Digital Commons Network^™

Evaluating Adherence To Fetal Heart Rate Monitoring Guidelines As A Decision For Primary Cesarean Deliveries, Sarai Trenhs Do, Laurel Pietrzak Do, Manuel Lamptey Ms, Jessica Jf Kram Mph, Callie Cox Bauer Do

Scientific Day

Background/Significance:

Cesarean delivery rates in the United States remain high at ~32% of deliveries. Primary cesarean deliveries or Nulliparous, Term, Singleton, Vertex (NTSV) cesareans are ~26%. National benchmarks focus on reducing NTSV cesareans as a key strategy to addressing the overall cesarean delivery rate. While the NTSV benchmark (NTSV rate 23.6% or lower) is an important benchmark for quality improvement, it does not account for clinical factors that may influence delivery decisions. Non-reassuring fetal status (Category II or III) is a frequent indication for NTSV cesareans, yet it is inconsistently defined and fetal heart rate (FHR) monitoring guidelines (Clark guidelines) …

Implications Of The Dobbs Vs. Jackson Women's Health Organization Decision On The Incidence Rate Of Ruptured Ectopic Pregnancies, Nirja Inamdar Do, Haley Primuth Md, James O. Adefisoye Phd, Jessica Jf Kram Mph, Elizabeth Bruce Bs, Marie Forgie Do

Scientific Day

Background/Significance:

Ectopic pregnancy (EP) requires timely diagnosis and treatment as delays increase the risk of rupture and maternal morbidity/mortality. Delays to reproductive healthcare access due to legal ambiguity, clinic closures, and widespread misinformation post-Dobbs vs. Jacksonmay have increased the incidence of ruptured EPs in Wisconsin. Similar delays may have also been experienced during COVID- 19 increasing ruptured EPs.

Purpose:

To examine the impact of restricted reproductive healthcare access in Wisconsin post-Dobbson EP rupture incidence proportion (IP), presentation, and management.

Methods:

Our retrospective cohort study looked at EPs within one healthcare system at 63 facilities located predominately …

Improving Continuous Glucose Monitor Prescribing Through Emr Standardization And Resident Education In A Family Medicine Residency Program, Collin Spencer Do, Robert Hackney Md, Michelle Won Md, Zachary Wallace Md, Alonzo Jalan Md, Lisa Sullivan Vedder Md

Scientific Day

Background/Significance:

Continuous glucose monitors (CGMs), including Dexcom G7 and FreeStyle Libre 3, improve glycemic control and reduce hypoglycemia in insulin-treated patients with diabetes. Despite strong evidence supporting their use, prescribing CGMs in primary care requires detailed documentation to meet Medicare and commercial insurance criteria. Incomplete documentation and uncertainty regarding eligibility can result in delays, denials, and underutilization. Baseline data within our residency clinics suggested inconsistent prescribing patterns and variability in required documentation. We sought to determine whether implementation of a standardized documentation template combined with resident education would increase CGM prescribing utilization and improve workflow efficiency.

Purpose:

To increase CGM …

Clinically Confounded: Pericardial Effusion As The Initial Presentation Of Diffuse Large B-Cell Lymphoma In A Patient With Cirrhosis, Aditya Lakkamsani Do, Ronak Patel Do, Samiuddin Syed Md, Viktoriya Bikeyeva Md, Shams Bufalino Md

Scientific Day

Introduction/Background:

Pericardial effusion as the initial manifestation of diffuse large B-cell lymphoma (DLBCL) is a rare, extranodal presentation that upstages the disease to stage IV, per Lugano classification. In patients with underlying cirrhosis or volume overload, such effusions can be misattributed, delaying oncologic evaluation. We present a case of new pericardial effusion found to be DLBCL in the setting of alcoholic cirrhosis.

