Pediatrics Commons^™

Exploring Adolescent Hearing Aid Usage And Appearance Of Psychiatric Symptoms In Adolescents Using Hearql-28 Surveys, Courtney J. Austin, Dylan Chan

MEDI 9331 Scholarly Activities Clinical Years

Approximately 2% of DHH people in need of mental health services actually receive these services. Among pediatric hearing loss populations, co-occurring cognitive and physical impairments are risk factors for poor mental health status. Due to language barriers and isolation, more children with hearing loss do not have access to mental health services. Cochlear implants have been shown to improve mental health status among the DHH population. Current literature focuses on the mental health status of children with cochlear implants, with little focus on hearing aid users. Using HEAR28 data and surveys, we can quantify the incidence of psychiatric symptoms among …

Sepsis At Children's Mercy: A Descriptive Study, Katlyn Mayer, Leslie Hueschen, Grace E. Arends Md, Ashley Sherman

Presentations

No abstract provided.

Prospective Validation Of Selective Serotonin Reuptake Inhibitor Pharmacokinetic Models For Precision Dosing In Children And Adolescents, Ethan A. Poweleit, Whitney Sparks Ms, Catherine Koertje, Addison Pritchett Ms, Gail Robertson, Lindsey Malloy-Walton, Stephani Stancil, Jeffrey R. Strawn, Alexa L. Pagano, Kathryn Kyler, Jonathan B. Wagner, Brandon Retke, Paul C. Toren, J Steven Leeder Pharmd, Phd, Laura B. Ramsey

Posters

Background: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to children and adolescents with anxiety and depression. However, their clinical use is complicated by marked interindividual variability in exposure, which contributes to differences in treatment response and side effects. Further, SSRIs are commonly dosed using a trial-and-error approach. Model-informed precision dosing could improve treatment outcomes, yet existing SSRI population pharmacokinetic (PK) models have not been prospectively validated and may not generalize to pediatric patients. This study aims to evaluate how accurately these models predict exposure for three SSRIs—escitalopram (ESC), sertraline (SRT), and fluoxetine (FLX)—and refine them to develop tools for …

Trauma: Blunt Solid Organ Injury, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Enhancing Pediatric Tube Weaning With Remote Patient Monitoring: A Pilot Quasi-Experimental Study, Sarah T. Edwards, Dana Bakula, Kristina Nash, Saiyara Baset, Amy Ricketts, Julianne Brogren, Ryan M. Thompson, Sarah Bullard, Rachel Graham, Janelle R. Noel-Macdonnell Phd, Brenda Fetter, Lori A. Erickson

Manuscripts, Articles, Book Chapters and Other Papers

Objective: Feeding-tube weaning is conducted in both inpatient and outpatient settings, with significant logistical, financial, and structural barriers to both approaches. We sought to assess whether remote patient monitoring (RPM), using a mobile application, which would overcome many of these barriers, could be effective in helping patients tube wean. Methods: We prospectively enrolled patients with a feeding tube, aged 0–3 years. Enrolled families entered data daily into the remote application. Data were monitored by a nurse and reviewed weekly by a multidisciplinary team. A standard hunger provocation protocol was used, paired with medical, behavioral, oral motor, and nutrition interventions, as …

Pharmacogenetics Of Cyp3a5 In Pediatric Patients With Eosinophilic Esophagitis., Janelle R. Noel-Macdonnell Phd, Norah Almahbub, Erin C. Boone, Wendy Y. Wang, Dilyara Cheranova, Lisa Harvey, Valentina Shakhnovich, Rachel Chevalier

