Medical Specialties Commons^™

Implementation Of A Clinical Pathway For Complicated Appendicitis In Children, Kristin E. Lemarbe, Andrew Glaza, Alexander L. Chen, Diane Studzinski, Amanda Henderson, Anthony Stallion, Nathan Novotny, Begum Akay, Pavan Brahmamdam

Conference Presentation Abstracts

No abstract provided.

When The Right Ventricle Fails After Left Ventricular Assist Device Implantation: Prediction Tools, Recognition Strategies, And Support Options, Juan Jose Rodriguez Arias, James Schurr, Phyllis Billia, Joyce W. Wald

Journal of Shock and Hemodynamics

The incidence of right heart failure (RHF) during durable left ventricular assist device (LVAD) surgery ranges from 9% to 42%, depending on the definition. RHF can be divided into three peri-implantation categories: early acute, early, and late. Despite many available risk models, predicting RHF before durable LVAD implantation has been difficult. Preemptive right-sided temporary mechanical circulatory support can improve outcomes; however, if intraoperative RHF is not suspected, early recognition and appropriate intervention after surgery are important.

Emergency Medicine Residency Website Wellness Pages: A Content Analysis, Alexandra Sappington, Brian Milman

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic impacted the way medical students seek residency positions. In 2020, the Accreditation Council for Graduate Medical Education advocated for virtual interviews. Most emergency medicine (EM) interviews in 2023 remained virtual, and this format will persist for the foreseeable future. Since students are not evaluating programs in person in most cases, residency websites are crucial for prospective residents. Resident wellness is critical for resident training and important to prospective residents; it follows that programs must be transparent about resident wellness on websites. In this study we aimed to quantify the number of EM programs with wellness pages …

Epigastric Hernia With Unusual Contents, Katelyn Ward, Melanie Ermler, Alexis Lonjin, Kathryn Ziegler

Conference Presentation Abstracts

No abstract provided.

High Kynu Expression Is Associated With Poor Prognosis, Keap1/Stk11 Mutations, And Immunosuppressive Metabolism In Patient-Derived But Not Murine Lung Adenocarcinomas, Ling Cai, Thomas J Rogers, Reza Mousavi Jafarabad, Hieu Vu, Chendong Yang, Nicole Novaresi, Ana Galán-Cobo, Luc Girard, Edwin J Ostrin, Johannes F Fahrmann, Jiyeon Kim, John V Heymach, Kathryn A O'Donnell, Guanghua Xiao, Yang Xie, Ralph J Deberardinis, John D Minna

Faculty, Staff and Student Publications

Background/Objectives: We aimed to discover genes with bimodal expression linked to patient outcomes, to reveal underlying oncogenotypes and identify new therapeutic insights in lung adenocarcinoma (LUAD).

Methods: We performed meta-analysis to screen LUAD datasets for prognostic genes with bimodal expression patterns. Kynureninase (KYNU), a key enzyme in tryptophan catabolism, emerged as a top candidate. We then examined its relationship with LUAD mutations, metabolic alterations, immune microenvironment states, and expression patterns in human and mouse models using bulk and single-cell transcriptomics, metabolomics, and preclinical model datasets. Pan-cancer prognostic associations were also assessed.

Results: Model-based clustering of KYNU expression outperformed median-based dichotomization …

Postoperative Calcium Supplementation Adherence In Total Thyroidectomy And Parathyroidectomy Patients - Risk Factors And Outcomes, Katelyn Ward, Cydney Mcchesney, John Nida, Negin Mohtashemian, Jacob Mesiti, Emmanuel Nageeb, Diane Studzinski, Rose Callahan, Peter Czako, Sapna Nagar

Conference Presentation Abstracts

No abstract provided.

Surgical Site Infection Bundle For Babies - Preliminary Data, Cullen Woodley, Katelyn Ward, John Nida, Alexis Lonjin, Diane Studzinski, Nathan Novotny, Pavan Brahmamdam, Begum Akay

Conference Presentation Abstracts

No abstract provided.

