Digital Commons Network^™

Assessing Body Fat In Pediatric Osteogenesis Imperfecta: A Preliminary Comparison Of Anthropometric Techniques, Arianna Dalamaggas, Megan Gillespie, Adriano Dellapolla, Kaeli Samson, Elizabeth Strudthoff, Vincent Eaton, Maegen Wallace

Child Health Research Institute Pediatric Research Forum

Background: Osteogenesis Imperfecta (OI) is a genetic disorder causing brittle bones, extremity deformities, short stature, and scoliosis, resulting in decreased physical function. Body Mass Index (BMI) is used as a proxy for body fat in the general population, however, it is particularly inaccurate measure to gauge body fat in OI patients due to skeletal deformities and short stature. There is a critical need to identify the anthropometric and body composition characteristics that contribute to important health outcomes and improve disease management in patients with OI. Current literature is lacking data on percent body fat (% BF) composition in patients …

Assessing The Safety And Efficacy Of Tranexamic Acid Usage In Osteogenesis Imperfecta Patients, Vincent Eaton, Makayla Schissel, Elizabeth Strudthoff, Maegen Wallace

Child Health Research Institute Pediatric Research Forum

Background: This study aims to evaluate the safety and efficacy of tranexamic acid (TXA) usage to reduce blood loss in surgeries in children with Osteogenesis Imperfecta (OI). We want to assess the potential benefits, risks, and complications involved in the usage of TXA in this pediatric orthopedic population.

Significance of Problem: Due to increased fracture burden and bone deformity caused by OI, patients tend to have numerous operations throughout their life. In addition to these skeletal manifestations, there is a potential increase in susceptibility to bleeding due to the increased frequency of orthopedic procedures. Increased blood loss during orthopedic procedures …

Quantifying Intraoperative Blood Loss In Osteogenesis Imperfecta Patients, Vincent Eaton, Kaeli Samson, Elizabeth Strudthoff, Adriano Dellapolla, Maegen Wallace

Child Health Research Institute Pediatric Research Forum

Background: Osteogenesis Imperfecta (OI) is a collagen disorder with numerous multisystemic manifestations, including potential for increased vascular fragility and, consequently, increased bleeding. Since these patients are prone to fractures and multiple surgeries, the associated risk of increased intraoperative blood loss is potentially elevated compared to the general population.

Significance: Knowing if OI type, bone, or the number of bones operated on simultaneously is associated with more intraoperative blood loss can aid in preoperative planning in this population.

Hypothesis: We aim to investigate intraoperative blood loss in OI patients undergoing intramedullary rodding of lower extremity long bones to assess quantitative differences …

Retrospective Study On Maternal Bmi And Length Of Stay For Neonates With Hypoxic Ischemic Encephalopathy Treated With Hypothermia, Sonya Flaten, Emily Poellinger, Terence Zach

Child Health Research Institute Pediatric Research Forum

Background

Neonatal hypoxic ischemic encephalopathy (HIE) causes significant morbidity and mortality. Therapeutic hypothermia (TH) is an important treatment in HIE. There is a need to better understand the antepartum factors associated with HIE. Maternal obesity has been previously identified as a risk factor for HIE. There is likely a positive correlation between the severity of HIE, abnormal MRI results, and the length of a neonate’s NICU stay before discharge.

Purpose

This retrospective study compares the maternal BMI at delivery to the MRI results of the newborn at 4-7 days after birth and to the NICU length of stay with HIE …

Tocopherol Content Of Maternal Breast Milk And Impact On Neonatal Growth, Alyssa Freeman, Alex Hergenrader, Olivia Paetz, Sarah Sweeney, Lauren Wegner, Nicole Bender, Ridhi Chaudhary, Khadijjta Ali, Matthew Van Ormer, Maranda Thompson, Rebecca Slotkowski, Corrine K. Hanson, Melissa K. Thoene, Ann Anderson-Berry

Child Health Research Institute Pediatric Research Forum

Background: Vitamin E is a fat-soluble nutrient consisting of α-, β-, δ-, and γ-tocopherol isoforms that has established effects on neonatal growth in utero. Higher maternal plasma tocopherol concentrations in pregnancy are associated with increased neonatal weight, length, and head circumference percentiles at birth. However, less is known about the impacts of tocopherols on post-natal growth. Since many neonates consume maternal breast milk as their post-natal nutrient source, it is important to understand the tocopherol content of breast milk and associations with neonatal growth.

