Medicine and Health Sciences Commons^™

Methodological Progress Note: Logic Models, Molly J Horstman, Kyler M Godwin

Faculty and Staff Publications

Logic models are an accessible tool to organize the planning, management, and evaluation of programs across healthcare disciplines. This methodological progress note describes the five standard components of a logic model (Inputs, Activities, Outputs, Outcomes, and Impact) and provides guidance for developing a logic model. Logic models offer a visual representation of the work and theory of a program and should be created with input from all interested parties. Logic models are living tools that need to be revised as programs evolve and new information becomes available.

Use Of Inverse Probability Weighting In Cardiovascular Surgical Outcomes Research: Principles, Limitations, And Recommendations, Zhongjian Liu, Wei-Guo Ma, Lei Liu, Prashanth Vallabhajosyula, Haibo Wang

2020-Current year OA Pubs

This statistical primer presents a comprehensive introduction to the use of inverse probability of treatment weighting (IPTW), a method for rebalancing group confounders at baseline in cardiovascular surgical outcomes research. We leveraged a retrospective study comparing the outcomes of 2 different surgical approaches to aortic arch pathology to illustrate the essential aspects of performing IPTW, including basic theories, application, extreme weights, underestimated variance, heterogeneity of treatment effect, and multicollinearity. The limitations of IPTW were discussed with examples of solutions. Ten practical recommendations are made on avoiding the pitfalls in the use of IPTW. Proper use of IPTW may effectively reduce …

Tfeb Degradation Is Regulated By An Ikk/Β-Trcp2 Phosphorylation-Ubiquitination Cascade, Yan Xiong, Jaiprakash Sharma, Meggie N Young, Wen Xiong, Ali Jazayeri, Karl F Poncha, Ma Xenia G Ilagan, Qing Wang, Bei Gao, Hui Zheng, Nicolas L Young, Marco Sardiello

2020-Current year OA Pubs

Transcription factor EB (TFEB) is a master regulator of lysosomal biogenesis and cellular clearance pathways. TFEB activity is tightly controlled by multiple post-translational mechanisms, but the exact molecular mechanism controlling its stability has remained elusive. Here, we identify the IκB kinase (IKK) complex as a key regulator of TFEB protein stability through a phosphorylation-ubiquitination cascade. A high-content kinase inhibitor screen reveals that IKK inhibition increases TFEB protein levels, and genetic ablation of IKK components increases TFEB stability, upregulates lysosomal genes, and enhances lysosomal biogenesis and degradative capacity. Mechanistically, we show that IKK phosphorylates TFEB on a cluster of serine residues …

Author Correction: Phenome-Wide Analysis Of Copy Number Variants In 470,727 Uk Biobank Genomes, Xueqing Zoe Zou, Fengyuan Hu, Haiyi Lou, Oliver S Burren, Xiaoyin Li, Karyn Megy, Eleanor Wheeler, Qiang Wu, Santosh S Atanur, Marcin Karpinski, Douglas Loesch, Zammy Fairhurst-Hunter, Sri V V Deevi, Erin Oerton, Sean Wen, Xiao Jiang, Cecilia Salvoro, Jonathan Mitchell, Abhishek Nag, Ben Hollis, Amanda O'Neill, Astrazeneca Genomics Initiative, Jen Harrow, Stewart Macarthur, Sebastian Wasilewski, Sean O'Dell, Lifeng Tian, Katherine R Smith, Guillermo Del Angel, Margarete Fabre, Ryan S Dhindsa, Quanli Wang, Slavé Petrovski, Keren Carss

Duncan NRI Faculty and Staff Publications

No abstract provided.

Resilience Factors For Physical Activity After Completion Of Intensive Interdisciplinary Pain Treatment: A Qualitative Analysis., William R. Black, Lora L. Black, Jennifer Christofferson, Liesbet Goubert, Cara M. Hoffart, Dustin Wallace

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study explored potential resilience factors that facilitate engagement in physical activity (PA) among adolescents with chronic musculoskeletal pain after completing intensive interdisciplinary pain treatment.

