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Purpose: Neonates who require Extracorporeal Membrane Oxygenation (ECMO) are at risk for calcium derangements and associated adverse outcomes. A large children’s hospital in the Southwest changed their practice from using calcium gluconate in priming their neonatal ECMO to using calcium chloride. The impact of this change was not investigated. Methods: A

Purpose: Neonates who require Extracorporeal Membrane Oxygenation (ECMO) are at risk for calcium derangements and associated adverse outcomes. A large children’s hospital in the Southwest changed their practice from using calcium gluconate in priming their neonatal ECMO to using calcium chloride. The impact of this change was not investigated. Methods: A retrospective chart review of 56 neonates who required ECMO support one year prior to and one year following the practice change was conducted. Descriptive data was collected along with the first ionized calcium measured following ECMO initiation. Results: Upon review of the data, the post-ECMO calcium levels were not significant between the calcium gluconate and calcium chloride groups using a Mann Whitney U test (U = 315.5, z = -1.25, p = .213). However, a Chi-square test was significant (χ2(1) = 4.94, p = .026) for having calcium values outside of a normal range in the calcium gluconate group. Fisher’s exact test revealed an odds ratio of 3.43 for the first calcium being outside normal range in the calcium gluconate group. Implications: While comparison of the first measured ionized calcium post-ECMO between the two groups was not statistically significant, there was a significant correlation with normal post-ECMO calcium in the calcium chloride group. This suggest that both calcium gluconate and calcium chloride are appropriate for use in priming the neonatal ECMO circuit, however calcium chloride may provide tighter control of calcium during ECMO initiation in neonates.
Created2021-04-25
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Description
Background
Fruit fly embryogenesis is one of the best understood animal development systems, and the spatiotemporal gene expression dynamics in this process are captured by digital images. Analysis of these high-throughput images will provide novel insights into the functions, interactions, and networks of animal genes governing development. To facilitate comparative analysis,

Background
Fruit fly embryogenesis is one of the best understood animal development systems, and the spatiotemporal gene expression dynamics in this process are captured by digital images. Analysis of these high-throughput images will provide novel insights into the functions, interactions, and networks of animal genes governing development. To facilitate comparative analysis, web-based interfaces have been developed to conduct image retrieval based on body part keywords and images. Currently, the keyword annotation of spatiotemporal gene expression patterns is conducted manually. However, this manual practice does not scale with the continuously expanding collection of images. In addition, existing image retrieval systems based on the expression patterns may be made more accurate using keywords.
Results
In this article, we adapt advanced data mining and computer vision techniques to address the key challenges in annotating and retrieving fruit fly gene expression pattern images. To boost the performance of image annotation and retrieval, we propose representations integrating spatial information and sparse features, overcoming the limitations of prior schemes.
Conclusions
We perform systematic experimental studies to evaluate the proposed schemes in comparison with current methods. Experimental results indicate that the integration of spatial information and sparse features lead to consistent performance improvement in image annotation, while for the task of retrieval, sparse features alone yields better results.
ContributorsYuan, Lei (Author) / Woodard, Alexander (Author) / Ji, Shuiwang (Author) / Jiang, Yuan (Author) / Zhou, Zhi-Hua (Author) / Kumar, Sudhir (Author) / Ye, Jieping (Author) / Biodesign Institute (Contributor) / Center for Evolution and Medicine (Contributor) / Ira A. Fulton School of Engineering (Contributor) / College of Liberal Arts and Sciences (Contributor) / School of Life Sciences (Contributor)
Created2012-05-23
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Description
Background
Drosophila melanogaster has been established as a model organism for investigating the developmental gene interactions. The spatio-temporal gene expression patterns of Drosophila melanogaster can be visualized by in situ hybridization and documented as digital images. Automated and efficient tools for analyzing these expression images will provide biological insights into the