Description:

A 79-year-old male with alcoholic cirrhosis presented with bilateral lower extremity edema, abdominal edema, and hypotension that was unresponsive to outpatient diuresis. On admission, day 0, imaging showed cardiomegaly concerning pericardial effusion and left pleural effusion. Echocardiography …

A Rare Case Of Pulmonary Metastasis From Malignant Intracranial Meningioma, Ronak Patel Do, Jason Macklis Md

Scientific Day

Introduction/Background:

Meningiomas are the most common primary central nervous system (CNS) tumors arising from the meninges. Although typically benign, extracranial metastasis is rare, occurring in less than 1% of cases, most often involving the lungs, bones, or liver. We present a case of recurrent meningioma with malignant transformation and pulmonary metastases in an elderly patient following multiple resections and radiation treatments.

Description:

An 86-year-old male was diagnosed in 2013 with a WHO grade I meningioma treated with bifrontal craniotomy and resection. In 2020, he developed progression along the superior sagittal sinus and received radiation therapy. Imaging in 2024–2025 revealed recurrent …

The Importance Of Pedal Acceleration Time (Pat): A Case Study, Kelly N. Bui

Undergraduate Project Award

A case study manuscript about the importance of pedal acceleration time (PAT) exams in assessing lower extremity perfusion at the level of the foot and its role in clinical decision making. The diagnostic value of PAT exams is compared with other methods such as ankle brachial indices (ABI), toe-brachial indices (TBI), and lower extremity arterial duplex. This case presents a patient with a complex medical history and the ultrasound exams listed above displayed its strengths and limitations as to how it contributed to the patient's overall vascular assessment.

Comparing Treatment Options For Impending Axillobifemoral Bypass Graft Failure, Marcus Allan Alonzo

Undergraduate Project Award

This is a case study detailing the importance of ultrasound maintenance for axillobifemoral bypass grafts and how findings can influence treatment options. Additionally, the case study addresses how language barriers can deter the choice to seek healthcare and provides solutions to mitigate risks from language barriers.

Echocardiography Evaluation Of Aortic Dissection: A Case Study, Alyssa Garvey

Undergraduate Project Award

Case study on aortic dissection.

Introducing Our New Intranet Platform, Glenn Lockhart, Shannon Augustine, Maria Petrova-Margason

Staff Professional Development Week

Join us to learn about what’s replacing MyGU and how it is designed to enhance student organizations, university events, and engagement among students, staff and faculty. Get an overview of its features, rollout plans, and how the platform can streamline communication, collaboration, and campus connection.

Turn Your Expertise Into Income Through Goal, Russell Stein

Staff Professional Development Week

Russell Stein introduces staff to GOAL and the Learning and Training Center as a simple way to turn their knowledge into short, online learning modules. The main idea: staff already have valuable knowledge, and this workshop shows how to share it in a way that helps others and may also bring in income.

Participants will learn how GOAL supports lifelong learning and may offer ways to earn money in the future. The workshop will also introduce a flexible profit sharing model and explain how Instructor Design Services makes things easier. Staff do not need to build a full course. They …

Population Pharmacokinetic Analysis Of R- And S-Fluoxetine And Norfluoxetine In Children And Adolescents, Ethan A. Poweleit, Whitney Sparks Ms, Catherine Koertje, Addison M. Pritchett Ms, Angela Wiedner, Gail Robertson, Lindsey Malloy-Walton, Stephani L. Stancil, Alexa L. Pagano, Kathyrn Kyler, Jonathan B. Wagner, Jeffrey R. Strawn, Brandon Retke, Paul C. Toren, J Steven Leeder, Laura Ramsey

Research Showcase

Background: Fluoxetine is a commonly prescribed selective serotonin reuptake inhibitor in children and adolescents. It is administered as a racemate where the R- and S-enantiomers differ in pharmacological activity and metabolism. Additionally, fluoxetine and its primary metabolite, norfluoxetine, contribute to overall therapeutic effects. S-fluoxetine is primarily metabolized by CYP2D6 to form S-norfluoxetine, while R-fluoxetine is metabolized by CYP2D6, CYP2C9, and CYP2C19 to form R-norfluoxetine. These enzymes are highly polymorphic, and the combination of alleles an individual carries corresponds to a metabolizer phenotype, such as CYP2D6 poor (PM), intermediate (IM), normal (NM), and ultrarapid metabolizers (UM). Further, fluoxetine and norfluoxetine are …

