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Developing A Stand-Alone Children’S Hospital In Southern Nevada: Improving Pediatric Care And Diversifying The Regional Economy, The Lincy Institute Sep 2024

Developing A Stand-Alone Children’S Hospital In Southern Nevada: Improving Pediatric Care And Diversifying The Regional Economy, The Lincy Institute

Lincy Institute Events

Southern Nevada is the largest metropolitan region in the country without a stand-alone children's hospital. The absence of such a facility results in poor health outcomes for children, fragmented and inadequate specialized care, and a shortage of pediatric medical professionals. Currently ranked last in clinical care nationwide, Nevada urgently needs a centralized, academic-based children's hospital to improve health services.

The Lincy Institute hosted a community forum to release the findings of a new report conducted by Tripp Umbach detailing why Southern Nevada needs a stand-alone children’s hospital. Tripp Umbach is a recognized industry leader, with 30 years of successful partnerships …


Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report, Kathryn E. Mcgraw, Amanda P. Porter, Alyssa M. Moffitt, Marina E M Golden, Heather Stewart Aug 2024

Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report, Kathryn E. Mcgraw, Amanda P. Porter, Alyssa M. Moffitt, Marina E M Golden, Heather Stewart

HCA Healthcare Journal of Medicine

Background

Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy that presents with a triad of hemolytic anemia, thrombocytopenia, and acute kidney impairment. It can be attributed to mutations in an array of different complement proteins leading to the overactivation of the complement system, the most impacted being the alternative pathway. Though rare, influenza B has been documented as a potential trigger to the development of aHUS.

Case Presentation

We discuss a 10-year-old girl with a history of aHUS who was found to have a repeat episode of aHUS following an influenza B infection. There have only been a few …


Development Of A Sensory-Based Intervention Manual For Educators, Bralie Dent, Zeida Gutierrez Aug 2024

Development Of A Sensory-Based Intervention Manual For Educators, Bralie Dent, Zeida Gutierrez

Summer 2024 OTD Capstone Symposium

This project focused on the development of an educational manual on sensory processing disorder (SPD) for educators. The manual was created as a resource to enhance teachers' understanding of SPD and confidence in implementing sensory-based interventions and accommodations in the classroom for students who have sensory processing difficulties.


Examining The Impact Of Telehealth Visits On Patient And Family Experience In A Pediatric Emergency And Urgent Care Center, Abigail Gauthier Md, Callie Krentz Md, Shiran Chan Ms, Michelle Widecan Dnp, Aprn, Cpnp, Ac/Pc, Adam A. Vukovic Md, Med Aug 2024

Examining The Impact Of Telehealth Visits On Patient And Family Experience In A Pediatric Emergency And Urgent Care Center, Abigail Gauthier Md, Callie Krentz Md, Shiran Chan Ms, Michelle Widecan Dnp, Aprn, Cpnp, Ac/Pc, Adam A. Vukovic Md, Med

Patient Experience Journal

Providers and healthcare organizations have created novel ways of evaluating patients using telehealth. Patient volumes in urgent cares (UCs) and emergency departments (EDs) continue to climb, contributing to longer wait times and suboptimal patient and family experiences (PFEs). Optimizing use of telehealth may not only impact PFE of those evaluated virtually, but also reduce crowding in EDs and UCs, indirectly impacting PFE in those spaces as well. The purpose of this study is to identify any association between telehealth encounters and PFE scores. This is a retrospective review of patients seen via telehealth in virtual urgent care, UC, or the …


Genomic Insights Into Pediatric Intestinal Inflammatory And Eosinophilic Disorders Using Single-Cell Rna-Sequencing., Marissa R. Keever-Keigher, Lisa Harvey, Veronica Williams, Carrie A Vyhlidal, Atif A Ahmed, Jeffrey J. Johnston, Daniel A. Louiselle, Elin Grundberg, Tomi Pastinen, Craig A. Friesen, Rachel Chevalier, Craig Smail, Valentina Shakhnovich Aug 2024