Significance of Problem: Although the tocopherols demonstrate positive associations with neonatal growth in utero, the role …

Evaluation Of Tocopherol Isoforms In Maternal Breast Milk And Their Relationship With Maternal Dietary Intake, Alyssa Freeman, Alex Hergenrader, Olivia Paetz, Sarah Sweeney, Lauren Wegner, Nicole Bender, Ridhi Chaudhary, Khadijjta Ali, Matthew Van Ormer, Maranda Thompson, Rebecca Slotkowski, Corrine K. Hanson, Melissa K. Thoene, Ann Anderson-Berry

Child Health Research Institute Pediatric Research Forum

Background: Vitamin E is an essential, fat-soluble nutrient with four isoforms: α-, β-, δ-, and γ-tocopherol. These isoforms differentially modulate inflammation and show variable associations with perinatal outcomes, such as preterm delivery and Apgar scores. However, little is known about the role of these isoforms on post-natal outcomes and their presence in maternal breast milk, a neonate’s ideal nutrition source.

Significance of Problem: To analyze the role of tocopherols on post-natal growth and inflammation, it is critical to first assess their presence in maternal breast milk. Relating these measures to maternal dietary intake can advance our understanding of breast milk …

Omega-3 And Omega-6 Polyunsaturated Fatty Acid Levels In Placental Tissue And Association With Maternal Dietary Intake, Alexandra Hergenrader, Matthew Van Ormer, Maranda Thompson, Rebecca Slotkowski, Alyssa Freeman, Olivia Paetz, Sarah Sweeney, Lauren Wegner, Khadijjta Ali, Nicole Bender, Ridhi Chaudhary, Melissa K. Thoene, Corrine K. Hanson, Ann Anderson-Berry

Child Health Research Institute Pediatric Research Forum

Background: Omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) are precursors to lipid mediators that modulate inflammation throughout the body. Derivatives of n-3 PUFAs have anti-inflammatory properties and promote growth and neurodevelopment in the fetus. Conversely, n-6 PUFA metabolites exert pro-inflammatory effects and may contribute to adverse pregnancy and birth outcomes. Studies have shown that maternal dietary intakes of n-3 and n-6 PUFAs are associated with their levels in maternal serum, but less is known about the association between PUFA intake and placental levels of these nutrients. A fetus must obtain essential PUFAs from their mother through the placenta, …

Assessing The Impact Of Socioeconomic Status On Maternal And Cord Serum Omega-3 Polyunsaturated Fatty Acid Levels, Alexandra Hergenrader, Matthew Van Ormer, Maranda Thompson, Rebecca Slotkowski, Alyssa Freeman, Olivia Paetz, Sarah Sweeney, Lauren Wegner, Khadijjta Ali, Nicole Bender, Ridhi Chaudhary, Melissa K. Thoene, Corrine K. Hanson, Ann Anderson-Berry

Child Health Research Institute Pediatric Research Forum

Background: Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) modulate inflammation throughout the lifespan and are essential in fetal growth and development. Previous studies have demonstrated that individuals with lower socioeconomic status (SES) may be at risk for low intake of n-3 PUFAs; however, no research has compared the concentrations of these nutrients present in maternal and cord serum between markers of SES.

Significance of Problem: Individuals with low serum levels of n-3 PUFAs may suffer from unfavorable birth and pregnancy outcomes. Therefore, it is important to identify populations who may have decreased serum levels of these nutrients in order to provide …

Phm Triage Curriculum Enhances Residents’ Skills And Comfort Of Leading Triage Calls, Sheridan Jost, Jason Burrows, Michelle Howell-Smith

Child Health Research Institute Pediatric Research Forum

Background: Though hospital triage is typically considered a role of pediatric hospitalists, these skills are important for residents to learn for any pediatric subspeciality. Additionally, many of these skills are addressed in the Accreditation Council for Graduate Medical Education’s (ACGME) Pediatric Milestones and the American Board of Pediatrics’ (ABP) Entrustable Professional Activities (EPA) as competencies expected of residency graduates. Currently, the pediatric residents at our medium-sized midwestern program do not participate in hospital triage, leaving this as a large gap in their education.