Background
Drosophila melanogaster has been established as a model organism for investigating the developmental gene interactions. The spatio-temporal gene expression patterns of Drosophila melanogaster can be visualized by in situ hybridization and documented as digital images. Automated and efficient tools for analyzing these expression images will provide biological insights into the gene functions, interactions, and networks. To facilitate pattern recognition and comparison, many web-based resources have been created to conduct comparative analysis based on the body part keywords and the associated images. With the fast accumulation of images from high-throughput techniques, manual inspection of images will impose a serious impediment on the pace of biological discovery. It is thus imperative to design an automated system for efficient image annotation and comparison.
Results
We present a computational framework to perform anatomical keywords annotation for Drosophila gene expression images. The spatial sparse coding approach is used to represent local patches of images in comparison with the well-known bag-of-words (BoW) method. Three pooling functions including max pooling, average pooling and Sqrt (square root of mean squared statistics) pooling are employed to transform the sparse codes to image features. Based on the constructed features, we develop both an image-level scheme and a group-level scheme to tackle the key challenges in annotating Drosophila gene expression pattern images automatically. To deal with the imbalanced data distribution inherent in image annotation tasks, the undersampling method is applied together with majority vote. Results on Drosophila embryonic expression pattern images verify the efficacy of our approach.
Conclusion
In our experiment, the three pooling functions perform comparably well in feature dimension reduction. The undersampling with majority vote is shown to be effective in tackling the problem of imbalanced data. Moreover, combining sparse coding and image-level scheme leads to consistent performance improvement in keywords annotation.
ContributorsSun, Qian (Author) / Muckatira, Sherin (Author) / Yuan, Lei (Author) / Ji, Shuiwang (Author) / Newfeld, Stuart (Author) / Kumar, Sudhir (Author) / Ye, Jieping (Author) / Biodesign Institute (Contributor) / Center for Evolution and Medicine (Contributor) / College of Liberal Arts and Sciences (Contributor) / School of Life Sciences (Contributor) / Ira A. Fulton School of Engineering (Contributor)
Created2013-12-03
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Description
Objective: Delirium frequently occurs in Pediatric Cardiac intensive Care Units (PCICU) of hospitals with critically ill patients. An inflammatory process of the brain causes neurotransmitters imbalances and neuronal alterations, leading to increased days on mechanical ventilation, length of stay in the ICU, and possible self -harm. Delirium can be reduced

Objective: Delirium frequently occurs in Pediatric Cardiac intensive Care Units (PCICU) of hospitals with critically ill patients. An inflammatory process of the brain causes neurotransmitters imbalances and neuronal alterations, leading to increased days on mechanical ventilation, length of stay in the ICU, and possible self -harm. Delirium can be reduced and controlled if detected early through frequent patient monitoring and screening. The purpose of this project is to evaluate the implementation of a delirium screening tool along with education on delirium Study Selection: An education module on delirium and the Cornell Assessment of Pediatric Delirium (CAP-D) screening tool along with a non-pharmacological bundle was implemented on a pediatric cardiac intensive care unit for patients 2 to 18 years of age, admitted to an Arizona metropolitan children’s hospital. All nurses were required to attend the education session. Data was collected by using pre- and post-survey questions on delirium for those nurses who chose to participate in the study. Data Synthesis: The results from the pre- and post-tests suggest there was an increase in education. The average score for the 15 nurses on the pre-test was 87.1% while the same nurses scored 100% on the post-test. Chart reviews of the CAP-D screening tool from November 2000 – February 2021 had 71 patients on the unit and had 8 patients scored on the CAP-D screening tool. Chart reviews after implementation of the education module from November 2021 – February 2022, were conducted and 118 patients were on the unit while only 23 patients were scored on the CAP-D screening tool. Conclusion: So far, the use of an education module and implementation of a non-pharmacological bundle has proven some promising results in helping with delirium and its reduction in the PCICU.
Created2022-04-26
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Description
Objective: To understand and prevent adverse discharge events, the project assesses the needs and gaps of discharge care coordination for child(ren) with medical complexities (CMC). The National Survey of Children’s Health show 87.4% of CMC does not receive care in a well-functioning system, and 47.4% did not receive adequate care