Genomic Insights Into Pediatric Intestinal Inflammatory And Eosinophilic Disorders Using Single-Cell Rna-Sequencing., Marissa R. Keever-Keigher, Lisa Harvey, Veronica Williams, Carrie A Vyhlidal, Atif A Ahmed, Jeffrey J. Johnston, Daniel A. Louiselle, Elin Grundberg, Tomi Pastinen, Craig A. Friesen, Rachel Chevalier, Craig Smail, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Chronic inflammation of the gastrointestinal tissues underlies gastrointestinal inflammatory disorders, leading to tissue damage and a constellation of painful and debilitating symptoms. These disorders include inflammatory bowel diseases (Crohn's disease and ulcerative colitis), and eosinophilic disorders (eosinophilic esophagitis and eosinophilic duodenitis). Gastrointestinal inflammatory disorders can often present with overlapping symptoms necessitating the use of invasive procedures to give an accurate diagnosis.

METHODS: This study used peripheral blood mononuclear cells from individuals with Crohn's disease, ulcerative colitis, eosinophilic esophagitis, and eosinophilic duodenitis to better understand the alterations to the transcriptome of individuals with these diseases and identify potential markers of …


Using A Collaborative Learning Health System Approach To Improve Disease Activity Outcomes In Children With Juvenile Idiopathic Arthritis In The Pediatric Rheumatology Care And Outcomes Improvement Network., Julia G. Harris, Catherine A. Bingham, Sheetal S. Vora, Cagri Yildirim-Toruner, Michelle Batthish, Danielle R. Bullock, Jon M. Burnham, Danielle C. Fair, Kerry Ferraro, Suhas Ganguli, Mileka Gilbert, Beth S. Gottlieb, Olha Halyabar, Melissa M. Hazen, Ronald M. Laxer, Tzielan C. Lee, Alice Liu, Daniel J. Lovell, Melissa L. Mannion, Edward J. Oberle, Nancy Pan, Michael Shishov, Jennifer E. Weiss, Esi M. Morgan Aug 2024

Using A Collaborative Learning Health System Approach To Improve Disease Activity Outcomes In Children With Juvenile Idiopathic Arthritis In The Pediatric Rheumatology Care And Outcomes Improvement Network., Julia G. Harris, Catherine A. Bingham, Sheetal S. Vora, Cagri Yildirim-Toruner, Michelle Batthish, Danielle R. Bullock, Jon M. Burnham, Danielle C. Fair, Kerry Ferraro, Suhas Ganguli, Mileka Gilbert, Beth S. Gottlieb, Olha Halyabar, Melissa M. Hazen, Ronald M. Laxer, Tzielan C. Lee, Alice Liu, Daniel J. Lovell, Melissa L. Mannion, Edward J. Oberle, Nancy Pan, Michael Shishov, Jennifer E. Weiss, Esi M. Morgan

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) is a North American learning health network focused on improving outcomes of children with juvenile idiopathic arthritis (JIA). JIA is a chronic autoimmune disease that can lead to morbidity related to persistent joint and ocular inflammation. PR-COIN has a shared patient registry that tracks twenty quality measures including ten outcome measures of which six are related to disease activity. The network's global aim, set in 2021, was to increase the percent of patients with oligoarticular or polyarticular JIA that had an inactive or low disease activity state from 76% to …


Tailored Approach To Participant Recruitment And Retention To Maximize Health Equity In Pediatric Cancer Research., Carolyn R. Bates, Renee M. Gilbert, Kelsey Dean, Keith August, Christie A. Befort, Shallyn Ward, Mary Gibson, Meredith Dreyer Jul 2024

Tailored Approach To Participant Recruitment And Retention To Maximize Health Equity In Pediatric Cancer Research., Carolyn R. Bates, Renee M. Gilbert, Kelsey Dean, Keith August, Christie A. Befort, Shallyn Ward, Mary Gibson, Meredith Dreyer

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Lack of diversity in participants throughout the research process limits the generalizability of findings and may contribute to health disparities. There are unique challenges to recruitment of families to pediatric cancer research studies, especially for those from disadvantaged backgrounds. Thus, there is a need to evaluate the most effective recruitment and retention strategies to optimize equitable recruitment of diverse participants.