Manuscripts, Articles, Book Chapters and Other Papers

Eosinophilic esophagitis (EoE) is an atopic inflammatory disease with limited treatment options. Though swallowed topical steroids are commonly used, they are not effective in all patients. We investigated the presence of CYP3A4/5 and ABCB1 (P-glycoprotein) mRNA in esophageal tissue and its differential expression by genotype in pediatric patients. Esophageal tissue biopsies were obtained from pediatric patients undergoing standard of care endoscopy. Levels of CYP3A4, CYP3A5, and ABCB1 mRNA were measured using droplet digital PCR and compared across patients with and without EoE. Genotypes for common, clinically relevant CYP3A5 variants were evaluated in a cohort of individuals with and without EoE. …

Prior Head Circumference Measurements In Infants With Older Subdural Hematomas: Did We Miss It?, Maryann Alvarez Griffis, Nancy D. Kellogg, Wouter Koek

School of Medicine Publications

Objective: To establish whether infants with macrocephaly and non-acute subdural hematomas (SDHs) had missed opportunities for measuring fronto-occipital circumference (FOC) and obtaining neuroimaging prior to diagnosis. Macrocephaly due to SDH in infancy is initially detected by FOC measurements and/or neuroimaging, as neurologic symptoms may be subtle or missed.

Methods: Retrospective chart review of infants with macrocephaly and non-acute SDHs referred to child abuse pediatricians for suspected abusive head trauma (AHT) over an 8-year period. A study sample of 35 infants met inclusion criteria and had complete prior medical records which were reviewed for missed opportunities for earlier SDH diagnosis. Four …

The Role Of Top-Down Appetite Self-Regulation In The Development Of Healthy Eating Behaviors Among Children: A Narrative Review And Socialization Framework, David J Bridgett, Sheryl O Hughes, Matthew Broussard, Daniela Mccourt, Christina M Croce, Jennifer O Fisher

Faculty, Staff and Students Publications

Appetite self-regulation (ASR) among children is thought to have a fundamental role in shaping the development of healthy eating behaviors, dietary intake, and growth during childhood. Parallel to developmental frameworks for understanding "general" self-regulation among children, ASR has been described as involving children's use of "top-down" cognitive processes to moderate "bottom-up" biological drives around food approach and avoidance in the interest of achieving desired eating behaviors or outcomes. Whereas bottom-up ASR processes during early childhood are well characterized, particularly in the context of dysregulation and obesity risk, the role of top-down ASR processes in the development of healthy eating behaviors …

Surgical Repair Of Double-Outlet Right Ventricle With Doubly Committed Juxtaarterial Ventricular Septal Defect: The Role Of Virtual Reality, Fumiya Yoneyama, Jonathan Awori, Shagun Sachdeva, Kaimal A Jayakumar, Javier Brenes, Jeffery S Heinle

Faculty, Staff and Students Publications

Double-outlet right ventricle (DORV) with a doubly committed juxtaarterial ventricular septal defect (VSD) presents significant surgical challenges. We report a neonate with DORV, a hypoplastic aortic arch, and a patent ductus arteriosus. Virtual reality (VR) imaging provided detailed visualization, confirming the VSD's position beneath both great arteries. Intraventricular rerouting was unfeasible given the patient's small systemic structures and tricuspid valve chordae. The patient underwent successful VSD closure through a transarterial approach, arterial switch operation, and arch repair. This case highlights the utility of VR-based planning in optimizing surgical strategy for complex congenital heart defects.

Hes V2.0 Validation And Performance Compared To Galad And Asap In The Heds Cohort, Hashem B El-Serag, Camden Lopez, Michelle Luster, K Rajender Reddy, Neehar Parikh, Amit G Singal, Jorge A Marrero, Aaron P Thrift, Jagpreet Chhatwal, Ziding Feng, Stephanie Page-Lester, Qingchun Jin, Nabihah Tayob, Fasiha Kanwal

Faculty, Staff and Students Publications

Background & aims: We previously developed HES V2.0, a biomarker panel (age, ALT, platelets, etiology, AFP, AFP-L3, DCP, and their 1-year gradients) for early detection of hepatocellular carcinoma (HCC) among patients with cirrhosis. We externally validated HES V2.0 and compared its performance with HES V1.0, GALAD, and ASAP.