METHODS: Ten adolescents aged 13 to 17 years with a history of chronic musculoskeletal pain from a mid-western pediatric hospital in the United States participated in this qualitative study. Participants provided demographic information and completed semistructured virtual interviews. The interviews focused on their pain experiences, resilience, and engagement in PA. Transcripts were analyzed using primarily directed content analysis based on a pain resilience framework.

RESULTS: Participants highlighted several key resilience factors that influenced their …

Complex Iliac Artery And Iliocaval Venous Reconstruction Using Temporary, Redundant Graft To Facilitate Resection Of Recurrent Metastatic Sex Stromal Tumor, Shah-Jahan M Dodwad, Blaz Podgorsek, Ezra Koh, Taha S Zaidi, Justin E Bird, Shalin S Patel, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Student Publications

We report a complex case of recurrent, metastatic sex cord stromal tumor involving the pelvic vasculature and spinal nerves. Posterior and anterior approaches were required with redo iliac artery reconstruction using a temporary, redundant aortoiliac to right external iliac artery graft and iliocaval venous reconstruction. After completion of tumor resection from nerve structures, reconstruction of the right iliac veins was completed and the redundant aortoiliac arterial graft was shortened. The redundant graft minimized ischemia time, enabling meticulous dissection and tumor removal. This case underscores the importance of multidisciplinary collaboration in managing rare, aggressive malignancies with complex vascular and neural involvement.

Weaning Drives Microbiome-Mediated Epigenetic Regulation To Shape Immune Memory In Mice, Li Yang, Robert C Peery, Shirui Zhou, Xiaomin Chen, Leah M Farmer, Fabiola Gutierrez, Stephanie Fowler, Lanjing Zhang, Julia M Salamat, Karen Riggins, Jiejun Shi, Lanlan Shen

Children’s Nutrition Research Center Staff Publications

During weaning, the transition to solid food diversifies the gut microbiome, triggering a programmed immune response critical for long-lasting mucosal immunity. Previous work showed that the gut microbiome mediates epigenetic development in intestinal stem cells (ISCs) during suckling, but what happens during weaning is unclear. Here, genome-wide profiling revealed that weaning-driven microbiome changes shape the DNA methylome and transcriptome of murine ISCs in an IFNγ-dependent manner. Specifically, we observe demethylation of enhancer elements essential for MHC class II genes, which results in a transcriptional memory that persists through differentiation into adulthood. IFNγ blockade, or low-dose penicillin to target Gram-positive bacteria, …

Functional Bipartite Invariance In Mouse Primary Visual Cortex Receptive Fields, Zhiwei Ding, Dat Tran, Kayla Ponder, Zhuokun Ding, Rachel Froebe, Lydia Ntanavara, Paul G Fahey, Erick Cobos, Luca Baroni, Maria Diamantaki, Eric Y Wang, Andersen Chang, Stelios Papadopoulos, Jiakun Fu, Taliah Muhammad, Christos Papadopoulos, Santiago A Cadena, Alexandros Evangelou, Konstantin Willeke, Fabio Anselmi, Sophia Sanborn, Jan Antolik, Emmanouil Froudarakis, Saumil Patel, Edgar Y Walker, Jacob Reimer, Fabian H Sinz, Alexander S Ecker, Katrin Franke, Xaq Pitkow, Andreas S Tolias

Faculty, Staff and Students Publications

Sensory systems support generalization by representing features that persist under input variation; however, identifying the neuronal basis of these invariances remains difficult due to high-dimensional and nonlinear neural computations. Here we leverage the inception loop paradigm, iterating between large-scale recordings, predictive models and in silico experiments with in vivo verification, to characterize neuronal invariances in mouse primary visual cortex (V1). We synthesize varied exciting inputs (VEIs), dissimilar images that drive target neurons. These VEIs revealed a new bipartite invariance: one subfield encodes a shift-tolerant high-frequency texture and the other encodes a fixed low-frequency pattern. This division aligns with object boundaries …

