Digital Commons Network^™

Dave Eggers On The Importance Of Talking To Strangers, Jeff Gordinier

Creative Nonfiction Magazine

No abstract provided.

The Resume, Catherine Elcik

Creative Nonfiction Magazine

No abstract provided.

El Valle, 1991, Aurelia Kessler

Creative Nonfiction Magazine

No abstract provided.

Honoring The Seams: The Memoir-In-Pieces, Beth Kephart

Creative Nonfiction Magazine

No abstract provided.

How To Hang A Mezuzah, Rachel Beanland

Creative Nonfiction Magazine

No abstract provided.

Igg4-Related Disease Associated With Pearson Syndrome: A Case Of Rapid Decline, Kai-Jing Zhang, Xiao-Juan Lv, Qin-Qin Zhao, Wan-Wan Xu

Journal of Pediatric Infectious Diseases

We report a diagnostically challenging case of a 1-year-old female with refractory thrombocytopenia, sideroblastic anemia, pancreatitis and metabolic decompensation, ultimately attributed to coexisting IgG4-related disease (IgG4-RD) and Pearson syndrome (PS)—a previously undocumented association. Key findings of the case were 1. Treatment resistant thrombocytopenia despite IVIG, corticosteroids, and eltrombopag (transient response only). 2. Elevated IgG4 (840 μg/mL) and pancreatitis thought to be secondary to IgG4-RD. 3. Mitochondrial DNA deletion (m.10052_15604 del, 93.2% heteroplasmy) and ringed sideroblasts secondary to PS. 4. Fatal Metabolic Crisis with hyperlactatemia (peak 8.4 mmol/L) and cardiac failure, underscoring PS's rapid progression. This is the first reported association …

Il-36Γ And The Development And Validation Of An Early Prediction Model For Severe Mycoplasma Pneumoniae Pneumonia In Children, Xiaodong Tang, Ying Li, Pao Yu, Wenpeng Wang, Bi Zhou

Journal of Pediatric Infectious Diseases

Objective: This study aimed to retrospectively analyze clinical data from pediatric patients with Mycoplasma pneumoniae pneumonia (MPP), investigate the expression and clinical significance of serum IL-36γ, and to develop and validate an early identification model for severe MPP (SMPP). Methods: Clinical data were collected from 345 children diagnosed with MPP in our department between July 1, 2023, and December 31, 2024. Based on diagnostic criteria, enrolled patients were categorized into an SMPP group (n=145) and a non-severe MPP (NSMPP) group (n=200). Serum IL-36γ levels at admission were measured using ELISA. Independent risk factors for SMPP were identified via binary logistic …

Evaluation Of The Oral Mycobiota In Pediatric Patients With Newly Diagnosed Malignancy, Gülşah Ece Özmerdiven, Gonca Erköse Genç, Serap Karaman, İlvana Çaklovica Küçükkaya, Zeynep Karakaş, Deniz Tuğcu, Ayşe Özkan Karagenç, Hikmet Gülşah Tanyıldız, Ayşegül Ünüvar, Zayre Erturan

Journal of Pediatric Infectious Diseases

Objective: This study examines whether the oral mycobiome of pediatric patients with newly diagnosed hematologic or oncologic malignancies differs from that of healthy children before treatment begins. Methods: The study included 117 children under 18 years of age: 67 patients and 50 healthy controls. Oral swab/rinse samples were cultured on various agar media, and fungal species were identified using conventional methods, API ID 32C, and MALDI-TOF MS. Antifungal susceptibility testing of non-albicans Candida (NAC) isolates was performed using VITEK2. Results: Yeast growth was observed in 58.2% of patients and 68% of healthy children. Candida albicans was the most frequently isolated …

Characterisics Of Children Evaluated For Simultaneous Crimean-Congo Hemorrhagic Fever And Brucellosis In An Endemic Region, Kübra Fırtına Topcu, Ayşe Hümeyra Taşkın Kafa, Elif Ünver Korğalı Sivas Cumhuriyet University, Faculty Of Medicine, Department Of Pediatrics, Sivas, Türkiye