Methods: We conducted a PRoBE (prospective specimen-collection, retrospective blinded-evaluation) cohort study in the HEDS (Hepatocellular Carcinoma Early Detection Strategy) cohort of 1,485 patients with cirrhosis, of whom 119 developed HCC. Patient- and test-level true positive rates (TPR) for HCC were calculated at 6, 12, and 24 months before diagnosis, using thresholds at …

Defining The Society Of Pediatric Liver Transplantation (Split) Research Agenda: A Delphi Consensus Project, Sharad I Wadhwani, Pooja Reddy Spector, Amy G Feldman, Katryn N Furuya, Kayla Hartjes, Chaowapong Jarasvaraparn, Beau Kelly, Stacee M Lerret, Krupa Mysore, Arti Pawaria, Philip Rosenthal, Amy Shui, Voytek Slowik, Sarah Taylor, Jennifer Vittorio, Pamela L Valentino

Faculty, Staff and Students Publications

Background: Despite major advances in surgical and medical management, only one-third of pediatric liver transplant (LT) recipients remain morbidity-free at 10 years. The Society of Pediatric Liver Transplantation (SPLIT) published a research agenda over 10 years ago, and much progress has been made since then. An updated consensus-driven SPLIT research agenda could guide future research and funding priorities. We aimed to identify and prioritize key research needs across the continuum of pediatric LT care using a modified Delphi consensus approach.

Methods: We conducted a three-round modified Delphi process among SPLIT members. In round 1, participants submitted open-ended research priorities. In …

Predominant Symptom In Gastroparesis: Relationships To Quality Of Life, Treatments, And Outcome, Henry P Parkman, Laura A Wilson, William L Hasler, Madhusudan Grover, Bruno P Chumpitazi, Helen Burton-Murray, Irene Sarosiek, Baha Moshiree, Geoffrey A Preidis, Robert J Shulman, Laura A Miriel, Dave Shade, Braden Kuo, Richard W Mccallum, Thomas L Abell, Pankaj J Pasricha

Faculty, Staff and Students Publications

Background: Patients with gastroparesis (Gp) can have a variety of symptoms. Apart from use of prokinetics, symptomatic therapies for the predominant symptom (PrS) are used.

Aims: (1) To classify Gp patients based on their PrS; (2) To determine differences in Gp symptoms, gastric emptying (GE), quality of life (QOL), treatments, and symptom improvement among Gp patients with different PrS.

Methods: Gp patients were enrolled in a multicenter registry and followed for 96-weeks. Patients recorded their PrS and completed questionnaires assessing symptoms and QOL at enrollment and at follow up visits.

Results: Of 1013 Gp patients (361 diabetic, 607 idiopathic, 45 …

Relationship Between Heart Rate Variability And Sleep Among Girls And Boys With Abdominal Pain-Related Disorders Of Gut-Brain Interaction, Kendra J Kamp, Robert L Burr, Camden E Matherne, Emily Simonds, Tasha Murphy, Margaret M Heitkemper, Rona L Levy, Robert J Shulman, Miranda A L Van Tilburg

Faculty, Staff and Students Publications

Background: Children with abdominal pain-related disorders of gut-brain interaction (AP-DGBI) often experience sleep disturbances which may be linked to the autonomic nervous system. Heart rate variability (HRV) is a non-invasive measure of autonomic nervous system activity. Our aim was to examine if HRV was associated with characteristics of disturbed sleep in children with AP-DGBI in order to elucidate the underlying physiological mechanisms of disturbed sleep.

