Pediatrics Commons^™

Seizure Action Plan, Ian Holt, Sy Jama

East Florida Division GME Research Day 2025

No abstract provided.

Tickborne Illness, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Animal Bites (Mammal), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Case Report: Disseminated Herpes Simplex Virus Complicated By Hemophagocytic Lymphohistiocytosis In A Neonate, Nicholas Tadros, Nihal Godiwala

School of Medicine Faculty Publications

Neonatal herpes simplex virus (HSV) infection carries a high mortality rate due to its potential to cause disseminated disease involving multiple organ systems, which can rapidly progress to shock and death if not promptly treated. In rare cases, neonates may mount an uncontrolled inflammatory response leading to hemophagocytic lymphohistiocytosis (HLH), a severe hyperinflammatory syndrome. We present a case of neonatal HSV infection complicated by HLH, highlighting the challenges of managing both conditions concurrently. Our therapeutic approach demonstrated a reduction in systemic inflammation and viral load; however, despite these efforts, the patient developed multiorgan failure and ultimately died from the initial …

Can Fat Absorption Be Enhanced With A Novel Medical Food?, Cassie Brown

2025

No abstract provided.

Approval Of Parent-Child Aggression As A Mediator Of Intergenerational Child Abuse Risk: An Evaluation Of Racial Differences, Casie H. Morgan, Christina M. Rodriguez, Doris F. Pu, Zoe O. Elkins

Psychology Faculty Publications

Purpose

Personal history of parent-child aggression (PCA) can predict future parenting behavior, but some effects may differ between racial groups. Black parents in the U.S. are more likely to encounter discrimination and personally experience and approve of PCA, which may account for previously reported group differences. This study examined whether personal PCA history predicted later parental child abuse risk mediated by PCA approval across the transition to parenthood, and whether effects differed by race.

Methods

Expectant parents (non-Hispanic White sample: 95 mothers with 86 fathers; Black sample: 94 mothers with 85 fathers) participated in a prospective longitudinal study, assessed prenatally …

The Impact Of Peer Observational Learning On Honesty Following A Transgression, Hannah M. Sliman, George H. Noell

Psychology Faculty Publications

Parents and teachers worry about how lying affects children's development and socialization, as research links persistent lying to delinquency, aggression, and conduct issues. To investigate this, we examined two groups: Honest and Praise versus a Control Group, exploring how exposure influenced children's honesty and confession after transgressions. The study aimed to see if observing peers receive praise for honesty could promote truthfulness. Gender's impact on reporting honesty was assessed. Results showed no significant difference in honesty between the HP and CG groups; children confessed at similar rates in both conditions. Gender did not affect honest reporting. These findings differ from …

Academic Proficiency In Ugandan Children With Sickle Cell Anemia: A Cross-Sectional Study, Robert Opoka, Shubaya Kasule Naggayi, Paul Bangirana, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Ann Jacqueline Nakitende, Dennis Kalibbala

Paediatrics and Child Health, East Africa

Introduction: Academic proficiency is crucial for advancing learning goals, school advancement, and future economic security. Children with sickle cell anemia (SCA) in sub-Saharan Africa (SSA) may be at risk of disease-associated learning difficulties. Limited data exist on this topic among school-age children in the region. We aimed to assess academic proficiency in a sample of children with SCA in Uganda compared with unaffected controls.

Methods: This cross-sectional study was conducted in Kampala, Uganda. Participants were school-going children with SCA, aged 6–12 years, attending Mulago Hospital SCA Clinic, and age-matched sibling controls without SCA. Academic proficiency was assessed by the Wide …

Incontinentia Pigmenti Diagnosed In Newborn Nursery, Virginia Ramsey Aldrich, Andrea Heuser

South Atlantic Division GME Research Day 2025

No abstract provided.

Breaking The Blockade: A Retrospective Analysis Of Pediatricconstipation In Hospitalized Patients, Yenamala Reddy, Jaicy Pottokaran, Eric K. Shaw, Aimee Behnke, Jean B. Wiggins, Lauren Hebert, Norman Taylor Parks

South Atlantic Division GME Research Day 2025

No abstract provided.

