Pediatrics

Metabolic Syndrome In Transgender Youth

Faculty Mentor’s Name: Dr. Kristin Dayton
Email: kristinjohnson23@ufl.edu 
Phone Number: (727) 409-1852 
Project Category: Clinical
International Component or Travel: No

Research Project Description:
This project aims to screen for metabolic syndrome in the pediatric transgender population undergoing hormone treatment at the UF Health Youth Gender Clinic. Additionally, the project aims to characterize the prevalence of various mood disorders in those with metabolic syndrome. We have received IRB approval for this chart review study, and it is ready for a medical student to begin collecting and analyzing data.

Demographic, Clinical Characteristics and Outcome of Ventilator-associated Tracheitits and Pneumonia in a Pediatric Population

Faculty Mentor’s Name: Dr. Silvana Carr
Email: s.carr1@peds.uf..edu 
Phone Number: (813) 312-4881
Project Category: Medical Record Review
International Component or Travel: No

Research Project Description:
Researchers at UF Health Shands Children’s Hospital plan to study the demographics, clinical features and outcome of pediatric patients (28 days-18 years of age) who were admitted to the NICU (Neonatal Intensive Care Unit), PICU (Pediatric Intensive Care Unit) and PCICU (Pediatric Cardiac Intensive Care Unit) and developed VAT/VAP while under positive pressure ventilation. Electronic medical records from January 01, 2015 through December 31,2019 will be reviewed. This information will help us to better understand the epidemiology, risk factors and outcome of VAT/VAP in children.

Epidemiology, clinical features and outcome of pediatric hematology and oncology patients with CLABSI

Faculty Mentor’s Name: Dr. Silvana Carr
Email: s.carr1@peds.uf..edu 
Phone Number: (813) 312-4881
Project Category: Medical Record Review
International Component or Travel: No

Research Project Description:
Study the epidemiology, clinical features and outcome of pediatric hematology and oncology patients with CLABSI, admitted to Shand’s pediatric onco-hematology unit during the period of Jan 01,2015 through December 31,2019. This information will help us to develop an anti-infective lock therapy guideline to this population

Identification and Evaluation of Obesity and its Comorbidities in University of Florida Primary Care

Faculty Mentor’s Name: Dr. Jacqueline Michel
Email: j.michel@ufl.edu
Phone Number: (715) 681-0692
Project Category: CQI
International Component or Travel: No

Research Project Description:
According to the CDC Childhood Obesity Facts, obesity affects roughly 13.7 million children and adolescents in the United States and is a growing health concern with lifelong associated morbidity and mortality. It is recommended that all children have blood pressure screening yearly starting at the age of 3. The American Diabetes Association recommends that overweight children with two risk factors (family history of type 2 diabetes mellitus, race/ethnicity at higher risk of diabetes mellitus, or signs of or conditions associated with insulin resistance) be screened with a fasting glucose every 2 years starting at 10 years of age or at the onset of puberty if this occurs before age 10. The National Heart, Lung and Blood institute recommends screening all children for dyslipidemia between the ages of 9-11 and 17-21, along with additional screening under certain conditions. However, the identification of and evaluation of obesity and its comorbidities are not always addressed at routine well child care. Furthermore there are currently no universal guidelines on defining, diagnosing and treating metabolic syndrome in children.

It is also widely documented that the prevalence of obesity is higher in children with autism spectrum disorder, and I am currently working on a project where I hypothesized that this population has a higher rate of metabolic syndrome. Our study found that metabolic syndrome is a significant health concern for children with autism spectrum disorder and highlights the importance of obesity prevention, treatment, and routine screening for metabolic syndrome in children with autism spectrum disorder.

This project will have multiple components with up to two students able to participate. As part of the Department of Pediatrics, students on this project will participate in a meeting series on academic output, culminating in an oral presentation to department chairs in Pediatrics and OB/GYN. There is no current funding for this project.

Identification and Evaluation of Obesity and its Comorbidities in University of Florida Primary Care
a. Development of UF Institutional Review Board (IRB) approved research plan
b. Development of a research database through REDCap (Research Electronic Data Capture)
c. Perform Chart Review of UF Pediatric Primary Care Charts assessing the identification and evaluation of obesity and its comorbidities
d. Perform literature review and identify the best intervention to improve the identification and evaluation of obesity and its comorbidities for UF Pediatric Patients
e. Implement the above intervention
f. Publication and presentation of findings (potential options include: an article discussing how a busy primary care provider can address this issue, an article reviewing findings of the quality improvement project identifying the intervention and if it improved patient care or identified health concerns in patients that would not otherwise be identified or how it affected HEDIS measures).

Identification and Evaluation of Obesity and Metabolic Syndrome in Children with Autism Spectrum Disorder or Intellectual Disability at the University of Florida

Faculty Mentor’s Name: Dr. Jacqueline Michel
Email: j.michel@ufl.edu
Phone Number: (715) 681-0692
Project Category: CQI
International Component or Travel: No

Research Project Description:
According to the CDC Childhood Obesity Facts, obesity affects roughly 13.7 million children and adolescents in the United States and is a growing health concern with lifelong associated morbidity and mortality. It is recommended that all children have blood pressure screening yearly starting at the age of 3. The American Diabetes Association recommends that overweight children with two risk factors (family history of type 2 diabetes mellitus, race/ethnicity at higher risk of diabetes mellitus, or signs of or conditions associated with insulin resistance) be screened with a fasting glucose every 2 years starting at 10 years of age or at the onset of puberty if this occurs before age 10. The National Heart, Lung and Blood institute recommends screening all children for dyslipidemia between the ages of 9-11 and 17-21, along with additional screening under certain conditions. However, the identification of and evaluation of obesity and its comorbidities are not always addressed at routine well child care. Furthermore there are currently no universal guidelines on defining, diagnosing and treating metabolic syndrome in children.

