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Developing Morally Sensitive Policy In The Nicu: Donation After Circulatory Determination Of Death, Michael van Manen, Nicole Kain 2017 University of Alberta Faculty of Medicine and Dentistry

Developing Morally Sensitive Policy In The Nicu: Donation After Circulatory Determination Of Death, Michael Van Manen, Nicole Kain

The Qualitative Report

Policy development is an important activity for the practice of healthcare. Policies, after all, may cultivate common practices and ensure that best available evidence is employed in clinical decision making. Qualitative research and individuals with expertise in qualitative research methods have much to offer policy makers. We were confronted with the situation of developing policy for donation after circulatory death (DCD) for our newborn intensive care program. Due the moral-ethical complexities surrounding DCD, and the limited experience with DCD in this context, we approached policy development from an iterative design perspective employing qualitative methods. We describe our experience in employing ...


High Levels Of Iron Supplementation Prevents Neural Tube Defects In The Fpn1(Ffe) Mouse Model., Bethany A Stokes, Julia A Sabatino, Irene E. Zohn 2016 George Washington University

High Levels Of Iron Supplementation Prevents Neural Tube Defects In The Fpn1(Ffe) Mouse Model., Bethany A Stokes, Julia A Sabatino, Irene E. Zohn

Pediatrics Faculty Publications

BACKGROUND: Periconception maternal nutrition and folate in particular are important factors influencing the incidence of neural tube defects (NTDs). Many but not all NTDs are prevented by folic acid supplementation and there is a pressing need for additional strategies to prevent these birth defects. Other micronutrients such as iron are potential candidates, yet a clear role for iron deficiency in contributing to NTDs is lacking. Our previous studies with the flatiron (ffe) mouse model of Ferroportin1 (Fpn1) deficiency suggest that iron is required for neural tube closure and forebrain development raising the possibility that iron supplementation could prevent NTDs.

METHODS ...


Sirt1 Regulates Glial Progenitor Proliferation And Regeneration In White Matter After Neonatal Brain Injury., Beata Jablonska, Marcin Gierdalski, Li-Jin Chew, Teresa Hawley, Mackenzie Catron, Arturo Lichauco, Juan Cabrera-Luque, Tracy Yuen, David Rowitch, Vittorio Gallo 2016 George Washington University

Sirt1 Regulates Glial Progenitor Proliferation And Regeneration In White Matter After Neonatal Brain Injury., Beata Jablonska, Marcin Gierdalski, Li-Jin Chew, Teresa Hawley, Mackenzie Catron, Arturo Lichauco, Juan Cabrera-Luque, Tracy Yuen, David Rowitch, Vittorio Gallo

Pediatrics Faculty Publications

Regenerative processes in brain pathologies require the production of distinct neural cell populations from endogenous progenitor cells. We have previously demonstrated that oligodendrocyte progenitor cell (OPC) proliferation is crucial for oligodendrocyte (OL) regeneration in a mouse model of neonatal hypoxia (HX) that reproduces diffuse white matter injury (DWMI) of premature infants. Here we identify the histone deacetylase Sirt1 as a Cdk2 regulator in OPC proliferation and response to HX. HX enhances Sirt1 and Sirt1/Cdk2 complex formation through HIF1α activation. Sirt1 deacetylates retinoblastoma (Rb) in the Rb/E2F1 complex, leading to dissociation of E2F1 and enhanced OPC proliferation. Sirt1 knockdown ...


Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu 2016 University of San Francisco

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones ...


Evidence-Based Decision Support For Pediatric Rheumatology Reduces Diagnostic Errors., Michael M. Segal, Balu Athreya, Mary Beth F. Son, Irit Tirosh, Jonathan S. Hausmann, Elizabeth YN. Ang, David Zurakowski, Lynn K. Feldman, Robert P. Sundel 2016 SimulConsult

Evidence-Based Decision Support For Pediatric Rheumatology Reduces Diagnostic Errors., Michael M. Segal, Balu Athreya, Mary Beth F. Son, Irit Tirosh, Jonathan S. Hausmann, Elizabeth Yn. Ang, David Zurakowski, Lynn K. Feldman, Robert P. Sundel

Department of Pediatrics Faculty Papers

BACKGROUND: The number of trained specialists world-wide is insufficient to serve all children with pediatric rheumatologic disorders, even in the countries with robust medical resources. We evaluated the potential of diagnostic decision support software (DDSS) to alleviate this shortage by assessing the ability of such software to improve the diagnostic accuracy of non-specialists.

METHODS: Using vignettes of actual clinical cases, clinician testers generated a differential diagnosis before and after using diagnostic decision support software. The evaluation used the SimulConsult® DDSS tool, based on Bayesian pattern matching with temporal onset of each finding in each disease. The tool covered 5405 diseases ...