Poor Oral Health Is Associated With Social Vulnerability In Critically Ill Trauma Patients, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Chelsea J Guy-Frank, Gabrielle E Hatton, Kayli A Quinton, Sophia Syed, Erin E Fox, Charles E Wade, Kimberly A Mankiewicz, Lillian S Kao

Faculty, Staff and Student Publications

Background: Social factors affect oral health status, and poor oral health has been associated with worse health outcomes. Using the Oral Health Risk Assessment Value Index (OHRAVI), a bedside tool for non-dentists to assess oral health, we investigated the interplay of oral health with social drivers of health and social vulnerability, as measured by the Social Vulnerability Index (SVI), in severely injured patients.

Methods: Our retrospective study included dentulous critically ill trauma patients who were previously assigned an OHRAVI score (range 0-3; unhealthy score >1). Patient demographics, comorbidities, and self-reported social drivers were obtained from health records. SVI was calculated …

The Special Issue “The 20th Anniversary Of Pharmaceuticals—Multi-Targeted Natural Products As Therapeutics” Editorial—Multi-Targeted Therapeutics From Natural Sources: What Do We Know?, Elena Y. Enioutina, Katheleen M. Job, Catherine M.T. Sherwin

Pediatrics Faculty Publications

Herbal and marine products in the form of extracts, infusions, and decoctions have been used for centuries in folk and traditional medicine. Preparations typically contain multiple biologically active compounds. The World Health Organization (WHO) estimated that about 65% of consumers worldwide use natural remedies containing bioactive molecules to treat various diseases [1]. Most single-molecule drugs of natural origin were developed in the middle of the 20th century through the active screening of natural products for bioactive molecules [2]. Examples include artemisinin, cyclosporine, taxol, doxorubicin, and many others. However, at the beginning of the 21st century, we saw a decline in …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

Educational Interventions To Improve Pediatric Emergency Care: A Qualitative Assessment Of The Perspectives Of African Healthcare Workers, Emily A. Hartford, Chris A. Rees, Isaac Kihurani, Raana Hussain, Elena Seifert, Alexis Schmid, Tigist Bacha, Carol C. Chen, Megan L. Schultz

Paediatrics and Child Health, East Africa

Pediatric emergency care (PEC) training for health care workers (HCWs) is commonly offered in the form of short courses. This study gathers the perspectives of HCWs from eight African countries on how to best deliver and implement short training courses in PEC. This is a qualitative study using semi-structured key informant (KI) interviews. Utilizing the African Federation for Emergency Medicine (AFEM) member list serve, we identified African HCWs who had previous experience participating in and/or delivering short training courses in PEC. From this cohort, four interviewers were selected. These interviewers all received training in qualitative interviewing and then each recruited …

Improving Hospital Discharge Readiness Among Caregivers Of Children With Complex Medical Needs, Megan M. Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

Advancements in medicine and technologies have led to an increase in the population of children living with complex and chronic health conditions. Children with medical complexities (CMCs) and their caregivers frequently have challenges navigating home life after transitioning from hospital to home-based care. A 14-week doctoral capstone project was conducted at Dayton Children’s Hospital to improve caregiver readiness for hospital discharge. Project participants included caregivers of CMCs (n = 6) admitted to the hospital and pediatric acute care occupational therapists (n = 4). The Pediatric Readiness for Hospital Discharge Scale – Long Form (Peds-RHDS) was used as a pre-and post-intervention …

Implementing A Remote Patient Monitoring Program To Improve Nutrition Status In Infant With Cystic Fibrosis, Jessica Jones, Stacie Hunter, Kelli Williams, Petrissa Ncomo, Rapheal Peeples, Alex Pottorff, Lauren Lazar, Meghana Sathe

2025

No abstract provided.

