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  1. Article ; Online: A Quality Improvement Initiative to Transform Seasonal Immunization Processes Using Learning from the Coronavirus 2019 Pandemic.

    Robinette, Eric D / Nelly, Pamela M / Engler, Laurie J / Bigham, Michael T

    Pediatric quality & safety

    2024  Volume 9, Issue 1, Page(s) e716

    Abstract: Background: Surge demands for annual influenza vaccines challenge healthcare systems. Mass immunizations differ from the traditional care model. The coronavirus 2019 (COVID-19) pandemic challenged current care models with amplified demand and infection ... ...

    Abstract Background: Surge demands for annual influenza vaccines challenge healthcare systems. Mass immunizations differ from the traditional care model. The coronavirus 2019 (COVID-19) pandemic challenged current care models with amplified demand and infection risks while challenging the organization to create new and improve existing processes.
    Methods: Using the Model for Improvement, the team set out to (1) safely meet a surge in vaccination demand and (2) adopt pandemic-driven innovations into routine immunization practice.
    Results: This free-standing pediatric system delivered 87,000 COVID-19 vaccines (~1.3% state total). It administered over 50% of COVID-19 vaccines using new mass immunization processes, including 37,000 adult vaccines before pediatric authorization. In the 2021-2022 influenza season, it used the new or improved immunization processes to deliver 22% of influenza vaccines.
    Conclusions: Pandemic-driven adaptation for the COVID-19 vaccine substantially increased the efficiency of influenza vaccination processes but did not result in a clear increase in influenza vaccine administration rates.
    Language English
    Publishing date 2024-02-09
    Publishing country United States
    Document type Journal Article
    ISSN 2472-0054
    ISSN (online) 2472-0054
    DOI 10.1097/pq9.0000000000000716
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  2. Article ; Online: Identifying asthma-related risks during hospitalization using the child asthma risk assessment tool.

    Schuler, Christine L / Kercsmar, Carolyn / Mansour, Mona / McDowell, Karen M / Huang, Guixia / Hossain, Md Monir / Robinette, Eric D / Beck, Andrew F

    The Journal of asthma : official journal of the Association for the Care of Asthma

    2023  Volume 60, Issue 12, Page(s) 2189–2197

    Abstract: Objective: ...

    Abstract Objective:
    MeSH term(s) Humans ; Child ; Asthma/diagnosis ; Asthma/epidemiology ; Asthma/therapy ; Aftercare ; Patient Discharge ; Hospitalization ; Risk Assessment ; Hypersensitivity/complications
    Language English
    Publishing date 2023-07-02
    Publishing country England
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603816-5
    ISSN 1532-4303 ; 0277-0903
    ISSN (online) 1532-4303
    ISSN 0277-0903
    DOI 10.1080/02770903.2023.2228897
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  3. Article ; Online: Abnormal Newborn Screening Follow-up for Severe Combined Immunodeficiency in an Amish Cohort with Cartilage-Hair Hypoplasia.

    Scott, Ethan M / Chandra, Sharat / Li, Jinzhu / Robinette, Eric D / Brown, Miraides F / Wenger, Olivia K

    Journal of clinical immunology

    2020  Volume 40, Issue 2, Page(s) 321–328

    Abstract: Cartilage-hair hypoplasia (CHH) is an autosomal recessive, short limb skeletal dysplasia with a variable immunologic phenotype. The spectrum of immune function ranges from clinically normal to severe combined immunodeficiency (SCID). Multiple studies ... ...