Journal of Pediatric Infectious Diseases

Objective: Crimean–Congo hemorrhagic fever (CCHF) and brucellosis are two zoonoses that co-circulate in overlapping endemic areas and share similar clinical features. They may occur concurrently in the same patient. Methods: We aimed to investigate the occurrence of concurrent CCHF and brucellosis in pediatric patients from our endemic region. Results: We reviewed 31 patients younger than 18 years who, between January 2018 and December 2024, underwent concurrent testing with CCHF PCR and the Brucella serum agglutination test (SAT), along with their presenting complaints. Rural residence was present in 45.2% of cases, and a history of tick bite prior to presentation in …

Expression Of Metrnl, Presepsin, And Bmp9 In Peripheral Blood Of Children With Sepsis And Their Roles In Diagnosis And Prognosis, Yang Liu, Cheng Wei

Journal of Pediatric Infectious Diseases

Objective: Meteorin-like protein (METRNL), soluble CD14 subtype (presepsin), and bone morphogenetic protein 9 (BMP9) show promising for sepsis diagnosis and prognosis assessment in children. Their diagnostic and prognostic utility is comprehensively assessed in this study. Methods: A total of 360 children, aged 3-14 years, with sepsis, infection, and healthy groups were retrospectively analyzed. Receiver Operating Characteristic curve evaluated the diagnostic performance of METRNL, presepsin, and BMP9 for sepsis. The 28-day prognostic information was collected for the sepsis group. Risk factors for poor prognosis in the sepsis group were analyzed using logistic regression. A nomogram prediction model for prognostic prediction in …

Bronchiectasis In Children, Murat Kuru, Tamer Altınok

Journal of Pediatric Infectious Diseases

Bronchiectasis, although less common in children than in adults, is an important long-standing respiratory disease marked by permanent enlargement of the bronchi and impaired airway function. The main symptom is a chronic wet cough. This condition presents a considerable health challenge in children, especially in developing countries where access to healthcare may be limited. Although cystic fibrosis (CF)-related bronchiectasis is relatively common, non-CF bronchiectasis, often triggered by post-infectious causes, predominates in pediatric populations. The diagnosis of bronchiectasis is confirmed by demonstrating a bronchoarterial ratio > 0.8 on high-resolution computed tomography. Medical treatment includes mucolytic agents, bronchodilators and antibiotics. Surgical resection of …

Contributing Reviewers In 2025, - -

Journal of Pediatric Infectious Diseases

No abstract provided.

Hemodynamic And Oximetric Response To Sodium Bicarbonate Boluses In Children With Single Ventricle Parallel Circulation: A Retrospective, Single-Center Study, Fabio Savorgnan, Saul Flores, Rohit S. Loomba, Sebastian Acosta

Journal of Pediatric Intensive Care

Introduction: To evaluate the hemodynamic and oximetric changes in patients with parallel circulation (Norwood, hybrid, and BT-shunted) after sodium bicarbonate bolus administration. Methods: Retrospective analysis of physiologic data. To eliminate confounders, sodium bicarbonate boluses concurrently administered with normal saline, 5% albumin, epinephrine boluses, blood transfusions, change in VIS or mechanical circulatory support were excluded. Blood pressure, arterial oxygen saturation, heart rate, cerebral and renal NIRS were continuously recorded from one-hour pre to one-hour post each intervention. Results: Out of 429 boluses, 293 boluses met the inclusion criteria. Measurements show an increase in blood pressure (p = 0.01) and heart rate …

Role Of Orbital Ultrasound In The Monitoring Of Children With Raised Intracranial Pressure-Prospective Observational Study Conducted In Tertiary Care Centre, Nithiya Selvam, Narayanan Parameswaran, Ramesh Ananthakrishnan

Journal of Pediatric Intensive Care

Objectives: To evaluate the role of optic nerve sheath diameter measurement by orbital ultrasound in monitoring children with non-traumatic coma and increased ICP. Methods: A single-centre prospective observational study. conducted in the PICU of a tertiary care teaching hospital in Puducherry, INDIA. Children admitted to the PICU with features of raised ICP were enrolled. Baseline characteristics and raised ICP characteristics were recorded.ONSD measurements were taken in all children in the supine position using bedside ultrasound with a twelve MHZ linear probe. The probe was initially placed in the axial plane and measurements were taken at a distance of 3 mm …

Heart Rate Variability In Children With Moderate And Severe Traumatic Brain Injury: A Prospective Observational Study, Sophie Martin, Geneviève Du Pont-Thibodeau, Andrew Je Seely, Guillaume Emeriaud, Christophe L. Herry, Morgan Recher, Jacques Lacroix, Laurence Ducharme-Crevier