Methods: This analysis used baseline data from a randomized control trial of 156 children ages 7-12 years with AP-DGBI. HRV was measured after dinner using a Polar monitor. Sleep disturbances were evaluated using the Children's …

Statistical Methods In Aging Research: Improving Current Practices And Embracing Emerging Approaches, Deependra K Thapa, Erik S Parker, Mounika Kandukuri, Xi Rita Wang, Thirupathi R Mokalla, Olivia C Robertson, Wasiuddin Najam, Andrew E Teschendorff, Andrew W Brown, John R Speakman, Yisheng Peng, Bernard S Gorman, Heping Zhang, Luis-Enrique Becerra-Garcia, Colby J Vorland, David B Allison

Faculty, Staff and Students Publications

Aging research relies on varied statistical methods, and applying these methods appropriately is important for scientific rigor. However, proper use of these statistical techniques is a challenge. We discuss two categories of statistical methods in aging research: (a) emerging methods requiring further validation, including techniques to examine compression of morbidity, maximum lifespan, immortal time bias, molecular aging clocks, and treatment response heterogeneity, and (b) classic and existing methods needing reconsideration and improvement, such as stepwise regression, generalized linear models, methods for accounting for clustering and nesting effects, methods for testing for group differences, methods for mediation …

Risk Factors For Acute Rejection In Pediatric Lung Transplantation And Its Impact On Graft Failure, Sophie Li, Spoorthi Kamepalli, David Moreno Mcneill, Selena Li, Abbas Rana

Faculty, Staff and Students Publications

Background: Although acute rejection is a common complication of lung transplantation, few studies have analyzed risk factors for acute rejection in pediatric lung transplant patients. The purpose of this study was to examine risk and protective factors for acute rejection in pediatric lung transplantation and its impact on graft failure.

Methods: A retrospective analysis was performed on lung transplant data for a cohort of 906 pediatric patients from the Organ Procurement and Transplantation Network (OPTN) Database between October 1, 1987, and June 30, 2023. Multivariable logistic regression was conducted to identify risk and protective factors for acute rejection, adjusting for …

Cardiac Catheterization In American Indian/Alaska Native Populations: Empowering Communities, Providers, And Systems Toward Equity, Joseph Burns, Daniel J Penny, Keila N Lopez, Lindsay F Eilers, Athar M Qureshi, Christine J Chung, Jason F Deen

Faculty, Staff and Students Publications

American Indian/Alaska Native (AI/AN) people face numerous health disparities, including alarming rates of cardiovascular morbidity and mortality. These inequities are closely tied to unique social, political, and economic circumstances due to the ongoing consequences of systemic racism. Although poorly described, these cardiovascular inequities extend to adult and pediatric interventional cardiology. AI/AN adults are less likely to undergo cardiac catheterization and are more likely to experience complications. There are no published studies on pediatric interventional cardiology outcomes in AI/AN children. The scarcity of available data underscores the need for novel studies to investigate the epidemiology, sociodemographic associations, and outcomes of AI/AN …

Health Care Worker-Reported Barriers And Potential Facilitators Of Acute Lower Respiratory Infection Care Deliver For Children At Mchinji District Hospital In Malawi, Shubhada Hooli, Beatwil Zadutsa, Everlisto Phiri, Karina Hofstee, Nichole Davis, Eric D Mccollum, Charles Makwenda, Carina King

Faculty, Staff and Students Publications

Objectives: We sought to understand barriers to high-quality hospital-based child acute lower respiratory infection (ALRI) care at Mchinji District Hospital in Malawi.

Methods: In 2020, we conducted focus group discussions (FGDs) with clinical officers (COs) who provided direct clinical care after a half-day refresher course on pediatric ALRI case management. The underpinning research methodology of the FGDs was phenomenology, and they were analyzed using inductive and deductive thematic analysis.

Results: We recruited 16 COs to participate in three FGDs. Five themes emerged: lack of confidence in ALRI diagnosis and management, high clinical burden with understaffing, dysfunctional team dynamics, limited physical …

Adenovirus Disease Following Pediatric Liver Transplantation: 10-Year Experience From A Large Pediatric Transplant Program, Anna M Banc-Husu, Sara Hassan, N Thao N Galvan, Elizabeth A Moulton, Jeremy M Schraw, Kathleen Hosek, Dana Cerminara, Flor M Munoz, Krupa Mysore

Faculty, Staff and Students Publications

Background: Human adenovirus in immunocompromised patients can be life-threatening. We describe the prevalence, clinical presentation, and treatment of adenovirus after pediatric liver transplantation at a large transplant center.