METHODS: The present study adapted and implemented methods outlined previously in the literature. These previous efforts were developed to address barriers to pediatric research, behavioral health intervention research and research with Black adolescents. Recruitment and retention strategies are described …


Bringing Virtual Reality To Mainstream Pediatric Care, Wayne Kuang, Eric J. Yang, Roland Truong, Benjamin K.P. Woo Jul 2024

Bringing Virtual Reality To Mainstream Pediatric Care, Wayne Kuang, Eric J. Yang, Roland Truong, Benjamin K.P. Woo

Journal of Patient-Centered Research and Reviews

Virtual reality (VR) stands as an innovative technology transforming our interactions with the digital world. Its integration into health care has proven advantageous for both patients and health care providers across multiple levels and modalities. Given that VR is becoming increasingly accessible and prevalent, health care providers should explore incorporating the technology into their practices, particularly within the pediatric population, which is becoming progressively more accustomed to the technology. This topic synopsis provides a broad discussion of the current literature, exploring current and probable future applications of VR in pediatric patient care, particularly in improving the hospital experience, facilitating education …


The Use Of Hearing Tests To Assess Otitis Media With Effusion In Children With Down Syndrome., Mackenzie O'Donnell, Nasrin Sultana, Nasreen Talib, Jason May, Michael Slogic Jul 2024

The Use Of Hearing Tests To Assess Otitis Media With Effusion In Children With Down Syndrome., Mackenzie O'Donnell, Nasrin Sultana, Nasreen Talib, Jason May, Michael Slogic

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Down syndrome is associated with an increased risk for otitis media with effusion (OME), a childhood condition in which fluid accumulates in the middle ear, potentially leading to hearing loss. The American Academy of Pediatrics Down syndrome guidelines and the American Academy of Otolaryngology - Head and Neck Surgery OME guidelines recommend hearing testing to assess the hearing status of children with Down syndrome diagnosed with OME.

METHODS: Through an Institutional Review Board approved retrospective chart review at Children's Mercy, this project assessed how clinical factors affect the frequency in which children with Down syndrome receive hearing testing after …


Digital Gaming And Exercise Among Youth With Type 1 Diabetes: Cross-Sectional Analysis Of Data From The Type 1 Diabetes Exercise Initiative Pediatric Study., Susana R. Patton, Robin L. Gal, Simon Bergford, Peter Calhoun, Mark A. Clements, Jennifer L. Sherr, Michael C. Riddell Jun 2024

Digital Gaming And Exercise Among Youth With Type 1 Diabetes: Cross-Sectional Analysis Of Data From The Type 1 Diabetes Exercise Initiative Pediatric Study., Susana R. Patton, Robin L. Gal, Simon Bergford, Peter Calhoun, Mark A. Clements, Jennifer L. Sherr, Michael C. Riddell

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Regular physical activity and exercise are fundamental components of a healthy lifestyle for youth living with type 1 diabetes (T1D). Yet, few youth living with T1D achieve the daily minimum recommended levels of physical activity. For all youth, regardless of their disease status, minutes of physical activity compete with other daily activities, including digital gaming. There is an emerging area of research exploring whether digital games could be displacing other physical activities and exercise among youth, though, to date, no studies have examined this question in the context of youth living with T1D.

OBJECTIVE: We examined characteristics of digital …


Covid-19 Vaccine Confidence, Concerns, And Uptake In Children Aged 5 And Older In Calgary, Alberta: A Longitudinal Cohort Study, Emily J Doucette, Leah Ricketson, Tarannum Tarannum, Isabella Alatorre, Joslyn Gray, Cora Constantinescu, Susan Kuhn, Jessica K E Dunn, James D Kellner Jun 2024

Covid-19 Vaccine Confidence, Concerns, And Uptake In Children Aged 5 And Older In Calgary, Alberta: A Longitudinal Cohort Study, Emily J Doucette, Leah Ricketson, Tarannum Tarannum, Isabella Alatorre, Joslyn Gray, Cora Constantinescu, Susan Kuhn, Jessica K E Dunn, James D Kellner

Student and Faculty Publications

OBJECTIVES: Beginning early in the pandemic, there was a worldwide effort to develop effective vaccines against the SARS-CoV-2 virus. Before and after the approval and implementation of vaccines, there were concerns about their need as well as their safety and rapid development. We explored child demographic characteristics and parental concerns to identify factors associated with the decision to vaccinate.