Evaluation Of The Effectiveness Of In-Line Immobilized Lipase Cartridge In Enterally Fed Patients With Short Bowel Syndrome: A Retrospective Case Series, Elizaveta Khenner, Jennifer Morton, Laura Green, Kayla Paul, Ashlee Yoder, Ann E. Remmers, William San Pablo

Research Showcase

Patients with short bowel syndrome (SBS) experience nutrient malabsorption. The clinical manifestations of malabsorption are heterogeneous due to the variety of congenital and acquired anatomic abnormalities that result in SBS. Because of various gastrointestinal pathophysiologic alterations, fat malabsorption is an important nutritional factor to consider. The Intestinal Rehabilitation Program at Children’s Mercy has been providing a comprehensive approach to caring for children with SBS, and has incorporated RELiZORB (Alcresta Therapeutics, Inc.) immobilized lipase cartridge (ILC) into their treatment armamentarium. ILC is a single-use digestive enzyme cartridge that connects in-line with enteral feeding circuits to hydrolyze triglycerides in enteral formulas. Although …

Recombinant Erythropoietin (Repo) Use For Anemia Of Prematurity- A Three-Year Single Center Experience, Hannah Darland, Krishna Dummula, Chaitali Mahajan, Vishal Pandey

Research Showcase

Background: Anemia is a common disorder of prematurity secondary to limited blood volume, excessive blood draws, inadequate nutrition, poor iron reserves, and insufficient endogenous erythropoietin. While many NICUs use recombinant erythropoietin (rEpo) to treat anemia of prematurity, the absence of universal guidelines has

led to variability in dosing and schedules. Here we present our experience on the use of rEpo in a level 3 NICU. Our unit protocol uses 400 IU/kg three times a week for a total of 9 doses if hematocrit < 30%.

Objectives/Goal: The purpose of this study was to evaluate the response to rEpo in infants with anemia …

Unclear Source Of Gastrointestinal Bleeding: Utilizing Small Bowel Capsule To Detect An Enteric Duplication Cyst, Victoria Sarata, Kirby Lampe, Kathyn Clarkston

Research Showcase

Enteric duplication cysts (EDCs) are rare congenital anomalies of the gastrointestinal (GI) tract that may present with abdominal pain, vomiting, palpable mass, or bleeding, depending on their location. We present a case of a 9-year-old male with recurrent rectal bleeding who was ultimately diagnosed with an EDC via small bowel capsule endoscopy and laparoscopy. The patient had a history of iron deficiency anemia and recurrent admissions for hematochezia and fatigue. Previous imaging and endoscopy procedures were unrevealing. A small bowel capsule was completed and identified an area of narrowing, mucosal disruption, and ulceration suggestive of a short-segment stricture. Additionally, another …

Refractory Benign Esophageal Strictures Complicated By Esophageal Perforation And Treated With Serial Dilations And Stent Placement In A Pediatric Patient, Victoria Sarata, Kirby Lampe, Nadia Ibrahimi

Research Showcase

Background: Refractory benign esophageal strictures (RBES) are persistent esophageal narrowings resistant to repeated surgical or endoscopic treatment. RBES may result from various causes, including chemical injury, gastroesophageal reflux disease, tracheoesophageal fistula, achalasia, or congenital esophageal stenosis (CES). CES is a rare congenital anomaly caused by tracheobronchial remnants, segmental fibrosis, or membranous diaphragm. Management varies based on severity and includes endoscopic dilation, stent placement, and surgical esophagoplasty.

Objective: We discuss a rare case of CES with spontaneous esophageal perforation after balloon dilation. Patient's course was complicated by severe stenosis requiring frequent stent replacement, stent removal, re-stenosis, and Mitomycin-C application. Case Report: …

Pharmacokinetic Profiles Of Dexmedetomidine During Pediatric Ecmo, Mackenzie Dreher, Kathryn Pavia, Jonathan B. Wagner, Allison Scott, Paul C. Toren, Brandon Retke

Research Showcase

Background:

Dexmedetomidine is a highly hydrophilic alpha-2 agonist commonly used for sedation in critically ill patients to maintain devices and support.  However, critical illness can prolong its elimination in the critically ill child. A problem that is likely due to reduced metabolic metabolism and increased volume of distribution.

