Medicine and Health Sciences Commons^™

How To Create This Gynecological Task Trainer, Jami Monico, Karen S. Carlson

Posters and Presentations: Obsetrics & Gynecology

This document contains instructions for how to create a gynecological task trainer with a 3D-printed uterus and silicone cervix.

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

Early Systolic Dysfunction And Impact Of Gene Mutation Severity In Marfan Syndrome, Aaron Clem, Lois J. Starr, David Danford, Mary Craft, Ling Li, Jason Christensen, Anji Yetman

Child Health Research Institute Pediatric Research Forum

Background

Marfan syndrome is caused by a mutation in the fibrillin-1 gene that manifests with a variety of features including aortic root dilation. Recent research has identified a primary cardiomyopathy in patients with Marfan syndrome, hypothesized to be due to the presence of abnormal fibrillin-1 in the myocardium. Controversy over the nature and significance of this cardiomyopathy remains. Echocardiographic measurement of the first-phase of ejection (defined as the beginning of systole to peak aortic valve flow) may be more sensitive to systolic dysfunction and provide useful clinical information. The purpose of this study is to:

1. Assess systolic dysfunction in patients …

Do I Add Value? A Mixed Methods Study Comparing Medical Students’ Experiences With Patient Documentation, Shannon Haines, Kari Nelson, Kaeli Samson, Nathan Gollehon

Child Health Research Institute Pediatric Research Forum

Background

Clinical documentation is an essential skill for practicing physicians, yet many medical students are not prepared for the documentation demands required during residency.^1,2 Recent CMS rule changes now allow medical students’ notes to be used for billing.³ Previous studies have shown positive perceptions of medical students whose notes were used in an outpatient setting.⁴ We utilized Constructivist Learning Theory to frame our work, where students construct their knowledge as faculty and residents facilitate the process.⁵

Objectives

To explore if using student documentation for billing impacts student perceptions and experiences during the pediatric clerkship.

Methods

Pediatric …

Novel Mouse Model For Analysis Of Macrophage Function In Neuroblastoma, Gabrielle L. Brumfield, Shelby M. Knoche, Alaina C. Larson, Brittany Poelaert, Benjamin T. Goetz, Poomy Pandey, Don W. Coulter, Joyce C. Solheim

Child Health Research Institute Pediatric Research Forum

Background: Neuroblastoma is the third most common childhood cancer and accounts for 12% of cancer-associated deaths in children under the age of 15. Patients with high risk neuroblastoma have a poor 5-year survival rate of less than 50%. Neuroblastoma tumors treated with the histone deacetylase inhibitor (HDACi) vorinostat have increased infiltration of macrophages with upregulated immune cell-surface receptors. Neuroblastoma cells release VEGF and M-CSF, which may alter intratumoral macrophage populations. VEGF has also been implicated in alteration of amyloid precursor protein family processing. Our lab demonstrated that amyloid precursor protein 2 (APLP2), a member of the amyloid precursor protein …

Fit For Life: Educating About A Healthy Lifestyle In Omaha Elementary Schools, Emilee Greager, Mary Conklin, Jordan Nustad, Tyler Bendrick, Haley Bremer, Tavishi Chopra, Jane Driano, Connor Eggleston, Lily Foley, Jeffrey Kepple, Ryan Leuty, Taylor Mattice, Alison Mause, Elizabeth Mause, Molly Olsen, Breanne Parets, Heerali Patel, Thomas Pennington, Miranda Prints, Eva Schaible, Christopher Toivonen, Grace Vitek, Claire Willman, Allen Zheng, Kody Moffatt

Child Health Research Institute Pediatric Research Forum

Background: The prevalence of childhood obesity is increasing across the country. Health education at a young age is critical for children to establish healthy habits. The Fit for Life program is put together by Creighton medical students to inspire elementary students to lead a healthy lifestyle. The curriculum integrates physical exercise, real organ demonstrations, emotional wellness exercises, and nutritious meal building to model and encourage healthy habits.