Objective: To evaluate how a Pediatric Hospital Medicine (PHM) Triage Curriculum enhances pediatric residents’ knowledge, skills, and …

Health Care Access And Use Among Children & Adolescents With History Of Parental Incarceration — United States, 2019, Rohan Khazanchi, Nia Heard-Garris, Tyler N.A. Winkelman

Child Health Research Institute Pediatric Research Forum

Background: Children and adolescents exposed to parental incarceration (PI) have suboptimal health care access, utilization, and outcomes in adulthood. However, very little is known about health care access and use during childhood itself for children and adolescents exposed to PI.

Significance: The United States incarcerates more people and at a higher rate than any other country in the world, with stark spillover impacts on the lives of over 5 million children who have had an incarcerated parent.

Objective: Using the nationally representative 2019 National Health Interview Survey (NHIS) Child Sample, we examined the relationship between PI and key measures …

Mechanism Of Cyclophosphamide-Induced Ovarian Follicle Loss In The Prepubertal Mouse, Yi Luan, Seok-Yeong Yu, Ibrahim F. Elesh, Rosemary Dong, Amirhossein Abazarikia, So-Youn Kim

Child Health Research Institute Pediatric Research Forum

Background: Cancer therapies cause serious side effects, affecting the quality of life for young cancer survivors. The ovary is affected by cancer therapies, causing premature ovarian insufficiency, leading to endocrine dysfunction, infertility, and ovarian aging. Thus, maintaining ovarian function against cancer treatment is an unmet need for female cancer patients. Cyclophosphamide (CPA), a common chemotherapeutic agent, forms DNA crosslinks to induce apoptosis in rapidly proliferating tumor cells. However, the underlying mechanism of the CPA-induced oocyte death in ovarian reserve remains unclear.

Experimental design: This study aims to investigate the mechanism of oocyte death in primordial follicles by generating …

A King’S Secret: The Reason For Regression In A 14-Month-Old Male, Kelli Mans, Whitney Bossert, Nathaniel Goodrich, Terri L. Love

Child Health Research Institute Pediatric Research Forum

A 14-month-old male with constipation and a recent viral exanthem presents with 8 weeks of progressive gross motor regression. He no longer walks, crawls, or sits unassisted. No loss of social, speech, or fine motor milestones. No fever, rash, cough, congestion, or diarrhea. No known trauma. Family history negative for muscle, nerve, autoimmune, and developmental conditions. He was born abroad and lived on a dairy farm in New Zealand until 5 months ago. Vaccines up to date. Recently exposed to raw honey and a petting zoo.

Neurologic and musculoskeletal exams pertinent for refusal to bear weight or crawl. Resists sitting …

Crisis In The Nicu And The Medley With Midazolam, Nghi M. Nguyen, Jordan Hernandez, Adrian Flores, Jina Yi, Reeyan Bhakat, Neetha N. Vellichiramma, Chittibabu Guda, Sowmya V. Yelamanchili, Gurudutt Pendyala

Child Health Research Institute Pediatric Research Forum

Epidemiologic studies of human patients have revealed a correlation between childhood exposure to general anesthetic and sedative agents and subsequent cognitive deficits. This association is supported by data from animal models, which shows that developmental exposure to both anesthetics and sedatives causes lasting impairments in learning. This study focused on midazolam (MDZ), a common benzodiazepine regularly used as a sedative agent on neonates in the Neonatal Intensive Care Unit (NICU). However, a knowledge gap that remains is how long-term exposure to MDZ during very early stages of life impacts synaptic alterations and neurobiological mechanisms. Elucidation of these mechanisms is of …

Sap30, A Novel Oncogenic Transcription Factor In High-Risk Neuroblastoma: Clinical Significance And Role In Tumor-Progression, Survival, And Drug Resistance, Anup Pathania, Philip Prathipati, Nagendra K. Chaturvedi, Subash Gupta, Don W. Coulter, Kishore Challagundla

