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3. Prospective Evaluation of the Fungitell® (1→3) Beta-D-Glucan Assay as a Diagnostic Tool for Invasive Fungal Disease in Pediatric Allogeneic Hematopoietic Cell Transplantation: A Report from the Childrens Oncology Group.

Author

Otto, William, Boge, Craig, Ostrosky-Zeichner, Luis, Esbenshade, Adam, Nieder, Michael, Alexander, Sarah, Steinbach, William, Dang, Ha, Villaluna, Doojduen, Chen, Lu, Skeens, Micah, Zaoutis, Theoklis, Sung, Lillian, Fisher, Brian, and Dvorak, Christopher

Subjects
beta-D-glucan, hematopoietic cell transplantation, invasive fungal disease, sensitivity, specificity, Adolescent, Child, Humans, Young Adult, Antifungal Agents, beta-Glucans, Hematopoietic Stem Cell Transplantation, Invasive Fungal Infections, Randomized Controlled Trials as Topic, Sensitivity and Specificity
Abstract

BACKGROUND: Invasive fungal disease (IFD) is a major source of morbidity and mortality for hematopoietic cell transplant (HCT) recipients. Non-invasive biomarkers, such as the beta-D-glucan assay, may improve the diagnosis of IFD. The objective was to define the utility of surveillance testing using Fungitell® beta-D-glucan (BDG) assay in children receiving antifungal prophylaxis in the immediate post-HCT period. METHODS: Weekly surveillance blood testing with the Fungitell® BDG assay was performed during the early post-HCT period in the context of a randomized trial of children, adolescents, and young adults undergoing allogeneic HCT allocated to triazole or caspofungin prophylaxis. Positivity was defined at the manufacturer cutoff of 80 pg/ml. IFD was adjudicated using blinded central reviewers. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the Fungitell® BDG assay for the outcome of proven or probable IFD. RESULTS: A total of 51 patients (out of 290 patients in the parent trial) contributed blood specimens. In total, 278 specimens were evaluated. Specificity was 80.8% (95% confidence interval [CI]: 75.6%-85.3%), and NPV was over 99% (95% CI: 86.8%-99.9%). However, there were no true positive results, resulting in sensitivity of 0% (95% CI: 0.0%-84.2%) and PPV of 0% (95% CI: 0.0%-6.7%). CONCLUSIONS: Fungitell® BDG screening is of limited utility in diagnosing IFD in the post-HCT period, mainly due to high false-positive rates. Fungitell® BDG surveillance testing should not be performed in children during the early post-HCT period while receiving antifungal prophylaxis as the pretest probability for IFD is low.