Yield Of Injury Testing For Contacts Of Children Evaluated For Physical Abuse, Lígia Batista, Joanne N Wood, Tagrid M Ruiz-Maldonado, M Katherine Henry, Jan Leonard, Angela Bachim, James D Anderst, Farah W Brink, Hannah B Sahud, Lori D Frasier, Nancy S Harper, Natalie Laub, Colleen J Bressler, Daniel M Lindberg

Faculty, Staff and Students Publications

Background: Siblings and household contacts of physically abused children are at increased risk for physical abuse and may have injuries that are not clinically apparent. However, injury testing recommendations for contact children remain debated.

Objective: Our objective was to describe testing practices and yield for contacts of physically abused children.

Participants and settings: This is a cross-sectional study of children < 10 years old evaluated for physical abuse at 10 US pediatric referral centers in the CAPNET research network.

Methods: We report the proportion of contact children who had a skeletal survey (SS) or neuroimaging and describe the proportion of tests that identified injuries.

Results: Among 6256 index evaluations, 4863 contacts were identified. Among 794 contacts with physical examinations, …

Widespread Distribution Of Alu/Alu-Mediated Genomic Rearrangement Predisposing To A Broad Range Of Mendelian Disease And Cancer In Human Populations, Ruizhi Vince Duan, Haowei Du, Shruti Pande, Ahmed K Saad, Meryem M Atik, Minal Jamsandekar, Karen J Coveler, Zain Dardas, Shalini N Jhangiani, Jennifer E Posey, Richard A Gibbs, James R Lupski

Faculty, Staff and Students Publications

Background

Genome-wide distributions of Alu elements contribute to a broad range of structural variants (SVs) through Alu/Alu-mediated genomic rearrangement (AAMR). Yet, the prevalence and characteristics of AAMR on the human genome and its scale in generating pathogenic SVs remain poorly understood.

Methods

We established a disease-focused, AAMR-SV dataset and a control dataset to comprehensively delineate the genomic landscape of Alu mutagenesis. The disease-focused dataset included 407 published pathogenic AAMR-SV alleles in 115 known genes for Mendelian disorders or traits through a literature survey. A control dataset was collected from short-read genome sequencing analyses of 100 randomly selected, healthy individuals. …

Non-Invasive Intracranial Pressure Estimation In The Intensive Care Unit: Narrative Review Of Methods And Clinical Applications, Edoardo Picetti, Daniele Guerino Biasucci, Elisa Gouvea Bogossian, Sérgio Brasil, Danilo Cardim, Marek Czosnyka, Daniel A Godoy, Gregory W J Hawryluk, Mohammad I Hirzallah, Frank A Rasulo, Carla Bittencourt Rynkowski, Andres M Rubiano, Fabio Silvio Taccone, Chiara Robba

Faculty, Staff and Students Publications

Despite invasive methods are the gold standard for intracranial pressure (ICP) measurement, several non-invasive techniques (nICP) have been proposed as surrogate, although their use remains insufficiently recognized in clinical practice. These include transcranial Doppler blood flow velocity  assessment (arterial or venous), optic nerve sheath diameter (ONSD), automated pupillometry, measurement of skull expansion and compliance, brain imaging, double-depth ophthalmic artery blood flow velocity, and ultrasound time-of-flight. The main limitations of all indirect methods are calibration and zeroing, which constrain the absolute accuracy of non-invasive ICP monitoring. For transcranial Doppler-based methods, the 95% limits of agreement are approximately ± 7-15 mmHg, while …

Ethical Controversies In Organ Procurement: A National Survey On Public Perceptions Of Thoracoabdominal Normothermic Regional Perfusion, Trevor M Bibler, Jill Oliver Robinson, Adam Omelianchuk, Tariq Nisar, Savitri Fedson, Ariel N Levchenko, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Thoracoabdominal normothermic regional perfusion (TA-NRP) would likely expand the quantity and quality of organs procured after controlled circulatory death donation in the United States, yet its ethical permissibility remains contested. We surveyed a representative sample of US adults (n = 975) with the goal of assessing their perspectives on the ethical permissibility of TA-NRP. After reading a neutral description of TA-NRP, participants judged its permissibility, reviewed 5 critic and 5 supporter arguments (in random order), and chose which argument they found most convincing. Multivariable logistic regression examined predictors of agreeing with critics. Before exposure to the arguments, 51.5% stated that …