Objective: To understand and prevent adverse discharge events, the project assesses the needs and gaps of discharge care coordination for child(ren) with medical complexities (CMC). The National Survey of Children’s Health show 87.4% of CMC does not receive care in a well-functioning system, and 47.4% did not receive adequate care coordination 1. Therefore, does initiating measurement tools and communication before and after discharge identify and prevent discharge related adverse events? Methods: After IRB approval, a mixed-methods approach project occurred at southwestern pediatric free-standing hospital. Through eight weeks of convenience sampling, CMC caregivers were recruited in the inpatient setting (n=5). Qualitative and quantitative data were obtained through: [Pediatric] Care Transitions Measurement Tool – 15 (CTM- 15), with a Cronbach’s alpha of .932; a demographics survey; a post-discharge survey; and electronic health records. Results: The CTM-15 post-discharge score was 83.3 (N = 4, SD = 9.83, SE¬M = 4.92). CTM-15 qualitative data included: communication issues; rushed discharge; poor discharge anticipatory guidance; hospital policy concerns; follow-up appointment issues; and prescription errors. LOS average for all participants was 137.8 days (SD = 102.75, SEM = 45.95) with 40 unintended hospital days (SD = 41.55, SEM = 18.51). Issues encountered 30 days post-discharge included: prescription errors, follow-up issues, and home health issues. Conclusion: Hospitalized CMC have an increased risk to encounter a discharge adverse event because of a complex intertwining of disciplines, services, medications, and needs. Communication, tools, and surveys did not capture all the problems encountered by families with CMC; however, it did identify areas of notable concern.
Created2022-05-02
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Description
Successful management of pediatric procedures is challenging. Many procedures have a detailed list of pre-procedural requirements and post-procedural pain control regimens. Patients and families often get lost in the many requirements needed before scheduling the procedure and often delay intervention. This delay can cost both the families and facility time

Successful management of pediatric procedures is challenging. Many procedures have a detailed list of pre-procedural requirements and post-procedural pain control regimens. Patients and families often get lost in the many requirements needed before scheduling the procedure and often delay intervention. This delay can cost both the families and facility time and money but often leave the patient needlessly suffering. Inadequate pain control results in emergency room (ER) visits or hospital admissions for acute postoperative pain management. The opioid epidemic has significantly impacted postoperative opioid prescriptions at discharge. The limited prescriptions available after discharge, paired with inadequate understanding and support of discharge postoperative instructions by the family, result in increased acute postoperative pain management admissions. Postoperative pain is the leading cause of hospital readmissions within 48 hours of discharge. These ER visits are typically for issues that are easily addressed at home. Teach-back methods have shown to be the cornerstone of education, resulting in knowledge gained and increased pain regimen adherence. A literature review exploring current evidence regarding postoperative pain control and interventions coupled with teach-back was conducted to address this concern, and an evidenced-based intervention is proposed.
Created2021-04-20
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Description
Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated,

Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated, triage-based CS administration and determine the effect on overall length of stay (LOS). Methods: For this quality improvement initiative, ED nurses at a large, freestanding, children’s emergency department in the southwestern United States were given education on inclusion and exclusion criteria for nurse-initiated CS in ED triage. Time to CS administration, LOS, and whether the ED nurse or provider ordered the CS were evaluated through chart reviews of patients presenting with a chief complaint of difficulty breathing. These metrics were compared to charts from the previous year during the same timeframe to evaluate for improved timeliness of CS delivery. Results: Time to CS administration decreased from a mean of 98.6 minutes to 57.6 minutes. LOS decreased from an average of 259.3 minutes to 169.6 minutes. The effect of timely CS on LOS was significant for December p =.003, January p =.002, and February p = <.001. Conclusion: A streamlined process for CS delivery to pediatric patients experiencing an asthma exacerbation can enable providers to achieve efficient and effective care in the ED and decrease a patient’s overall LOS.
Created2021-04-23
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Description
Objective A needs assessment identified a nursing knowledge gap of chemotherapy-induced neurotoxicity (CIN) symptoms as a significant factor in delayed recognition of patients' neurologic decline. The quality improvement (QI) project aimed to increase nursing comfort levels and knowledge related to screening for CIN in hospitalized pediatric hematology, oncology, and bone marrow