    Abstract Cartilage-hair hypoplasia (CHH) is an autosomal recessive, short limb skeletal dysplasia with a variable immunologic phenotype. The spectrum of immune function ranges from clinically normal to severe combined immunodeficiency (SCID). Multiple studies have shown that abnormal immune parameters may not predict severe outcomes. Newborn screening (NBS) using T cell receptor excision circle (TREC) assay can now effectively identify infants with severe T cell deficiency who are at risk for SCID. NBS has allowed for cost-effective identification of patients with SCID and improved outcomes with hematopoietic stem cell transplant (HSCT). Ohio reports two abnormal TREC results: decreased and absent TREC. This study evaluated the laboratory and clinical differences in eight Amish patients with CHH with an abnormal TREC result on the NBS. There were four patients with absent TREC and four patients with decreased TREC. The absent TREC patients had lower CD3, CD4, naïve CD4, CD8 cells, and phytohemagglutinin (PHA)-induced lymphocyte proliferation. Three patients with absent TREC were diagnosed with SCID and two underwent successful HSCT. Patients with absent TREC experienced more CHH-related morbidity including anemia requiring transfusion, Hirschsprung's disease, and failure to thrive. No patients with decreased TREC required HSCT. Our study indicates that CHH patients with absent TREC tend to have more severe immunological and clinical phenotype than patients with decreased TREC. Confirmation of these trends in a larger group would guide providers and parents in a timely referral for HSCT, or cost-effective surveillance monitoring of children with a life-threatening illness.
    MeSH term(s) Amish ; Cells, Cultured ; Child, Preschool ; Cohort Studies ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Infant ; Infant, Newborn ; Lymphocyte Activation ; Neonatal Screening ; Pathology, Molecular/methods ; Prognosis ; Receptors, Antigen, T-Cell/genetics ; Severe Combined Immunodeficiency/diagnosis ; Severe Combined Immunodeficiency/genetics ; T-Lymphocytes/immunology ; Treatment Outcome ; Trichothiodystrophy Syndromes/diagnosis ; Trichothiodystrophy Syndromes/genetics
    Chemical Substances Receptors, Antigen, T-Cell
    Language English
    Publishing date 2020-01-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779361-3
    ISSN 1573-2592 ; 0271-9142
    ISSN (online) 1573-2592
    ISSN 0271-9142
    DOI 10.1007/s10875-019-00739-9
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  4. Article ; Online: Use of a Clinical Care Algorithm to Improve Care for Children With Hematogenous Osteomyelitis.

    Robinette, Eric D / Brower, Laura / Schaffzin, Joshua K / Whitlock, Patrick / Shah, Samir S / Connelly, Beverly

    Pediatrics

    2018  Volume 143, Issue 1

    Abstract: Background and objectives: Acute hematogenous osteomyelitis (AHO) causes significant morbidity in children. Quality improvement (QI) methods have been used to successfully improve care and decrease costs through standardization for numerous conditions, ... ...

    Abstract Background and objectives: Acute hematogenous osteomyelitis (AHO) causes significant morbidity in children. Quality improvement (QI) methods have been used to successfully improve care and decrease costs through standardization for numerous conditions, including pediatric AHO. We embarked on a QI initiative to standardize our approach to the inpatient management of AHO, with a global aim of reducing inpatient costs.
    Methods: We used existing literature and local consensus to develop a care algorithm for the inpatient management of AHO. We used the Model for Improvement as the framework for the project, which included process mapping, failure mode analysis, and key driver identification. We engaged with institutional providers to achieve at least 80% consensus regarding specific key drivers and tested various interventions to support uptake of the care algorithm.
    Results: Fifty-seven patients were included. There were 31 patients in the preintervention cohort and 26 in the postintervention cohort, of whom 19 were managed per the algorithm. Mean inpatient charges decreased from $45 718 in the preintervention cohort to $32 895 in the postintervention cohort; length of stay did not change. Adherence to recommended empirical antimicrobial agents trended upward.
    Conclusions: A simple and low-cost QI project was used to safely decrease the cost of inpatient care for pediatric AHO at a tertiary care children's hospital. A robust local consensus process proved to be a key component in the uptake of standardization.
    MeSH term(s) Adolescent ; Algorithms ; Child ; Child, Preschool ; Cohort Studies ; Female ; Follow-Up Studies ; Health Care Costs/standards ; Humans ; Male ; Osteomyelitis/diagnostic imaging ; Osteomyelitis/economics ; Osteomyelitis/therapy ; Patient Care/economics ; Patient Care/standards ; Quality Improvement/economics ; Quality Improvement/standards ; Retrospective Studies ; Young Adult
    Language English
    Publishing date 2018-12-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2018-0387
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  5. Article: A comparison of the polycation receptors of Paramecium tetraurelia and Tetrahymena thermophila.

    Robinette, Eric D / Gulley, Kevin T / Cassity, Katherine J / King, Erin E / Nielsen, Amber J / Rozelle, Cristine L / Warren, Timothy J / Morrow, James M / Kuruvilla, Heather G

    The Journal of eukaryotic microbiology

    2008  Volume 55, Issue 2, Page(s) 86–90

    Abstract: Chemorepellents are compounds that cause ciliated protozoans to reorient their swimming direction. A number of chemorepellents have been studied in the ciliated protozoans, Paramecium and Tetrahymena. Chemorepellents, such as polycations, cause the ... ...