Roles Of Class Iii Phosphatidylinositol 3-Kinase, Vps34, In Phagocytosis, Autophagy, And Endocytosis In Retinal Pigmented Epithelium, Feng He, Ralph M Nichols, Melina A Agosto, Theodore G Wensel

Faculty, Staff and Students Publications

Phosphatidylinositol-3-phosphate (PI(3)P) is important for multiple functions of retinal pigmented epithelial (RPE) cells, but its functions in RPE have not been studied. In RPE from mouse eyes and in cultured human RPE cells, PI(3)P-enriched membranes include endosomes, the trans-Golgi network, phagosomes, and autophagophores. Mouse RPE cells lacking activity of the PI-3 kinase, Vps34, lack detectable PI(3)P and die prematurely. Phagosomes containing rod discs accumulate, as do membrane aggregates positive for autophagosome markers. These autophagy-related membranes recruit LC3/Atg8 without Vps34, but phagosomes do not. Vps34 loss leads to accumulation of lysosomes which do not fuse with phagosomes or membranes with …

Integrating Social Work In An Aboriginal Community Controlled Health Service Primary Health Care Setting: The First Three Months Of Data, Ines Sofia Zuchowski, Erin Waters, Albert Kuruvila, Brodie Kuhn, Rebecca Lee

Journal of the Australian Indigenous HealthInfoNet

Background

Social work within General Practice is an emerging contributor to primary healthcare aiming to address social determinants of health. Aboriginal and Torres Strait Islander people experience higher rates of health inequity and racism than non-Indigenous Australians. The Townsville Aboriginal and Islander Health Service [TAIHS] is an Aboriginal and Torres Strait Islander Community Controlled Health Service [ATSICCHS] whose mission is to deliver culturally appropriate services to achieve better health and wellbeing outcomes for Aboriginal and Torres Strait Islander people.

Objective

This article reports on the first three months of data collection of a social worker employed at TAIHS as part …

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …

A Description Of Mental Health Policies In Ohio Secondary Schools, Laura L. Harris, Molly Rowe

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE To compare secondary school mental health policies implemented for the student body with those implemented for student athletes.

Athletic Trainers Confidence In Evaluating And Treating Emergent Conditions, Andrea Cripps, Jenny Toonstra, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE The profession of Athletic Training (AT) has undergone a substantial educational overhaul in the last decade, adding more advanced knowledge and skills than ever before. With more than 50% of the profession having obtained their certification more than 10 years prior,¹ it is essential that we understand the varying levels of confidence in evaluating and managing these new skills, so that appropriate continuing education opportunities can be developed to bridge any gaps that may be identified. The purpose of this study to examine self-reported confidence in evaluating and managing acute care skills.

Sternocleidomastoid Syndrome In A Collegiate Basketball Athlete: A Case Study, Sara Stiltner, Rob Whitehurst, Eric Avers

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

BACKGROUND
20-year-old male basketball athlete with recurring upper and lower extremity instability injuries presented fall 2021 with shoulder and ankle instability. A past medical history of thermal capsulorrhaphy from high school with surgical intervention May 2021 (college first year). October 2021 athlete began experiencing rotator cuff strains in both shoulders. November 2021, December 2021, January 2022 athlete experiences recurrent right ankle sprains. Each ankle sprain resulted in two weeks of lost participation, followed by one week of active participation. The third ankle sprain associated with increased swelling and pain over medial ankle. Upon referral and MRI a deltoid ligament sprain …

Causes Of Athletic Trainer Attrition: A Critically Appraised Topic, Mckenna E. Tuttle, Klevione D. Brown, Elizabeth A. Starns

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Athletic Training (AT) attrition has been a persistent issue within the profession for years^1,2. By identifying the factors contributing to the attrition rates among Athletic Trainers, targeted interventions can be developed to mitigate turnover and decrease attrition within the profession.

Kinematic Analysis Of Lower Extremity Movement Patterns During Functional Tests In Collegiate Track And Field Runners To Predict Injury Incidence, Maddie Hoyt, Brooke Parker, Bailey Weise, Andrew Busch

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
Lower extremity overuse injuries are becoming increasingly more prevalent in endurance-based running sports^1,2,3,4,5,6. These injuries negatively impact an athlete’s sports performance and increase the risk of additional injuries^3,4. The purpose of this study was to first examine kinematic and kinetic variables within distance runners and compare those with previous lower extremity injuries to those without reported injuries; and second to understand if such variables predicted future injuries sustained throughout a track season.

Injury Epidemiology In Collegiate Marching Band, Morgan Davis, Jinghzen Yang, Matthew Brancaleone

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
Marching bands have become more popular and physically demanding, with performers taking up to 16,174 steps on game days, which may increase their risk of musculoskeletal injuries. However, research on these performers remains limited. The purpose of this study was to describe the incidence of reported injury and pain and soreness experienced by marching artists within a collegiate marching band.

Atypical Anterior Tibial Stress Fracture Leading To Acute Fracture And Intermedullary Rodding, Emily Mulkey Swisher, Chad Cochran, Raymond Duffett

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
This case highlights an unusual stress fracture progressing to an acute tibial fracture requiring intermedullary rodding.