Extracorporeal life support (ECLS), including extracorporeal membrane oxygenation (ECMO), further alters drug pharmacokinetics through increased distribution volume, reduced clearance, and drug sequestration with the circuit. Dexmedetomidine is known to adsorb to ECMO components; however, it currently comes from ex vivo studies circuit studies.   Prospective data in vivo, particularly in pediatric populations and …

Rare Tbl1xr1::Jak2 Fusion In A Patient With Pediatric T-All Identified By Optical Genome Mapping And Long-Read Sequencing, Aravindh Nagarajan, John Herriges, Lei Zhang, Elena Repnikova, Lisa Lansdon, Midhat Farooqi

Research Showcase

Introduction

JAK2 rearrangements are recurrently observed (and correlate with some of the lowest survival rates) within Ph-like B-cell acute lymphoblastic leukemia but are very rare in T-cell Lymphoblastic Leukemia (T-ALL). Here we present a patient with pediatric T-ALL who was shown to have a TBL1XR1::JAK2 fusion by Optical Genome Mapping (OGM), which was further supported by long-read sequencing. This is only the second report of JAK2 fusing with TBL1XR1 in pediatric T-ALL.

Case Presentation

A 15-year-old male presented with intermittent fever, fatigue, and nausea for the past 7 days, bruising on extremities and chest, small nodules on the scalp, and …

Pharmacogenetic Associations Of Methotrexate Metabolism In A Jia Cohort, Nuria Lara Castillo, Marc Sudman, Sasi Arunachalam, Brooke Fridley Ms, Phd, Susan Thompson, Mara Becker, Laura Ramsey

Research Showcase

Background:

Methotrexate (MTX) is a slow-acting disease modifying anti-rheumatic drug and one of the first drugs of choice for the treatment of juvenile idiopathic arthritis (JIA). Efficacy is observed within 6 months, and approximately one third of patients are nonresponders.  Delays in obtaining early disease control place nonresponders at risk for lifelong disability. Therefore, predicting responsiveness to MTX treatment can prevent long-term consequences in these patients. Methotrexate is a folate agonist and undergoes intracellular processing by addition of up to seven glutamate residues by the cytosolic enzyme folylpolyglutamate synthetase encode by the gene FPGS. It has been reported that patients …

Make Your Office Globally Accessible Without Adding To Your Workload, Rowena Winiarczyk, Fiona Grugan

Staff Professional Development Week

CORE’s Rue Winiarczyk and ACS’s Fiona Grugan often see that in today’s increasingly global campus environments, staff interact daily with students and colleagues from diverse cultural and linguistic backgrounds. Many common challenges, such as misinterpreted email tone, delayed responses, or unclear expectations, often come from small, everyday communication habits.

This session offers practical, low-effort strategies to make routine interactions more globally accessible without adding to staff workload. Rather than focusing on theory, the session centers on real scenarios staff already encounter, including writing emails, responding to questions, and navigating misunderstandings. Participants will learn simple adjustments that can immediately improve clarity …

Benefits Of A Blended Diet: Secondary Analysis Of The Impact Of Diet Type On Feeding Tube Weaning Success, Kristina Nash, Dana Bakula, Rachel Graham, Brenda Fetter, Sarah Bullard, April Escobar, Julianne Brogren, Amy Ricketts, Ryan Thompson, Lori A. Erickson, Sarah Edwards

Research Showcase

Background: Enteral feeding tubes are often required to support growth and nutrition in children with pediatric feeding disorder. When children are medically ready, feeding tube weaning can improve patient and family satisfaction, reduce health care costs, and enhance mealtime experiences. Many children receive traditional formulas, other families prefer diets made from foods that resemble a typical oral diet. Blended tube feeding provides this option and may improve feeding tolerance and gastrointestinal symptoms which can support improved oral intake and successful tube weaning.