Methods: Over four weeks, medical students taught the 4^th and 5^th graders of two Omaha schools over live video while they followed along with hands-on activities. Before and after the program, …

Postnatal Diagnosis Of Dandy Walker Malformation With Encephalocele, Heerali Patel

Child Health Research Institute Pediatric Research Forum

Encephalocele is a defect of the neural tube. Dandy Walker malformation (DWM) is a defect involving agenesis or hypoplasia of the cerebellar vermis, cystic dilation of the fourth ventricle, and enlargement of the posterior fossa. This is a case of a female preterm infant born at 36 weeks’ gestation who presented with DWM and an encapsulated occipital encephalocele at birth. The pregnancy was complicated by poorly controlled maternal diabetes. Prenatal ultrasound indicated a central nervous system anomaly. Amniocentesis did not show chromosomal abnormality. The infant also presented with polydactyly of the right thumb. MRI showed evidence of soft tissue within …

Evaluation Of Brain Cholesterol Metabolism After Neonatal Hypoxic-Ischemic Brain Injury, Amanda Dave, Luke Allen, Zeljka Korade, Eric Peeples

Child Health Research Institute Pediatric Research Forum

Introduction

Neonatal hypoxic-ischemic brain injury (HIBI), resulting from impaired cerebral blood flow and oxygen delivery to the brain, affects at least 1.5 per 1,000 live births each year in the United States. Altered levels of cholesterol and cholesterol metabolites have been identified in brain tissue and in serum after adult brain injury such as traumatic brain injury and stroke. We hypothesized that there would be temporal and brain region-specific alterations in cholesterol and sterol precursors after neonatal HIBI.

Methods

Postnatal day 9 CD1 mouse pups were anesthetized with isoflurane and randomized to HIBI induced by carotid artery ligation or controls …

Perceptions Of Pediatricians On The Sars-Cov2 Vaccine, Karl Khandalavala, Kari Simonsen, Jeffrey A. Robinson

Child Health Research Institute Pediatric Research Forum

Introduction: The novel SARs-CoV2 coronavirus has infected approximately 30,000,000 people in the USA. To date, approximately 146 million doses of SARs-CoV2 vaccines have been administered. Perceptions of rapid vaccine development have resulted in reported vaccine hesitancy and refusal. Though not currently FDA approved for use in pediatric populations, but pediatric vaccination may contribute to herd immunity. Previous study demonstrates that physician recommendations significantly impact perceptions of routine pediatric immunizations among parents. Given this historical data, this study aimed to describe the strength of recommendation by pediatricians for the SARs-CoV2 vaccine for pediatric patients and their parents.

Methods: A …

Food Protein Induced Enterocolitis Syndrome Triggers At Children’S Hospital, Rachel Nelson, Russell Hopp

Child Health Research Institute Pediatric Research Forum

Background

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food disease characterized by delayed vomiting and diarrhea, often at the first ingestion of the food. The clinical phenotype of FPIES, including trigger food and disease course, varies by region. A literature review of the most common FPIES foods in children in the United States and worldwide includes cow’s milk, soy, oats, rice, and egg.

Objective:

We sought to survey the most common FPIES foods seen at Children’s hospital in the past five years.

Methods:

A data search of the EPIC electronic medical record using FPIES codes ICD-10 (K52.21) and ICD-9 …

Femoral And Tibial Indications For Initial And Reoperation Surgeries With Fassier-Duval Intramedullary Rods For Children With Osteogenesis Imperfecta, Adriano Dellapolla, Kaeli Samson, Tinotenda Sekeramayi, Arianna Dalamaggas, Megan Gillespie, Vincent Eaton, Elizabeth Strudthoff, Maegen Wallace

Child Health Research Institute Pediatric Research Forum

Background: Osteogenesis imperfecta (OI) is a genetic connective tissue disorder affecting quantity and integrity of collagen type I, which is integral for the strength of osseus tissue. OI has a heterogenous molecular inheritance pattern – divided into four major subgroups (I-IV). Defects in collagen protein products lead to poor development of skeletal structures and increased fracture rates. Children with OI suffer from multiple fractures and bone deformities often requiring surgical intervention with osteotomies and intramedullary telescoping rods, most often with Fassier-Duval (FD) rods. Our study–updated cohort from 2018 paper Azzam et al.–looked at the relationship between initial and reoperation indications …

Evaluation Of Pseudomonas Aeruginosa Eradication Protocol In Pediatric Patients With Cystic Fibrosis: A Retrospective Medical Chart Review, Adam Devries, Heather Thomas, Diane Acquazzino

Child Health Research Institute Pediatric Research Forum

Background

Pseudomonas aeruginosa (Pa) is a leading cause of lung infection in patients with cystic fibrosis (CF), increasing morbidity and mortality. Despite this, there is no standardized treatment among the medical community for Pa eradication in patients with CF. The Nebraska Regional Cystic Fibrosis Center at Children’s Hospital and Medical Center (CHMC) in Omaha, Nebraska has a Pa eradication protocol. This study aims to increase Pa eradication for children with CF by investigating the effectiveness and adherence to the current Pa eradication protocol.