METHODS: A cohort of 1035 children from Calgary was assembled in 2020 to participate in 5 visits every 6 months for survey completion and blood sampling for SARS-CoV-2 antibodies. Visits 1 to 2 occurred before approval of vaccines for children; Visits …


Developing And Validating A Nomogram For Early Predicting The Need For Intestinal Resection In Pediatric Intussusception, Yuan-Yang Yu, Jia-Jie Zhang, Ya-Ting Xu, Zheng-Xiu Lin, Shi-Kun Guo, Zhong-Rong Li, Hui-Ya Huang, Xiao-Zhong Huang May 2024

Developing And Validating A Nomogram For Early Predicting The Need For Intestinal Resection In Pediatric Intussusception, Yuan-Yang Yu, Jia-Jie Zhang, Ya-Ting Xu, Zheng-Xiu Lin, Shi-Kun Guo, Zhong-Rong Li, Hui-Ya Huang, Xiao-Zhong Huang

Student and Faculty Publications

PURPOSE: Develop and validate a nomogram for predicting intestinal resection in pediatric intussusception suspecting intestinal necrosis.

PATIENTS & METHODS: Children with intussusception were retrospectively enrolled after a failed air-enema reduction in the outpatient setting and divided into two groups: the intestinal resection group and the non-intestinal resection group. The enrolled cases were randomly selected for training and validation sets with a split ratio of 3:1. A nomogram for predicting the risk of intestinal resection was visualized using logistic regression analysis with calibration curve, C-index, and decision curve analysis to evaluate the model.

RESULTS: A total of 547 cases were included …


The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman May 2024

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …


How Psychological And Nonpharmacological Treatment Modalities Reduce The Disease Burden Of Amplified Musculoskeletal Pain Syndromes In Pediatrics, Aalia Narvel, Sabrina Gmuca May 2024

How Psychological And Nonpharmacological Treatment Modalities Reduce The Disease Burden Of Amplified Musculoskeletal Pain Syndromes In Pediatrics, Aalia Narvel, Sabrina Gmuca

Rowan-Virtua Research Day

The prevalence of pediatric chronic musculoskeletal pain ranges from 8.5% to 40%.1 This literature review examined the treatment of amplified musculoskeletal pain syndrome (AMPS), which is a general term that represents a spectrum of pain disorders for patients who may not satisfy specific diagnostic criteria.2 Specifically, sources were analyzed to compare the efficacy of individual components in the nonpharmacological, interdisciplinary treatment of AMPS against pain medications. These components included cognitive behavioral psychotherapy (CBT), physical therapy (PT), as well as occupational therapy (OT). There is limited information that assesses these components individually, but there is ample evidence that when …


Standardization Of Discharge Instructions For Mild Traumatic Brain Injury/Concussion In Children Presenting To Ed: A Qi Project, Niralee K. Rana, Nicole Gerber Md, Michael Alfonzo Md, Snezana Osorio Md, Deborah Levine Md May 2024

Standardization Of Discharge Instructions For Mild Traumatic Brain Injury/Concussion In Children Presenting To Ed: A Qi Project, Niralee K. Rana, Nicole Gerber Md, Michael Alfonzo Md, Snezana Osorio Md, Deborah Levine Md

Rowan-Virtua Research Day

Background: Mild traumatic brain injuries (mTBI) or concussions account for high rates of emergency department (ED) visits. Concussion diagnoses are used less often in young children leading to a variability in parental education and discharge instructions. Lack of discharge guidance may increase parental anxiety, impact recovery, and increase ED visits.

Objectives: To increase the proportion of ED patients discharged with age-appropriate instructions for mTBI by 50% by June 1, 2024, and to determine the impact age-appropriate instructions have on decreasing parental anxiety.