Journal of Pediatric Intensive Care

Objective: To assess feasibility of continuous monitoring of heart rate variability (HRV) in children with traumatic brain injury (TBI) hospitalized in a Pediatric Intensive Care Unit (PICU) and collect preliminary data on the association between HRV, neurological outcome and complications. Method: Prospective observational cohort study in a tertiary academic PICU. Children are admitted to the PICU 24 h after moderate or severe TBI were included. Children suspected of brain death at PICU entry or with a pacemaker were excluded. Children underwent continuous monitoring of electrocardiographic (ECG) waveforms over 7 days post TBI. HRV analysis was performed retrospectively, using a standardized, …

Unplanned Extubations In Pediatric Critical Care: A Case-Control Study, Krista Wollny, Cameron B. Williams, Raghad Al-Abdwani, Carol Cartelle, Jason Macartney, Helena Frndova, Norbert Chin, Christopher Parshuram

Journal of Pediatric Intensive Care

Objectives: To quantify associations between the risk of unplanned extubation and patient-, environment-, and care-related factors in pediatric critical care; and to compare outcomes between children who did and did not experience an unplanned extubation. Methods: Retrospective case-control analysis including patients <18 years who experienced an unplanned extubation during ICU admission (2004-2014). Cases were matched by age, duration of mechanical ventilation, and date to control-patients (4:1) who were intubated but did not experience an unplanned extubation. Conditional logistic regression was used to evaluate associations between unplanned extubations and the abstracted characteristics. Results: We identified 1601 eligible controls matched to 458 case-patients. When adjusted for confounders, eight variables were associated with unplanned extubation: three patient-related factors (previous ICU admission, previous intubation, and the volume of secretions); one environment-related factor (patient room set-up); and four care-related factors (intubation route, and the use of sedation, muscle relaxation and restraints). Patients who had an unplanned extubation had longer length of stay, but lower rate of mortality. Conclusions: This is the largest case-control study identifying variables associated with unplanned extubation in pediatric critical care. Several are potentially modifiable and may provide opportunities to improve quality of care in controlled ICU environments.

Methylene Blue Use In Pediatrics, Rachel Moss, Kim R. Derespina, Jessica Frye, Shubhi Kaushik

Journal of Pediatric Intensive Care

Objectives: Catecholamine-resistant shock, also known as vasoplegia, is a challenging entity with significant risk of mortality. We aimed to provide further data on the safety and effectiveness of methylene blue (MB) for vasoplegic shock in the pediatric population. Methods: We conducted a retrospective observational study of pediatric patients admitted to the Pediatric Intensive Care Unit (PICU) or Pediatric Cardiac Intensive Care Unit (PCICU) at Mount Sinai Kravis Children’s Hospital from 2011 to 2021 who received MB for refractory shock. A list of patients was obtained by performing a pharmaceutical query from 2011-2021 for “methylene blue.” Chart review was performed to …

Utility Of Pediatric Early Warning Sign Score In Predicting Outcome Of Picu Admissions At A Suburban Tertiary Care Hospital, Deepika Aggarwal, Shahzad Alam, Rufaida Mazahir, Rupa Rajbhandari Singh, Baljeet Maini

Journal of Pediatric Intensive Care

Background: Assessment of the severity of illness is very important in ICU care for quality assessment, assessing prognosis, and proper counselling. The goal of the study was to see how well the Pediatric Early Warning Score (PEWS) predicted the outcome of PICU patients. Methods: This prospective cross-sectional study included children under 18 years of age. PEWS was calculated at presentation. The outcomes analysed were mortality (primary outcome), need for mechanical ventilation, inotropic support, and length of stay (LOS). A median score was calculated and compared across the outcome groups. The performance of the PEWS was assessed for calibration and discrimination, …

Dexmedetomidine Opioid Sparing Effect In Mechanically Ventilated Children (Dose): Trial Of Fentanyl Vs. Fentanyl + Dexmedetomidine For Maintenance Of Sedation, Mara L. Becker, Gwenyth Fischer, Chi D. Hornik, Omar Alibrahim, Kelechi Iheagwara, Kamal Abulebda, Andora L. Bass, Katherine Irby, Anjali Subbaswamy, Elizabeth E. Zivick, Jill Sweney, Anne G. Stormorken, Erin E. Barker, Shruthi Mahadaveiah, Riad Lutfi, Michael C. Mccrory, John M. Costello, Kate G. Ackerman, Jennifer C. Munoz-Pareja, Bryan J. Feger, J. Michael Dean, Daniel F. Hanley, Rachel G. Greenberg, Radhika Avadhani, Richard E. Thompson, Daniel K. Benjamin, Christoph P. Hornik, Kanecia O. Zimmerman