Methods

This study is a retrospective medical chart review of 1–21-year-olds with CF receiving care …

3d Printed Adjustable Glasses: A New Model Of Corrective Lens Delivery For Pediatric Refractive Error In Underserved Communities, Nathan Ostlie, Mari Ogino, Donny Suh, Gabe Linke, James Hermsen

Child Health Research Institute Pediatric Research Forum

Purpose:

Uncorrected refractive error (URE) remains a major cause of preventable vision impairment in the pediatric population with large inequities in disease burden. The present study aims to elucidate the global burden of pediatric URE and explore the current lens delivery systems which address this problem. Within this framework, we introduce a new model of corrective lens delivery that may improve upon existing models.

Methods:

The present study involved an extensive literature review of epidemiological data to determine the global prevalence of URE. Prevalence data was then compared against WHO data on refractionist coverage gaps divided by region. …

Power Training Improves The Sensorimotor Cortical Oscillations In Youth With Cerebral Palsy, Morgan Busboom, Anna Reelfs, Mike Trevarrow, Brad Corr, Heidi Reelfs, Sarah Baker, Hannah Bergwell, Tony W. Wilson, Max J. Kurz

Child Health Research Institute Pediatric Research Forum

Background: Our magnetoencephalographic (MEG) brain imaging studies have shown that youth with cerebral palsy (CP) demonstrate altered sensorimotor beta (18-24Hz) cortical oscillations when controlling their leg motor actions and these anomalous cortical oscillations are linked with the extent of their mobility impairments. Current therapeutic trends for improving mobility have shifted from strength training to high-velocity power training, which has shown improvements in isokinetic strength, power production and mobility of youth with CP. However, no studies have assessed whether these clinically relevant improvements are linked with changes in the sensorimotor cortical oscillations. The objective of this study was to utilize MEG …

Profound Neonatal Anemia Due To A Fetal To Maternal Hemorrhage: A Case Study, Margaret Hogan Smoot, Terrance Zach

Child Health Research Institute Pediatric Research Forum

A female infant was born by cesarean section at 36 weeks of gestation after the mother presented with perceived decreased fetal movement, blood-tinged mucous vaginal discharge, and a non-reactive non-stress test. Upon delivery, the infant appeared extremely pale and in mild respiratory distress. A complete blood count upon admission showed profound neonatal anemia, and a Kleihaur-Betke test confirmed fetomaternal hemorrhage as the cause. Transfusions corrected the infant’s hematocrit levels, and she was discharged on day 8 following a normal brain MRI. Fetal to maternal hemorrhage is a known cause of neonatal anemia, however the presentation is nonspecific leading to underdiagnosis …

Direct Hyperbilirubinemia In Infants With Trisomy 13 And 18, Jeffrey Kepple, Eric Peeples

Child Health Research Institute Pediatric Research Forum

Background: Survival in trisomy 13 (T13) and 18 (T18) has increased in recent years, but little is known about the prevalence and management of the non-lethal complications in these populations.

Significance of Problem: A subjectively high rate of direct hyperbilirubinemia (DH) was noted at Children’s Hospital & Medical Center compared to the general population. Defining the prevalence, timing, and risk factors for DH will allow for the development of screening and management guidelines.