Tfeb Degradation Is Regulated By An Ikk/Β-Trcp2 Phosphorylation-Ubiquitination Cascade, Yan Xiong, Jaiprakash Sharma, Meggie N Young, Wen Xiong, Ali Jazayeri, Karl F Poncha, Ma Xenia G Ilagan, Qing Wang, Bei Gao, Hui Zheng, Nicolas L Young, Marco Sardiello

Center on Aging Staff Publications

Transcription factor EB (TFEB) is a master regulator of lysosomal biogenesis and cellular clearance pathways. TFEB activity is tightly controlled by multiple post-translational mechanisms, but the exact molecular mechanism controlling its stability has remained elusive. Here, we identify the IκB kinase (IKK) complex as a key regulator of TFEB protein stability through a phosphorylation-ubiquitination cascade. A high-content kinase inhibitor screen reveals that IKK inhibition increases TFEB protein levels, and genetic ablation of IKK components increases TFEB stability, upregulates lysosomal genes, and enhances lysosomal biogenesis and degradative capacity. Mechanistically, we show that IKK phosphorylates TFEB on a cluster of serine residues …

Perceptions Of Virginia Dentists And Dental Hygienists Towards Emerging Alternative Dental Hygiene Workforce Provider Models, Lauren B. Mangum

Dental Hygiene Theses & Dissertations

Background: A perceived shortage of dental hygienists in the United States has been linked to delays in preventive care and concerns about declining oral health outcomes. In response, some states have proposed alternative pathways permitting internationally trained dentists, dental students, and oral preventive assistants (OPAs) with limited or inconsistent education requirements to provide dental hygiene services. Limited evidence exists regarding whether these strategies would effectively address access to care and workforce challenges. Concerns have also been raised about the potential effects of expanding scope of practice for providers with limited education or training on patient safety and quality of care. …

Rearfoot Realignment As A Prophylactic Strategy For Recurrent Lateral Column Ulcers In Diabetic Foot: A Case-Based Hypothesis, Christopher I. Anjorin Ms Dpmc, Ali-Abdul Kareem Dpm

School of Podiatric Medicine - Student Research

Lateral column ulcerations remain a persistent and complex challenge in diabetic foot management. Although procedures such as tailor’s bunionectomy may provide localized pressure relief, they often fail to address the underlying biomechanical contributors, most notably rearfoot deformities such as calcaneal varus or pes cavovarus frequently observed in diabetic patients. These structural abnormalities shift the weight‑bearing axis laterally, increasing ground reaction forces along the fifth metatarsal and predisposing individuals with diabetic peripheral neuropathy and impaired proprioception to recurrent ulceration. This case explores the hypothesis that prophylactic rearfoot realignment may offer superior long‑term outcomes by correcting the mechanical etiology of lateral column …

Electromyography, Prosthetic Properties, And Running Biomechanics In Recreationally Active Persons With Lower Extremity Amputation, Paige M. Agnew

Rehabilitation Sciences Theses & Dissertations

Lower extremity loss affects nearly 150,000 individuals in the United States yearly yielding extreme health care costs annually. Typically, prosthetic devices are prescribed for 5-8 years despite known changes to an individual’s gait as time progresses. Patients can expect to undergo approximately 8-12 weeks of gait retraining to improve their comfort and efficiency. Biomechanical changes occur when running with a specific running prosthetic including considerable biomechanical and neuromuscular interlimb asymmetries and alterations in loading patterns. The purpose of this dissertation was to investigate the biomechanical demands for lower extremity prosthesis users during running. The first study synthesized peer reviewed evidence …

Modeling Early Indicators For Success In An Associate Degree In Nursing Program, Joseph D. Moss

Educational Leadership & Workforce Development Theses & Dissertations

Persistent nursing workforce shortages across the United States have increased the importance of Associate Degree in Nursing (ADN) programs as primary entry points into the profession. Community colleges prepare a substantial portion of the nursing workforce; however, attrition within ADN programs limits the number of graduates entering practice. Understanding factors associated with academic performance and program completion is essential for strengthening nursing education pathways and supporting workforce development. The purpose of this quantitative study was to examine early academic and sociodemographic factors associated with successful completion of an ADN program at a suburban community college.