Exploring The Feasibility Of Incorporating Sexual Education Into Routine Adolescent Office Visits, Holly A. Rankin, Alisa LoSasso, MD, Beth I. Schwartz, MD 2016 Nemours duPont Department of Pediatrics

Exploring The Feasibility Of Incorporating Sexual Education Into Routine Adolescent Office Visits, Holly A. Rankin, Alisa Losasso, Md, Beth I. Schwartz, Md

CWIC Posters

Preventative sexual education can reduce the negative health outcomes of sexual behavior in adolescent populations.1 The objective of this pilot study was to determine if sexual education can be delivered as a scripted five-minute module during a routine adolescent office visit in a manner that is non-disruptive of clinic flow and acceptable to both patients and providers.

• 85% of providers reported the intervention did not interrupt clinic flow

• 86% of patients reported the intervention to be appropriate and 92% of providers were satisfied overall with the intervention

These pilot data highlight that the incorporation of brief scripted sexual education ...


Photothermal Therapy Improves The Efficacy Of A Mek Inhibitor In Neurofibromatosis Type 1-Associated Malignant Peripheral Nerve Sheath Tumors., Elizabeth E. Sweeney, Rachel A. Burga, Chaoyang Li, Yuan Zhu, Rohan Fernandes 2016 George Washington University

Photothermal Therapy Improves The Efficacy Of A Mek Inhibitor In Neurofibromatosis Type 1-Associated Malignant Peripheral Nerve Sheath Tumors., Elizabeth E. Sweeney, Rachel A. Burga, Chaoyang Li, Yuan Zhu, Rohan Fernandes

Pediatrics Faculty Publications

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive tumors with low survival rates and the leading cause of death in neurofibromatosis type 1 (NF1) patients under 40 years old. Surgical resection is the standard of care for MPNSTs, but is often incomplete and can generate loss of function, necessitating the development of novel treatment methods for this patient population. Here, we describe a novel combination therapy comprising MEK inhibition and nanoparticle-based photothermal therapy (PTT) for MPNSTs. MEK inhibitors block activity driven by Ras, an oncogene constitutively activated in NF1-associated MPNSTs, while PTT serves as a minimally invasive method to ablate ...


The Emerging Genetics Workforce: A Study Of Physician Geneticists' Professional Lives, Heather Gosnell 2016 University of Kentucky

The Emerging Genetics Workforce: A Study Of Physician Geneticists' Professional Lives, Heather Gosnell

Posters-at-the-Capitol

PURPOSE: The purpose of this study is to explore the current practice and geographic location trends of physicians certified in clinical genetics, clinical biochemical genetics, and medical biochemical genetics during the 2011, 2013, and 2015 certification cycles.

METHODS: Physicians’ personal data was collected from public internet domains including the American Board of Medical Genetics and Genomics (ABMGG) provider database, the CMS National Plan and Provider Enumeration System, publically available professional-biographies, and university affiliations. The search results were cross-referenced for the greatest accuracy. Geographic location data was plotted onto maps.

RESULTS: Approximately 27% (n=69) physicians board-certified in genetics are currently ...


Targeted Gene Delivery To The Enteric Nervous System Using Aav: A Comparison Across Serotypes And Capsid Mutants, Matthew J. Benskey, Nathan C. Kuhn, James J. Galligan, Joanna Garcia, Shannon E. Boye, William W. Hauswirth, Christian Mueller, Sanford L. Boye, Fredric P. Manfredsson 2016 Michigan State University

Targeted Gene Delivery To The Enteric Nervous System Using Aav: A Comparison Across Serotypes And Capsid Mutants, Matthew J. Benskey, Nathan C. Kuhn, James J. Galligan, Joanna Garcia, Shannon E. Boye, William W. Hauswirth, Christian Mueller, Sanford L. Boye, Fredric P. Manfredsson

Christian Mueller

Recombinant adeno-associated virus (AAV) vectors are one of the most widely used gene transfer systems in research and clinical trials. AAV can transduce a wide range of biological tissues, however to date, there has been no investigation on targeted AAV transduction of the enteric nervous system (ENS). Here, we examined the efficiency, tropism, spread, and immunogenicity of AAV transduction in the ENS. Rats received direct injections of various AAV serotypes expressing green fluorescent protein (GFP) into the descending colon. AAV serotypes tested included; AAV 1, 2, 5, 6, 8, or 9 and the AAV2 and AAV8 capsid mutants, AAV2-Y444F, AAV2-tripleY-F ...


