Medicine and Health Sciences Commons^™

The Impact Of Health-Related Social Needs On Health Outcomes Among Youth Presenting To A Midwest Pediatric Diabetes Clinic Network, Jasmine Roghair, Emily Dewit, Katelyn Evans, Mitchell Barnes, Heather Feingold, Samantha Jacob, Courtney M. Winterer, Jeffrey D. Colvin, Mark A. Clements, Shilpi Relan, Kelsee Halpin

Research Days

Screening for health-related social needs (HRSNs) is recommended as part of routine diabetes care given the impact of social factors on health outcomes.

Youth presenting to a tertiary diabetes center will have different diabetes-related health outcomes based on positive or negative HRSNs screenings at routine clinic visits.

Baseline data were collected from patients whose parent/guardian completed a HRSN screen as part of their child’s diabetes clinic intake from 9/1/21 to 8/30/22. The screen is a 6-item questionnaire adapted from the Accountable Health Communities HRSNs Screening Tool to screen for HRSNs in 4 domains (housing, utilities, transportation, and food). Longitudinal data …

Thyroid Dysfunction In Patients Receiving Immune Checkpoint Inhibitors, Emily Metzinger, Jennifer Boyd, Julia Broussard, Christopher Klockau

Research Days

The use of immune checkpoint inhibitors (ICI) is increasing in the treatment of different cancers. This study investigates ICI and thyroid dysfunction in pediatric patients at Children's Mercy Kansas City. This is a retrospective chart review that looked at development of thyroid disorders in patients who received PD-1 inhibitors, PD-L1 inhibitors, or CTLA-4 inhibitors in 19 pediatric patients. Results showed that hypothyroidism developed in 3 patients who received any of these medications. Additionally, 2 patients had thyroid dysfunction prior to starting ICI therapy, and 1 of these patients developed hyperthyroidism shortly after beginning ICI therapy. Thyroid dysfunction can be seen …

Simultaneous Vertical Sleeve Gastrectomy And Deceased Donor Liver Transplant In A Pediatric Patient With Cirrhosis And Class 3 Obesity, Lakshmi Kunam, Voytek Slowik, Brooke Sweeney, Ryan T. Fischer, Jason D. Fraser, Bhargava Mullapudi, Richard J. Hendrickson

Research Days

Background: Liver transplantation is a life saving procedure for children with end-stage liver disease with the goal of returning to a normal healthy life. Obesity and weight gain can lead to post-transplant steatosis and contribute to patient morbidity and mortality. In patients with obesity, simultaneous bariatric surgery can lead to reduced body mass index (BMI) and decrease allograft steatosis and patient metabolic syndrome.

Methods: After obtaining patient and family assent/consent, patient records were reviewed and analyzed.

Results: The patient was initially evaluated at 8 years of age for right upper quadrant pain. Imaging consistent with cirrhosis and portal hypertension prompted …

A Genomics Driven Induced Pluripotent Stem Cell Model Of Infant Acute Lymphoblastic Leukemia - Early Results, Meagan Vacek, Jacqelyn Nemechek, Irina Pushel, Bradley Thornton, Molly Leyda, Priyanka Prem Kumar, Midhat Farooqi, Jay L. Vivian, Erin M. Guest, John M. Perry

Research Days

While the cure rates for pediatric ALL have improved over the decades, infants with ALL (iALL) have not benefitted from these advances and continue to have a devastating prognosis. Unfortunately progress in treatment has also been slowed by inadequate research models. With this project, we address this unmet need by investigating a novel model to understand the cellular and molecular changes that occur during iALL onset and progression.

Opioid Use After In Situ Fixation Of Slipped Capital Femoral Epiphysis, Stephanie Coupal, Colleen Moreland, Jonathan R. Warren, Mckenna C. Noe, Lisa Berglund, Caleb Grote

Research Days

Preliminary results of a prospective single-institution study evaluating opioid use following in situ screw fixation of Slipped Capital Femoral Epiphysis (SCFE) in pediatric patients.

