
- Full Text
- View/download PDF
42. Correction: Genetic variation in CRHR1 is associated with short-term respiratory response to corticosteroids in preterm infants at risk for bronchopulmonary dysplasia
- Author
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Lewis, Tamorah, Truog, William, Norberg, Mike, Ballard, Philip L., Torgerson, Dara, and for the TOLSURF Study Group
- Published
- 2019
- Full Text
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43. Inhaled nitric oxide usage in preterm infants in the NICHD neonatal research network: inter-site variation and propensity evaluation
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Truog, W E, Nelin, L D, Das, A, Kendrick, D E, Bell, E F, Carlo, W A, Higgins, R D, Laptook, A R, Sanchez, P J, Shankaran, S, Stoll, B J, Van Meurs, K P, and Walsh, M C
- Published
- 2014
- Full Text
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44. Conflicts of interest in critical care partnerships: are we living up to our values?
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Truog, Robert D. and Curtis, J. Randall
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- 2018
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45. South Africa's Search for Educational Equity.
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Truog, Anthony L.
- Abstract
Since 1994, South Africa's pivotal concern has been access to educational resources for its diverse population. Supply is not meeting demand for either schools or housing. Problems with integrating curricula with salable skill; improving school- university linkages, and improving teacher qualifications are discussed. (MLH)
- Published
- 2000
46. Principals' Perspectives on New Teachers' Competencies: A Need for Curricular Reform?
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Truog, Anthony L.
- Abstract
Examined elementary, middle, and high school principals' perspectives on their first-year teachers' competencies. Survey data indicated that principals had mixed feelings about new teachers' competencies. They believed new teachers needed improvement in discipline, diversity, technology, and curricular integration/flexibility issues. Perceived new teacher strengths included positive attitudes toward students, colleagues, and administrators and the ability to work cooperatively. (SM)
- Published
- 1998
47. Predicting death or tracheostomy placement in infants with severe bronchopulmonary dysplasia
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Murthy, K, Savani, R C, Lagatta, J M, Zaniletti, I, Wadhawan, R, Truog, W, Grover, T R, Zhang, H, Asselin, J M, Durand, D J, Short, B L, Pallotto, E K, Padula, M A, Dykes, F D, Reber, K M, and Evans, J R
- Published
- 2014
- Full Text
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48. Impact of intercurrent respiratory infections on lung health in infants born <29 weeks with bronchopulmonary dysplasia
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Taylor, J B, Nyp, M F, Norberg, M, Dai, H, Escobar, H, Ellerbeck, E, and Truog, W E
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- 2014
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49. Infants born at <29 weeks: pulmonary outcomes from a hybrid perinatal system
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Truog, W E, Nyp, M F, Taylor, J, Gratny, L L, Escobar, H, Manimtim, W M, Lachica, C I, Khmour, A, Oluola, O O, Oshodi, A A, Norberg, M, Dai, H, and Pallotto, E K
- Published
- 2014
- Full Text
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50. Triage of intensive care patients: identifying agreement and controversy
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Sprung, Charles L., Danis, Marion, Iapichino, Gaetano, Artigas, Antonio, Kesecioglu, Jozef, Moreno, Rui, Lippert, Anne, Curtis, J. Randall, Meale, Paula, Cohen, Simon L., Levy, Mitchell M., and Truog, Robert D.
- Published
- 2013
- Full Text
- View/download PDF
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