Hypothesis, Problem or Question: We hypothesized that infants with T13 and T18 would have high rates of DH, with no significant difference in prevalence between …

Mir-1253 Potentiates Cisplatin Response In Pediatric Medulloblastoma By Regulating Ferroptosis, Ranjana K. Kanchan, Naveenkumar Perumal, Pranita Atri, Ramakanth C. Venkata, Ishwor Thapa, Mohd W. Nasser, Surinder K. Batra, Sidharth Mahapatra

Child Health Research Institute Pediatric Research Forum

Introduction Among CNS tumors, medulloblastoma (MB) is the most common malignant pediatric brain tumor. Of the four subgroups, group 3 (G3MB) tumors fare the worst. Haploinsufficiency of 17p13.3 is a hallmark of these high-risk tumors; included within this locus is miR-1253, which has tumor suppressive properties in medulloblastoma. Therapeutic strategies capitalizing on the anti-neoplastic properties of miRNAs can provide promising adjuncts that can improve efficacy while mitigating toxicity of current chemotherapeutic drugs.

Objective In this study, we explored the potentiation of miR-1253 on cisplatin cytotoxicity in group 3 MB.

Methods We used RNA Sequencing to isolate a putative target for …

Severe Colitis And Malnutrition In Association With Neonatal Hemophagocytic Lymphohistiocytosis, Laura Tarantino

Child Health Research Institute Pediatric Research Forum

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of overwhelming immune activation causing multiorgan dysfunction that may be genetic and/or acquired. Patients with familial HLH often present by one year of age, though most are asymptomatic in the first month of life. We present the case of a neonate with diarrhea and malnutrition who developed signs and symptoms consistent with a clinical diagnosis of HLH.

Case: A neonate born at 35 5/7 weeks was transferred to a Level IV neonatal intensive care unit at 39 4/7 weeks for failure to thrive. Though feeding adequately and non-dysmorphic, he had …

Klinefelter’S Syndrome: A Fortuitously Diagnosed By Non-Invasive Prenatal Testing, Steven V. Yackley, Terence L. Zach

Child Health Research Institute Pediatric Research Forum

Case Report: A male infant born at 37 weeks gestation. His mother was a 29-year-old, gravida 4 para 3 woman. During her pregnancy she was curious as to the gender of the fetus and requested a non-invasive prenatal test (NIPT) rather than fetal ultrasound. The NIPT returned with a karyotype of XXY. The male infant was born vaginally with a birth weight of 2670 grams. Apgar scores were 8 and 9 at one and five minutes respectively. He was admitted to the newborn intensive care unit secondary to respiratory distress. He had no obvious dysmorphic features. He had normal appearing …

Expanding The Phenotype Of Hnrnpu-Related Disorders To Include Brief, Resolved, Unexplained Events (Brue), Jonah Scheffler, Kristen P. Fishler, Lois J. Starr

Child Health Research Institute Pediatric Research Forum

hnRNP-U deficiency is caused by pathogenic variants in HNRNPU, which encodes the heterogeneous nuclear ribonucleoprotein U (HNRNPU), a highly conserved protein responsible for assisting spliceosomes in mediating transcription and alternative splicing activity. HnRNPs are responsible for the regulation of translation at the presynaptic sites as well as the transportation of stabilized mRNAs along the axonal cytoskeleton. Here, we report a 2-year-old-male with a HNRNPU variant with a new presentation of apparent recurrent apneic spells with an underlying epileptic origin. These were described as apnea followed by desaturation and tachycardia in the 180's-200 range prior to resolution of symptoms. He also …

Relationship Between Mir-335 And Sterol Levels After In Vitro Hypoxia-Ischemia Of Primary Brain Cells, Namood-E Sahar, Zeljka Korade, Eric Peeples

Child Health Research Institute Pediatric Research Forum

Background/Purpose: Cholesterol homeostasis is vital for synaptogenesis and myelination during fetal and neonatal brain development. Both brain and plasma sterol levels have been shown to be associated with outcomes in adult stroke, and animal studies have suggested brain and plasma sterol changes in neonatal hypoxic-ischemic brain injury. MicroRNA-335 (miR-335) has been associated with brain sterol metabolism and our preliminary data showed that sterol metabolism is dysregulated in the brain after hypoxic-ischemic injury in a mouse model. This study sought to describe the effect of oxygen-glucose deprivation in vitro on individual brain cell populations and to validate the associations between sterol …

Reorganizing Emergency Department Information Systems To Reduce Physician Cognitive Load, James C. Mcclay, Jeffery Nielson, Benjamin Slovis

Posters and Presentations: Emergency Medicine

No abstract provided.