Journal of Pediatric Intensive Care

Objectives: To observe the mean daily dose of fentanyl required for adequate sedation in critically ill, mechanically ventilated children randomized to receive dexmedetomidine or placebo. Methods: We conducted Dexmedetomidine Opioid Sparing Effect in Mechanically Ventilated Children (DOSE), a multicenter, double-blind, randomized, placebo-controlled, dose-escalating trial. We enrolled children aged 35 weeks post-menstrual to 17 years (inclusive) admitted across 13 pediatric multidisciplinary and cardiac intensive care units. Adequate sedation was based on a State Behavioral Score and Richmond Agitation-Sedation Scale of -1 or lower. Only the first two dexmedetomidine dosing cohorts opened for enrollment, due to early trial closure during the coronavirus …

Variability In Clinician Awareness Of Intravenous Fluid Administration In Critical Illness: A Prospective Cohort Study, Stephen M. Gorga, Alexander L. Sliwicki, Julie Sturza, Erin F. Carlton, Ryan P. Barbaro, Rajit K. Basu

Journal of Pediatric Intensive Care

Objective: Intravenous (IV) fluids are commonly administered to critically ill children, but clinicians lack effective guidance for the correct dose and duration of therapy resulting in variation of prescribing habits which harm children. It is unknown if clinicians recognize the amount of IV fluid that patients receive. We aimed to determine clinician accuracy in the identification of the volume of IV fluids patients will receive over the next 24 hours. Methods: Prospective cohort study enrolled all patients admitted to the PICU from May-August 2021 at the University of Michigan’s C.S. Mott Children’s Hospital Pediatric Intensive Care Unit (PICU). For each …

Emergent Bedside Re-Sternotomy: An Innovative Simulation Model For Training Pediatric Cardiac Intensive Care Teams, Toluwani Akinpelu, Nikhil R. Shah, Mohammed Alhendy, Malarvizhi Thangavelu, Karen Weaver, Nicole Muller, James Mcelroy, Utpal S. Bhalala

Journal of Pediatric Intensive Care

Introduction: Cardiac tamponade after cardiac surgery is a life-threatening event that requires simultaneous resuscitation and emergent re-sternotomy by the intensive care team. A simulated scenario using an innovative mannequin with sternotomy wound has the capability of reproducing cardiac arrest associated with postoperative tamponade. We evaluated the validity of this mannequin to investigate the confidence level and crisis resource management skills of the team during bedside re-sternotomy to manage postoperative cardiac tamponade. Methods: The simulation scenario was developed using the sternotomy mannequin for a pediatric cardiac intensive care unit (CICU) team. The case involved a 3-year-old male, intubated, mechanically ventilated after …

Peri-Intubation Cardiorespiratory Arrest Risk In Pediatric Patients: A Systematic Review, Rohit S. Loomba, Riddhi Patel, Elizabeth Kunnel, Enrique G. Villarreal, Juan S. Farias, Saul Flores

Journal of Pediatric Intensive Care

Background: Endotracheal intubation is associated with an increased risk of cardiorespiratory arrest. Various factors modulate the risk of peri-intubation cardiorespiratory arrest. The primary objective of this study was to determine the risk of peri-intubation cardiorespiratory arrest in pediatric patients in a hospital setting, and the secondary objective was to determine the effect of various factors on the peri-intubation cardiorespiratory arrest risk. Methods: A systematic review was performed to identify eligible manuscripts. Studies were deemed appropriate if they included pediatric patients in a hospital setting not exclusively intubated for an indication of cardiorespiratory arrest. Data was extracted from studies deemed eligible …

Data Provenance Verification For Multi-Stage Processing Pipelines — Chained Integrity Binding, Jayson Winchester

Defensive Publications Series

This publication discloses methods and systems for constructing and verifying provenance chains that link verifiable commitments across the semantically distinct processing stages of a determination pipeline, providing data provenance verification for multi-stage processing pipelines. In one embodiment, a provenance chain is formed by producing a verifiable commitment at each processing stage, where each stage’s commitment incorporates the preceding stage’s commitment together with the current stage’s content, creating stage-to-stage binding that makes the chain tamper- evident. The resulting forward-only provenance chain ensures that stages cannot be reordered, removed, or inserted without producing a detectably different commitment at each subsequent stage. In …