Published
2023

6. Contributors

Author

Abzug, Mark J., primary, Adderson, Elisabeth E., additional, Agarwal, Aastha, additional, Agwu, Allison L., additional, Albenberg, Lindsey, additional, Albert, Jonathan, additional, Alby, Kevin, additional, Aldrovandi, Grace M., additional, Allen, Upton D., additional, Alvarez-Hernndez, Gerardo, additional, Ampofo, Krow, additional, Anderson, Evan J., additional, Appiah, Grace D., additional, Ardura, Monica I., additional, Arnon, Stephen S., additional, Aronson, Naomi E., additional, Arvin, Ann M., additional, Ashkenazi, Shai, additional, Ashkenazi-Hoffnung, Liat, additional, Asturias, Edwin J., additional, Aukstuolis, Kestutis, additional, Badalyan, Vahe, additional, Baker, Carol J., additional, Balakrishnan, Karthik, additional, Barnett, Elizabeth D., additional, Bechtel, Kirsten, additional, Benitz, William E., additional, Berkovich, Rachel, additional, Berman, David M., additional, Bialek, Stephanie R., additional, Bijker, Else M., additional, Bizzarro, Matthew J., additional, Bloch, Karen C., additional, Bocchini, Joseph A., additional, Boyce, Thomas G., additional, Bradley, John S., additional, Bratcher, Denise F., additional, Braverman, Paula K., additional, Brook, Itzhak, additional, Brown, Kevin Edward, additional, Bryant, Kristina P., additional, Camacho-Gonzalez, Andres F., additional, Caete-Gibas, Connie F., additional, Cantey, Joseph B., additional, Cantey, Paul, additional, Cardemil, Cristina V., additional, Caserta, Mary T., additional, Castagnini, Luis A., additional, Cataldi, Jessica R., additional, Chadwick, Ellen Gould, additional, Chancey, Rebecca J., additional, Cherry, Cara C., additional, Chiang, Silvia S., additional, Choi, Mary, additional, Christenson, John C., additional, Coffin, Susan E., additional, Cohn, Amanda, additional, Contopoulos-Ioannidis, Despina G., additional, Conway, James H., additional, Cortese, Margaret M., additional, Creech, C. Buddy, additional, Crews, Jonathan D., additional, Curtis, Donna, additional, Curtis, Nigel, additional, Danziger-Isakov, Lara A., additional, Darville, Toni, additional, Dasch, Gregory A., additional, Daskalaki, Irini, additional, Davies, H. Dele, additional, Dawood, Fatimah S., additional, Day, J. Christopher, additional, Teresa de la Morena, M., additional, DeMuri, Gregory P., additional, Despommier, Dickson D., additional, Dodson, Daniel S., additional, Dolgner, Stephen J., additional, Dunn, Clinton, additional, Dyal, Jonathan, additional, Edwards, Kathryn M., additional, Edwards, Morven S., additional, Eichenfield, Dawn Z., additional, Eichenfield, Lawrence F., additional, Elston, Dirk M., additional, Emerson, Beth, additional, Enane, Leslie A., additional, Ephros, Moshe, additional, Erdem, Guliz, additional, Eremeeva, Marina E., additional, Esposito, Douglas H., additional, Farley, Monica M., additional, Feingold, Anat R., additional, Feja, Kristina N., additional, Finn, Adam, additional, Fischer, Marc, additional, Fisher, Brian T., additional, Fisher, Randall G., additional, Flynn, Patricia Michele, additional, Foster, Monique A., additional, Fox, LeAnne M., additional, Frank, Michael M., additional, Fredrick, Douglas R., additional, Frenck, Robert W., additional, Gaensbauer, James, additional, Gans, Hayley A., additional, Gauthier, Gregory M., additional, Gavigan, Patrick, additional, Gerber, Jeffrey S., additional, Gernez, Yael, additional, Gigliotti, Francis, additional, Gilger, Mark A., additional, Glaser, Carol A., additional, Gould, Jane M., additional, Graziano, James, additional, Green, Amanda M., additional, Green, Michael, additional, Griffin, Daniel, additional, Griffin, Patricia M., additional, Griffith, David C., additional, Gupta, Piyush, additional, Gutelius, Bruce J., additional, Gutman, Julie R., additional, Hall, Aron J., additional, Hamdy, Rana F., additional, Han, Jin-Young, additional, Handy, Lori K., additional, Hanisch, Benjamin, additional, Harper, Marvin B., additional, Harris, Aaron M., additional, Harrison, Christopher J., additional, Haslam, David B., additional, Haston, Julia C., additional, Hawkes, Sarah.J., additional, Heald-Sargent, Taylor, additional, Hendley, J. Owen, additional, Hersh, Adam L., additional, Hilinski, Joseph A., additional, Hills, Susan L., additional, Hong, David K., additional, Hotez, Peter J., additional, Hsu, Katherine K., additional, Huang, Felicia Scaggs, additional, Hunstad, David A., additional, Hunt, W. Garrett, additional, Hwang, Loris Y., additional, Ilboudo, Christelle M., additional, Jaggi, Preeti, additional, Jean, Sophonie, additional, Jhaveri, Ravi, additional, Jirk-Pomajbkov, Kateina, additional, Kadry, Nadia A., additional, Kamb, Mary L., additional, Kapadia, Ronak K., additional, Katz, Ben Z., additional, Katz, Sophie E., additional, Kaur, Ishminder, additional, Kersh, Gilbert J., additional, Khan, Muhammad Ali, additional, Khurana, Ananta, additional, Kimberlin, David W., additional, Klein, Bruce, additional, Kobayashi, Miwako, additional, Kociolek, Larry K., additional, Koh, Andrew Y., additional, Kotloff, Karen L., additional, Kroger, Andrew T., additional, Kronman, Matthew P., additional, Lalor, Leah, additional, Lauren, Christine T., additional, Leber, Amy, additional, Leshem, Eyal, additional, Lewis, David B., additional, Livingston, Robyn A., additional, Llata, Eloisa, additional, Lloyd, Kevin, additional, Loh, Katrina, additional, Long, Sarah S., additional, Lopman, Benjamin A., additional, Lucero, Yalda C., additional, Lugo, Debra