Diabetes Device Knowledge And Confidence Among School Nurses: A Mixed Methods Study, Cassandra F. Moffitt

Nursing Theses and Dissertations

Problem: Type 1 diabetes is one of the most common chronic medical conditions in childhood. While manageable, these children may spend half of their day in the school setting and often need assistance from a school nurse to manage their care.

Theory: Bandura’s Social Cognitive Theory (1977) served as the theoretical framework for this study.

Research Questions: The research questions explored knowledge, confidence, and additional predictors of confidence related to diabetes devices.

Design/Methods: An explanatory sequential mixed methods design was used. The Diabetes Device Confidence Scale (DDCS) was used to measure device confidence, while Subscale 10 of the KAT-1 instrument …

Rvd2 Mitigates Tnfɑ-Induced Mitochondrial Reactive Oxygen Species Through Nrf2 Signaling In Placental Trophoblasts, Taija Hahka, Deekshika Sekar, Prakash Kumar Sahoo, Aiswariya Ravi, Colman Freel, Chandan Krishnamoorthy, Sankar Ramamurthy, Rebekah Rapoza, Rebecca Drakowski, Anum Akbar, Matthew Van Ormer, Melissa Thoene, Corrine K. Hanson, Tara Nordgren, Sathish Kumar Natarajan, Ann Anderson-Berry

Journal Articles: Pediatrics

INTRODUCTION: Hypertensive disorders of pregnancy (HDP) are marked by elevated levels of TNFα, which increases reactive oxygen species (ROS) and disrupts metabolism of trophoblasts. Resolvin D2 (RvD2), an omega-3 fatty acid-derived lipid mediator, is known to resolve inflammation, but its role in protecting trophoblasts by promoting antioxidant responses to alleviate ROS remains unclear. Nuclear translocation of nuclear factor erythroid 2-related factor 2 (NRF2) controls cellular defense mechanisms against oxidative stress and helps with the maintenance of cellular redox homeostasis. Upon translocation to nucleus, NRF2 activates the antioxidant response element (ARE), inducing the expression of genes that can mitigate ROS. Hence, …

Efficacy And Safety Of Thrombolysis For Pediatric Venous Thromboembolism: A Systematic Review And Meta-Analysis, Hassan Kawtharany, Muayad Azzam, Aseel Alkhader, Marisol Betensky, Qais Hamarsha, Hadi K. Abou Zeid, Razan Mansour, Carine Tabak, Payal Patel, Sarah L. Baghdadi, Rachel S. Bercovitz, Rukhmi Bhat, Tina Biss, Brian R. Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Paul Monagle, Reem A. Mustafa

Journal Articles: Pediatrics

We conducted this systematic review to evaluate outcomes of thrombolysis followed by anticoagulation vs anticoagulation alone in pediatric patients with venous thromboembolism (VTE). This systematic review addresses mortality, VTE resolution, recurrence, bleeding, and organ-specific outcomes in 5 PICO (population, intervention, comparison, outcomes) questions on thrombolysis across pulmonary embolism (PE), extremity deep vein thrombosis (DVT), right atrial thrombosis (RAT), cerebral sinus venous thrombosis (CSVT), and renal vein thrombosis (RVT). Meta-analysis reported risk ratios or differences (95% confidence intervals [CIs]), and absolute effects per 1000 patients. Certainty of evidence was assessed using GRADE (Grading of recommendation, assessment, Development, and Evaluation) guidelines. Thirteen …

Challenges Faced In Managing The Hemodynamic Status Due To Recurrent Gastrointestinal Bleeding In Typhoid Fever With Uncorrected Double Outlet Right Ventricle Patient: A Case Report, Kellyn Trycia Zenjaya, Lindawati Wijoyo, Jovan Amadeo Muliyanto, Rizqi Rokhmadhoni Pikir, Dwi Putri Lestari, Esthy Poespitaningtyas

Journal of the Hong Kong College of Cardiology

Double Outlet Right Ventricle (DORV) is a rare cyanotic congenital heart defect often associated with polycythemia and bleeding risk. A 7-year-old boy with uncorrected DORV presented with fever, melena, and shock. He was cyanotic, tachypneic, and tachycardic, with SpO₂ of 68% and a harsh ejection systolic murmur. Labs showed anemia, thrombocytopenia, leukocytosis, and prolonged APTT. Tubex TF IgM was strongly positive. A diagnosis of typhoid fever with gastrointestinal bleeding and uncorrected DORV was made. Management included oxygen, inotropes, and fluid resuscitation. Propranolol was withheld. Severe infection with underlying cyanotic heart disease and coagulopathy presents a critical management dilemma.