Be A Hero Too, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Sé Un Héroe Tú También, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Following The Growth Of Sarah's Baby: An Ipe Activity For Medical Nutrition & Diagnostic Sonography Students, Tanya M. Custer, Megan Timmerman, Cynthia M. Schmidt, Teresa L. Hartman, Harlan Sayles, Kathryn Wampler, Lea Lambing, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: Interprofessional education (IPE) involves collaborative learning among students from different professions. While acceptance of these types of activities is increasing, there are opportunities to expand the number of health care professions involved in IPE. The purpose of this study was to explore student perceptions and outcomes after participation in a Diagnostic Medical Sonography (DMS) and Medical Nutrition Education (MNE) interprofessional education activity centered around a clinical case study on fetal growth. Subjects & Methods: The IPE activity was administered to four student cohorts from academic years to 2015-2016 to 2018-2019. Participants included 66 students (n=39 DMS and n=27 MNE). …

Interoperable Knowledge Modeling In Emergency Care: Application Of The Hl7 Emergency Care Domain Analysis Model, James C. Mcclay, Laura Heermann Langford

Posters and Presentations: Emergency Medicine

The Emergency Care System (ECS) in the United States provides intermittent unscheduled care to an increasing number of patients annually. Every ECS patient encounter generates data in a myriad of unlinked systems at regional emergency services and hospitals. Often, their prior health records are not available in a timely manner, fragmented, or not found. To address availability and interoperability data relevant to emergency care, the Health Level Seven (HL7) Emergency Care Workgroup seeks to ensure evolving health data interoperability standards incorporate ECS considerations. Foundational to that effort is a comprehensive model of Emergency Care information. This emergency care domain analysis …

Mindful Meditation Practice For Imaging Professionals, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Although a career in medical imaging is very fulfilling and rewarding, research shows that health care professionals are becoming more prone to burnout. The healthcare environment can be face-paced, stressful and demanding. Burnout syndrome results from emotional exhaustion that causes depersonalization and decreased professional accomplishment.1-3 Burnout can have a negative impact not only on the individual, but the environment as well. Decreased patient satisfaction and increased errors are both associated with burnout in the healthcare setting.2

Mindfulness can be defined as the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of …

Improving Antimicrobial Stewardship Programs In Small Community Hospitals Through An Assessment And Feedback Model, Philip Chung, Kate Tyner, Scott Bergman, Terry Micheels, Mark Rupp, Michelle Schwedhelm, Maureen Tierney, Muhammad Salman Ashraf, Trevor Van Schooneveld

Posters and Presentations: Nebraska ASAP

Small community hospitals often lack expertise and resources for antimicrobial stewardship program implementation. Using an assessment-and-feedback model, Nebraska ASAP performed onsite assessment of antimicrobial stewardship efforts in 5 small community hospitals and provided facility specific feedback on implementation/augmentation of antimicrobial stewardship program. As a result of this model, participating small community hospitals were able to increase the number of antimicrobial stewardship core elements implemented while reducing antibiotic use and incidence of CDI.

Patient Care In High-Level Containment Care Units: In A Resourced Setting, Angela M. Vasa, Kate C. Boulter, Jolene M. Horihan, David S. Cates, Craig A. Piquette, James N. Sullivan, Daniel W. Johnson, Angela L. Hewlett

Books and Book Chapters: Nebraska Medicine

Vasa, A., Boulter, K., Horihan, Cates, D., Piquette, C., Sullivan, J., Johnson, D, & Hewlett, A. (2019). Patient Care in High-Level Containment Care Units. In T. Cieslak, M. Kortepeter, C. Kratochvil, & J. Lawler (Eds.), Nebraska Isolation and Quarantine Manual (pp. 87-101). Lincoln, NE: University of Nebraska Press.

Open Book Testing In Health Science Education: Student Perceptions And Outcomes In Ultrasound Physics, Kim Michael, Tanya M. Custer

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: The purpose of this study was to investigate the use of open book exams (OBE) in the education of imaging students and to assess the beliefs and perceptions of the students in regard to the use of open book testing.

Subjects & Methods: Study participants included twenty-seven sonography students enrolled in an academic health sciences center. OBE was implemented in two ultrasound physics courses. Data was collected through focus groups & exam outcomes. Creswell’s procedure for data analysis & representation was followed.

Results: Overall outcomes showed no statistically significant difference between exam grades for the different cohorts with the …