Digital Commons Network^™

Large Single Center Experience In Pediatric Oncology And Bone Marrow Transplant Patients On Ecmo: How Should We Decide Candidacy?, Jordan Marquess

Research Days

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Background: ECMO is rarely utilized in pediatric oncology and bone marrow transplant (BMT) populations due to concerns surrounding poor prognoses and high rates of complications. Patients with malignancies are often not offered ECMO as an option. There is paucity of data to determine whether a pediatric oncology or bone marrow transplant patient is an appropriate candidate for ECMO.

Methods: This is a single center retrospective cohort study on pediatric patients with primary oncologic diagnosis or history of bone marrow transplant who required VA- or VV-ECMO from 2015-2020.

Results: Twelve patients were identified with a 58% …

Safety, Timing And Outcomes Of Early Postoperative Cardiac Catheterization Following Congenital Heart Surgery, Karoline Krzywda

Research Days

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Background: Early postoperative ( < 6weeks) cardiac catheterization (EPOCC) has been considered high risk and often delayed. Recently, the safety of EPOCC has been demonstrated. The optimal timing of catheterization and its outcomes in struggling postoperative patients remains uncertain.

Objective: To describe EPOCC in our center and its impact on length of stay (LOS), number of mechanical ventilation days, number of ECMO days, and catheter-based interventions.

Methods: This is a retrospective cohort study of patients who underwent cardiac surgery between 01/01/2010 and 12/31/2019 and EPOCC within 30 days after surgery. Cohorts were early EPOCC (≤72 hr) vs late EPOCC ( >72 hr). Data on timing, indication, and complications of EPOCC; days of mechanical ventilation and ECMO; and CICU/total hospital LOS were collected. Data was analyzed using chi-square and Student’s t-test, …

Increased Prevalence Of Parenteral Nutrition-Associated Liver Disease In Neonates With Congenital Heart Disease, Yasasvhinie Santharam

Research Days

Background: A life-sustaining therapy, use of total parenteral nutrition (TPN) allows for meeting nutritional needs of low birth weight, premature, or otherwise complex infants with conditions that prevent feeding through the GI tract. However, 40-60% of infants on long-term TPN have been shown to develop parenteral nutrition-associated liver disease (PNALD)1 , a serious condition characterized by cholestatic jaundice, steatosis, and hepatic fibrosis. Given these risks, providers must account for risk of hepatic injury when prescribing TPN, including attributes of gestational age, infection, surgical and diagnosis history2-6 . Yet with a multifactorial pathogenesis, significant heterogeneity in PNALD incidence still occurs. Looking …

Pharmacometabolomics Profiling Of Preterm Infants Validates Patterns Of Metabolism Associated With Response To Dexamethasone Treatment For Bronchopulmonary Dysplasia, Bradley C. Stockard

Research Days

Background: Bronchopulmonary dysplasia (BPD) is one of the most common health complications of premature birth. Corticosteroids are commonly used for treatment of BPD, but their use is challenging due to variability in treatment response.

Objectives/Goal: Previous pharmacometabolomics study has established patterns of metabolite levels with response to dexamethasone. We obtained additional patient samples for metabolomics analysis to find associations between the metabolome and dexamethasone response in a validation cohort.

Methods/Design: 14 infants provided 15 plasma and 12 urine samples. The measure of treatment response was the calculated change in respiratory severity score (deltaRSS) from pre-to-post treatment. Each metabolite was assessed …

Association Of Patient Demographics, Code Characteristics, And Survival To Discharge After In-Hospital Cardiac Arrests In The Pediatric Intensive Care Unit, Nathan Lavoy

Research Days

Background: Lower socioeconomic status and minority background have been linked to worse outcomes after out-ofhospital and in-hospital cardiac arrests (IHCA). Despite this, there has not been a focus on IHCA within a pediatric intensive care unit (PICU) evaluating patient demographics and code characteristics.

Objectives/Goal: The primary objective is to describe patient demographics, code characteristics, and survival to discharge of patients that suffer IHCA in a quaternary PICU. The goal of this descriptive, retrospective study is to identify possible differences in outcomes related to patient demographics, laying the foundation for further QI initiatives.

Methods/Design: Participants included patients between 24 hours and …

Neonatal Hypoxia Due To Pulmonary Artery Thrombus, Bianca Cherestal

Research Days

Background: Pulmonary artery thrombus is rare and should be considered in neonates with refractory hypoxia.