J., additional, Lujn-Zilbermann, Jorge, additional, Maldonado, Yvonne A., additional, Manaloor, John J., additional, Manthiram, Kalpana, additional, Martin, Stacey W., additional, Mathew, Roshni, additional, Mazzulli, Tony, additional, McFarland, Elizabeth J., additional, McGann, Kathleen A., additional, McNamara, Lucy A., additional, Meislich, Debrah, additional, Meissner, H. Cody, additional, Mejias, Asuncion, additional, Mertsola, Jussi, additional, Messacar, Kevin, additional, Mhaissen, Mohammad Nael, additional, Michaels, Marian G., additional, Miller, Melissa B., additional, Miller-Handley, Hilary, additional, Mintz, Eric, additional, Mohan, Parvathi, additional, Montgomery, Susan P., additional, Montoya, Jose G., additional, Moorman, Anne C., additional, Moro, Pedro L., additional, Moscicki, Anna-Barbara, additional, Muller, William J., additional, Myers, Angela L., additional, Nadel, Simon, additional, Nayak, Jennifer Lynn, additional, Neely, Michael Noel, additional, Neil, Karen P., additional, Nelson, Christina A., additional, Nelson, Noele P., additional, Nichols, Megin, additional, Nicholson, William, additional, Nopper, Amy Jo, additional, Norton, Laura E., additional, Ochoa, Theresa J., additional, Olarte, Liset, additional, Onarecker, Timothy R., additional, Orenstein, Walter A., additional, ORyan, Miguel, additional, Otto, William R., additional, Ouellette, Christopher P., additional, Paddock, Christopher D., additional, Palazzi, Debra L., additional, Panuganti, Suresh Kumar, additional, Pappas, Diane E., additional, Paret, Michal, additional, Pastula, Daniel M., additional, Patterson, Thomas F., additional, Petersen, Brett W., additional, Petrosyan, Mikael, additional, Pickering, Larry K., additional, Pindyck, Talia, additional, Pinninti, Swetha, additional, Pittet, Laure F., additional, Planet, Paul J., additional, Pollard, Andrew J., additional, Posfay-Barbe, Klara M., additional, Poulsen, Casper S., additional, Poutanen, Susan M., additional, Powers, Ann M., additional, Prasanphanich, Nina Salinger, additional, Pritt, Bobbi S., additional, Prober, Charles G., additional, Puar, Neha, additional, Quilter, Laura A.S., additional, Ramilo, Octavio, additional, Rao, Suchitra, additional, Ratner, Adam J., additional, Rawstron, Sarah A., additional, Read, Jennifer S., additional, Relich, Ryan F., additional, Reller, Megan E., additional, Robinson, Candice L., additional, Romero, Jos R., additional, Rosen, David A., additional, Ross, Shannon A., additional, Rours, G. Ingrid J.G., additional, Rowe, Peter C., additional, Rowley, Anne H., additional, Rubin, Lorry G., additional, Ryan, Edward T., additional, Sacharok, Alexandra, additional, Sandora, Thomas J., additional, Sapp, Sarah G.H., additional, Sardana, Kabir, additional, Sauberan, Jason B., additional, Schaffzin, Joshua K., additional, Schillie, Sarah, additional, Schuster, Jennifer E., additional, Schwartz, Kevin L., additional, Sederdahl, Bethany K., additional, Serpa-Alvarez, Jose, additional, Shah, Kara N., additional, Shah, Samir S., additional, Shaikh, Nader, additional, Shane, Andi L., additional, Shapiro, Eugene D., additional, Shaw, Jana, additional, Shetty, Avinash K., additional, Shope, Timothy R., additional, Dairiki Shortliffe, Linda M., additional, Shulman, Stanford T., additional, Shust, Gail F., additional, Siberry, George Kelly, additional, Siegel, Jane D., additional, Siegel, Robert David, additional, Simonsen, Kari A., additional, Singh, Upinder, additional, Smith, Christiana, additional, Smith, Lauren L., additional, Song, Eunkyung, additional, Souder, Emily, additional, Spearman, Paul, additional, St. Geme, Joseph W., additional, Staat, Mary Allen, additional, Staples, J. Erin, additional, Starke, Jeffrey R., additional, Statler, Victoria A., additional, Steinbach, William J., additional, Stensvold, Christen Rune, additional, Stokes, Erin K., additional, Stoner, Bradley P., additional, Storch, Gregory A., additional, Straily, Anne, additional, Sullivan, Kathleen E., additional, Swanson, Douglas S., additional, Tanz, Robert R., additional, Taormina, Gillian, additional, Tate, Jacqueline E., additional, Taveras, Jeanette, additional, Tebruegge, Marc, additional, Teshale, Eyasu H., additional, Thompson, George R., additional, Thompson-Stone, Robert, additional, Thomsen, Isaac, additional, Thomson, Richard B., additional, Thorell, Emily A., additional, Tien, Vivian, additional, Tobin, Nicole H., additional, Toltzis, Philip, additional, Treat, James, additional, Troy, Stephanie B., additional, Van Dvke, Russell B., additional, Vaz, Louise Elaine, additional, Vijayan, Vini, additional, Vodzak, Jennifer, additional, Wagner, Thor A., additional, Wald, Ellen R., additional, Wallihan, Rebecca, additional, Wang, Huanyu, additional, Wangu, Zoon, additional, Washam, Matthew, additional, Waters, Valerie, additional, Watson, Joshua R., additional, Weatherhead, Jill E., additional, Weinberg, Geoffrey A., additional, Weng, Mark K., additional, Wiederhold, Nathan P., additional, Wiesenfeld, Harold C., additional, Williams, Cydni, additional, Williams, John V., additional, Willoughby, Rodney E., additional, Wittler, Robert R., additional, Wood, James B., additional, Woods, Charles Reece, additional, Workowski, Kimberly A., additional, Wright, Terry W., additional, Wu, Hsi-Yang, additional, Xu, Huan, additional, Yagupsky, Pablo, additional, Yi, Jumi, additional, Yoder, Jonathan, additional, Young, Edward J., additional, Zaenglein, Andrea L., additional, Zimmermann, Petra, additional, and Zong, Wenjing, additional