Child Health Research Institute Pediatric Research Forum

Neuroblastoma is the most common devastating extracranial solid malignancy in children, accounting for 15% of childhood cancer-related mortality. Despite an intense treatment regimen, approximately 50% of children treated for high-risk neuroblastoma have more aggressive tumor relapse with less than 20% five-year overall survival. Amplification of the oncogene MYCN is associated with a high risk of relapse. However, only 25% of high-risk neuroblastomas are MYCN-amplified, indicating that the rest are driven by factors other than MYCN. Therefore, it is essential to identify novel driver transcription factors but not passenger genes that improve prediction efficacy of therapy response and association with high-risk, …

Case Report Of Rare Mycobacterium Isolated From Mediastinal Abscess, Olivia Person, Andrew S. Huang Pacheco, Hana Niebur, Melissa Suh, Kari Neemann

Child Health Research Institute Pediatric Research Forum

Introduction

Mycobacterium arupense, a member of the Mycobacterium terrae complex identified in 2016, rarely causes infections despite isolation from multiple environmental sources, including water, soil and fish tanks.¹ Case reports have described tenosynovitis, osteomyelitis and disseminated infection in an immunocompromised host.^1-3 Here we describe a case of M. arupense identified in a polymicrobial mediastinal abscess in a pediatric patient subsequently diagnosed with autosomal dominant hyper-IgE syndrome (AD-HIES).

Case Description

A 4-year-old female with a history of pneumonia, herpetic skin infection, orbital cellulitis, and eczema presented in respiratory distress with concern for pneumonia. Imaging revealed a posterior mediastinal …

Exploring Nonlinearity In The Association Between Birth Defect Rates And Agrichemicals In Groundwater In An Agricultural State, Martha G. Rhoades, Debora L. Barnes-Josiah, Roy F. Spalding, Leslie M. Howard, Colleen E. Steele, Cheryl L. Beseler

Child Health Research Institute Pediatric Research Forum

Background: Agricultural practices over the last 70 years have led to increased agrichemical contamination in some drinking water supplies. Studies report an elevated risk of birth defects associated with exposure to nitrate or atrazine, but little is known about effects of co-exposure. This ecological study evaluated the relationship between the concomitant presence of nitrate and atrazine in Nebraska drinking water supplies and risk for birth defects.

Methods: County birth data were combined with water chemistry data retrieved from a state-sponsored agrichemical contaminant database. Segmented linear regression was used to examine associations between percentage of wells with nitrate and atrazine (separately …

Feasibility And Application Of Early Enteral Feeding Initiation In Extremely Low Birth Weight Infants, Lauren Ridgway, Melissa K. Thoene, Ann Anderson-Berry

Child Health Research Institute Pediatric Research Forum

Background: Extremely low birth weight (ELBW) infants (< 1000g) have specialized nutritional needs to promote best outcomes, so identifying optimal nutrition therapies is critical. Previous studies indicate that late initiation of enteral feeds (>3 days) is associated with increased inflammation and adverse neonatal outcomes. Delayed breastfeeding after the first hour of life in term infants has also been associated with increased mortality. In consideration of these factors and the heterogeneity that exists between enteral feeding initiation in an ELBW population, there is a lack of studies examining the hour of life in which enteral feeds are initiated in ELBW infants. This study evaluates the feasibility of early initiation of enteral feeds in ELBW infants and describes the impact on time to reach full enteral feeds. …

Slurred, Blurred, And A Hard-To-Find Word: Acute Progressive Neurologic Changes In A Pediatric Patient, Lauren Ridgway, Amelia Sneve, Andrew Nguyen, Aleisha Nabower

Child Health Research Institute Pediatric Research Forum

Background: Acute disseminated encephalomyelitis (ADEM) is typically a viral sequelae, with a 1-3% mortality rate. ADEM has been described as a consequence of acute SARS-CoV-2 infection. This case report describes a child diagnosed with ADEM in the setting of acute SARS-CoV-2 infection with the clinical course complicated by co-infection with Human herpesvirus 6 (HHV-6). HHV-6 positivity in the CSF is often considered an incidental finding, but it has been shown to cause encephalopathy, seizures, and demyelinating disease. This case is unique in that the dual infection with SARS-CoV-2 and HHV-6 may have contributed to the development of ADEM, poor clinical …