Case: Preterm female neonate had persistent hypoxia after birth despite intubation, high-frequency oscillatory ventilation (FiO2 100%), and inhaled nitric oxide. Delivery was via c-section at 33 weeks 4 days for new onset hydrops and poor biophysical profile. Echocardiogram revealed echo brightness in the lumen of the left pulmonary artery (LPA) with no color flow (figure 1a), concerning for occlusive thrombus. Chest CT angiogram confirmed the diagnosis (figure 1b, c). Hematology was consulted and recommended systemic thrombolysis (tissue plasminogen activator, tPA) with concomitant anticoagulation (Bivalirudin). Imaging …

The Effects Of Necrotizing Enterocolitis And Short Chain Fatty Acids On The Developing Brain In Mice, Maribel Martinez, Venkatesh Sampath, Paula Nichols, Wei Yu, Suban Burale, Tianhua Lei

Research Days

Background: Necrotizing enterocolitis (NEC) is a devastating disease in premature infants characterized by acute intestinal inflammation and necrosis with a mortality of 15%-30%. Approximately 50% of infants that survive NEC will develop neurodevelopmental defects[1]. Studies on the effects of NEC on the neonatal brain are limited, however it’s postulated that neurodevelopmental damage is induced via cytokine activation of toll-like-receptor 4 (TLR4) by high mobility group box protein 1 (HMGB1) on the microglia Accumulation of reactive oxygen and demyelination contribute to neuronal damage. Therapies that limit the development of NEC can potentially also limit the neuroinflammatory changes seen in NEC[2]. We …

Repeat Tracheal Aspirates In Pediatric Intensive Care Patients: Understanding Clinical Application, Edward Lyon

Research Days

Background: Tracheal aspirate cultures (TA) are regularly obtained in the pediatric intensive care unit (PICU) when clinical changes in intubated or tracheostomy dependent children occur. Positive TA results are often unable to distinguish infection from colonization. There is no data describing the frequency and impact of repeated TAs on patients in the PICU.

Goal: Our objectives were to describe the frequency of repeated TAs in PICU children and emergence of multidrug resistant organisms (MDRO), identify bacterial profile of TAs, and examine antibiotic prescribing patterns related to these cultures.

Methods: A retrospective chart review occurred on 15 patients in the PICU …

Rates Of Physical Abuse Screening And Detection In Infants With Brief Resolved Unexplained Events (Brues), Angela Doswell

Research Days

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Background: “Apparent Life-Threatening Events” (ALTEs) have been associated with child physical abuse (CPA). In 2016, “Brief Resolved Unexplained Event” (BRUE) and development of its clinical guidelines and risk-stratification replaced ALTE. It is unknown if there is a similar association between BRUEs and CPA.

Objectives: To determine the rate of CPA in infants presenting with a BRUE, examine differences between infants with/without CPA, and examine rates of diagnostic testing used to detect CPA.

Methods/Design: This study was part of the BRUE Research and Quality Improvement Network, composed of 15 academic and community hospitals. Subjects were infants …

Healthcare Utilization Of Victims Of Commercial Sexual Exploitation Compared To Non-Victims, Cree Kachelski

Research Days

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Background: Approximately 17,000 US children are victims of Commercial Sexual Exploitation of Children (CSEC) annually. Nearly 75% of adolescent CSEC victims received medical care within 6 months prior to identification. Screening tools have been developed based on known characteristics of CSEC victims; however, little is known about how CSEC victims compare to non-CSEC adolescents in healthcare utilization. Thus, appropriate medical CSEC screening settings are unknown.

Objectives/Goal: We aimed to identify where and how often adolescents presented to medical care in the 12 months prior to CSEC identification. We hypothesized that compared to controls, CSEC positive …

Cvst As A Rare Complication Of Acute Pediatric Covid-19, Erin Bolen

Research Days

Background: A previously healthy 13-year-old male was admitted to the hospital for a bacterial superinfection in the setting of recent COVID-19, including orbital cellulitis and pansinusitis with subgaleal, epidural, and subdural empyema. Further workup identified an occult, non-occlusive cerebral venous sinus thrombosis (CVST) along the length of the superior sagittal sinus.

