Translational Medical Research Commons^™

Chri Research Operations Summit Building Bridges Across Chri, Tina Freese Decker, Paula Schuiteman-Bishop, Surender Rajasekaran, Matthew Sims

Website/Multimedia Contributions

The CHRI Research Operations Summit is the premier event for all research team members and leaders across CHRI. Our theme of Building Bridges highlights our commitment to strengthening connections, fostering collaboration, and unifying our efforts across all regions.

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.

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.

High Ligation Versus Floor Repair For Adolescent Inguinal Hernias: A Matched Comparison Of Recurrence And Complications, Katelyn Ward, Melanie Ermler, Elizabeth Theirl, Ryan Davis, Huong Tran, Begum Akay, Anthony Stallion, Nathan Novotny, Pavan Brahmamdam

Conference Presentation Abstracts

Background: The optimal surgical approach for inguinal hernias in adolescent patients remains an area of debate. While high ligation (HL) for indirect hernias is standard in younger children, floor repair (FR), usually with mesh, is preferred in adults due to the higher incidence of direct hernias and weakness of the abdominal wall. This study compares recurrence rates and perioperative complications between HL and FR in adolescent patients.

Methods: A retrospective study was performed on 10-17 year old patients who underwent inguinal hernia repair within a single hospital system between 7/2013 and 6/2023. Operations were performed by pediatric surgeons, pediatric urologists, …

Associations Between Health Literacy And Comprehension Of Health Visits In A Community Setting, Amanda Romaya, Adel Andemeskel, Salim Abdul-Razak, Linda Dillon, Victoria Lucia

Posters

Low health literacy is a significant social determinant of health that is associated with poor health outcomes1-3. Bringing attention to health literacy will aid in promoting the health of the population. However little has been done to implement national policies and interventions that address patient health literacy, especially in a community setting4.

We hypothesized that our assessment of the identified patient population’s health literacy will not meet adequate standards and will indeed demonstrate a need for community-focused interventions

Assessing Disparities In Sep-1 Bundle Compliance At Corewell Health, Zachary Awad, Mark Munir, Paul Bozyk, Ramin Homayouni

Posters

Sepsis, a life-threatening condition resulting from a dysregulated immune response to infection, carries significant mortality. To improve sepsis management, the Centers for Medicare & Medicaid Services (CMS) introduced the SEP-1 bundle, outlining critical interventions within specified timelines. This study aimed to investigate disparities in SEP-1 bundle compliance, examining variations among septic patients based on sociodemographic factors like age, race, and area deprivation index (ADI), as well as clinical factors like chronic health conditions.

Allergies Coinciding With Central Sensitization Syndromes (Access), Jacqueline Morey, Alemu Fite, Carl Lauter, Matthew Sims

Posters

Significance of Reported Allergies: Many reported drug allergies are mislabeled side effects or misinterpretations, leading to suboptimal treatment, antibiotic resistance, and worse patient outcomes.¹

Central Sensitization Syndromes (CSS): CSSs are chronic pain conditions linked to altered sensory perception, including pain, fatigue, and neurologic dysfunction.² These patients may be more likely to misattribute medication side effects as allergies.

Previous Findings & Hypothesis: Prior research found high allergy reporting in interstitial cystitis and fibromyalgia—both CSS conditions.⁴ We hypothesized that other CSS diagnoses also correlate with increased allergy reporting, emphasizing the need for better allergy evaluation.

Epic Best Practice Alerts Increases Sep1 Orderset Usage, Mark Munir, Zachary Awad, Paul Bozyk, Ramin Homayouni

Posters

Sepsis is a massive, system-wide inflammatory response to an infection that can lead to multisystem organ failure.1 Sepsis has a very high mortality rate of 20-50% in patients with severe sepsis and is the 10th leading cause of death in the United States.2 One of the most significant ways of reducing mortality from sepsis is timely detection and initiation of treatment in septic patients.3

Electronic medical records such as Epic have implemented sepsis warning algorithms and alerts to facilitate quicker detection of sepsis and thus earlier initiation of treatment. The goal of this study is to determine if an Epic …

Implementation Of An Opioid Free Pediatric Hernia Repair Protocol, Corey Shafer, Antonela Muca, Randy Hilleary, Kristin Lemarbe, Diane Studzinsk, Kaveh Aslani, Nathan Novotny, Pavan Brahmamdam, Begum Akay

Posters

Surgery most often provides children with their first exposure to opioids which may lead to misuse and overuse. Protocolizing pain management perioperatively can reduce opioid exposure in children while still providing adequate pain management.