Objective A needs assessment identified a nursing knowledge gap of chemotherapy-induced neurotoxicity (CIN) symptoms as a significant factor in delayed recognition of patients' neurologic decline. The quality improvement (QI) project aimed to increase nursing comfort levels and knowledge related to screening for CIN in hospitalized pediatric hematology, oncology, and bone marrow transplant (Heme/Onc/BMT) patients. Methods Nursing CIN education and pre- and post-education assessment questions were created using best practice parameters to screen and monitor CIN in Heme/Onc/BMT pediatric patients. Pre- and post-surveys included a valid Likert-type scale to assess comfort levels using neurotoxicity screening tools (NST) followed by knowledge-based formative assessments. ASU IRB and hospital QI board standards were maintained. Results Heme/Onc/BMT nurses (n=37) participated. The most frequent pre-education comfort level was three or somewhat comfortable (n=13). Most frequent post-education comfort level is four or very comfortable (n=21). The two-tailed Wilcoxon signed rank test for pre- and post-education comfort levels was significant based on an alpha value of .05 and p < .001. Conclusion Nursing comfort and knowledge of screening for CIN increased. Early recognition of CIN will improve outcomes for high-risk hospitalized Heme/Onc/BMT pediatric patients.
ContributorsBest, Brianne (Author) / Bucci, Aimee (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
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Description

Background:
Drosophila gene expression pattern images document the spatiotemporal dynamics of gene expression during embryogenesis. A comparative analysis of these images could provide a fundamentally important way for studying the regulatory networks governing development. To facilitate pattern comparison and searching, groups of images in the Berkeley Drosophila Genome Project (BDGP) high-throughput

Background:
Drosophila gene expression pattern images document the spatiotemporal dynamics of gene expression during embryogenesis. A comparative analysis of these images could provide a fundamentally important way for studying the regulatory networks governing development. To facilitate pattern comparison and searching, groups of images in the Berkeley Drosophila Genome Project (BDGP) high-throughput study were annotated with a variable number of anatomical terms manually using a controlled vocabulary. Considering that the number of available images is rapidly increasing, it is imperative to design computational methods to automate this task.

Results:
We present a computational method to annotate gene expression pattern images automatically. The proposed method uses the bag-of-words scheme to utilize the existing information on pattern annotation and annotates images using a model that exploits correlations among terms. The proposed method can annotate images individually or in groups (e.g., according to the developmental stage). In addition, the proposed method can integrate information from different two-dimensional views of embryos. Results on embryonic patterns from BDGP data demonstrate that our method significantly outperforms other methods.

Conclusion:
The proposed bag-of-words scheme is effective in representing a set of annotations assigned to a group of images, and the model employed to annotate images successfully captures the correlations among different controlled vocabulary terms. The integration of existing annotation information from multiple embryonic views improves annotation performance.

ContributorsJi, Shuiwang (Author) / Li, Ying-Xin (Author) / Zhou, Zhi-Hua (Author) / Kumar, Sudhir (Author) / Ye, Jieping (Author) / Biodesign Institute (Contributor) / Ira A. Fulton School of Engineering (Contributor) / School of Electrical, Computer and Energy Engineering (Contributor) / College of Liberal Arts and Sciences (Contributor) / School of Life Sciences (Contributor)
Created2009-04-21
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Description
The impact of finite dielectric-covered ground-plane edge diffractions on the amplitude patterns of circular apertures is investigated. The model is based on the Geometrical Optics (GO) and the Uniform Theory of Diffraction (UTD) for an impedance wedge. The circular aperture antenna is mounted on square and circular finite ground planes

The impact of finite dielectric-covered ground-plane edge diffractions on the amplitude patterns of circular apertures is investigated. The model is based on the Geometrical Optics (GO) and the Uniform Theory of Diffraction (UTD) for an impedance wedge. The circular aperture antenna is mounted on square and circular finite ground planes that are coated with a thin lossy dielectric layer. The predictions based on the GO/UTD model are validated by comparisons to experimental results and simulated data.
Created2014-11-30