Measuring The Prevalence Of Microcytosis Of Red Blood Cells Among Different Pediatric Age Groups. A Retrospective Study., Sarah Mohammad Atef Mostafa, Mary Shaker Zakher Gerges

Journal of Medicine in Scientific Research

Aim: Detect the prevalence of microcytosis of red blood cells (RBCs) and pattern of morphological classification of anemia among different paediatric age groups during their visit to the out-patient clinics in the hospital. Methods: An observational study was carried out during the period from January 2022 to April 2023. All pediatric patients (aged from day one to18years old) complete blood count (CBC) reports recorded on the hospital laboratory outpatient’s database were included. Age, gender, and RBCs parameters; haemoglobin, red cell distribution width (RDW) and mean corpuscular volume (MCV) were collected, percentages of distribution of microcytosis and type of anemia among …

Effect Of Family-Centered Care Interventions On Motor And Neurobehavior Development Of Very Preterm Infants: A Systematic Review And Meta-Analysis, Manasa Kolibylu Raghupathy, Shradha S. Parsekar, Shubha R. Nayak, Kalesh M. Karun, Sonia Khurana, Alicia J. Spittle, Leslie Edward S. Lewis, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Aim

To assess the effectiveness of family-centered care (FCC) interventions on motor and neurobehavior development of very preterm infants.

Method

Randomized and quasi-randomized trials assessing the effect of FCC on motor and neurobehavioral outcomes in very preterm infants (28–32 wk gestation) were included. Five electronic databases and grey literature were searched from January 2010 to August 2022. Two reviewers independently screened the titles/abstracts and full texts, assessed the risk of bias, and extracted data. The Cochrane Risk of Bias 2.0 Tool and GRADE were used for risk and evidence certainty assessments. Meta-analysis or narrative synthesis was performed based on data …

Protocol For Development And Validation Of An Early Intervention Device And Its Influence Using Structured Early Physiotherapy (Preemiestep) Intervention On Neuromotor Development In Preterm Infants, Indira D. B. Naidu Boddapati, Sivakumar Gopalakrishnan, Sonia Khurana, Jayashree Purkayastha, Bhaskar Bhatt, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Early physiotherapy interventions for Moderate to Late Preterm (MLP) infants often lack continuity of care from hospital to home settings. This research aims to develop an Early Intervention (EI) device for home program and determine its influence using STructured Early Physiotherapy (Preemie STEP) intervention in MLP infants. For phase I, qualitative interviews will be conducted with healthcare professionals and parents, to understand user needs on developed prototype. Based on identified needs, an EI device will be developed using a human-centered design approach and iterative design process. In phase II, usability and validity of EI device will be …

Therapy-Based Strategies To Support Tummy Time In Infants Post-Hospital Discharge: A Scoping Review Protocol, Ketaki Inamdar, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Tummy time is essential for infant development, yet many caregivers face significant challenges with adherence due to behavioral and contextual barriers. While numerous tummy time interventions exist, a limited understanding of their behavioral components hinders effective replication and implementation. This scoping review aims to identify multidisciplinary interventions used to promote tummy time in infants aged 0–12 months, evaluate their impact on adherence, developmental and health outcomes, and examine the behavior change techniques employed using the Theoretical Domains Framework (TDF). Following the Joanna Briggs Institute (JBI) methodology, a comprehensive search will be conducted in MEDLINE (PubMed), Web of Science Core Collection, …

Impact Of Fast Advancement And Early Fortification Of Enteral Feedings In Preterm Infants, A Retrospective, Observational Study., Enrique Gomez-Pomar, Holly Clarke, Jamie Adams

Pediatrics Faculty Publications

UNLABELLED: We aimed to evaluate the outcomes and growth of preterm infants at a Neonatal Intensive Care Unit that focuses on early initiation, fast advancement, and early fortification of enteral feeds.