Novel Mutation Of Interferon-Γ Receptor 1 Gene Presenting As Early Life Mycobacterial Bronchial Disease, Maria J. Gutierrez, Neelu Kaira, Alexandra Horwitz, Gustavo Nino 2016 George Washington University

Novel Mutation Of Interferon-Γ Receptor 1 Gene Presenting As Early Life Mycobacterial Bronchial Disease, Maria J. Gutierrez, Neelu Kaira, Alexandra Horwitz, Gustavo Nino

Pediatrics Faculty Publications

Mendelian susceptibility to mycobacterial diseases (MSMD) are a spectrum of inherited disorders characterized by localized or disseminated infections caused by atypical mycobacteria. Interferon-γ receptor 1 (IFNGR1) deficiency was the first identified genetic disorder recognized as MSMD. Mutations in the genes encoding IFNGR1 can be recessive or dominant and cause complete or partial receptor deficiency. We present the case of a 2½-year-old boy with a history of recurrent wheezing, diagnosed with endobronchial mycobacterial infection. Immunological workup revealed a homozygous nonsense mutation in the IFNGR1 gene, a novel mutation predicted in silico to cause complete IFNGR1 deficiency. This case demonstrates that (a ...


Standardization Of Postoperative Transitions Of Care To The Pediatric Intensive Care Unit Enhances Efficiency And Handover Comprehensiveness, Anthony Sochet, Ashley Simms, Grace Ye, Nihal Godiwala, Lauren Hebert, Christine O. Corriveau 2016 George Washington University

Standardization Of Postoperative Transitions Of Care To The Pediatric Intensive Care Unit Enhances Efficiency And Handover Comprehensiveness, Anthony Sochet, Ashley Simms, Grace Ye, Nihal Godiwala, Lauren Hebert, Christine O. Corriveau

Pediatrics Faculty Publications

Introduction: To determine the impact of standardization of postoperative transitions of care to the pediatric intensive care unit on handover efficiency and the quality of healthcare data exchange.

Methods: This was a prospective, pre–post observational study after standardization of postoperative transitions in a 44-bed pediatric intensive care unit in a 313-bed tertiary care pediatric hospital from April to July 2015. Standardization was completed using a multidisciplinary handover checklist. Primary outcomes were efficiency expressed as mean handover duration and the comprehensiveness of healthcare data exchange.

Results: Forty-seven postoperative transitions were observed of which 23 were preintervention and 24 were postintervention ...


Data From: Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise S. Maranda, Ninfa Candela 2016 University of Massachusetts Medical School

Data From: Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise S. Maranda, Ninfa Candela

Pediatric Research Data

This dataset is the primary data source for a manuscript submitted for publication.

Manuscript abstract:

Importance: Irritable bowel syndrome (IBS) is associated with significant morbidity in children and adolescents, and the therapeutic efficacy of available treatment options is limited. The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown. Equally the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear.

Aim: To characterize the vitamin D status of pediatric patients with IBS using a case-control study design.

Hypothesis: Serum 25-hydroxyvitamin D [25 ...


A Proteogenomic Approach To Understanding Myc Function In Metastatic Medulloblastoma Tumors., Jerome A Staal, Yanxin Pei, Brian R. Rood 2016 George Washington University

A Proteogenomic Approach To Understanding Myc Function In Metastatic Medulloblastoma Tumors., Jerome A Staal, Yanxin Pei, Brian R. Rood

Pediatrics Faculty Publications

Brain tumors are the leading cause of cancer-related deaths in children, and medulloblastoma is the most prevalent malignant childhood/pediatric brain tumor. Providing effective treatment for these cancers, with minimal damage to the still-developing brain, remains one of the greatest challenges faced by clinicians. Understanding the diverse events driving tumor formation, maintenance, progression, and recurrence is necessary for identifying novel targeted therapeutics and improving survival of patients with this disease. Genomic copy number alteration data, together with clinical studies, identifies c-MYC amplification as an important risk factor associated with the most aggressive forms of medulloblastoma with marked metastatic potential. Yet ...


Associations Of Peripubertal Serum Dioxin And Polychlorinated Biphenyl Concentrations With Pubertal Timing Among Russian Boys, Jane S. Burns, Mary M. Lee, Paige L. Williams, Susan A. Korrick, Oleg Sergeyev, Thuy Lam, Boris Revich, Russ Hauser 2016 Harvard School of Public Health

Associations Of Peripubertal Serum Dioxin And Polychlorinated Biphenyl Concentrations With Pubertal Timing Among Russian Boys, Jane S. Burns, Mary M. Lee, Paige L. Williams, Susan A. Korrick, Oleg Sergeyev, Thuy Lam, Boris Revich, Russ Hauser

Mary M. Lee

BACKGROUND: Dioxins, furans, and polychlorinated biphenyls (PCBs), dioxin-like and nondioxin-like, have been linked to alterations in puberty. OBJECTIVES: We examined the association of peripubertal serum levels of these compounds (and their toxic equivalents (TEQs)) with pubertal onset and maturity among Russian boys enrolled at ages 8-9 years and followed prospectively through ages 17-18 years. METHODS: At enrollment, 473 boys had serum dioxin-like compounds and PCBs measured. At the baseline visit and annually until age 17-18 years, a physician performed pubertal staging [Genitalia (G), Pubarche (P), and testicular volume (TV)]. 315 subjects completed the follow-up visit at 17-18 years of age ...


