{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:57:40Z","timestamp":1765976260368,"version":"3.48.0"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:00:00Z","timestamp":1759622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In low\u2010 and middle\u2010income countries, infections remain the leading cause of treatment\u2010related mortality in pediatric patients with cancer. To address this, the Golden Hour Collaborative\u2014developed in Mexico in alliance with St. Jude\u2014was designed to promote timely antibiotic administration for febrile pediatric hemato\u2010oncology patients through a multidisciplinary approach, continuous caregiver and staff training, standardized protocols, and supply availability. This study evaluates the clinical and economic impact of implementing the MAS Collaborative at the ISSEMyM Maternal\u2013Infant Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>A prospective cohort study with historical controls was conducted. Outcomes were analyzed with nonparametric tests. Costs per febrile neutropenia (FN) episode were estimated using official state cost tables (adjusted to 2025 USD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 160 episodes were analyzed: 80 in the pre\u2010intervention period (2015\u20132018) and 80 in the post\u2010intervention period (2019\u20132022). After implementation, the proportion of patients receiving antibiotics within 60 min increased from 3.8% to 98% (median time\u2010to\u2010antibiotic (TTA) 198\u00a0vs. 42\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Outcomes improved with shorter hospital stays (9\u00a0vs. 8 days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), reduced pediatric intensive care unit (PICU) admissions (20%\u00a0vs. 7.5%, OR 0.32,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), decreased septic shock (25%\u00a0vs. 8.7%), and no infection\u2010related deaths post\u2010intervention (vs. 7.5% pre\u2010intervention). Discharge without complications rose from 50% to 83%. Mean healthcare cost decreased from USD 8,580 to USD 2,835.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this resource\u2010limited setting, the MAS Collaborative shows that multidisciplinary, context\u2010adapted interventions can improve timeliness of care, reduce complications and mortality, and lower short\u2010term costs, highlighting their potential for scalability in LMICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.32075","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T03:49:36Z","timestamp":1759722576000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Economic Impact of the Mexico in Alliance With St. Jude Golden Hour Collaborative in a Mexican Hospital"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7297-2293","authenticated-orcid":false,"given":"Norma Araceli","family":"L\u00f3pez Facundo","sequence":"first","affiliation":[{"name":"Servicio De Oncolog\u00eda Hematolog\u00eda Pedi\u00e1trica Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Alc\u00e1ntara Gardu\u00f1o","family":"B","sequence":"additional","affiliation":[{"name":"Servicio De Urgencias Pedi\u00e1tricas Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivonne","family":"Esteban","sequence":"additional","affiliation":[{"name":"Servicio De Urgencias Pedi\u00e1tricas Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Cervantes","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Servicio De Pediatr\u00eda Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith De La Torre","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Servicio De Enfermer\u00eda Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena Gavia","family":"Encastin","sequence":"additional","affiliation":[{"name":"Servicio De Enfermer\u00eda Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanci Reyes","family":"Felipe","sequence":"additional","affiliation":[{"name":"Servicio De Enfermer\u00eda Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Concepci\u00f3n Hern\u00e1ndez","family":"Cruz","sequence":"additional","affiliation":[{"name":"Servicio De Enfermer\u00eda Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla Ivonne Gonz\u00e1lez","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika Patricia","family":"Buend\u00eda Tinoco","sequence":"additional","affiliation":[{"name":"Servicio De Pediatr\u00eda Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Tejeda","sequence":"additional","affiliation":[{"name":"Servicio De Urgencias Pedi\u00e1tricas Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico 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S\u00e1nchez","family":"Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Servicio De Urgencias Pedi\u00e1tricas Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn Becerril","family":"Becerril","sequence":"additional","affiliation":[{"name":"Servicio De Urgencias Pedi\u00e1tricas Hospital Materno Infantil ISSEMyM  Toluca Estado de M\u00e9xico Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jafet","family":"Arrieta","sequence":"additional","affiliation":[{"name":"Institute For Healthcare Improvement  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Echandia\u2010Abud","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee 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