Published
2023
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7. Candida Species

Author

Otto, William R., primary, Steinbach, William J., additional, and Fisher, Brian T., additional

Published
2023
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8. Clinical Impact of Bronchoalveolar Lavage in Pediatric and Young Adult Patients With Cancer and Suspected Respiratory Infections.

Author

Whitehurst, Daniel, Otto, William, Verkamp, Bethany, Paulsen, Grant, Danziger-Isakov, Lara, and Miller-Handley, Hilary

Subjects
*RESPIRATORY infections, *RESEARCH funding, *CANCER patients, *RETROSPECTIVE studies, *BRONCHOALVEOLAR lavage, *PNEUMOCYSTIS pneumonia, *BRONCHOSCOPY, *CHILDREN, *SYMPTOMS, *ADOLESCENCE, *ADULTS
Abstract

Background Respiratory infections cause a significant amount of morbidity and mortality in pediatric and young adult patients with malignancy. Bronchoscopy with bronchoalveolar lavage (BAL) is frequently utilized in the diagnostic process, but which patients would most benefit is poorly understood. Methods A retrospective study from 2013 to 2022 examined patients with active malignancy who underwent bronchoscopy with BAL. Positive and negative clinical impacts were assessed by 3 independent reviewers according to predetermined criteria. Mixed-effects logistic regression was performed to identify factors associated with positive and negative clinical impact. Results In total, 145 bronchoscopies met inclusion criteria with a median patient age of 12 years (interquartile range 5-17). A total of 30.3% of bronchoscopies had a positive clinical impact with 17.2% leading to a new diagnosis, most commonly Pneumocystis jirovecii pneumonia (PJP) (7.6%). Comparatively, 18.6% had a negative clinical impact, most commonly from a procedural complication (13.1%). Trimethoprim-sulfamethoxazole (TMP-SMX) initiation for treatment of suspected PJP prior to BAL (adjusted odds ratio [aOR] 11.20, 95% CI 1.32-95.29) was associated with positive clinical impact. Requirement for ICU-level care (aOR 18.85, 95% CI 3.60-98.69) or oxygen supplementation by nasal cannula prior to BAL (aOR 18.41, 95% CI 4.78-70.95) were associated with negative clinical impact while prior invasive ventilation (aOR 0.09, 95% CI 0.01-0.58) was associated with the absence of negative clinical impact. Conclusions Patients with potential respiratory infections with high clinical suspicion for PJP who had been started on treatment TMP-SMX prior to BAL benefit most from bronchoscopy with BAL. Patients intubated prior to BAL who were deemed clinically safe for bronchoscopy tolerated the procedure better than those in the ICU not requiring intubation or those requiring supplemental oxygen via nasal cannula. [ABSTRACT FROM AUTHOR]