Hypertensive Disorders Of Pregnancy Are Associated With Differences In Maternal Serum Concentrations Of Arachidonic Acid Metabolites, Rebecca Slotkowski, M. Van Ormer, M. Thompson, T. Nordgren, M. Thoene, E. Lyden, M. Mukherjee, A. Yuil-Valdes, A. Ulu, S. Nataragan, T. Hahka, A. Akbar, C. Hanson, A. Anderson Berry

Child Health Research Institute Pediatric Research Forum

Background: Hypertensive disorders of pregnancy (HDP), including gestational hypertension, chronic hypertension, and preeclampsia, are a significant cause of maternal morbidity and mortality in the United States. Dysregulation of inflammation is thought to play a role in the development of HDP. Maternal diet has the potential to alter the risk of HDP by modulating inflammation. Arachidonic acid (AA) is a dietary polyunsaturated fatty acid which can be metabolized into both pro- and anti-inflammatory bioactive metabolites.

Significance of Problem: HDP places women and their infants at risk for potentially severe pregnancy complications including placental abruption, embolism, end-organ failure, or death. Few treatments …

Maternal And Cord Β-Carotene Levels And Their Association With Newborn Hearing Screen Results, O. Paetz, R. Slotkowski, A. Freeman, A. Hergenrader, S. Sweeney, K. Ali, N. Bender, R. Chaundary, M. Vanormer, M. Thompson, M. Thoene, C. Hanson, A. Anderson-Berry

Child Health Research Institute Pediatric Research Forum

Background. β-carotene is one of the few carotenoids that can be endogenously converted to vitamin A, a nutrient essential for inner ear development. While previous studies have identified a protective effect of carotenoids on hearing in adults, the impact of β-carotene on hearing outcomes in neonates is not well understood. The purpose of this study is to investigate the relationship between maternal β-carotene intake, maternal plasma, and umbilical cord plasma β-carotene levels and abnormal Newborn Hearing Screen (NHS) results.

Significance of Problem. The prenatal period is critical for auditory development; thus, effectors of auditory development may significantly impact long-term hearing …

Thematic Analysis Of Third-Year Medical Student Reflections On Social Determinants Of Health During Their Pediatric Clerkship: Emergent Themes And Topic Interconnectedness, Paul Witt, Michelle Howell Smith, Shirley F. Delair, Nathan Gollehon, Sharon R. Stoolman, Jason Burrows

Child Health Research Institute Pediatric Research Forum

Background. Social determinants of health (SDOH), as defined by the World Health Organization, are the “non-medical factors that influence health outcomes… the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” Studies have estimated that SDOH account for 30-55% of health outcomes. Understanding the impact of SDOH can be integrated into medical education in different formats, here we explore student reflections.

Methods. In the 2021-2022 academic year, third-year medical students at a midwestern medical school submitted discussion board reflections on their experiences …

Therapeutic Potential Of Suvorexant On Intergenerational Maternal Oxycodone Exposure, Jina Yi, Sneh Koul, Gurudutt Pendyala, Sowmya V. Yelamanchili

Child Health Research Institute Pediatric Research Forum

Background:

Maternal opioid misuse is a rising public health concern. Our lab previously published findings that in-utero oxycodone exposure (IUO) has detrimental impacts that persist to the F2 generation, including abnormal genetic expression, increased anxiety, and a difference in phenotypic measurements. The estimated cost of hospital admissions for infants suffering from Neonatal Abstinence Syndrome was $316 million in 2012 and is still rising. This figure does not take into account long-term costs, nor does it consider lasting effects on the F2 generation. Thus, it is critical to find a way to mitigate the negative impacts of IUO.

Suvorexant (suvo) is …

Fortuitous Diagnosis Of Total Anomalous Pulmonary Venous Return In A Newborn With Hypoglycemia, Joseph Maes, Terence Zach

Child Health Research Institute Pediatric Research Forum

No abstract provided.