Objectives/Goal: This study aimed to compare whether children receiving blended diets achieved a successful tube wean faster than …

Diagnosis Of Whim Syndrome In An Adolescent With Cavitary Pneumonia And Chronic Leukopenia, Katey Campbell Md, Mary Nguyen Jacobson Md Faaaai Facaai

Research Showcase

Introduction: WHIM syndrome is a rare, autosomal dominant primary immunodeficiency characterized by Warts, Hypogammaglobulinemia, Infections, and Myelokathexis. It results from gain-of-function mutations in the CXCR4 gene and often presents with recurrent infections and severe leukopenia. Early diagnosis is critical to prevent infectious and long-term complications.

Case Description: A 16-year-old male with chronic leukopenia presented with fatigue, fevers, night sweats, and persistent cough. Initial labs showed profound leukopenia (WBC 0.93 K/µL), severe neutropenia (ANC 260), and lymphopenia (450). CT chest demonstrated a thick-walled cavitary lesion. He was admitted and started on broad-spectrum antibiotics. Further workup included flow cytometry which demonstrated markedly …

Symptomatic Hyponatremia: A Rare Complication Of Double Balloon Enteroscopy; A Case Report., Kirby Lampe, Victoria Sarata, Thomas M. Attard

Research Showcase

Background:  

Double balloon enteroscopy (DBE) is a novel technique increasingly used for the visualization of the small intestine. It is used to investigate overt gastrointestinal (GI) bleeding or iron deficiency anemia without a clear source and to evaluate for small intestinal polyps, strictures, neoplasms, and inflammatory bowel disease. In particular, it can be highly valuable in patients with Peutz-Jeghers syndrome (PJS) and familial adenomatous polyposis (FAP). Complications such as pancreatitis, perforation, and bleeding have been reported but occur rarely. Here, we report the case of an 11-year-old female who developed symptomatic hyponatremia after DBE, resulting in a tonic-clonic seizure. 

Conclusions: …

A Rare Instance Of Ogilvie Syndrome In A Pediatric Patient With A Complex Medical History; A Case Report., Kirby Lampe, Aileen Har, Victoria Sarata, Fernando Zapata

Research Showcase

Background: Acute colonic pseudo-obstruction (ACPO) or Ogilvie’s syndrome is a disorder that most commonly occurs in the cecum and right colon but can extend to the rectum and is noted as an acute dilatation without presence of an obstructive lesion (1). Those patients who are usually diagnosed with this disorder are above the age of 60 and have a predisposing risk factor such as hospitalization, long-term care facilities, severe illness, post-surgery, or metabolic/medication causes like antipsychotics and chemotherapy medications (2). There is an association with hypothyroidism but otherwise there are no pathognomonic laboratory findings in these patients (3). Abdominal CT …

Erythrocytosis In Transgender Adolescents Receiving Injectable Testosterone: A Single-Center Retrospective Cohort Study, Seth Lamb, Janelle Noel-Macdonnell, Michelle Knoll

Research Showcase

Objectives: Erythrocytosis is a recognized complication of testosterone therapy, yet adolescent-specific safety data remain limited. We sought to determine the incidence of erythrocytosis and characterize hematocrit trajectories in transgender adolescents receiving injectable testosterone esters.

Methods: We conducted a retrospective chart review of transgender adolescents and young adults initiating gender-affirming testosterone therapy at a pediatric endocrinology referral center (2012-2021). Patients receiving injectable testosterone esters (cypionate or enanthate) for ≥3 months with serial hematocrit monitoring were included. The primary outcome was erythrocytosis, defined as hematocrit ≥50%. Pearson correlations assessed relationships between treatment duration, cumulative dose, and maximum hematocrit.

Results: Eighty-nine patients were …

Pursuit Of A Full Night's Sleep, Kennison Adams Md, Andrew Donaldson Md, Brian Harvey Do

Research Showcase

Introduction: As hip pain increases in pediatric athletes, it’s essential to maintain a wide differential. With consideration of impingement, necrosis, tears, or even neoplasm, workup and management of hip pain is vast, sometimes without improvement. Knowing specific, distinguishing symptoms can help pinpoint a diagnosis.