Published
2025
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10. Wave Induced Motions of a Floating Mega Island

Author

Otto, William, Waals, Olaf, Bunnik, Tim, Ceneray, Coline, di Prisco, Marco, Series Editor, Chen, Sheng-Hong, Series Editor, Vayas, Ioannis, Series Editor, Kumar Shukla, Sanjay, Series Editor, Sharma, Anuj, Series Editor, Kumar, Nagesh, Series Editor, Wang, Chien Ming, Series Editor, Lim, Soon Heng, editor, and Tay, Zhi Yung, editor

Published
2020
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13. ADVANCING SCIENCE AND SERVICES DURING THE 2015/16 EL NIÑO : The NOAA El Niño Rapid Response Field Campaign

Author

Dole, Randall M., Spackman, J. Ryan, Newman, Matthew, Compo, Gilbert P., Smith, Catherine A., Hartten, Leslie M., Barsugli, Joseph J., Webb, Robert S., Hoerling, Martin P., Cifelli, Robert, Wolter, Klaus, Barnet, Christopher D., Gehne, Maria, Gelaro, Ronald, Kiladis, George N., Abbott, Scott, Akish, Elena, Albers, John, Brown, John M., Cox, Christopher J., Darby, Lisa, de Boer, Gijs, DeLuisi, Barbara, Dias, Juliana, Dunion, Jason, Eischeid, Jon, Fairall, Christopher, Gambacorta, Antonia, Gorton, Brian K., Hoell, Andrew, Intrieri, Janet, Jackson, Darren, Johnston, Paul E., Lataitis, Richard, Mahoney, Kelly M., McCaffrey, Katherine, McColl, H. Alex, Mueller, Michael J., Murray, Donald, Neiman, Paul J., Otto, William, Persson, Ola, Quan, Xiao-Wei, Rangwala, Imtiaz, Ray, Andrea J., Reynolds, David, Dellaripa, Emily Riley, Rosenlof, Karen, Sakaeda, Naoko, Sardeshmukh, Prashant D., Slivinski, Laura C., Smith, Lesley, Solomon, Amy, Swales, Dustin, Tulich, Stefan, White, Allen, Wick, Gary, Winterkorn, Matthew G., Wolfe, Daniel E., and Zamora, Robert

Published
2018

16. Developmental progression of the nasopharyngeal microbiome during childhood and association with the lower airway microbiome

Author

Hernandez-Leyva, Ariel J, primary, Rosen, Anne L., additional, Tomera, Christopher P., additional, Lin, Elaina E., additional, Akaho, Elikplim, additional, Blatz, Allison M., additional, Otto, William R., additional, Logan, Joey, additional, Young, Lisa R., additional, Harris, Rebecca M, additional, Kau, Andrew L., additional, and Odom John, Audrey Ragan, additional

Published
2023
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17. Infectious Diseases Evaluation of the Child With Suspected Hemophagocytic Lymphohistiocytosis.