Methods: This observational time series with planned sequential experimentation is in progress at a Pediatric ED affiliated with …


Approach For Defining Human Adenovirus Infection And Disease For Central Review Adjudication In Clinical Studies., Brian T. Fisher, Jesse Blumenstock, Craig L K Boge, Sydney Shuster, Alix E. Seif, Michael Green, Marian G. Michaels, Jessie L. Alexander, Monica I. Ardura, Tamara P. Miller, Diego R. Hijano, William J. Muller, Jennifer E. Schuster, Abby M. Green, Daniel E. Dulek, Adriana E. Kajon, Lara Danziger-Isakov May 2024

Approach For Defining Human Adenovirus Infection And Disease For Central Review Adjudication In Clinical Studies., Brian T. Fisher, Jesse Blumenstock, Craig L K Boge, Sydney Shuster, Alix E. Seif, Michael Green, Marian G. Michaels, Jessie L. Alexander, Monica I. Ardura, Tamara P. Miller, Diego R. Hijano, William J. Muller, Jennifer E. Schuster, Abby M. Green, Daniel E. Dulek, Adriana E. Kajon, Lara Danziger-Isakov

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pediatric allogeneic hematopoietic cell transplant (allo-HCT) recipients are at risk for morbidity and mortality from human adenovirus (HAdV). HAdV can be detected in an asymptomatic state, referred to as infection or with signs or symptoms of illness, referred to as disease. Standardized case definitions are needed to distinguish infection from disease and allow for consistent reporting in both observational cohort studies and therapeutic clinical trials.

METHODS: A working group of experts in virology, transplant infectious disease, and HCT was assembled to develop HAdV infection and disease definitions with the degree of certainty (i.e., possible, probable, and proven). Definitions were …


Increasing Equitable Access To Pediatric Specialty Care In Maine Through Implementation Of Econsults, David Ireland, Rachel Rockers, Sarah M. Gabrielson, Anya K. Cutler, Laura J. Faherty, Genevieve Whiting May 2024

Increasing Equitable Access To Pediatric Specialty Care In Maine Through Implementation Of Econsults, David Ireland, Rachel Rockers, Sarah M. Gabrielson, Anya K. Cutler, Laura J. Faherty, Genevieve Whiting

Costas T. Lambrew Research Retreat 2024

Introduction

•Barriers to accessing pediatric specialty care exist for many and are not experienced equally by all.

•eConsults are an asynchronous provider-provider referral modality to obtain low-barrier specialist input in place of some face-to-face (F2F) visits.

•We evaluated sociodemographic factors associated with referral to and receipt of specialist input before and after eConsult implementation at MaineHealth to examine equity implications.


An Assessment Of The Needs Of Maine Primary Care Providers Relating To Tobacco Prevention, Assessment, And Treatment Of Lgbtqia+ Youth And Young Adults, Logan Gerchman, Sarah M. Gabrielson, Toni Eimicke, Brandy Brown May 2024

An Assessment Of The Needs Of Maine Primary Care Providers Relating To Tobacco Prevention, Assessment, And Treatment Of Lgbtqia+ Youth And Young Adults, Logan Gerchman, Sarah M. Gabrielson, Toni Eimicke, Brandy Brown

Costas T. Lambrew Research Retreat 2024

Most primary care providers in Maine ask youth about tobacco use but don’t adjust strategies for LGBTQIA+ youth.

Most want LGBTQIA+ specific resources for smoking prevention and cessation.


Adductor Canal Regional Anesthetic Placement In Pediatric Patients For Knee Arthroscopy: Defining The Optimal Location And Analysis Of Other Trends, Isaac Jin, Christine Song, Sujay Deshpande, Andrew Yang, Ethan Schollaert, Neha Divi, Aysha Hasan Md Apr 2024

Adductor Canal Regional Anesthetic Placement In Pediatric Patients For Knee Arthroscopy: Defining The Optimal Location And Analysis Of Other Trends, Isaac Jin, Christine Song, Sujay Deshpande, Andrew Yang, Ethan Schollaert, Neha Divi, Aysha Hasan Md

Tower Health Research Day

No abstract provided.