Remote Sensing & Land Surface Temperature From Satellite Observations, Isatu Jollah

Publications and Research

The Moderate Resolution Imaging Spectroradiometer (MODIS) instrument is designed and developed in 1995. • It is a critical instrument aboard Terra and Aqua satellites. Terra's orbit around the Earth is timed so that it crosses the equator from north to south in the morning, while Aqua crosses the equator from south to north in the afternoon. • Every 1 to 2 days, Terra MODIS and Aqua MODIS scan the entire Earth's surface, collecting data in groups of wavelengths. • In this research, a whole month of MODIS Land Surface Temperature data from both Aqua and Terra were explored and investigated.

Synodality As The Listening Church: Pope Francis Continues And Expands Vatican Ii's Teaching On Collegiality, Toan Van Phan O.Cist

School of Theology and Seminary Graduate Papers/Theses

At the Ceremony Commemorating the 50th Anniversary of the Institution of the Synod of Bishops, 17 October 2015, Pope Francis affirmed that synodality is an essential dimension of the Church, and it is what the Lord asks the Church in the third millennium. The goal of this thesis is to investigate the origins and history of the concept of synodality in the life and mission of the Church in the light of theology and doctrine. The theoretical intention is to study what is old and what is new in Pope Francis’s idea of synodality and how the old is made …

The Dream Of The Common Good: Not A Nightmare, Jackson Gregory Dellinger

Honors Theses

This paper examines an emerging position in the philosophy of law, common-good constitutionalism. In the first two parts of the paper, I explain the position and constitutionalism more generally, examining how common-good constitutionalism fits within the definition of constitutionalism providing by a neutral scholar. In the next five parts, I attempt to show that common-good constitutionalism’s preference for explicit adherence to the common good does not violate constitutionalism. In doing so, I provide an examination of common-good constitutionalism’s relationship with three important constitutional principles and the separability of common-good constitutionalism as a whole and the infamous views of its most …

A Comprehensive Study Of Accounting Methodologies Through Case Studies, Sahara Karki

Honors Theses

This honors case study aims to study the different areas in accounting and dig deeper into some of the accounting scenarios used in the real world. This research is based on different case studies done in the classroom done by analyzing the financials of different companies. These case studies provide students a great opportunity to understand the different accounting concepts by researching and analyzing real-life topics and situations faced by some of the top companies in the nation. This also allowed students to meet professionals from the particular industry to discuss and understand the accounting methodologies and apply that to …

Sources Of Patient Information For Type 2 Diabetes Self-Care In Northern Mississippi, Minh-Sang La

Honors Theses

Given the prevalence of Type 2 Diabetes Mellitus in the United States and the continuous rise of cases, especially within Mississippi, there is an increasing need to identify if, and how, patients with Type 2 Diabetes receive information about self-care. While there is data available on the topic of where patients receive their information and the influence it has on their health in other countries of the world, the research on the source of Type 2 Diabetes education in the United States is scarce. Therefore, this study aims to bridge the gap of understanding where patients with Type 2 Diabetes …

Content Analysis Of Vitiligo Portrayal On Social Media, Mary Miller

Honors Theses

Given that vitiligo affects a small percentage of the world population, and its affects are not widely known, there is an increasing need to learn of its effects on those with vitiligo, both physical and psychological. Social media has become an influential platform to spread awareness and build confidence in those with vitiligo. This study aims to find how vitiligo is portrayed through social media using content analysis procedures. This is a cross-sectional content analysis that utilized a codebook to analyze Instagram posts. The results were analyzed by interrater reliability and frequency for each coder. The findings of this content …

How Immigration Policy Affects Migratory Flows And Immigrant Experiences: A Comparative Analysis Of Policy Impacts On Northern Triangle And Venezuelan Immigrants In The United States, Audrey Lynn Mcdonough

Honors Theses

In the past two decades, the US has experienced a large influx of immigrants from Venezuela and the Northern Triangle countries of Guatemala, Honduras and El Salvador. Due to these unprecedented increases, there has been numerous notable shifts in Immigration control policy between the presidencies of Barack Obama and Donald Trump. Generally, policies under Obama were favorable and reflected pro-immigrant rhetoric. Meanwhile, Trump took a drastic turn toward restrictionist, unfavorable policies. This study aims to examine the impact of immigration policy on migratory flows and the immigrant experience in the US. Using both quantitative and qualitative methods, I examine data …