Characteristics And Clinical Outcomes Of Iud Insertion Under Conscious Sedation In Pediatric And Adolescent Patients, Alleana Corpin, Madeline Ross, Anne-Marie Priebe, Ashli A. Lawson

Research Days

Intrauterine devices (IUDs) are a favorable option for adolescents for contraception and menstrual suppression. However, few choose this option citing anxiety and concern for pain related to insertion procedure. Our institution proposes utilizing conscious sedation techniques for anxiolysis and analgesia during IUD insertion. The objective of this study was to identify characteristics of teens choosing conscious sedation for this procedure and likelihood of successful insertion.

Key Words: Intrauterine device (IUD), adolescent, conscious sedation

Testing For Bleeding Disorders In Child Abuse: Adherence To Aap Recommendations And Results Of Testing., Lyndsey Hultman, James Anderst, Henry T. Puls, Shannon L. Carpenter, Angela Doswell, Angela N. Bachim, Joanne Wood, Kristine Campbell, Daniel M. Lindberg

Research Days

This was a retrospective, descriptive study of bleeding disorder testing practices among subjects in CAPNET, a multicenter research network of children evaluated by Child Abuse Pediatricians for concern of child physical abuse.

Case Of An Adolescent Girl With Familial Vulvar Leiomyoma, Madeline Ross, Charlene Dekonenko, Rebecca Rentea, Tazim Dowlut-Mcelroy

Research Days

Background

While uterine leiomyomas remain a common occurrence affecting nearly 30% of adult women above 35yo, leiomyomas can arise anywhere smooth muscle cells are located in the body. Vulvar leiomyomas are a particularly rare diagnosis, often misdiagnosed as Bartholin gland cyst, comprising 0.07% of vulvar tumors, and thought to arise from smooth muscle within the round ligament, erectile tissue, and dartos muscle. Even more rare is the presentation of vulvar leiomyoma in the adolescent population and family history of vulvar leiomyoma.

Case

We present the case of a 16yo girl who noticed a painless vulvar mass that had increased in …

Increasing Palliative Care Team Involvement In Pediatric Hematopoietic Stem Cell Transplant Patients, Meagan Vacek, Lisa Tarbell, Melissa List, Erin Hall, Jennifer Linebarger, Kelstan Ellis, Gina Jones, Joel Thompson

Research Days

Early implementation of palliative care in pediatric oncology is well established but its role in pediatric hematopoietic stem cell transplant (HSCT) patients is yet to be fully determined. Multiple organizations encourage palliative care involvement in HSCT patients. Our aim was to increase palliative care team consults for patients receiving HSCT for our targeted diagnosis. Though we did not achieve this aim, we were able to increase the palliative care team's involvement in the total cohort of patients undergoing HSCT.

An Increased Failure Rate Of Asparaginase Desensitization With Calaspargase Pegol, Jillian Fry, Erin Guest, Keith August

Research Days

BACKGROUND: Pegaspargase (SS-PEG) became unavailable to younger patients in 2022, leaving calaspargase pegol (SC-PEG) as the only available long-acting asparaginase formulation. SC-PEG has been compared to SS-PEG and found to have similar rates of adverse events and event-free survival. Our institution uses a desensitization protocol for those with asparaginase hypersensitivity reactions. Here we review our experience with desensitization since the transition to SC-PEG. OBJECTIVES: To compare the rate of hypersensitivity reactions, success of desensitization, and need for alternative asparaginase preparations between patients receiving SC-PEG and SS-PEG. METHOD: This is a retrospective, single center study of pediatric patients who received >2 …

Effects Of Drug Delivery On Ppi-Responsive Esophageal Eosinophilia, Alex Biller, Rachel Chevalier, Amornluck Krasaelap, Janelle R. Noel-Macdonnell

Research Days

Determine if formulation of proton pump inhibitory (pill/capsule vs liquid) affects eosinophilic infiltration of esophagus in patients with PPI-Responsive Esophageal Eosinophilia.