Occupational Impact Of Caregivers In Pediatric Palliative Care, Lezlye Ramos, Karen Park, Jazminne O. Arteaga Apr 2024

Occupational Impact Of Caregivers In Pediatric Palliative Care, Lezlye Ramos, Karen Park, Jazminne O. Arteaga

Spring 2024 Virtual OTD Capstone Symposium

The purpose of this study is to understand the occupational impact for caregivers who had a child with a life-limiting or life-threatening condition who had received pediatric palliative care. A lack of understanding of occupational therapy’s role in end-of-life care ultimately underutilizes and under-prepares occupational therapists to work in this practice area. Becoming a medical family caregiver, neglecting personal needs and desires becomes a norm having a in-direct effect on physical and psychological health and well-being. Findings from this study suggest that it is reasonable to infer that occupational participation among caregivers is influenced by finding time for self and …


Quality Of Life In A Cohort Of Kenyan Children With Cerebral Palsy, Pauline Samia, Melissa Tirkha, Amina Kassam, Richard Muindi, Wahu Gitakah, Susan Wamithi, James Orwa, Eugene Were, Michael Shevell Apr 2024

Quality Of Life In A Cohort Of Kenyan Children With Cerebral Palsy, Pauline Samia, Melissa Tirkha, Amina Kassam, Richard Muindi, Wahu Gitakah, Susan Wamithi, James Orwa, Eugene Were, Michael Shevell

Paediatrics and Child Health, East Africa

Aim: The objective of the study was to evaluate the quality of life in Kenyan children (age 4–18 years) with cerebral palsy (CP).

Methods: A cross-sectional descriptive study was conducted. Children with CP were recruited from the pediatric clinics at the Aga Khan hospital Nairobi (AKUHN). Parent proxy-reports using CPQoL-child and CPQoL-adolescents were obtained. Clinical and demographic data were compiled from medical records and parent interviews. A Likert scale was utilized to determine QoL across several domains.

Results: One hundred and fourteen child–parent dyads with CP were recruited. The median age of study participants was 8 years (IQR 3–13 years), …


Pediatric Beta Blocker Therapy: A Comprehensive Review Of Development And Genetic Variation To Guide Precision-Based Therapy In Children, Adolescents, And Young Adults., Mollie Walton, Jonathan B. Wagner Mar 2024

Pediatric Beta Blocker Therapy: A Comprehensive Review Of Development And Genetic Variation To Guide Precision-Based Therapy In Children, Adolescents, And Young Adults., Mollie Walton, Jonathan B. Wagner

Manuscripts, Articles, Book Chapters and Other Papers

Beta adrenergic receptor antagonists, known as beta blockers, are one of the most prescribed medications in both pediatric and adult cardiology. Unfortunately, most of these agents utilized in the pediatric clinical setting are prescribed off-label. Despite regulatory efforts aimed at increasing pediatric drug labeling, a majority of pediatric cardiovascular drug agents continue to lack pediatric-specific data to inform precision dosing for children, adolescents, and young adults. Adding to this complexity is the contribution of development (ontogeny) and genetic variation towards the variability in drug disposition and response. In the absence of current prospective trials, the purpose of this comprehensive review …


Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone Mar 2024

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …


Associations Between Anemia And Fgf23 In The Ckid Study., Elizabeth Thomas, Alexandra M. Klomhaus, Marciana L. Laster, Susan L. Furth, Bradley A. Warady, Isidro B. Salusky, Mark R. Hanudel Mar 2024

Associations Between Anemia And Fgf23 In The Ckid Study., Elizabeth Thomas, Alexandra M. Klomhaus, Marciana L. Laster, Susan L. Furth, Bradley A. Warady, Isidro B. Salusky, Mark R. Hanudel

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that plays a central role in chronic kidney disease-mineral bone disorder and is associated with CKD progression and cardiovascular morbidity. Factors related to CKD-associated anemia, including iron deficiency, can increase FGF23 production. This study aimed to assess whether anemia and/or iron deficiency are associated with increased circulating concentrations of FGF23 in the large, well-characterized Chronic Kidney Disease in Children (CKiD) study cohort.