A Longitudinal Study Of Peripubertal Serum Organochlorine Concentrations And Semen Parameters In Young Men: The Russian Children's Study, Lidia Minguez-Alarcon, Oleg Sergeyev, Jane S. Burns, Paige L. Williams, Mary M. Lee, Susan A. Korrick, Luidmila Smigulina, Boris Revich, Russ Hauser 2016 Harvard T.H. Chan School of Public Health

A Longitudinal Study Of Peripubertal Serum Organochlorine Concentrations And Semen Parameters In Young Men: The Russian Children's Study, Lidia Minguez-Alarcon, Oleg Sergeyev, Jane S. Burns, Paige L. Williams, Mary M. Lee, Susan A. Korrick, Luidmila Smigulina, Boris Revich, Russ Hauser

Pediatric Publications and Presentations

BACKGROUND: Exposures to endocrine disrupting chemicals during critical phases of testicular development may be related to poorer semen parameters. However, few studies have assessed the association between childhood organochlorine (OC) exposure and adult semen parameters.

OBJECTIVE: We examined whether peripubertal serum OC concentrations are associated with semen parameters among young Russian men.

METHODS: From 2003 to 2005, 516 boys were enrolled at age 8-9 years and followed for up to ten years. Serum OCs were measured in the enrollment samples using high-resolution mass spectrometry. At age 18-19 years, 133 young men provided one or two semen samples (256 samples) collected ...


Celiac Disease Presenting As Intussusception From Giardia Lamblia, Adam R. Paul DO 2016 Lehigh Valley Health Network

Celiac Disease Presenting As Intussusception From Giardia Lamblia, Adam R. Paul Do

Department of Pediatrics

No abstract provided.


Exploring Patient And Family Satisfaction In Pediatric Neurological Surgery, Randa R. Barsoom, Todd A. Maugans, James F. Burrows, Paul Rosen 2016 Thomas Jefferson University

Exploring Patient And Family Satisfaction In Pediatric Neurological Surgery, Randa R. Barsoom, Todd A. Maugans, James F. Burrows, Paul Rosen

Student Papers

Introduction Patient and family satisfaction during outpatient visits is correlated with a continuance of care and likelihood to recommend the practice to others. Additionally, patient-family satisfaction can determine the success of the practice and influence medical outcomes. Utilizing a well-validated surveys instrument, patient and family satisfaction can be explored in the office setting. Methods During a consecutive 36 month period, a standardized and validated patient satisfaction survey instrument was provided to the family members of patients who presented to two pediatric neurosurgery clinics associated with Nemours Children's Health System. The completed surveys were analyzed statistically to identify correlations between ...


Recent Strategies To Improve Community Case Management Of Diarrhea Among Children Under Five In Developing Countries, Fauzia Rabbani, Aysha Zahidie 2016 Aga Khan University

Recent Strategies To Improve Community Case Management Of Diarrhea Among Children Under Five In Developing Countries, Fauzia Rabbani, Aysha Zahidie

Community Health Sciences

No abstract provided.


Comparison Of The Prevalence And Characteristics Of Inpatient Adverse Events Using Medical Records Review And Incident Reporting, William Macharia, Charles Muteshi, Sikolia Wanyonyi, Abraham Mukaindo, Ahmed Ismail, Herman Ekea, Abdallah Abdulkarim, John Tole, Anthony Ngugi 2016 Aga Khan University

Comparison Of The Prevalence And Characteristics Of Inpatient Adverse Events Using Medical Records Review And Incident Reporting, William Macharia, Charles Muteshi, Sikolia Wanyonyi, Abraham Mukaindo, Ahmed Ismail, Herman Ekea, Abdallah Abdulkarim, John Tole, Anthony Ngugi

Paediatrics and Child Health, East Africa

No abstract provided.


Rate Of Detection Of Multiple Organisms With Multiplex Pcr Gastrointestinal Panel In Pediatrics, Saisho Mangla DO, Tibisay Villalobos MD, Kristin M. Held Wheatley PharmD 2016 Lehigh Valley Health Network

Rate Of Detection Of Multiple Organisms With Multiplex Pcr Gastrointestinal Panel In Pediatrics, Saisho Mangla Do, Tibisay Villalobos Md, Kristin M. Held Wheatley Pharmd

Department of Pediatrics

No abstract provided.


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