The Athletic Trainer's Responsibility In Disability Exercise Adherence, Elizabeth Starns, Stephanie M. Kubiak, Rebecca J. Wehler

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
This study examined exercise adherence to aerobic and strength training exercise guidelines in individuals with disabilities, highlighting the implications for athletic training (AT). Because disabilities impact over 25% of the U.S. population¹, an understanding of the varied exercise adherence patterns can inform inclusive AT best practices and assist in promoting exercise and sport participation.

Emergency Action Planning In Collegiate Athletics: An Evaluation Of The Current Adoption Of Best Practice Recommendations, Kyler Conn, Ken Blood, Genna Fusco

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
The primary objective of this study was to assess the current adoption of the National Athletic Trainers’ Association’s (NATA) best practice recommendations regarding emergency planning, outlined in the NATA Position Statement: Emergency Planning in Athletics, at the collegiate level.

Effect Of Hearing Status On Modified Balance Error Scoring System Performance, Matthew Brancaleone, Claire Akard, Jaclyn Caccese

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE
Concussion assessments typically include evaluations of self-reported symptoms, neurocognitive function, and postural control. Specifically, postural control is often assessed using the modified Balance Error Scoring System (mBESS). Although normative mBESS data exist, they may not be appropriate for all athletes, such as those who are deaf or hard-of-hearing (D/HoH). Given the relationship between the cochlea and the vestibular system, athletes who are D/HoH may exhibit differences in postural control due to potential vestibular dysfunction. Therefore, the objective of this study was to compare mBESS performance between athletes who are D/HoH and athletes who are hearing.

Spontaneous Pneumothorax In A Male High School Wrestler, Laura Breese, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/BACKGROUND
A pneumothorax is the presence of air in the pleural space, it is a life threatening condition and can be classified as spontaneous, acquired, or by pathophysiology. (1)(2) This specific case presents the incident of a spontaneous pneumothorax in an adolescent population.

Novel Rpl30 Variant In Diamond Blackfan Anemia Demonstrates Early Impact On Erythroid Differentiation With Downregulated Gata1-Hsp70, Alexandra Prosser-Dombrowski, Irina Pushel, Jacqelyn Nemechek, Priyanka Kumar, Jay L. Vivian, Jennifer Gerton, John M. Perry

Research Days

Background: Diamond Blackfan anemia (DBA) is an inherited bone marrow failure syndrome caused by ribosomal protein gene mutations leading to apoptosis of erythroid progenitors. We identified a novel heterozygous variant (c.167+769C>T) in the noncoding region of RPL30 in a patient diagnosed with DBA.

Objectives/Goal: We hypothesized that this variant stunts erythroid differentiation at the proerythroblast stage and is pathogenic for DBA.

Methods/Design: We developed an induced pluripotent stem cell (iPSC) model with a wild type (WT) and three CRISPR-Cas9 edited RPL30 mutant clones. iPSCs were differentiated into hematopoietic stem cells, which were assessed by flow cytometry and single cell …

Duration Of Labor And Umbilical Artery Acidosis In Critical Congenital Heart Disease, Sarah Gwazdacz Md, Teresa Nguyen Bs, Mary Donofrio Md, Faap, Facc, Fase, Timothy Bennett Md, Amanda Mcintosh Md, Faap, Facc.

Research Days

Standard delivery protocols for most prenatally diagnosed CCHD is induction of labor at 39 weeks with aims of a vaginal delivery (VD) near a tertiary care center. There is no benefit to planned Cesarean delivery (CD) over VD for most infants with CCHD. However, longer durations of labor (DOL) in CCHD have been described as a risk factor for umbilical artery (UA) acidosis. We aim to describe the relationship between DOL and UA pH and neonatal outcomes in those with prenatally diagnosed CCHD.

Retrospective chart review of prenatally diagnosed with CCHD born at Children’s Mercy from 2012 – 2023. Inclusion …

The Impact Of Cultures On Treating Abscesses Associated With Appendicitis, Cory Nonnemacher, Seth Saylors, Meredith Elman, Tolulope A. Oyetunji Md Mph, Shawn D. St Peter

Research Days

Background/Purpose

Perforated appendicitis is associated with elevated risk of post-operative intra-abdominal abscess (PIAA) formation. Small PIAAs can be successfully treated without drainage, while larger ones warrant Interventional Radiology drainage. Routine culture of drained abscesses occurs at most institutions, with some prior studies showing resistance rates of 40-50%, prompting change of post-drainage antibiotics. The purpose of our study is to evaluate if culture results impact the antimicrobial therapy chosen for patients with PIAA, with our hypothesis being that routine culture does not have a significant impact on patient outcomes.

Methods

Patients < 18 years of age who were treated for perforated appendicitis at a standalone tertiary children’s hospital from 2011 to 2024 were retrospectively evaluated for abscess formation and extracted those who underwent drainage procedures with abscess cultures to assess the need for antibiotic adjustments from the standard of care based on culture results.