METHODS: Hemoglobin concentrations, iron parameters, C-terminal (total) FGF23, intact FGF23, and relevant covariables were measured in cross-sectional analysis of CKiD study subjects.

RESULTS: In 493 pediatric patients with …


Comparison Of In-Person Versus Virtual Ultrasound Instruction For Pediatric Residents, Jason T. Gillon, E. Liang Liu, Valerie Dutreuil, Stephanie G. Cohen, Lekha A. Shah Feb 2024

Comparison Of In-Person Versus Virtual Ultrasound Instruction For Pediatric Residents, Jason T. Gillon, E. Liang Liu, Valerie Dutreuil, Stephanie G. Cohen, Lekha A. Shah

School of Medicine Faculty Publications

Purpose: Point-of-care ultrasound (POCUS) instruction is prevalent in medical schools but not in pediatric residency programs, even though the majority of pediatric residents desire POCUS instruction. Virtual ultrasound instruction with affordable handheld ultrasound devices may help remedy this deficiency by allowing qualified instructors to circumvent geographic and financial limitations to reach this population. This study sought to determine if virtual ultrasound instruction is an effective alternative to traditional in-person instruction in a cohort of pediatric residents for the extended Focused Assessment with Sonography in Trauma (eFAST) exam. Methods: Pediatric residents were randomized to receive either in-person or virtual instruction to …


Pediatric Spinal Ependymoma With Chromothripsis Of Chromosome 6: A Case Report And Review Of The Literature., Keela R. Scott, Melissa Gener, Elena Repnikova Feb 2024

Pediatric Spinal Ependymoma With Chromothripsis Of Chromosome 6: A Case Report And Review Of The Literature., Keela R. Scott, Melissa Gener, Elena Repnikova

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Ependymomas are the third most common central nervous system tumor in the pediatric population; however, spinal ependymomas in children are rare. Ependymomas affecting the spinal cord most frequently occur in adults of 20-40 years of age. The current World Health Organization classification system for ependymomas is now composed of ten different entities based on histopathology, location, and molecular studies, with evidence that the new classification system more accurately predicts clinical outcomes.

CASE PRESENTATION: We present the case of a 16-year-old Caucasian female patient with a history of type 2 neurofibromatosis with multiple schwannomas, meningioma, and spinal ependymoma. Chromosome analysis …


A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, Carter A. Schulz, Joshua D. Mohs, Andrew M. Reuter Feb 2024

A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, Carter A. Schulz, Joshua D. Mohs, Andrew M. Reuter

Aesculapius Journal (Health Sciences & Medicine)

Case summary: A 15-year-old female presented with chest pain, dyspnea, and weight loss. A chest X-ray and subsequent CT scan revealed a large anterior mediastinal mass with cervical lymphadenopathy and pericardial effusion. Two biopsies under general anesthesia were performed, with the latter confirming classic Hodgkin lymphoma, nodular sclerosis subtype.

Discussion: This case underscores the significant clinical challenges posed by anterior mediastinal masses due to their proximity to vital cardiovascular and respiratory structures. Physiologic changes during general anesthesia can exacerbate these challenges. Preoperative assessment, including imaging and symptom evaluation, is crucial to guide operative planning. It is key to individualize the …


The Durability Of Antibody Responses Of Two Doses Of High-Dose Relative To Two Doses Of Standard-Dose Inactivated Influenza Vaccine In Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial., Jennifer E. Schuster, Lubna Hamdan, Daniel E. Dulek, Carrie L. Kitko, Einas Batarseh, Zaid Haddadin, Laura S. Stewart, Anna Stahl, Molly Potter, Herdi Rahman, Spyros A. Kalams, Claire E. Bocchini, Elizabeth A. Moulton, Susan E. Coffin, Monica I. Ardura, Rachel L. Wattier, Gabriela Maron, Michael Grimley, Grant Paulsen, Christopher J. Harrison, Jason L. Freedman, Paul A. Carpenter, Janet A. Englund, Flor M. Munoz, Lara Danziger-Isakov, Andrew J. Spieker, Natasha B. Halasa, Pediatric Hct Flu Study Jan 2024