Schema Mapping — Fidelity-Tracked Transformation Between Independent Semantic Environments, Jayson Winchester

Defensive Publications Series

This publication discloses methods and systems for defining and applying explicit transformation declarations between independently maintained meaning environments, where each meaning environment governs locally-defined terms, type structures, and interpretation rules for a particular decision context. In one embodiment, a transformation declaration specifies mapping correspondences between meaning entries in a source meaning environment and meaning entries in a target meaning environment, and carries an information preservation classification indicating the nature and degree of information preservation achieved by the transformation. In one embodiment, transformation declarations may be composed sequentially to form transformation chains spanning multiple meaning environments, where the composed preservation classification …

Formal Specification Verification For Decision Record Completeness — Pre-Execution Contract Validation, Jayson Winchester

Defensive Publications Series

This publication discloses methods and systems for formal specification verification and specification-declared completeness verification applied to organisational decision questions. A specification declaring its own structural and governance requirements defines what data is needed, what outputs must be produced, what conditions determine whether the question was adequately answered, and how the question should be evaluated. A verification process distinguishes structural validity — whether a decision record conforms to the declared input and output requirements — from substantive completeness — whether the decision was adequately resolved according to declared completeness conditions. In one embodiment, the specification designates an evaluation pathway indicating how …

Orthognathic Surgery: Why Is It Done?, Mia Gou

Mentorship Program 2025-2026

No abstract provided.

An All-Inclusive Toolkit For Managing Workplace Violence In Healthcare, Brittney L. Williamson, Melissa Rouse

Creating Healthy Work Environments (CHWE)

Violence against nurses is a nationwide problem that has set the stage for unhealthy work environments and has driven nurses away from patient care. So, what can be done to retain our nurses and provide safer work environments? By creating an all-inclusive toolkit for managing violent and aggressive patients, this healthcare organization has made great strides to better protect their nurses.

Impact: To address this problem head on, evidence-based practices were used to develop an all-inclusive toolkit to implement a multifaceted approach to assessment, de-escalation, and allocation of resources. This approach took the guesswork out of what steps to take …

Using Simulation To Mitigate Workplace Violence, Lynda Sanchez, Monique D. Wilson, Derek Sanchez

Creating Healthy Work Environments (CHWE)

Workplace violence is not new to healthcare whether it is interprofessional, nurse to nurse, doctor to nurse, patient/patient family to healthcare worker. (Kumari et al., 2022) There is a need to provide the healthcare worker with tools and training on ways to mitigate workplace violence (WPV). Simulation is an effective evidence-based teaching and evaluation method often used in healthcare. (Brown et al., 2018; Gutiérrez-Puertas et al., 2020) In an attempt to mitigate WPV this organization began a mandated training using didactic classes from an external training program. This program involved required computer-based pre-work and attendance at a three-hour class which …

Resilient Dispute Resolution Systems For International Energy Conflicts, Guillermo J. Garcia Sanchez

Seattle University Law Review

Energy-related conflicts are on the rise, spanning diverse issues such as the impacts of rare mineral mining on local communities, the impacts of sanctions on energy investments due to the Russia-Ukraine war, and the impacts of expanded subsidies on the electric vehicle and solar panel industries. Increasingly, companies, communities, and governments are clashing over the challenges of pursuing disparate and sometimes competing energy policies. This Article argues that dispute resolution mechanisms in the energy investment sector must be fundamentally rethought. Traditional semi-adjudicatory models, which focus on winners and losers, fail to accommodate the complex and multifaceted nature of contemporary energy …

The Field Of International Business Transactions Law, Kathleen Claussen

Seattle University Law Review

This Article studies the evolution of the scholarly subfield referred to as the law of “international business transactions” (IBT). It reviews data on academic articles, courses, textbooks and other signifiers of the growth of this research area. Beginning around 1960, scholars began to use the term “international business transactions” and by the 1980s, several law schools were offering a course by that title. A handful of dedicated textbooks soon followed. These data reflect a gradual increase in research on the topic of IBT, particularly in the United States, but also considerable diversity of subject matters covered by those works. The …