Guided by Becker’s Human Capital …

Exploring The Perceptions Of United States Dentists And Dental Hygienists Towards Implementation Of New Workforce Shortage Policies, Hite N. Jones

Dental Hygiene Theses & Dissertations

Background: There is a perceived national dental hygiene shortage causing delays in receiving preventive treatment and potentially increasing oral disease risk. States are proposing alternative pathways to allow less-trained individuals to provide dental hygiene care to fill this perceived gap. There is no research to support whether such measures would mitigate the shortage issue. Purpose: Therefore, the purpose of this study was to examine the perceptions of United States (U.S.) dentists and dental hygienists (DH) towards the implementation of new workforce shortage policies and contributing factors and solutions to the workforce shortage. Methods: This descriptive, cross-sectional study included a convenience …

The Effects Of Covid 19 Job Demands On Public Sector Employees’ Organizational Commitment: The Mediating Roles Of Work Engagement And Job Burnout, And The Moderating Role Of Supervisor Support, Benjamin R. Kaufman

Psychology Theses & Dissertations

United States citizens rely on state government employees to provide essential public services. During the COVID-19 pandemic, these employees responded by administering both routine and novel procedures to protect public health, often placing them on the frontlines and at increased risk of contagion. Concurrently, the pandemic-driven economic downturn created budget shortfalls that threatened the job and financial security of the state workforce. Together, these conditions substantially increased job demands for state government employees.

Guided by the Job Demands–Resources (JDR) Model, this study examined how COVID‑19-related job demands influenced state employees’ work engagement, job burnout, and organizational commitment, and whether supervisor …

Ptsd Symptoms And Cannabis Use Among College Students: Examining The Role Of Trauma-Related Cannabis Use To Cope, Christopher T. Latourrette

Psychology Theses & Dissertations

Individuals with posttraumatic stress disorder (PTSD) are more than four times as likely to develop cannabis use disorder (CUD) as those without PTSD. This common co-occurrence is often interpreted through a self-medication framework in which cannabis is used to manage PTSD symptoms. Prior work has relied heavily on veteran samples, includes measures of cannabis coping that are not specific to PTSD, and has most commonly examined total PTSD symptom severity, limiting precision in understanding how discrete symptom clusters relate to cannabis outcomes. The present study sought to examine associations between individual PTSD symptom clusters and cannabis use severity and to …

“Recollecting The Told Story”: Storytelling, Activism, And The Black Maternal Health Emergency, Lamaya C. Williams

English Theses & Dissertations

Storytelling is a foundational component of Black knowledge creation and transmission. This dissertation centers Black women’s stories of birth and mothering—drawing on both primary source birth stories and fictional narratives—to examine the United States’ Black Maternal Health Emergency (BMHE). The BMHE is a complex and urgent issue wherein structural racism, medical bias, and intersecting social determinants disproportionately endanger the health of Black mothers. As such, Black mothers in the United States are three times more likely to die from a pregnancy-related condition compared to their white counterparts.