    Abstract Chemorepellents are compounds that cause ciliated protozoans to reorient their swimming direction. A number of chemorepellents have been studied in the ciliated protozoans, Paramecium and Tetrahymena. Chemorepellents, such as polycations, cause the organism to exhibit "avoidance behavior," a swimming behavior characterized by jerky movements and other deviations from normal forward swimming, which result from ciliary reversal. One well-characterized chemorepellent pathway in Tetrahymena is that of the proposed polycation receptor that is activated by lysozyme and pituitary adenylate cyclase activating polypeptide (PACAP). In this study, we compare the response of Paramecium to the chemorepellents lysozyme, vasoactive intestinal peptide (VIP), and PACAP to the previously studied polycation response in Tetrahymena. Our results indicate that lysozyme, VIP, and PACAP are all chemorepellents in Paramecium, just as they are in Tetrahymena. However, the signaling pathways involved appear to be different. While previous pharmacological characterization indicates that G-proteins are involved in polycation signaling in Tetrahymena, we present evidence that similar reception in Paramecium involves activation of a tyrosine kinase pathway in order for lysozyme avoidance to occur. Polycation responses of both organisms are inhibited by neomycin sulfate. While PACAP is the most effective of the three chemorepellents in Tetrahymena, lysozyme is the most effective chemorepellent in Paramecium.
    MeSH term(s) Animals ; Enzyme Inhibitors/pharmacology ; GTP-Binding Proteins/metabolism ; Locomotion/drug effects ; Muramidase/pharmacology ; Paramecium tetraurelia/drug effects ; Paramecium tetraurelia/physiology ; Pituitary Adenylate Cyclase-Activating Polypeptide/pharmacology ; Polyamines/pharmacology ; Protein-Tyrosine Kinases/metabolism ; Signal Transduction ; Tetrahymena thermophila/drug effects ; Tetrahymena thermophila/physiology ; Vasoactive Intestinal Peptide/pharmacology
    Chemical Substances Enzyme Inhibitors ; Pituitary Adenylate Cyclase-Activating Polypeptide ; Polyamines ; polycations ; Vasoactive Intestinal Peptide (37221-79-7) ; Protein-Tyrosine Kinases (EC 2.7.10.1) ; Muramidase (EC 3.2.1.17) ; GTP-Binding Proteins (EC 3.6.1.-)
    Language English
    Publishing date 2008-03
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 1147218-2
    ISSN 1550-7408 ; 1066-5234
    ISSN (online) 1550-7408
    ISSN 1066-5234
    DOI 10.1111/j.1550-7408.2008.00310.x
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  6. Article: A Comparison of the Polycation Receptors of Paramecium tetraurelia and Tetrahymena thermophila

    ROBINETTE, ERIC D / GULLEY, KEVIN T / CASSITY, KATHERINE J / KING, ERIN E / NIELSEN, AMBER J / ROZELLE, CRISTINE L / WARREN, TIMOTHY J / MORROW, JAMES M / KURUVILLA, HEATHER G

    Journal of eukaryotic microbiology. 2008 Mar-Apr., v. 55, no. 2

    2008  

    Abstract: Chemorepellents are compounds that cause ciliated protozoans to reorient their swimming direction. A number of chemorepellents have been studied in the ciliated protozoans, Paramecium and Tetrahymena. Chemorepellents, such as polycations, cause the ... ...

    Abstract Chemorepellents are compounds that cause ciliated protozoans to reorient their swimming direction. A number of chemorepellents have been studied in the ciliated protozoans, Paramecium and Tetrahymena. Chemorepellents, such as polycations, cause the organism to exhibit "avoidance behavior," a swimming behavior characterized by jerky movements and other deviations from normal forward swimming, which result from ciliary reversal. One well-characterized chemorepellent pathway in Tetrahymena is that of the proposed polycation receptor that is activated by lysozyme and pituitary adenylate cyclase activating polypeptide (PACAP). In this study, we compare the response of Paramecium to the chemorepellents lysozyme, vasoactive intestinal peptide (VIP), and PACAP to the previously studied polycation response in Tetrahymena. Our results indicate that lysozyme, VIP, and PACAP are all chemorepellents in Paramecium, just as they are in Tetrahymena. However, the signaling pathways involved appear to be different. While previous pharmacological characterization indicates that G-proteins are involved in polycation signaling in Tetrahymena, we present evidence that similar reception in Paramecium involves activation of a tyrosine kinase pathway in order for lysozyme avoidance to occur. Polycation responses of both organisms are inhibited by neomycin sulfate. While PACAP is the most effective of the three chemorepellents in Tetrahymena, lysozyme is the most effective chemorepellent in Paramecium.
    Language English
    Dates of publication 2008-03
    Size p. 86-90.
    Publisher Blackwell Publishing Inc
    Publishing place Malden, USA
    Document type Article
    ZDB-ID 1147218-2
    ISSN 1550-7408 ; 1066-5234
    ISSN (online) 1550-7408
    ISSN 1066-5234
    DOI 10.1111/j.1550-7408.2008.00310.x
    Database NAL-Catalogue (AGRICOLA)

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