Author

Leon, Maria Deza, Otto, William R, Danziger-Isakov, Lara, Kumar, Ashish, and Huang, Felicia Scaggs

Subjects
*COMMUNICABLE diseases, *HEMATOPOIETIC stem cell transplantation, *HEMOPHAGOCYTIC lymphohistiocytosis, *HYPERFERRITINEMIA, *HYPERLIPIDEMIA, *KILLER cells, *CYTOPENIA, *MACROPHAGES, *POLYMERASE chain reaction, *FEVER, *PANCYTOPENIA, *LEISHMANIA, *AMPHOTERICIN B, *DISEASE relapse, *INFLAMMATION, *SPLEEN diseases, *IMMUNOSUPPRESSION, *CHILDREN
Published
2024
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20. Infectious Diseases Evaluation of the Child With Suspected Hemophagocytic Lymphohistiocytosis

Author

Deza Leon, Maria, Otto, William R, Danziger-Isakov, Lara, Kumar, Ashish, and Scaggs Huang, Felicia

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive and maladaptive inflammation. In this review, we discuss how the clinical and laboratory features of HLH overlap with infection and propose a diagnostic and treatment strategy to identify patients with infections mimicking HLH.

Published
2024
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21. A Practical Guide to Antifungal Susceptibility Testing

Author

Otto, William R., Arendrup, Maiken Cavling, Fisher, Brian T., Otto, William R., Arendrup, Maiken Cavling, and Fisher, Brian T.

Abstract

We review antifungal susceptibility testing and the development of clinical breakpoints, and detail an approach to using antifungal susceptibility results when breakpoints have not been defined. This information may prove helpful when selecting therapy for invasive fungal infections in children.

Published
2023

23. Dynamic Prediction Modeling and Clinical Decision Support for Bloodstream Infections in Pediatric Acute Myeloid Leukemia (AML)

Author

Otto, William

Abstract

Children receiving chemotherapy for acute myeloid leukemia (AML) traditionally have been hospitalized for prolonged periods due to high risk of bloodstream infections (BSI). The goal of hospitalization is to allow patients to be closely monitored for early signs of BSI. This results in significant anxiety for patients and families. Recent research suggests that rates of BSI are similar for children observed as inpatients or outpatients. Outpatient management for children with AML may be beneficial by reducing costs and negative impacts on quality of life. Despite these potential benefits, clinicians are reluctant to observe these children in the outpatient setting during periods of high-risk for BSI. Real-time data on risk for infection will allow for individualized decision-making regarding outpatient management. The candidate for this K08 Mentored Career Development Award, William R. Otto, MD, MSCE, seeks to develop this clinically relevant, personalized data for children with AML through two complementary projects. In Aim 1, Dr. Otto will derive dynamic prediction models that identify periods when children with AML are at high risk of developing BSI. This model will guide oncologists when deciding whether or not a specific patient can be observed at home during periods of neutropenia. The model will be derived in a multicenter AML cohort containing electronic health record data from the Children’s Hospital of Philadelphia, Texas Children’s Hospital, and Children’s Healthcare of Atlanta (Aim 1A). The model will be validated in a cohort of patients from Cincinnati Children’s Hospital Medical Center (CCHMC), Seattle Children’s Hospital, and Children’s Mercy Hospital (Aim 1B). Simultaneously, Dr. Otto will utilize a rigorous human-centered design process to iteratively design and test a high-fidelity prototype clinical decision support (CDS) platform that translates output from the dynamic prediction models into a format that is useful to oncologists (Aim 2). This K08 Award encompasses the research and training plan to facilitate Dr. Otto’s transition to an independent clinical investigator. Dr. Otto is an Assistant Professor of Pediatrics and pediatric infectious diseases at CCHMC and the University of Cincinnati (UC). Dr. Otto’s long-term career goal is to be an independent investigator with expertise in epidemiology, dynamic prediction modeling, and clinical decision support. The proposed research and career development plan promote this goal by allowing Dr. Otto to obtain training in advanced statistical modeling with longitudinal data, human centered design, and implementation science. Dr. Otto has assembled an expert team of mentors, led by Brian Fisher, DO, MSCE, MPH. This accomplished advisory committee, comprised of experts in infectious diseases, oncology, biostatistics, and clinical informatics, combined with the exceptional research environment at CCHMC and UC, will provide the resources and expertise needed to guide Dr. Otto in his research. Completion of this project will lead to an independent research career aimed at developing validated dynamic models to predict infection risk, incorporating this information into functional CDS tools, and assessing the comparative effectiveness of these tools once implemented into clinical practice.