Methods: We performed a retrospective cohort study of adenovirus infection in children from 2013 to 2022. We compared incidence, clinical characteristics, and outcomes of post-transplant children by adenovirus treatment status.

Results: Adenovirus disease developed in 26% (84/320) children after liver transplant. Median age at liver transplant was 17.5 months, 48% were female; 50% had biliary atresia. Fever (53%), gastrointestinal symptoms (48%), and hepatitis (41%) were the most common clinical presentations at diagnosis. …

Examining Sleep-Related Problems In Youth With Misophonia, Kevin M Wagner, Matti Cervin, Catherine E Rast, Mered Parnes, Nicholas Murphy, Samuel Spencer, Eric A Storch, Andrew G Guzick

Faculty, Staff and Students Publications

The relationship between misophonia and sleep-related problems (SRPs) in youth is underexplored. This paucity of research is concerning because SRPs might be elevated among youth with misophonia. If left untreated, SRPs can contribute to long-term health consequences. Thus, in this study we examined the link between misophonia and SRPs in youth aged 8 to 17. In this study, we compared SRPs in 102 children and adolescents with clinically significant misophonia to SRPs in a normative youth sample and a sample of 94 youth with anxiety disorders. We also examined the extent to which SRPs were associated with misophonia severity. Approximately …

Aav Gene Therapy For Mps Iva With Induction Of Immune Tolerance Via Oral Administration Of Epitope Peptides Of N-Acetylgalactosamine-6-Sulfate Sulfatase, Sampurna Saikia, Yasuhiko Ago, Fnu Nidhi, Shaukat Khan, Zhengyu Ma, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis IVA (MPS IVA) is caused by the accumulation of undegraded glycosaminoglycans due to the deficiency of the N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme. MPS IVA manifests as progressive systemic skeletal dysplasia. Gene therapy (GT) is potentially a one-time treatment in which the enzyme is continuously produced, circulated, and delivered to target tissues. However, immune responses to gene products can diminish therapeutic efficacy. We hypothesized that oral delivery of tolerogenic peptides induces immune tolerance to human GALNS (hGALNS) in MPS IVA mice, enhancing therapeutic efficacy. Neonatal mice deficient in mouse GALNS (mGALNS) were treated orally with three T-cell/B-cell epitope peptides or hGALNS …

Atypical High-Burden Breakthrough Varicella: A Diagnostic Pitfall In The Two-Dose Vaccine Era, Smaran Marupudi, Jared Hensley, Robert Vezzetti

School of Medicine Publications

We present the case of a seven-year-old fully immunized male who developed an intensely pruritic, generalized maculopapular rash that progressed to vesicles. The patient’s rash was initially diagnosed by his primary care provider as possible scabies and treated with topical permethrin. Our examination revealed a diffuse maculopapular and vesicular exanthem with lesions at various stages of evolution, eventually progressing to secondary cellulitis. The patient’s presentation, consistent with varicella (chickenpox), highlights the diagnostic challenges of breakthrough varicella infection and potential complications in fully vaccinated children. Thus, we highlight the importance of having a high clinical index of suspicion for varicella, even …

A Comparative Effectiveness Trial For Universal Psychosocial Screening With The Psychosocial Assessment Tool (Pat) Across 18 Childhood Cancer Programs In The United States: Adoption, Penetration, And Health Equity, Lamia P. Barakat, Michele A. Scialla, Nithyasri Ramaswamy, Janet A. Deatrick, Kamyar Arasteh, Eric Sandler, Shannon N. Hammer, Anne E. Kazak

Department of Pediatrics Faculty Papers

BACKGROUND: Universal, systematic psychosocial screening in childhood cancer assures care matched to need and achieves a Standard of Psychosocial Care. It is accomplished inconsistently due to barriers at the family, provider, and institution level, potentially contributing to disparities in care and outcomes. We conducted a comparative effectiveness trial of two implementation strategies of an established measure (Psychosocial Assessment Tool; PAT3.0) across 18 children's cancer programs to identify strategies that resulted in higher levels of screening in English and Spanish (penetration, health equity). We also examined uptake at the institution level (adoption).