This study examines the birth stories of women who survived the BMHE and …

"On The Same Rope": An Exploratory Study Of Staff Experiences At The Mountain Seed Foundation's Healing Base Camp Program, Jill C. Kivikoski

Counseling & Human Services Theses & Dissertations

Since the escalation of Russia’s invasion of Ukraine in 2022, Ukrainians have faced significant social and public health challenges, particularly among Service Members, Veterans, and their Families (SMVF), including disability, traumatic stress, and barriers to mental health care (Kostenko et al., 2024; Krasnodemska et al., 2023; O’Grady & Galouchka, 2023). Retreat based programs grounded in shared military identity may offer an accessible form of support (Barrett & Currin, 2024). Mountain Seed Foundation’s (MSF) Healing Base Camp (HBC) was developed to promote healing and resilience among Ukrainian SMVF (Mountain Seed Foundation, n.d.).

This qualitative dissertation used a single-case study design (Yin, …

Predictors Of Opioid Misuse And Abuse Among Pregnant Women In The Us, Henry Ofori Duah, Diane Von Ah, Ethan Morgan

College of Nursing Faculty Research and Publications

Introduction

Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Methods

Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

Results

The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of …

Narratives Of Dis-Ease: A Genre Study Of Pathography, Sylvelyn Jo A. Almanzor

Akda: The Asian Journal of Literature, Culture, Performance

This essay establishes pathography as a distinct genre of creative nonfiction, tracing the development, form, and cultural significance of this body of literature. I have broadly defined it as narratives on personal experiences of Gabriel Marcel's "dis-ease"—covering and critiquing the human understanding and experience of sickness, pain, and grief—which has evolved from autobiographical narratives and life-writing of patients and medical professionals to a recognized form of creative nonfiction. This study will analyze the genre's structure, themes, and rhetorical strategies with consideration to cultural significance and how it negotiates the human understanding of suffering, healing, and societal attitudes toward existence and …

Proximal And Distal Factors Associated With Obesity In Childhood: An Exploratory Structural Equation Model., Joseph A. Skelton, Erinn T. Rhodes, Sarah Hampl, Ihuoma Eneli, Edward H. Ip, Sit Study Research Group

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Obesity in childhood is complex; structural equation modeling (SEM) offers an approach to ascertain complicated relationships between weight and proximal (health behaviors, child health) and distal (family/household, community) variables. The objective of the study was to use SEM to map the influence of different etiological clusters on obesity in childhood.

METHODS: Secondary analysis of baseline data from patients and parents enrolled in a multi-site study of pediatric weight management was conducted. The primary outcome was weight status (utilizing percentage above the 95th percentile BMI, %95BMI). SEM was used to evaluate the influences of variables proximal and distal to child …

Clostridioides Difficile Colonization And Infection In Pediatric Oncology And Stem Cell Transplant Patients, Daniel N. Willis, Erik R. Dubberke, Robert J. Hayashi, Phillip I. Tarr, David B. Haslam, Tiffany Hink, Jingqin Luo, Yu Tao, Amruta Padhye, Erin Hall, Gregory A. Storch

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pediatric oncology and hematopoietic stem cell transplant (HSCT) patients have elevated risk for Clostridioides difficile infection (CDI), which can prolong hospitalization and delay chemotherapy. Colonization is an important prelude to symptomatic CDI. We sought to characterize colonization status in these patients.

METHODS: We retrospectively studied 276 stools longitudinally collected over 34 months from 32 HSCT and 12 oncology patients treated at a single tertiary center. Specimens were cultured for C difficile and compared by whole genome sequencing. The fecal microbiome was characterized by 16S rRNA gene sequencing.

RESULTS: Baseline cultures were positive in 16 (50%) HSCT patients and 2 …

Factors Associated With Child Protective Services Referrals In Young Children With Isolated Skull Fractures., Karli Breeden-Carino, Joanne N. Wood, Cindy W. Christian, Tagrid M. Ruiz-Maldonado, Daniel M. Lindberg, Angela Bachim, Lori Frasier, Terra N. Frazier, Nancy S. Harper, Sara E. Kruczek, Farah Brink, Jennifer E. Wolford, Jan Leonard, M Katherine Henry

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Many young children with isolated skull fractures are referred to child protective services (CPS) despite being assessed to have a low likelihood of abuse. We sought to identify factors associated with CPS referrals in this population and to quantify hospital-level variation.