Published
2023
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26. Absolute lymphocyte count recovery following initial acute myelogenous leukemia therapy: Implications for adoptive cell therapy

Author

Molina, John C., primary, Li, Yimei, additional, Otto, William R., additional, Miller, Tamara P., additional, Getz, Kelly D., additional, Mccoubrey, Carly, additional, Ramos, Mark, additional, Krause, Edward, additional, Cao, Lusha, additional, Gramatges, M. Monica, additional, Rabin, Karen, additional, Scheurer, Michael, additional, Elgarten, Caitlin W., additional, Myers, Regina M., additional, Seif, Alix E., additional, Fisher, Brian T., additional, Shah, Nirali N., additional, and Aplenc, Richard, additional

Published
2022
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27. Prospective Evaluation of the Fungitell® (1→3) Beta‐D‐Glucan Assay as a Diagnostic Tool for Invasive Fungal Disease in Pediatric Allogeneic Hematopoietic Cell Transplantation: A Report from the Children's Oncology Group

Author

Otto, William R., primary, Dvorak, Christopher C., additional, Boge, Craig L. K., additional, Ostrosky‐Zeichner, Luis, additional, Esbenshade, Adam J., additional, Nieder, Michael L., additional, Alexander, Sarah, additional, Steinbach, William J., additional, Dang, Ha, additional, Villaluna, Doojduen, additional, Chen, Lu, additional, Skeens, Micah, additional, Zaoutis, Theoklis E., additional, Sung, Lillian, additional, and Fisher, Brian T., additional

Published
2022
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33. Experimental study on a breaking-enforcing floating breakwater

Author

van der Zanden, Joep (author), van der Hout, A.J. (author), Otto, William (author), Spaargaren, Floor (author), Walles, Brenda (author), de Wilde, Jaap (author), van der Zanden, Joep (author), van der Hout, A.J. (author), Otto, William (author), Spaargaren, Floor (author), Walles, Brenda (author), and de Wilde, Jaap (author)

Abstract

Floating breakwaters are moored structures that attenuate wave energy through a combination of reflection and dissipation. Studies into floating breakwaters have been generally restricted to optimising the attenuation performance. This study presents a novel floating breakwater type that was developed to have good attenuation performance while keeping wave drift loads as small as possible. The floating breakwater was designed as a submerged parabolic beach that enforces wave energy dissipation through breaking. The design was tested in a 3D shallow-water wave basin in captive and moored setups for regular and irregular wave conditions. Results are presented in terms of attenuation performance, motions, and (mooring) loads. The results show that the breaking of waves improves the attenuation performance of the floater in captive setup. However, in moored setup, the attenuation performance was dominated by diffraction and radiation of the wave field, with breaking being of secondary importance. This shows that breaking-enforcing floating breakwaters have potential, but require a high vertical hydrostatic and/or mooring stiffness in order to enforce intense breaking. Mean wave drift loads on the object showed significant difference between breaking and non-breaking waves in both setups, with breaking waves leading to lower normalized loads. This is attributed to breaking-induced set-up and set-down of the water level. As a result, the new breakwater design has a more favourable balance between wave attenuation and drift loads than common (i.e., box-, pontoon-, or mat-type) floating breakwater designs. Tests with varying surface roughness showed that floating breakwaters may benefit from dual-use functions that naturally increase the roughness (e.g., shellfish, vegetation), which have a marginal effect on the attenuation performance, but increase the added mass and hydrodynamic damping and as such, reduce mooring line loads., Rivers, Ports, Waterways and Dredging Engineering

Published
2022
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34. Experimental study on a breaking-enforcing floating breakwater

Author

van der Zanden, Joep, van der Hout, Arne, Otto, William, Spaargaren, Floor, Walles, B., de Wilde, Jaap, van der Zanden, Joep, van der Hout, Arne, Otto, William, Spaargaren, Floor, Walles, B., and de Wilde, Jaap