Surgical Site Infection Bundle For Babies: Preliminary Data, Cullen Woodley, John Nida, Alexis Lonjin, Katelyn Ward, Diane Studzinski, Begum Akay

Posters

Surgical Site Infections (SSIs) are infections that occur in or around the area where a surgery was recently performed. They are estimated to account for 20% of all healthcare associated infection, and lead to an increase in morbidity and mortality. Perioperative care bundles show promise in reducing SSIs in adults but are not often used in neonatal surgery. Infections in babies after surgery are less common than adults but carry significant morbidity in a fragile patient.

Enhancing Reproductive Anatomy Education: A Comprehensive Approach Integrating Near-Peer And Reciprocal Peer Tutoring, Hope Hefferan, Emelie-Jo Scheffler, Erin Mueller, Varna Taranikanti

Posters

• Near-peer tutoring (NPT): Tutors are more advanced than tutees, typically offering support in understanding complex concepts.1

• Reciprocal peer tutoring (RPT): Students with similar levels of training alternate between tutor and tutee roles, facilitating collaborative learning.1

• Peer tutoring fosters professional development and improves long-term retention of complex medical concepts.3,4,5

• Reproductive anatomy is a challenging area for many medical students; Innovative peer tutoring methods may help improve understanding and retention of anatomical structures.

• We hypothesize that integrating NPT and RPT within the laboratory setting in the reproductive organ system course will enhance student motivation, self-efficacy, and long-term …

Examining Health Disparities: An Observational Study On Peripheral Vascular Access Outcomes Among Hospitalized Patients, Charlotte O’Sullivan, Nicholas Mielke, Yuying Xing, Amit Bahl

Posters

Peripheral intravenous catheter (PIVC) placement is the most common invasive procedure performed in healthcare, with an estimated 90% of hospitalized patients requiring PIVC access during their stay. This equates to around two billion PIVCs used annually.1–3 Studies report 36% to 63% of catheters fail due to a variety of complications, including infiltration, occlusion, phlebitis, dislodgment, and infection. 2–6 These failures not only cause immediate patient discomfort and increased clinical workload but also have wider implications such as prolonged hospital stays and delays in critical treatments.2 The factors contributing to PIVC failure are multifaceted, involving clinical presentation, patient anatomy, provider skill …

Serum Metal Ion Levels In Patients Undergoing Revision Should Arthroplasty, Rishi Chatterji, Brandon Fisher, Avianna Elizabeth Arapovic, Yuying Xing, J Michael Wiater

Conference Presentation Abstracts

INTRODUCTION: Shoulder arthroplasty systems are transitioning towards more modular prosthesis options with the goal of reducing complication profiles and increasing range of motion. Modularity may increase the potential for fretting, corrosion, and subsequent release of metal ions. These events have been associated with adverse reactions in hip and knee arthroplasty, but not in the setting of revision shoulder arthroplasty. The purpose of this study was to identify associations between implant designs, metallurgy, patient characteristics, and serum metal ion levels in patients undergoing revision shoulder arthroplasty. METHODS: 51 patients that underwent revision shoulder arthroplasty were retrospectively reviewed based on prospectively collected …

Maternal Lipidomics For The Accurate Prediction Of Fetal Cyanotic Congenital Heart Defects, Onur Turkoglu, Nadia Ashrafi, Ali Yilmaz, Romana Ashrafi Mimi, Abdullah Khan, Perry Friedman, Ciara Talbot, Stewart Graham, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late diagnosis of cyanotic congenital heart defects (CCHD) significantly increases newborn morbidity and mortality. However, a significant percentage of CCHD cases remain undetected prenatally. Our objectives were therefore to evaluate the accuracy of maternal serum lipidomic markers for the prenatal detection of CCHD and also to elucidate the pathogenesis of these disorders. Study Design: This prospective case-control study included 40 cases of CHD (22 cyanotic, 18 acyanotic) and 39 unaffected controls. Maternal serum samples were profiled via a combination of Ultra-High-Performance Liquid Chromatography coupled with Mass Spectrometry and Nuclear Magnetic Resonance. The mean of each lipid specie was compared …

Evaluating The Impact Of Spot Position Errors On Dose Distribution: A Comparison Between Spot-Scanning Arc Therapy (Sparc) And Intensity-Modulated Proton Therapy (Impt), Peilin Liu, Lewei Zhao, Gang Liu, Xiaoda Cong, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To quantitatively investigate the impact of spot position error (PE) on the dose distribution in (Spot-scanning arc therapy) SPArc plans versus Intensity-Modulated Proton Therapy (IMPT).