Mathematical Modeling Suggests Pathways Of Systemic Dissemination Of Mycobacterium Tuberculosis In Mice, Vitaly V. Ganusov

Biology and Medicine Through Mathematics Conference

No abstract provided.

A Deeper Understanding Of Cell Movement: A Mathematical Perspective On Egg Chamber Architecture, Naghmeh Akhavan

Biology and Medicine Through Mathematics Conference

No abstract provided.

The Neural Dynamics Of Autism Spectrum Disorder And Typically Developing Individuals: Insights From Eeg Modeling And Mathematical Analysis, Sungwoo Ahn, Evie A. Malaia, Leonid L. Rubchinsky

Biology and Medicine Through Mathematics Conference

No abstract provided.

Determining The Impact Of Mindfulness Activities To Increase Joy In Work And Decrease Burnout: An Integrative Review, Kimberly Gleason Bogart

Doctoral Dissertations and Projects

This integrative review aims to evaluate whether mindfulness effectively increases joy in work and decreases nursing burnout. A lack of joy leads to feelings of burnout and negatively affects nurses and their desire to leave the profession. Nursing is often accompanied by intense emotional and physical demands that can lead to job dissatisfaction, anxiety, and stress. Burnout diminishes the quality of care and negatively impacts nurses’ well-being. This integrative review aims to explore mindfulness interventions to increase joy within nursing and potentially alleviate burnout. Drawing upon existing literature, this paper examines various mindfulness interventions and factors contributing to burnout among …

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Inservice Education: Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: In pediatric cancer patients, comprehensive treatment and its side effects, such as fever and neutropenia (FN), significantly impact physical and emotional well-being. Prompt evaluation and treatment of FN are crucial to prevent complications. Proper training of parents in preventing, recognizing, and managing low-grade fever and administering antibiotics at home or outpatient settings is essential for positive outcomes.

Local Problem: A multidisciplinary pediatric cancer treatment center in Northern California.

Methods: A pre- and post-assessment evaluation was conducted to evaluate the knowledge acquisition of nurses after an educational intervention.

Intervention: This Doctor of Nursing Practice (DNP) project aimed to enhance …

The Long-Term Effects Of Blood Urea Nitrogen Levels On Cardiovascular Disease And All-Cause Mortality In Diabetes: A Prospective Cohort Study, Hongfang Liu, Xiaoqin Xin, Jinghui Gan, Jungao Huang

Faculty, Staff and Student Publications

BACKGROUND: The long-term effects of blood urea nitrogen(BUN) in patients with diabetes remain unknown. Current studies reporting the target BUN level in patients with diabetes are also limited. Hence, this prospective study aimed to explore the relationship of BUN with all-cause and cardiovascular mortalities in patients with diabetes.

METHODS: In total, 10,507 participants with diabetes from the National Health and Nutrition Examination Survey (1999-2018) were enrolled. The causes and numbers of deaths were determined based on the National Death Index mortality data from the date of NHANES interview until follow-up (December 31, 2019). Multivariate Cox proportional hazard regression models were …

Meeting Abstracts From The 5th National Big Data Health Science Conference, Bankole Olatosi, Miranda Nixon, Xiaoming Li

Publications

No abstract provided.

Exploring Hispanic Immigrant Parents Literacy Needs In Navigating Life With Children In The United States, Michelle Lowry

Seton Hall University Dissertations and Theses (ETDs)

The responsibility of raising a child is demanding on all parents, but immigrant parents with limited literacy skills in English may find parenting even more demanding than native born parents. Hispanic immigrant parents are rarely consulted about their literacy needs. Furthermore, they are often overlooked as experts on their own needs. Using two of the most widely accepted models of literacy, The Simple View of Writing and The Simple View of Reading, this study explored Hispanic immigrant parents' literacy needs in the United States. The current study was conducted on N=30 Hispanic Immigrant parents, ages early 30s to mid 70s. …

Bilateral Corneal Perforations Due To Elder Neglect, Jaclyn Jordan, Katherine Selman, Richard Byrne

Journal of Geriatric Emergency Medicine

Introduction: Atraumatic corneal melting and perforation is a rare etiology of eye pain and visual loss in the Emergency Department (ED), and xerophthalmia from vitamin A deficiency is primarily described as a cause of blindness in pediatric patients.