METHODS: Retrospective study conducted at a community hospital level III NICU. Extensive feeding data and outcomes were collected by utilizing a NutritionIQ software application, NICUtrition®. Infants born between 26- and 34-weeks gestational age were included, whereas infants with congenital defects, deceased or with incomplete data were excluded. Frequency and descriptive statistical analysis were conducted using chi-square and Fisher's exact test. Unadjusted odds ratios were computed for categorical variables and …

Rcpneoperu Trial: A Cluster Randomized Pilot Trial To Assess Traditional Neonatal Resuscitation Compared To Partially Virtual Training In Remote Areas., Carlos A Delgado, Enrique Gómez Pomar, Pablo Velásquez, Víctor Sánchez, Roberto Shimabuku, Luis Huicho

Pediatrics Faculty Publications

OBJECTIVE: To assess the effects of a neonatal resuscitation training program using traditional training and partial distance learning.

METHOD: Through an open cluster-randomized trial, the authors compared a traditional approach involving face-to-face theory and practice sessions using information and communication technology to offer theory and distance examination, followed by face-to-face practice. Twelve health facilities were allocated by blocked randomization. Comparisons were made adjusting for clustering in qualitative and quantitative data. The primary outcome was the percentage of infants with heart rates ≥100 per minute at the second minute after birth. The authors performed a cluster-level analysis for cluster randomized trials, …

Congenital Malignant Ectomesenchymoma Presenting As A Neck Mass In A Newborn, Ianna S. C. Blanchard, Ravi C. Bhavsar, Ashley M. Olszewski, Nathan R. Shelman, John A. D'Orazio, Prasad Bhandary, Thitinart Sithisarn

Pediatrics Faculty Publications

Background: Malignant Ectomesenchymoma (MEM) is a rare, aggressive soft tissue neoplasm with both neuroectodermal and mesenchymal differentiation. Congenital cases are extremely uncommon, posing significant diagnostic and therapeutic challenges.

Case Presentation: We report a case of a full-term male neonate presenting with a large congenital neck mass and respiratory distress at birth. Imaging revealed a lobulated, heterogeneously enhancing mass in the left submandibular region with a mass effect on the airway. Open biopsy and gross resection on day six of life confirmed MEM with rhabdomyoblastic and neuroectodermal differentiation. Post-surgical staging classified the tumor as Stage I, Clinical Group II. Despite initial …

Clinical Relapse Versus Treatment Failure: The Case For Surveillance For Re-Appearance Of Minimal Measurable Disease In Pediatric Patients With Higher Risk B-All, Paul S. Gaynon, Linwei Li

School of Medicine Publications

No abstract provided.

American Society Of Hematology/International Society On Thrombosis And Haemostasis 2024 Updated Guidelines For Treatment Of Venous Thromboembolism In Pediatric Patients, Paul Monagle, Muayad Azzam, Rachel Bercovitz, Marisol Betensky, Rukhmi Bhat, Tina Biss, Brian Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Hassan Kawtharany, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Reem A. Mustafa

Journal Articles: Pediatrics

BACKGROUND: The American Society of Hematology (ASH) guidelines on treatment of pediatric venous thromboembolism (VTE) were published in 2018. In the last 6 years, there has been a 10-fold increase in the number of children involved in VTE treatment trials.

OBJECTIVE: The ASH Committee on Quality and Guidelines agreed to update the pediatric guidelines in conjunction with the International Society on Thrombosis and Haemostasis (ISTH). These ASH/ISTH evidence-based guidelines are intended to support patients, clinicians, and other health care professionals in the management of pediatric patients with VTE.

METHODS: ASH/ISTH formed a multidisciplinary guideline panel to minimize potential bias from …