METHODS: Sites were randomized to Strategy I (web-based training …

Increasing Ketamine Administration In Children's Hospitals For Youth With Sickle Cell Disease., Ashley M. Jenkins, Erin Hendry, Alexandra Power-Hays, Marin Valentino, Matthew Hall, Kathyrn Kyler, James W. Antoon, Sonya Tang Girdwood, Jennifer Goldman, Armand N. Morel, Timothy J. Savage, Lucas E. Orth, Natasha M. Archer

Manuscripts, Articles, Book Chapters and Other Papers

Ketamine is recommended as an opioid-sparing adjunct for sickle cell disease (SCD)-related pain management. Little is known regarding its use in hospitalized youth with SCD. We aimed to describe trends in ketamine administration and examine associations between ketamine administration and outcomes in hospitalized youth with SCD. We conducted a cross-sectional, multicenter study examining hospital admissions for youth with SCD from 44 children's hospitals in the United States from 2016 to 2023. Youth aged ≥6 months with SCD were identified using International Classification of Diseases tenth revision codes. Exposures included age, sex, race, payor, childhood opportunity index, hydroxyurea administration, and concomitant …

Novel Csf Biomarkers For Facilitating Diagnosis Of Cns-Hlh From Other Neuroinflammatory Disorders, Sharat Chandra, Kenneth D Greis, Somchai Chutipongtanate, Nathan Luebbering, Aaron Webster, Kelsey E Poisson, Kristen S Fisher, Kristi Smiley, Rebecca A Marsh, Michael B Jordan, Stella M Davies

Faculty, Staff and Students Publications

Central nervous system (CNS)-hemophagocytic lymphohistiocytosis (HLH) can mimic other neuroinflammatory disorders (ONID), often leading to misdiagnosis. Current diagnostic studies do not reliably distinguish CNS-HLH from ONID. We hypothesized that novel cerebrospinal fluid (CSF) biomarkers identified using unbiased proteomic analysis can facilitate diagnosis of CNS-HLH from ONID. Banked CSF samples were categorized into 3 groups, CNS-HLH, ONID, and controls without CNS inflammation. Proteomic analysis was performed on 25 samples per group (total N = 75). Proteins demonstrating significant changes (>1.5-fold higher and P< .05) in the CNS-HLH compared with ONID and associated with HLH pathophysiology were selected as candidate biomarkers. Cross-platform validation of candidate biomarkers, along with known biomarkers CXCL9 and osteopontin, was performed using enzyme-linked immunosorbent assay (ELISA). One hundred twenty-two proteins were identified on CSF proteomic analysis at 99% confidence. Of these, 10 proteins demonstrated a >1.5-fold change with a P< .05 in CNS-HLH compared with ONID. SerpinG1, lysozyme, and CD14 were selected as candidate biomarkers. ELISA confirmed significant elevation of all 5 biomarkers in CNS-HLH relative to ONID. Median SerpinG1 levels were1242.9 ng/mL in CNS-HLH vs 292.2 ng/mL in ONID (P ≤ .001), lysozyme 222.2 ng/mL vs 65.6 ng/mL (P = .001), and CD14 180.3 ng/mL vs 64.5 ng/mL (P ≤ .001). Median CXCL9 levels were 223.7 ng/mL in CNS-HLH vs 15.5 ng/mL in ONID (P ≤ .001), and osteopontin levels were 356.5 ng/mL vs 92.9 ng/mL (P = .001). These findings demonstrate that novel CSF biomarkers SerpinG1, lysozyme, CD14, and CXCL9 can facilitate diagnosis of CNS-HLH from ONID.