Objectives/Goal: To evaluate the reported cases of CVST as a potential complication of COVID-19 in the pediatric population and identify meaningful trends in demographics, presentation, and diagnostic course.

Methods/Design: A literature search was run with various combinations of the following terms, always including “COVID”: “pediatric,” “adolescent,” “CVST,” “cerebral venous …

Evaluation Of A Hirschsprung Disease Systemwide Enterocolitis De-Escalation Strategy, Albert Aickareth

Research Days

Problem Statement/Question: Components of systems that identify, treat and prevent enterocolitis are not well described. In addition, for patients with HSCR both pre and post pull-through, questions regarding a child’s clinical status occur through several different medical access points and may occur outside of colorectal center clinic hours.

Background/Project Intent (Aim Statement): Hirschsprung associated enterocolitis (HAEC) is a severe and potentially life-threatening complication of Hirschsprung Disease (HSCR) that can present with a variety of symptoms from mild abdominal pain to fulminant colitis. We evaluated our system-wide enterocolitis de-escalation strategy for both hospital staff and patient caregivers. Our primary analysis was …

Impact Of A Mental Health Screening Process In A Pediatric Ed, Bryan Stocker Do, Shobhit Jain Md, Kathryn Worland Msw, Celeste Tarantino Md, Lina Patel Md, Shayla Sullivant Md

Research Days

Background: Up to 20% of children in the United States experience a mental health disorder and suicide is the second leading cause of death among adolescents. Children presenting with mental health concerns to the Emergency Department (ED) can be challenging due to lack of access to trained professionals and long lengths of stay. Specialized teams have shown to be beneficial, but little is known about their impact in the ED.

Objectives/Goal: This study explored the impact of specialized social workers partnering with emergency medicine providers to provide care during an acute mental health crisis.

Methods/Design: We performed this work at …

X-Linked Nephrogenic Syndrome Of Inappropriate Antidiuresis Secondary To Vasopressin Receptor 2 Mutation, Erica Zarse

Research Days

Background: X-linked nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is a rare cause of hyponatremia with a similar biochemical evaluation to the syndrome of inappropriate antidiuretic hormone secretion but with suppressed vasopressin (AVP) levels.

Objectives: We present a case of hyponatremia due to NSIAD.

Results: A 25-month-old male with developmental delay became unresponsive 30 minutes after falling off a couch onto a hardwood floor. He presented with tonic-clonic movements and eye deviation requiring antiepileptics. Serum laboratories noted hyponatremia (123 mmol/L), hypoosmolality (262 mOsm/kg) and hypochloremia (90 mmol/L) prompting endocrine consult. Head imaging normal. Urine dilute with specific gravity 1.004, osmolality 160 …

Covid-19: Perspectives From Youth In Detention, April Mcneill-Johnson

Research Days

Background: The COVID-19 pandemic amplified health disparities among youth in detention. Understanding perspectives of these youth on the pandemic and COVID-19 vaccination may identify strategies to mitigate pandemic-related health disparities in this group.

Objectives/Goal: To explore perspectives on the COVID-19 pandemic, effect on detention experience and the COVID vaccine among youth in detention.

Methods/Design: This is a secondary analysis of a study examining healthcare needs and experiences of youth in detention. We recruited a convenience sample of youth (14-17 years) detained in urban midwestern juvenile detention centers from January-November 2021. We conducted semistructured individual interviews & used a thematic analysis …

Gastrointestinal Fibromatosis: A Case Of Successful Oral Tyrosine Kinase Inhibitor Delivery To An Infant With Proximal Duodenal Obstruction, Darius Blanding

Research Days

Background: Infantile myofibromatosis (IM) is a rare disorder characterized by the fibrous proliferation of the skin, bone, muscle, and viscera that usually presents at birth, or soon after. Although IM is a benign condition, significantly higher morbidity and mortality have been reported when the viscera is involved. This case report is of a 6-week-old female who presented with poor feeding along with subcutaneous nodules that were diagnosed as IM. Upper and lower endoscopy were performed for worsening feeding intolerance showing marked nodularity throughout the gastrointestinal (GI) tract, including partial obstruction of the proximal duodenum by biopsy-proven myofibromas, confirming visceral IM …

Subclinical Status Epilepticus In The Setting Of An Acute Covid-19 Infection, Thomas Rieth

Research Days

Background: While COVID-19 commonly presents as an upper respiratory infection, acute COVID infections has the potential to have multisystem involvement. Neurological symptoms, which have mainly been reported in adults, are rare in children and are not well recognized. Better understanding of the neurological manifestations of COVID-19 in children can lead to earlier detection of COVID-19 and help with medical decision making and treatment.