Case: A 68-year-old female presented to the ED with worsening eye pain and months of clouding and vision loss. History was limited by cognitive impairment and was provided by spouse. On exam, she was found to have a body mass index of 13.7 kg/m², dry mucous membranes, purulent discharge from both eyes, and opacification and erosion of both corneas. She …

Selective And Brain-Penetrant Acss2 Inhibitors Target Breast Cancer Brain Metastatic Cells, Emily Esquea, Lorela Ciraku, Riley Young, Jessica Merzy, Alexandra Talarico, Nusaiba Ahmed, Mangalam Karuppiah, Anna Ramesh, Adam Chatoff, Claudia Crispim, Adel Rashad, Simon Cocklin, Nathaniel Snyder, Joris Beld, Nicole Simone, Mauricio Reginato, Alexej Dick

Kimmel Cancer Center Faculty Papers

Breast cancer brain metastasis (BCBM) typically results in an end-stage diagnosis and is hindered by a lack of brain-penetrant drugs. Tumors in the brain rely on the conversion of acetate to acetyl-CoA by the enzyme acetyl-CoA synthetase 2 (ACSS2), a key regulator of fatty acid synthesis and protein acetylation. Here, we used a computational pipeline to identify novel brain-penetrant ACSS2 inhibitors combining pharmacophore-based shape screen methodology with absorption, distribution, metabolism, and excretion (ADME) property predictions. We identified compounds AD-5584 and AD-8007 that were validated for specific binding affinity to ACSS2. Treatment of BCBM cells with AD-5584 and AD-8007 leads to …

Antiseizure Properties Of Fenamate Nsaids Determined In Mature Human Stem-Cell Derived Neuroglial Circuits., Hamed Salmanzadeh, Robert F. Halliwell

School of Pharmacy Faculty Articles

Repeated and uncontrolled seizures in epilepsy result in brain cell loss and neural inflammation. Current anticonvulsants primarily target ion channels and receptors implicated in seizure activity. Identification of neurotherapeutics that can inhibit epileptiform activity and reduce inflammation in the brain may offer significant benefits in the long-term management of epilepsy. Fenamates are unique because they are both non-steroidal anti-inflammatory drugs (NSAIDs) and highly subunit selective modulators of GABA_A receptors. In the current study we have investigated the hypothesis that fenamates have antiseizure properties using mature human stem cell-derived neuro-glia cell cultures, maintained in long-term culture, and previously shown to …

Le Coût Des Lésions Psychologiques Liées Au Travail Au Québec, Martin Lebeau, Jaunathan Bilodeau, Marc-Antoine Busque

Portraits statistiques

Cette étude présente une analyse statistique des coûts des lésions psychologiques liées au travail au Québec. Les coûts financiers et humains engendrés par les lésions psychologiques acceptées à la Commission des normes, de l'équité, de la santé et de la sécurité du travail (CNESST), survenues entre 2014 et 2019, ont été évalués à 1,01 milliard de dollars. Cela correspond à un coût annuel moyen de 169 millions de dollars et un coût moyen par lésion de 121 590 $. En dollars constants, les coûts annuels de ces lésions ont augmenté de 195 % sur les six années à l’étude.