"The Only Place I Feel Understood": A Mixed Methods Survey Of Adolescent And Caregiver Perspectives On Social Media And Parental Controls, Melanie Watt Ramos, Constance M Wiemann, Lauren A Bretz

Faculty, Staff and Students Publications

Purpose

Methods

Results

Improving Structured Handoff Documentation In A Pediatric Emergency Department, Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson

Department of Pediatrics Faculty Papers

INTRODUCTION: The I-PASS handoff tool guides provider handoffs and reduces adverse events in the inpatient setting. Transitions of care occur frequently in the emergency department (ED), and the unpredictable environment can lead to less structured handoffs. Our goal was to increase the percentage of handoff notes that include all 4 I-PASS components by 20% within 6 months.

METHODS: We developed a handoff note template for the pediatric ED that included 4 key I-PASS elements: illness severity, patient care summary, action list, and situational awareness/contingency planning. Our primary outcome measure was the percentage of handoff notes that contained all 4 I-PASS …

Cancer Treatment Induced Skeletal Muscle Loss As A Predictor Of Late Cardiotoxicity In Aya: A Pilot Study, Savannah V. Rauschendorfer, Efstratios Koutroumpakis, Behrang Amini, Juhee Song, Michelle Hildebrandt, Anita Deswal Md Mph, J. Andrew Livingston, Michael Roth, Eugenie S. Kleinerman Md

Cancer Survivorship Research Retreat

No abstract provided.

Online Decision Support For Implementing Evidence-Based Hpv Vaccination Strategies In Texas Safety-Net Pediatric Clinics: Impact On Hpv, Mcv, And Tdap Initiation, Ross Shegog, Hanxiao Sun, Erica L Frost, Laura C Thormaehlen, Travis A Teague, Catherine Mary Healy, Hina Azam, Aadeel Khawaja, Laura Aubree Shay, Dale S Mantey, Sally W Vernon, Lara S Savas

Faculty, Staff and Students Publications

Introduction: HPV vaccination rates for adolescents in the United States are below recommended levels. The Adolescent Vaccination Program (AVP) guides pediatric clinics on how to implement evidence-based strategies to increase HPV vaccination rates. These strategies comprise the adoption of (1) immunization champions, (2) provider assessment and feedback, (3) continuing education, and (4) prompts, (5) parent reminders, and (6) parent education. The AVP systems-based intervention has demonstrated increased HPV vaccination rates in large urban pediatric clinic networks. The purpose of this study was to assess the feasibility of using an online decision support tool, the AVP Implementation Tool (AVP-IT), to …

Neonatal Sepsis: Empiric Treatment And Monitoring Of Gentamicin Troughs In The Nicu, Aleese Palfreyman

Annual Research Symposium

No abstract provided.

Epigenetic Age Acceleration In Young Adults With Congenital Heart Disease, Parag N Jain, Beryl C Zhuang, Joanne Whitehead, Julia L Macisaac, Kristy Dever, Mallory Gahm, Peter Ermis, Thomas W Mcdade, Michael S Kobor, Paul A Checchia

Faculty, Staff and Students Publications

Background: Adults with congenital heart disease (ACHD) having undergone palliative surgery experience chronic stress due to altered physiology and repeated surgical interventions since infancy.

Objectives: To investigate whether ACHD, who had experienced chronic physiological stress from their underlying condition and early-life cardiac surgeries, was associated with epigenetic age acceleration (EAA) and other DNA methylation (DNAm)-based biomarkers, and to assess the potential contribution of derived inflammatory markers to EAA.

Methods: A case-control study comparing ACHD patients and healthy adults. Whole blood DNAm profile was used to estimate DNAm-based blood cell type proportions, multiple epigenetic age measures, and interleukin-6 (IL-6) and C-reactive …