Objectives/Goal: To describe an unusual presentation of COVID-19 in a previously healthy female and explore the neurological presentations of COVID-19.

Results: A 10 year old previously healthy female presented with a 1 day history of altered mental …

A Case Of Fibrous Hamartoma In Term Neonate, Elizabeth Perry

Research Days

Case report abstract: Fibrous hamartoma of infancy (FHI) is a rare, benign lesion characterized as a tumor of myofibroblastic origin that has characteristic features of triphasic histology. FHI was first described in 1956 by Reye and formally named by Enzinger in 1965 (1, 2). The lesion is defined as a hamartoma due to the histologic presentation of disorganized mesenchymal, fibrous, and adipose tissue with absence of mitotic figures; this combination of derived tissue without evidence of anaplasia is diagnostic for FHI. These lesions typically arise as a single, solitary mass, are most commonly located on the extremities, trunk, sacrum, or …

Early Onset Obesity In A 4-Year-Old Female Found To Have Variants In Both The Single-Minded Homolog 1 And Sh2b Adaptor Protein 1 Genes, Erica Zarse

Research Days

No abstract provided.

Monitoring The M-Dwarf Host Stars Of Tess Exoplanet Candidates: Stellar Flares And Habitability, Ashley Lieber

Physics Undergraduate Honors Theses

In the search for life beyond our solar system, the study of M-dwarfs has become increasingly important due to their unique characteristics including their small size, flaring capabilities, and long lifespans. Their small size allows for exoplanet detection due to observable gravitational interactions, and the stellar flares could potentially trigger prebiotic life on exoplanets in the system. Lastly, their long lifespans may provide the conditions necessary to foster prebiotic life and the development of more complex organisms over time. Flare rate is a critical factor in determining the habitability of the exoplanet due to its potential to damage or incubate …

The Impact Of Peer Tutoring On Elementary Students’ Mathematical Education, Kristen Clapp

Master's Theses

This action research study utilized a mixed-methods approach to determine the impact peer tutoring can have in mathematical instruction within a fourth-grade classroom. Data was collected using student-surveys, personal journal entries, and student work samples over the course of a four-week time frame. Report findings show both unchanged and positive impacts in students’ achievement in math as well as data supporting the idea that students who present high mathematical comprehension prior to the study result in no significant impact in mathematical achievement through peer tutoring. This study also displays how student skill and personalities impact effectiveness and ineffectiveness in mathematical …

The Impact Of Internally Designed Mathematics Differentiation System On Gifted & Talented 5th & 6th Grade Students, Svetlana Kovalkova-Mckenna

Masters Theses & Specialist Projects

Mathematical talent development in middle school is significantly impacted by students’ access to academic learning opportunities that include collaborative learning with similar ability peers and match student’s interests and level of ability instead of age and grade-level. Access to and participation in domain-specific gifted programs for mathematically talented students has a significant impact on the level of their future talent development, their social-emotional wellbeing, and opportunities later in life. The purpose of this mixed-methods non-experimental action research study was to explore the impact an internally designed mathematics differentiation system (provided in a multiple days per week pull-out format by school’s …

Agriculture Education Teacher Perspectives On Stem In Secondary Classrooms -A Delphi Study, Nicholas Kyle Porter

Masters Theses & Specialist Projects

Recent statistics tell us that the number of jobs in Science, Technology, Engineering and Mathematics (STEM) related fields are growing at a rapid rate, it is projected that STEM related careers will grow 17% between 2008 and 2018 (Langdon, n.d.). Within these areas lies agriculture. Given the shift of career opportunities, such as in the areas of research and development, a change has to be made in the way students are educated within agriculture. The ultimate goal of all educators is to better prepare students for their future careers and endeavors because these students are the future of our food …

Beta Drift: Forecasting The Manifold Relationships Between Students And Their Pursuit Of Stem Careers, Douglas D. Havard