METHODS: We performed a multicenter retrospective cross-sectional study of children < 2 years with skull fractures with or without a small underlying intracranial hemorrhage (ICH) and no additional injuries undergoing a child abuse pediatrics (CAP) subspecialty evaluation. We explored associations between demographic factors, clinical characteristics, psychosocial risk factors, and hospital site with CPS referral status. We performed multivariable logistic regression, adjusting for transfer status and all significant covariates from unadjusted analyses. We utilized marginal standardization to calculate the estimated probability of CPS referrals at each site, adjusting for all factors in the final model.

RESULTS: Of 528 children, 303 (57.4%) were referred to CPS, with 86.5% referred before CAP consultation. In multivariable logistic regression, presence of psychosocial risk factors (OR 4.00; 95% CI 2.25, 7.11), in-person CAP consult (OR 3.93; 1.61, 9.62), inflicted or no trauma history provided (OR 6.15; 3.30, 11.45), …

Confessions In Cases Of Child Physical Abuse-A Capnet Study., Margaret R. Russell, Antoinette L. Laskey, Henry T. Puls, Suzanne P. Starling, Joanne N. Wood, Daniel M. Lindberg, Nancy S. Harper, Caitlin R. Mcnamara, Angela W. Bachim, Farah W. Brink, Lori D. Frasier, James Anderst, Porcia Vaughn, Kristine A. Campbell

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Prior research on confessions of physical abuse (PA) has explored mechanisms of injury. Little is known about conditions supporting a confession of abuse or how confessions may influence case outcomes.

METHODS: This cross-sectional study of suspected PA in children aged < 10 years at 10 centers participating in CAPNET, a multicenter child PA research network, included children with in-person Child Abuse Pediatrics (CAP) consultations between February 2021 and December 2022 and excluded children without injury. Our focus was a confession of inflicted injury known to the CAP during clinical involvement. We compared child and clinical characteristics, out-of-home (OOH) placements, and arrests between cases with and without confessions. Multivariable models using generalized estimating equations (GEE) produced adjusted predicted probabilities (APP) clustering by CAPNET site.

RESULTS: Confessions were known to CAPs in 115/4297 (2.7%) cases, with significant site variability. In a multivariable GEE model, confessions were more likely in cases with injuries with high specificity for abuse (APP 6.0% vs 1.6%, P < .001), near-fatality (APP 5.6% vs 2.3%, P < .001), and older children (APP 4.8% vs 2.5%, P = .025). OOH placements and arrests were more common in cases with confessions. CAP awareness of confessions, OOH placements, and arrests did not follow racial or ethnic patterns seen in the US child welfare system. Lower socioeconomic status was associated with OOH placements and arrests but not with CAP awareness of confessions.

CONCLUSIONS: Our findings highlight differences in case characteristics and outcomes where a confession is known to the CAP and raise questions about …

Exploitive Adolescent Labor And Labor Trafficking: Clinical Perspectives For Adolescent Healthcare Providers., Romina Barral, Michele A. Kelley, Abigail English, Marissa Raymond-Flesch, Tonya Chaffee, Veronica Svetaz, Tamera Coyne-Beasley, Nuray Kanbur

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Protocol For Non-Invasive Assessment Of Skeletal Muscle Structure And Function In Adolescents With Single Ventricle Heart Disease: A Cross-Sectional, Case-Control Study., Tyler A. Fick, Trent J. Herda, Emily Cramer, David A. White, Daniel Forsha

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Congenital heart disease (CHD) is the most common congenital malformation, and the most severe type, single ventricle (SV) heart disease, requires the Fontan surgical palliation. Fontan palliation minimizes hypoxemia and volume overload by separating systemic and pulmonary circulations, resulting in the absence of a sub-pulmonary pump. Skeletal muscle health may have a greater relative contribution to overall functional capacity of those with SV physiology, via the skeletal muscle (SkM) pump mechanism and oxidative capacity. The purpose of this study is to comprehensively evaluate multiple domains of SkM in this population compared to those with normal cardiac anatomy.

METHODS: Forty …