The Durability Of Antibody Responses Of Two Doses Of High-Dose Relative To Two Doses Of Standard-Dose Inactivated Influenza Vaccine In Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial., Jennifer E. Schuster, Lubna Hamdan, Daniel E. Dulek, Carrie L. Kitko, Einas Batarseh, Zaid Haddadin, Laura S. Stewart, Anna Stahl, Molly Potter, Herdi Rahman, Spyros A. Kalams, Claire E. Bocchini, Elizabeth A. Moulton, Susan E. Coffin, Monica I. Ardura, Rachel L. Wattier, Gabriela Maron, Michael Grimley, Grant Paulsen, Christopher J. Harrison, Jason L. Freedman, Paul A. Carpenter, Janet A. Englund, Flor M. Munoz, Lara Danziger-Isakov, Andrew J. Spieker, Natasha B. Halasa, Pediatric Hct Flu Study

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Our previous study established a 2-dose regimen of high-dose trivalent influenza vaccine (HD-TIV) to be immunogenically superior compared to a 2-dose regimen of standard-dose quadrivalent influenza vaccine (SD-QIV) in pediatric allogeneic hematopoietic cell transplant (HCT) recipients. However, the durability of immunogenicity and the role of time post-HCT at immunization as an effect modifier are unknown.

METHODS: This phase II, multi-center, double-blinded, randomized controlled trial compared HD-TIV to SD-QIV in children 3-17 years old who were 3-35 months post-allogeneic HCT, with each formulation administered twice, 28-42 days apart. Hemagglutination inhibition (HAI) titers were measured at baseline, 28-42 days following each …


Effect Of Maternal Adverse Childhood Experiences (Aces) And Maternal Resiliency On Early Childhood Outcomes On Vaccination Adherence And Emergency Department Visits, Leslie Abraham Md, Hsiao-Wei Banks Ba, John P. Gaughan Ms, Phd, Alla Kushnir Md Jan 2024

Effect Of Maternal Adverse Childhood Experiences (Aces) And Maternal Resiliency On Early Childhood Outcomes On Vaccination Adherence And Emergency Department Visits, Leslie Abraham Md, Hsiao-Wei Banks Ba, John P. Gaughan Ms, Phd, Alla Kushnir Md

Cooper Rowan Medical Journal

Introduction: Adverse Childhood Experiences (ACEs) are traumatic events that occurred to an individual during ages 0-17 years. The 1998 Adverse Childhood Experiences (ACE) suggested higher ACE scores contributed to negative future health outcomes. The tool is now used to screen at-risk populations for the development of chronic health conditions. Protective factors, such as resilience, were later studied and found to offset the negative health impacts of traumatic childhood events. The 7Cs questionnaire was a tool developed to measure resilience in adolescents and demonstrated better health outcomes despite the presence of higher ACE scores. This pilot study evaluated whether higher …


Barriers To Care For Children With Cerebral Palsy In The Rural State Of Maine: A Mixed-Methods Study, Rayne L. Whitten, Anya K. Cutler, Alexa K. Craig Jan 2024

Barriers To Care For Children With Cerebral Palsy In The Rural State Of Maine: A Mixed-Methods Study, Rayne L. Whitten, Anya K. Cutler, Alexa K. Craig

Journal of Maine Medical Center

Introduction: Guidelines on orthopedic hip surveillance in children with cerebral palsy have been published to minimize the effects of cerebral palsy and maximize quality of life. Researchers aimed to identify barriers to cerebral palsy care and to assess adherence to national hip-surveillance guidelines among a small subset of children with cerebral palsy who live in a rural state.

Methods: Parents of children with cerebral palsy were interviewed, and thematic analyses were performed on the recorded transcripts. Patient-specific data about imaging and demographics were manually extracted from the electronic health record to perform a mixed-methods analysis.

Results: Twenty-one parents were interviewed, …