Education (PhD) Dissertations

The purpose of this study was to examine the extent to which motivational and persistence factors predict the occupational career choices of underrepresented students in their pursuit of a STEM career. Data selected from the High School Longitudinal Study beginning with the base year through the fourth wave were employed in a large-scale multinomial regression analysis. Anticipated STEM occupation at the age of 30 was examined across six years of complex survey data using multiple taxonometric definitions. Social Cognitive Career Theory provided the theoretical framework for defining relevant factors affecting this STEM pursuit construct. The findings from the study suggest …

Virtual Reality As An Education Tool In Biomedical Engineering, Megan Wilkerson

Biomedical Engineering Undergraduate Honors Theses

Virtual Reality (VR) has become more accessible in recent years, both to experience and to create. Various studies have shown that incorporating VR in an educational setting can yield positive results. Virtual reality videos created using course-specific content could prove to be a beneficial educational tool. VR videos were implemented in a remote biomolecular engineering laboratory course. 180° VR videos of lab procedures were recorded and viewed by students using a Google Cardboard headset and their smartphones. After viewing all the VR lab videos, students were given a survey to report their experiences. The survey contained questions used to measure …

Generating And Sustaining Meaningful Professional Development Opportunities For Graduate Teaching Assistants Facilitating Course-Based Undergraduate Research Experiences In The Biological Sciences, Amie M. Kern

Open Access Theses & Dissertations

Current national efforts to reform postsecondary laboratory education have emphasized the incorporation of authentic research opportunities into science, technology, engineering, and mathematics (STEM) curricula. Within the last decade, course-based undergraduate research experiences (CUREs) have emerged as a viable mechanism to achieve this goal. Evidence within the biology education literature suggests that student engagement in CUREs has the potential to positively impact their development of scientific inquiry and process skills, content knowledge, and affect in the domain. While the majority of studies have focused on student outcomes, few studies have examined instructor outcomes in CURE learning environments. This is especially true …

Understanding The Transition From General To Organic Chemistry, Hannah Chan

Student Scholar Symposium Abstracts and Posters

Organic chemistry is commonly known to have high failure rates and regarded as one of the most difficult courses offered in undergrad. This study assessed whether a modified general chemistry curriculum allowing for more time focused on foundational organic chemistry concepts in general chemistry can improve students’ grade outcome and/or self efficacy when transitioning from general to organic chemistry courses. Two separate variables were tested: grade outcome and self efficacy. Using an independent sample t-test, a comparison of the two groups (modified versus traditional general chemistry) was performed. Grades were assessed by giving students four questions (out of 4 points …

Reflecting Back To Forge The Path Forward, Robert M. Capraro, Mary Margaret Capraro, Chance Lewis, Melva R. Grant, Marlon James, Eduardo Mosqueda, Jamaal Young, Jemimah Young, Ali Bicer, Tarcia Hubert, Alesia Mickle Moldavan, Susan Ophelia Cannon, Michael S. Rugh, Miriam Sanders, Jonas Chang

Teaching & Learning Faculty Publications

The JUME editorial team provides an update of the journal's health and progress during the 2021 calendar year and discusses coming changes and opportunities for growth.

A Limited Look At The Educational Experiences Of Black Stem Professionals From The Butler Community And Beyond, Victoria Ann Templin

Undergraduate Honors Thesis Collection

This project looks at the STEM educational experiences of Black professionals from both the Butler community and outside of it. It focuses on the perspectives of five individuals (three Butler graduates and two non-Butler graduates) interviewed via Zoom and analyzes how their experiences compare to those of other Black STEM professionals across the nation. After completing the interviews and conducting thorough background research, all data was examined. It was found that what was discussed during the interviews paralleled what was discovered in the research, such as the importance of mentors and broadening the image of what a scientist looks like. …

Judith Shakespeare's Problem : Using Timss To Examine Contextual Indicators In Girls' Mathematics Achievement, Elizabeth Ann S. Kelly

Legacy Theses & Dissertations (2009 - 2024)

Using the Trends in International Mathematics and Science Study Data (TIMSS) 2015 dataset, this study examines 30 different contextual indicators to determine significant predictors of girls’ mathematics achievement globally. The study design employs three nested levels in the hierarchical linear model (individual, classroom, and nation) to analyze cross-national scores and responses to the contextual questionnaires. Additionally, the focus is on girls as a standalone, independent population, not in comparison to boys. This research seeks to understand at which level of society the most variability is found, as well as analyze the comparative effect sizes of various explanatory contextual predictors within …