Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.

INTRODUCTION: Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates. METHODS: In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed. RESULTS: The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p \u3c 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p \u3c 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04). CONCLUSION: Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI

Parent and child attachment-like behaviors with conversational AI agents and perceptions of impact on family dynamics

Objective: We explored parents’ and children’s attachment-like behaviors with artificial intelligence (AI)-enabled smart speakers (often called digital assistants; DAs) and associations with perceived impacts on family dynamics. Background: DAs (e.g., Alexa) are increasingly integrated into homes, with prior research reporting varied uses, benefits, and concerns, including perceived emotional attachments among children. Method: We conducted an online survey of 351 parents who owned DAs to assess frequency of use, perception of positive/negative impacts, and attachment-like behaviors with DAs. Utilizing linear regression we examined associations between variables. Results: Approximately half reported at least daily DA use. Overall, participants reported moderate attachment-like behavior, with moderate positive impacts and low negative impacts; greater attachment-like behavior was positively associated with perceptions of both positive and negative impacts as well as frequency of use. Conclusion: Higher frequency of DA use and parents’ perceptions of impact—greater positive and greater negative—were associated with higher levels of attachment-like behavior. Implications: As DAs and generative AI become more advanced, human-AI relationships will likely become more complex, and continued research should assess their impact on families and child development. Full Report forthcomin

A Brief Commentary on Human-AI Attachment and Possible Impacts on Family Dynamics

Objective: In this brief commentary article, we outline an emerging idea that it may be possible that as Conversational Artificial Intelligence (CAI) becomes a part of an individual’s environment and interacts with them their attachment system may become activated, potentially leading to behaviors—such as seeking out the CAI to feel safe in times of stress—that have typically been reserved for human-to-human attachment relationships. We term this attachmentlike behavior, but future work must determine if these behaviors are driven by a Human-AI attachment or something else entirely. Background: CAI is an emerging technical advancement that is the cornerstone of many everyday tools (e.g., smartphone apps, online chatbots, smart speakers). With the advancement in generative and conversational AI, device affordances and technical systems are increasingly complex. For example, generative AI has allowed for more personalization, human-like dialogue and interaction, and the interpretation and generation of human emotions. Indeed, AI tools increasingly have the ability to mimic human caring—learning from past interactions with the individual and appearing to be emotionally available and comforting in times of need. Humans instinctually have attachment-related needs for comfort and emotional security, and therefore as individuals begin to feel their attachment-related needs are met by CAI they may begin to seek out the CAI as a source of safety or to comfort their distress. This leads to questions of whether Human-AI attachment is truly possible and, if possible, what this attachment might mean for family dynamics

Pro: The Use of Sugammadex Does Not Preclude the Need for Objective Neuromuscular Monitoring.

Based on strong evidence, optimal management of neuromuscular block should incorporate objective (or quantitative) neuromuscular monitoring with appropriately dosed antagonists such as sugammadex. Sugammadex has the unique ability to antagonize aminosteroidal-induced neuromuscular block at any level; however, neostigmine is a reasonable alternative at minimal levels. Blind or excessive administration of sugammadex does not eliminate the risk of patients having postoperative residual neuromuscular block. Significant variability exists in how patients respond both to neuromuscular blocking agents and their antagonists

Issue 14: Pulmonary & Critical Care Insider

Pulmonary & Critical Care Insider Issue 14 Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview. The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. Topics: Original Study Summaries: stereotactic body radiotherapy, surveillance over surgery for small pulmonary subsolid nodules, EBUS-TBNA sample acquisition and handling, Systolic arterial pressure targets in shock, stroke risk after AF, methotrexate versus prednisone, corticosteroid use in community-acquired pneumonia, dual-sequential defibrillation, biologic therapies for eosinophilic asthma, ASPEN trial, and Tirzepatide for obesity and sleep apne

Issue 13: Pulmonary & Critical Care Insider

Pulmonary & Critical Care Insider Issue 13 Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview. The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. Topics: Original Study Summaries from early 2025 with clinical implications: pGGNs thresholds, Phosphodiesterase-5 Inhibitors with COPD, TTIP ventilation, TAPSE/sPAP Ratio, Propofol, Triglycerides, & Pancreatitis, PEERLESS trial, Metagenomic NGS for SCAP, Termination of Resuscitation (TOR) Guidelines, Intermittent Fasting vs Daily Caloric Restriction, TASC trial, Wearable Ring Oximete

Evaluation and Optimization of Outpatient Parenteral Antimicrobial Therapy Laboratory Monitoring for Beta-Lactam Antibiotics.

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA This evaluation found that among patients who experienced eosinophilia, only one exhibited signs of hypersensitivity, while seven required a change in therapy. This indicates that while eosinophilia is a concern, its direct clinical impact may be limited for the majority of patients. In the cohort experiencing elevated LFTs including AST, ALT, or alkaline phosphatase levels, fewer than 2% necessitated a change in therapy. This low rate suggests that routine LFT monitoring may not always correlate with significant clinical decisions, raising questions about the necessity of frequent lab draws

Issue 15: Pulmonary & Critical Care Insider

Pulmonary & Critical Care Insider Issue 15 Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview. The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. Topics: 2025 Guidelines for ANCA Vasculitis Airway Scaffolds for Emphysema: Six-Month BREATHE TRIAL Results Tackling Emphysema-Related Hyperinflation: Scaffolds, Valves, or Vapor? How They Work? Bactericidal vs. Bacteriostatic Antibiotics in Critically Ill Patients Modified Cuff Leak Test (CLT) and Post-Extubation Stridor 2025 PADIS Guideline Updates Haloperidol is Safe- No Extra Arrhythmia Risk. A BREATHE of Fresh new antifibrotics? What You Eat is What You Breathe! :Systemic Inflammation, Diet Quality, and COPD Outcomes Rewriting the Playbook: Molecular Subtypes and Targeted Therapy in Small Cell Lung Cancer Segmentectomy, Lobectomy, or Wedge Resection in Stage IA NSCLC: What Does the Evidence Say

Forecasting the impact of artificial intelligence on clinical pharmacy practice

There is a need to understand contemporary scientific advances as clinical pharmacy evolves. One rapidly expanding area is artificial intelligence (AI), which has grown significantly over the past year because of the public availability of large language models. This commentary reviews published literature describing and evaluating applications of AI to each aspect of the medication use process and forecasts potential future roles for AI in pharmacy practice. Potential challenges in implementation are also described

Effect of Weighted Blanket Versus Traditional Practices on Anxiety and Pain in Patients Undergoing Elective Surgery: A Multicenter Randomized Controlled Trial.

Perioperative anxiety is common in surgical patients and linked to poor outcomes. This multicenter randomized controlled trial assessed the effect of the use of a warm weighted blanket on presurgical anxiety and pain, as well as postsurgical restlessness, nausea, and vomiting. Levels of anxiety and pain were measured in adult patients using a 100-point visual analog scale before elective surgery. Patients received either a warm weighted blanket (n = 74) or a traditional sheet or nonweighted blanket (n = 74). Patients in the intervention group had significantly lower preoperative anxiety scores (mean [SD] = 26.28 [25.75]) compared to the control group (mean [SD] = 38.73 [30.55], P = .008). However, the intervention had no significant effect on presurgical pain or postsurgical nausea, vomiting, or restlessness. These results suggest that weighted blankets reduce preoperative anxiety in adult patients