Case Description: A 12-year-old female presents to the Sports Medicine Clinic for left hip pain. Pain of the anterior hip began 8 months prior as an insidious onset ache that radiates distally. Despite 2 months of physical therapy prior to clinic visit, no improvement is seen. The 8/10 pain worsens with prolonged sitting and activity and …

Impacts Of Adverse Childhood Experiences On Single-Cell Gene Expression Among Children With Uncontrolled Asthma, Omowumi V. Akinjole Phd, Shireen Sadeghi, Setayesh Shirzad, Sui Par, Mckervin Reau, Abril Reyes, Kumal Udofia, Danielle Farr, Carl Schwendinger-Schreck, George E. Quaye, Brooke Fridley, Elin Grundberg, Bridgette L. Jones

Research Showcase

Background: Adverse childhood experiences (ACEs) are associated with increased asthma risk and outcomes as well as cytokine and gene expression changes relevant to asthma. However, ACE effects on immune cells at the single‑cell gene expression level, remain unclear.

Objectives/Goal: To investigate how high versus low ACE exposure influence immune cell makeup and differentially expressed genes (DEGs) in immune cells of children with uncontrolled, persistent allergic asthma

Methods/Design: We analyzed data and samples obtained from 19 children with uncontrolled persistent allergic asthma. Single cell RNA sequencing was performed on isolated peripheral blood mononuclear cells. Cell clusters were identified using Seurat v4.3, …

Measuring School Anxiety In Pediatric Chronic Pain: Initial Investigation Of The Psychometric Properties Of The School Anxiety Inventory For Chronic Pain (Sai-Cp), Caitlyn Maye, Robert C. Gibler, Kristen E. Jastrowski Mano, Dustin Wallace, Cara M. Hoffart, Jenny Scheurich

Research Showcase

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement.

Method: …

Exploring How Parental Involvement Impacts Police Encounters And Delinquent Behavior Among Black Adolescent Girls, Danielle V. Porter, Elizabeth Otto, Dyamon Brown, Jasmine Alli, Robyn Douglas, Noni Gaylord-Harden

Research Showcase

Adolescents’ contact with police is a complex outcome that is influenced by both individual behavior and the broader social context. Specifically, while delinquent behavior can lead to more police contact (Crutchfield et al., 2012), hyper-surveillance often occurs in marginalized communities, increasing unjustified police contact for youth of color (Campos-Manzo et al., 2020; Geller, 2021). Indeed, racial disparities in police contact during adolescence persist even after accounting for delinquent behavior (Campos-Manzo et al., 2020; Crutchfield et al., 2012). Thus, it is important to identify factors that may protect Black youth from contact with police. Parental involvement refers to parents’ active and …

Early Prediction Of Ssri Treatment Response In Adolescents With Depression Using Multimodal Machine Learning, Addison Pritchett Ms, Catherine Koertje Md, George Quaye Ms, Phd, Andrea Manlove Bsn, Whitney Sparks Ms, Brooke Fridley Ms, Phd, J Steven Leeder Pharmd, Phd

Research Showcase

Background:

Major Depressive Disorder (MDD) in adolescents is commonly treated with Selective Serotonin Reuptake Inhibitors (SSRIs). Treatment response is typically assessed every 4-6 weeks after initiating pharmacotherapy, and medication adjustments may be made if the initial regimen is ineffective. This standard-of-care delay can prolong or exacerbate symptom burden and functional impairment. Early prediction of treatment response could support more timely and personalized medication management in adolescents with MDD.

Objectives/Goal:

To develop and evaluate multimodal machine-learning models for early prediction of SSRI treatment response in adolescents with MDD, assessing the predictive value of clinical, wearable, and proteomic features both individually and …

Build Your Skills With Linkedin Training, Adrian Rivera

Staff Professional Development Week

GTS’s Adrian Rivera offers a chance to get acquainted with LinkedIn Training, which provides Gallaudet staff with a flexible, accessible way to strengthen professional skills and stay current with evolving workplace tools. With thousands of high‐quality online courses, employees can build confidence in areas such as communication, leadership, customer service, project management, and digital literacy. The platform allows staff to learn at their own pace, revisit topics as needed, and apply new skills directly to their daily responsibilities.

A key benefit for Gallaudet employees is the ability to stay updated on essential workplace technologies. Courses on Office 365 help staff …