Results

A total of 1736 patients treated for perforated appendicitis …

Opportunities For Solid Organ Donation In The Neonatal Intensive Care Unit, Sarah Pippin, Jotishna Sharma, Ashley Sherman, Julie Weiner

Research Days

This study aims to characterize the theoretical eligibility of neonates undergoing withdrawal of care in the NICU for donation after circulatory determination of death (DCDD), with a focus on warm ischemic time (WIT) ≤ 90 minutes.

Abusive Head Trauma (Aht) Diagnoses: The Influence Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela N. Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Christopher Greeley, Danielle Horton, Nicole Johnson, Jan Leonard, Megan Letson, Daniel M. Lindberg, Caitlin Mcnamara, Shalon Nienow, Ashley K. Sherman, Joanne Wood, James Anderst

Research Days

Background: In cases where Child Abuse Pediatricians (CAPs) diagnose abusive head trauma (AHT) in young children, some factors surrounding the diagnosis have been challenged including causative shaking, necessity of external signs of impact, or concomitant suspicious injuries. Evaluation of CAP diagnoses in children with subdural hemorrhage (SDH) can give insight into factors related to the frequency of abusive head trauma (AHT) diagnoses. Additionally, characterization of those with SDH+CSI without evidence of impact may inform controversies around AHT diagnoses.

Objectives/Goal: We aim to compare CAP diagnoses in subjects with SDH across clinical presentations and in the context of evidence of head …

In Search Of The Unknown Mimic Of Abusive Head Trauma., Ruairi Smith-Dewey, Angela N. Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Danielle Horton, Nicole Johnson, Jan Leonard, Megan Letson, Caitlin Mcnamara, Shalon Nienow, Ashley K. Sherman, Stuart Sommers, Joanne Wood, James Anderst

Research Days

Background:

Some claim that Child Abuse Pediatricians (CAPs) are misdiagnosing a yet-to-be-identified mimic as abusive head trauma (AHT), particularly in ill children with isolated subdural hemorrhage (SDH). Though not diagnostic criteria, specific social stressors have been identified as AHT risk factors. If a yet-to-be-identified mimic is meaningfully present within a group being evaluated for AHT, that group should have fewer AHT risk factors than children with actual AHT. The existence of such a mimic can be assessed by comparing the prevalence of AHT risk factors across groups: CAP-identified mimics, non-ill SDH only, ill SDH only, and SDH plus concomitant suspicious …

Engineering A Novel Treg Population To Control Autoimmune Diabetes, Sofia Colon Guzman, Elly Puckett, Mary A. Markiewicz, Ryan T. Fischer

Research Days

We created a model to test the immunosuppressive capacity of Helios+FOXP3+ eTregs compared to nTregs against islet-specific autoreactive T cells. We also showed that nTregs decrease the response of these cytotoxic T cells when co-cultured with BetaLox5 cells.

Growth Hormone Deficiency In Childhood Cancer Survivors: Response To Growth Hormone Therapy And Aromatase Inhibitors Compared To Growth Hormone Therapy Alone., Haya Azouz, Sarah Tsai, Keith August, Jennifer W. Boyd

Research Days

With evolving technologies leading to better cancer cure rate, the number of childhood cancer survivors has increased. There has been increasing reports of later endocrine effects including growth hormone deficiency (GHD). Our aim is to investigate the influence of adding aromatase inhibitors (AI) to growth hormone (GH) therapy in childhood cancer survivors with growth hormone deficiency (GHD). A retrospective chart review was performed looking at children between ages 0 and 18 years with history of malignancy and subsequent diagnosis of GHD at our institution. Fifty-nine children were included in this study. Participants were classified into 3 groups: (1) the target …

Improving Adherence To Evidence Based Sti Care For Patients Who Tested Positive At Ed Index Visit Qi Project, Noelle Tran, Melissa Miller, Kim Barbee, Julie Jost, Christopher Kaberline, M Smith

Research Days

Problem Statement/Question:

Previous work improved clinician sexually transmitted infection (STI) testing behaviors, but overlooked treatment interventions needed to facilitate risk reduction, HIV and syphilis (RPR) testing, and STI retesting at three months—critical components that reduce morbidity and disease spread. We are not adhering to evidence-based STI care for adolescents who tested positive for STIs at the ED index visit.

Background/Project Intent (Aim Statement):

According to the Centers for Disease Control and Prevention (CDC), in 2023, over 2.4 million cases of RPR, gonorrhea (GC), and chlamydia (CT) were diagnosed; about half of reported cases were among adolescents and young adults aged …