Methods:

Four representative disease sites, including brain, lung, liver, and prostate cancers, were retrospectively selected. Spot position errors were simulated during dynamic SPArc treatment delivery. Two types of errors were generated, including randomized error and systematic error. For each random error scenario, they were further examined across four sub-scenarios (25%, 50%, 75%, and 100% of spots affected) at 1 mm and 2 mm deviations.The randomized errors used two categories with and without Gaussian distribution …

Exploit The Potential Clinical Benefit Of Using Proton Arc Therapy For Esophageal Cancer, Peilin Liu, Xiaoda Cong, Raymond Dalfsen, Martin Soukup, James E. Dolan, Shupeng Chen, Craig Stevens, Rohan Deroniyagala, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

No abstract provided.

Quantitative Evaluation Of Gantry Rotation Perturbation Effects On Spot-Scanning Arc Therapy (Sparc), Peilin Liu, Lewei Zhao, Gang Liu, Xiaoda Cong, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To quantitatively assess the impact of random gantry rotation perturbations on spot-scanning arc (SPArc) therapy.

Methods:

To simulate random gantry rotation perturbations, the initial gantry angle of SPArc treatment plans was modified using an in-house script. Four cases from different disease sites include brain, lung, liver and prostate were selected to evaluate. Original SPArc plans (SPArc_org) were developed through iterative processes, including control point re-sampling, redistribution of control points & energy layers, energy layer filtration, and re-sampling. Considering potential limitations, rotation perturbations of 1mm and 2mm were applied to al SPArc_org plans to generate perturbed SPArc …

Insights From Targeted Fecal Metabolomic Analysis Reveal Altered Metabolic Pathways In Treatment-Naive Pediatric Subjects With Crohn's Disease, Nadia Ashrafi, Ali Yilmaz, Nicolette Monacelli, Rose E. Callahan, Ilyas Ustun, Nathan M. Novotny, J W. Rattray, Kypros Nicolaides, Stewart Graham

Conference Presentation Abstracts

Crohn’s disease (CD) is a heterogeneous and multifactorial inflammatory bowel disease with a significant global health impact. Genetic and lifestyle factors contribute to its etiology, emphasizing dysregulation of intestinal and dietary habits. Our study aimed to identify fecal metabolites from treatment-naïve, pediatric sufferers of CD, which allowed us to investigate the underlying biochemical perturbations associated with the disease, highlighting potential, translational targets. Using a Waters Acquity UPLC coupled with a Xevo-TQ-S mass spectrometer, we quantified >500 metabolites in fecal samples (n=72) of pediatric CD sufferers. We developed diagnostic tests capable of accurately discriminating between children with CD and healthy individuals …

Moonlighting: A Pilot Project To Assess Impact Of Extracurricular Activities On Career Satisfaction And Quality-Of-Life In Graduate Medical Education, Charlotte O'Sullivan, David Lee, Karen Childers, Justine Nasr

Conference Presentation Abstracts

Background: Moonlighting is the delivery of healthcare outside of training programs in exchange for compensation. The Accreditation Council on Graduate Medical Education allows individual training programs to permit or restrict moonlighting, which leads to variation in prevalence and practice. Guidelines and regulations for moonlighting vary greatly across graduate medical education programs. Yet, limited research has been done to determine resident and fellow physician attitudes towards moonlighting and its impact on quality-of-life. Objective: This pilot study investigates how participating in moonlighting and extracurricular activities may impact resident and fellow physicians’ self-perceptions of quality-of-life and career satisfaction. Methods: 442 residents and fellow …

Exploring Illness Beyond Disease: Development Of A Sense Of Identity In Patients With Inflammatory Bowel Disease (Ibd), Nicholas Totah, Jason Adam Wasserman

Posters

• Inflammatory bowel disease (IBD) poses significant challenges to an individual’s physical and emotional well-being, often reshaping their sense of self and life trajectories.
• Patient narrative can illuminate the illness experience in ways that are often unaddressed in the literature.

A Comparison Of Post-Operative Pain Management Following Lumbar Laminectomy Fusions Utilizing Tlip Or Intra-Operative Local Anesthesia Block, Lauren Eberhardt, Philip Zakko, Karen Childers, Daniel Park

Conference Presentation Abstracts

Background/Introduction: Spinal fusion patients suffer significant acute post-operative pain, potentially leading to chronic pain. Opioids are commonly used for peri-operative pain management despite significant side effects. The thoracolumbar interfascial plane (TLIP) and erector spinae plane (ESP) block, alternative analgesic options with rare side effects, have proven to reduce pain and opioid consumption compared to standard non-block care. This study aimed to determine if a significant difference exists between block groups with multi- and single level laminectomy fusions in post-operative and discharge opioid consumption and length of stay. Materials/Methods: A retrospective review was performed via data query for lumbar laminectomy fusion …

Smoking And Covid-19: An Analysis Of Demographics, Risk Factors, And Outcomes, Andrew Vrtar, Luca Cucullo, Richard H. Kennedy