Abstract

Floating breakwaters are moored structures that attenuate wave energy through a combination of reflection and dissipation. Studies into floating breakwaters have been generally restricted to optimising the attenuation performance. This study presents a novel floating breakwater type that was developed to have good attenuation performance while keeping wave drift loads as small as possible. The floating breakwater was designed as a submerged parabolic beach that enforces wave energy dissipation through breaking. The design was tested in a 3D shallow-water wave basin in captive and moored setups for regular and irregular wave conditions. Results are presented in terms of attenuation performance, motions, and (mooring) loads. The results show that the breaking of waves improves the attenuation performance of the floater in captive setup. However, in moored setup, the attenuation performance was dominated by diffraction and radiation of the wave field, with breaking being of secondary importance. This shows that breaking-enforcing floating breakwaters have potential, but require a high vertical hydrostatic and/or mooring stiffness in order to enforce intense breaking. Mean wave drift loads on the object showed significant difference between breaking and non-breaking waves in both setups, with breaking waves leading to lower normalized loads. This is attributed to breaking-induced set-up and set-down of the water level. As a result, the new breakwater design has a more favourable balance between wave attenuation and drift loads than common (i.e., box-, pontoon-, or mat-type) floating breakwater designs. Tests with varying surface roughness showed that floating breakwaters may benefit from dual-use functions that naturally increase the roughness (e.g., shellfish, vegetation), which have a marginal effect on the attenuation performance, but increase the added mass and hydrodynamic damping and as such, reduce mooring line loads

Published
2022

36. Risk of bacterial bloodstream infection does not vary by central-line type during neutropenic periods in pediatric acute myeloid leukemia

Author

Elgarten, Caitlin W., primary, Otto, William R., additional, Shenton, Luke, additional, Stein, Madison T., additional, Horowitz, Joseph, additional, Aftandilian, Catherine, additional, Arnold, Staci D., additional, Bona, Kira O., additional, Caywood, Emi, additional, Collier, Anderson B., additional, Gramatges, M. Monica, additional, Henry, Meret, additional, Lotterman, Craig, additional, Maloney, Kelly, additional, Modi, Arunkumar J., additional, Mian, Amir, additional, Mody, Rajen, additional, Morgan, Elaine, additional, Raetz, Elizabeth A., additional, Verma, Anupam, additional, Winick, Naomi, additional, Wilkes, Jennifer J., additional, Yu, Jennifer C., additional, Aplenc, Richard, additional, Fisher, Brian T., additional, and Getz, Kelly D., additional

Published
2022
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37. ICU Family Member's Experience With Bereavement: A Qualitative Approach

Author

Jones, Casey Otto William

Subjects
Nursing, Bereavement, Bereavement Intervention, ICU, ICU Death, Qualitative
Abstract

ABSTRACTObjective: To describe family members’ experiences with bereavement 13 months after the death of a family member in an adult ICU.Definition: Bereavement is an undefined time period after the death of a loved one, when family members or friends may experience grief and mourn the loss of the deceased. In varying degrees this may include physical, cognitive, behavioral and spiritual / religious experiences for the family member. For some people this period can be stressful and cause distressing symptoms. Design: An exploratory, descriptive analysis using semi-structured interviews.Setting: Interviews were conducted over the telephone. Handwritten responses were received by mail.Participants: 17 family members of 17 deceased ICU patients from two ICUs in a tertiary medical center in the Western United States represent the sample for this study.Methods and Results: A qualitative, descriptive technique was used for data analysis. Two independent raters coded transcripts of audiotaped interviews, handwritten responses to open- ended survey questions and one unsolicited letter in order to assess family members’ experiences with bereavement support provided by the ICU. Comments from family members were categorized into themes focusing on ICU family bereavement experiences. Three main themes emerged and consisted of: 1) bereavement as a unique experience for each family member, 2) situations occurring during the ICU encounter remained significant for family members beyond a year after the death, and 3) social, cultural and spiritual events after the death hold importance for ICU family members over time.Conclusions: Bereavement is a notable experience for family members of deceased ICU patients. The themes identified in this study add insight into the experiences of these surviving familyivv members. The results of this study may guide future clinical interventions to help supportbereaved ICU family members.Keywords: ICU, family bereavement, bereavement intervention, qualitative study.

Published
2016

46. General Notes

Author

de Beaufort, L. F., Test, Frederick H., Geist, Otto William, Taylor, Walter P., Swanson, Gustav, Johnson, Charles E., Lawrence, Barbara, Bebb, William, Wright, George M., Hamilton,, W. J., Gilmore, Raymond M., Salvesen, Sigvald, and Murie, Olaus J.

Published
1934
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