Les …

Misstatements, Misperceptions, And Mistakes In Controlling For Covariates In Observational Research, Xiaoxin Yu, Roger S Zoh, David A Fluharty, Luis M Mestre, Danny Valdez, Carmen D Tekwe, Colby J Vorland, Yasaman Jamshidi-Naeini, Sy Han Chiou, Stella T Lartey, David B Allison

Children’s Nutrition Research Center Staff Publications

We discuss 12 misperceptions, misstatements, or mistakes concerning the use of covariates in observational or nonrandomized research. Additionally, we offer advice to help investigators, editors, reviewers, and readers make more informed decisions about conducting and interpreting research where the influence of covariates may be at issue. We primarily address misperceptions in the context of statistical management of the covariates through various forms of modeling, although we also emphasize design and model or variable selection. Other approaches to addressing the effects of covariates, including matching, have logical extensions from what we discuss here but are not dwelled upon heavily. The misperceptions, …

Undergraduate Baccalaureate Nursing Student Knowledge And Attitudes Towards Neonatal And Pediatric Pain Management Practices, Jordan Lee Slowik

Doctoral Dissertations and Projects

Research has indicated that pain management practices amongst registered nurses is inadequate across all age groups; however, it is frequently noted that children receive less analgesia in comparable situations than adult clients leading to harmful and costly consequences. There is a distinct gap in nursing educational research understanding nursing student knowledge and attitudes towards neonatal and pediatric pain management practices. Using a convenience sample from a private, Christian-based university in the southeastern United States, this study used a quasi-experimental, one-group pretest/posttest design to understand the impact of elective nursing courses on undergraduate baccalaureate nursing student knowledge and attitudes towards neonatal …

An Interpretive Phenomenological Analysis Exploring African American Women’S Perceptions Of Access To Healthcare In The Midwest, Ramona D. Benson

Doctoral Dissertations and Projects

The purpose of this interpretive phenomenological study was to explore access to healthcare through the lens and lived experiences of African American Women (AAW) in Midwestern towns throughout the United States. African American women and other people of low socio-economic backgrounds continue to live with poorer health outcomes than many of their counterparts African American Women experience barriers to healthcare from a unique perspective than their White counterparts. Although medical professionals endeavor to attain equal treatment among each of their patients, significant healthcare disparities are prevalent among AAW Commonly recognized ethnic stereotypes are not always intentionally supported, however, their mere …

An Investigation Of The Effect Of A Combined Physical Exercise And Counseling As A Therapeutic Approach To Reducing Anxiety Symptoms, Andrea C. Beltran

Doctoral Dissertations and Projects

Mental health issues are on the rise as the increase in emotional, psychological, and social well-being affects how people think, act, or feel toward themselves and others. The topic of physical exercise and mental health services has been researched to show a strong relationship between physical activity and positive mental health outcomes. Anxiety is the most common mental health concern in the United States (Goodwin et al., 2020). This study aims to investigate and quantify the impact and explore the relationships of the combined intervention approach of physical activity and counseling in reducing symptoms of anxiety. This research will utilize …

A Causal Relationship Between Mobile Health Wearable Devices’ Use And Improved Hypertension Management In African-Born Immigrants Aged 45-75 In Maricopa County, Arizona, Nelson Mcnova Bryant

Doctoral Dissertations and Projects

The purpose of this causal-comparative study was to determine if differences exist between the use of mHealth wearable devices, specifically smartwatches, and the improvement in hypertension control. The target participants were 100 African-born immigrants, both males and females aged 45-75 who lived in Maricopa County, Arizona. In the study, 100 research participants with a hypertension diagnosis were divided into two equal groups. Group 1 consisted of 50 African-born immigrants who used mHealth wearable devices, specifically the Dafit M2 smartwatches to manage hypertension (which they received for free from the researcher). Group 2 consisted of 50 African-born immigrants who used a …

The Experiences Of Alaska Native Students' Decision To Enter Nursing School: A Transcendental Phenomenological Study, Denise Michelle Gilliland

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenology study was to examine the lived experiences of Alaska Native students’ decisions to enter nursing school, thus choosing nursing as a career. The increased recruitment of Alaska Natives into nursing is imperative. According to the research, a direct association exists between increasing the number of minority nurses and decreasing health inequities. Despite the demand, only a small number of Alaska Native students continue to enroll in nursing programs in Alaska. The theories guiding this study were Ryan and Deci’s self-determination theory and Lowe and Struthers’s theory of nursing in Native American culture. They provided …