Posters

• Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a respiratory pathogen that first emerged in late 20191 and was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020.
• Cigarette use is a significant public health concern throughout the world. Despite reductions in prevalence in recent years, tobacco smoking remains one of the main preventable causes of ill-health and premature death.
• Both tobacco smoking and vaping are phenomena that may increase the vulnerability of these individuals to COVID19 infection.4 Therefore, it is crucial to explore the medical consequences of and …

Analysis Of Ed Visitors For Dermatological Disorders Prior To And During The Covid Pandemic, Faris Alkhouri, Jacob Keeley, Ramin Homayouni

Posters

Dermatology-related Emergency Department (ED) visits make up more than 3% of total ED visits1; however, only around 2% of these visits can be considered true emergencies.2 To our knowledge, there are no studies that examined demographic influences on ED visits in regards to skin disorders in the adult population.

The sudden onset of the COVID-19 pandemic had significant effects on healthcare systems and policies, which resulted in a nationwide decline of 20-43% in ED visits.3 However, no studies have examined the impact of the pandemic on the presentation of skin disorders in the ED.

Use Of Early Enteral Nutrition In Mechanically Ventilated Covid-19 Patients, Vivian Chang, Ramin Homayouni, Virginia Uhley

Posters

Malnutrition in critically ill patients has been associated with a greater length of hospital stay, incidence of complications, and risk of death. Up to 37% of critically ill patients in the intensive care unit (ICU) are either moderately or severely malnourished1. Optimizing enteral nutrition delivery is key to maximizing the benefits of nutrition support for critically ill patients. At the onset of the COVID-19 pandemic in March 2020, the role of nutrition support for COVID-19 patients was poorly understood. In May 2020, the American Society of Parenteral and Enteral Nutrition (ASPEN) approved nutrition guidelines for COVID-19 patients that state that …

Association Between Primary Care And Emergency Department Utilization, Donna Kayal, Jacob Keeley, Ramin Homayouni

Posters

Emergency departments have been designed to provide rapid and accessible care for emergent and acute needs for a broad scope of illnesses and injuries.1-2 However, the emergency department (ED) has been facing an overwhelming increase in demand, leading to an increase in wait time and significant overcrowding, which decreases the effectiveness of the ED.1-4 A common explanation that has been noted over the years is utilization of ED services for non-emergent care, which professionals have often labeled as “inappropriate use.”2,5 Such encounters take away time from ED physicians and health care workers, compromising the care for true emergencies and leading …

Efficacy Of An Integrated Computer Assisted Learning (Cal) Module In Student Understanding Of Cardiovascular Embryology, Nicolaas Schimmel, Forrest Bohler, Varna Taranikanti

Posters

• Embryology is one of the most difficult topics for students to master1

Students’ perceptions of embryology are generally more negative:

• Not clinically important1

• More negative attitude than towards gross anatomy1

• Unhappy with current teaching methods and not confident learning it2

An integrated CAL module will allow a more linear model for learning congenital heart diseases, which may help improve students’ understanding of cardiovascular embryology.

• Compared to traditional, more segmental model where students learn embryology separately from clinical presentation, ECG interpretation, etc.
• CAL modules have proven effective for other organ systems3.

• We hypothesized that students would demonstrate …

Perioperative Antibiotic Use In Neonatal General Surgery: A Survey Of Apsa Membership, Samuel K. Osei, Ashley Williams, Diane Studzinski, Patrick Karabon, Begum Akay, Pavan Brahmamdam

Posters

• Guidelines for antibiotic prophylaxis for surgical site infection (SSI) are widely used for adult patients.
• There is limited data on prophylaxis in pediatrics, and there are no standardized guidelines for neonates.
• Perioperative antibiotic use in neonates based on the surgeon’s preference.

Characterizing The Effectiveness Of Prehospital Pediatric Pain Management In Children With Long Bone Fractures, Revelle Gappy, Ashima Goyal, John Frawley, Sariely Sandoval, Nai-Wei Chen, Remle Crowe, Robert Swor

Posters

Prehospital pediatric pain management has been poorly understood and sub-optimally treated.1-3 Pain scales for children differ from adult pain scales and it is unclear if pain assessments are well documented, particularly in infants and toddlers.4-6 Surveys of emergency medical services (EMS) personnel identify barriers to pain management including discomfort with emergency care of injured children, concern for allergic reactions, additional pain from intravenous catheter insertion, parental influence, as well as lack of knowledge and experience secondary to the relatively infrequent treatment of acutely injured children.7-9

The effectiveness of prehospital pain medication administration for children is unknown, as is the efficacy …

Diuretic Dose Ratio Is Associated With Reduced Hospital Length Of Stay In Acute Heart Failure, Sarah Galla, Yuying Xing, Lihua Qu, David A. Berger

Conference Presentation Abstracts

No abstract provided.