It is also widely documented that the prevalence of obesity is higher in children with autism spectrum disorder, and I am currently working on a project where I hypothesized that this population has a higher rate of metabolic syndrome. Our study found that metabolic syndrome is a significant health concern for children with autism spectrum disorder and highlights the importance of obesity prevention, treatment, and routine screening for metabolic syndrome in children with autism spectrum disorder.

This project will have multiple components with up to two students able to participate. As part of the Department of Pediatrics, students on this project will participate in a meeting series on academic output, culminating in an oral presentation to department chairs in Pediatrics and OB/GYN. There is no current funding for this project.
Project 2. Identification and Evaluation of Obesity and Metabolic Syndrome in Children with Autism Spectrum Disorder or Intellectual Disability at the University of Florida
a. Development of UF Institutional Review Board (IRB) approved research plan
b. Development of a research database through REDCap (Research Electronic Data Capture)
c. Perform Chart Review of UF Pediatric Charts assessing the identification and evaluation of obesity and metabolic syndrome in children with a diagnosis of autism or intellectual disability
d. Perform literature review and identify the best intervention to improve the identification and evaluation of obesity and metabolic syndrome in children with autism or intellectual disability
e. Implement the above intervention
f. Publication and presentation of findings (such as an article reviewing evidence of metabolic syndrome in children with autism and/or article reviewing findings of quality improvement project identifying the intervention and if it improved patient care or identified health concerns in patients that would not otherwise be identified).

Telehealth use in Pediatric Weight Management during COVID-19

Faculty Mentor’s Name: Dr. Angelina Bernier
Email:angelina@ufl.edu
Phone Number: (352) 265-7337
Project Category: Clinical
International Component or Travel: No

Research Project Description:
The goal of this project is to assess the implementation of telehealth-delivered pediatric weight management during COVID-19 and to identify potential disparities in accessing care among pediatric weight management patients before and during the COVID-19 pandemic. Researchers on this project will collect data pre and during COVID to determine differences in patient volume, show rates, use of telehealth, provision of training, implementation, RVU and then maintenance of telehealth post COVID. We will also assess how non-English interpretation services were made available, patient demographics and follow up. Students on this project will work through IRB submission, literature review, data entry and case reviews in addition to preparing a summary of outcomes measured.

Does the use of clinic-disbursed medical equipment improve medical care delivered during telemedicine visits at UF Health outpatient pediatric clinics?

Faculty Mentor’s Name: Dr. Molly Posa
Email: mollyposa@peds.ufl.edu
Phone Number: (352) 222-9688
Project Category: Clinical
International Component or Travel: No

Research Project Description:
The use of telemedicine had slowly been integrated into subspecialty and urgent care to increase accessibility in rural and underserved areas. The COVID-19 pandemic and subsequent stay at home order quickly caused telemedicine to become a necessity for many practices. Telemedicine allowed patients to continue to receive medical care while lessening the risk of exposure and transmission of COVID by decreasing the number of patients leaving their homes and physically being seen by in-person office visits. During the implementation process, numerous benefits were noted including decreasing the expense for families driving to clinic, decreasing exposure to infections, decreasing the need for parents to miss work and children to miss school. We also discovered drawbacks including but not being able to obtain vital signs (weight, blood pressure, oxygen levels), difficulty performing a thorough physical exam (including looking in ears/throat) and navigating the consent process. To ease some of the challenges, UF Health Pediatrics obtained grant funding to obtain equipment to improve medical care delivered during telemedicine visits. This equipment included infant and regular weight scales, automatic sphygmomanometers (blood pressure cuffs), Tyko kits (physical examination kits), web cameras and iPads. The study will allow us to distribute this equipment to our pediatric outpatient clinic patients for usage during their telemedicine visits. For example, providing a sphygmomanometer and scale to our ADHD and obese patients for their telemedicine follow-up visits to appropriately manage their chronic medical condition. The specific project objective can be determined by the student and study team (ie. compliance with obtaining weight and blood pressure measurements for ADHD telemedicine visits, compliance with obtaining weights and BP measurement for weight recheck telemedicine visits, evaluating if home blood pressure measurements decreases unnecessary nephrology referrals and laboratory workups for hypertension (white coat syndrome), evaluating the utility of home infant scales in neonates, or many other ideas).
This project can support 1-2 students. There is no current funding for this project as telemedicine equipment has already been purchased and is available to study.
1. Does the use of clinic-disbursed medical equipment improve medical care delivered during telemedicine visits at UF Health outpatient pediatric clinics?
a. Development and approval of a UF Quality Improvement Project Registry (QIPR) approved research project
b. Development and approval of an IRB to support their research project
c. Development of a research database through REDCap (Research Electronic Data Capture)
d. Perform Chart Review of UF Pediatric Primary Care patient medical records assessing the use of telemedicine and equipment (infant scales, scales, sphygmomanometer)
e. Perform literature review on current telemedicine guidelines for pediatric patient care
f. Manuscript publication and presentation of findings (i.e. an article discussing how providing patient equipment can help improve the medical provided by providers over telemedicine and/or presentation at a pediatric scientific meeting)

Potential Gene Therapy of Sickle Cell Disease and β-Thalassemia

Faculty Mentor’s Name: Dr. Arun Srivastava
Email: aruns@peds.ufl.edu
Phone Number: (352) 273-8259
Project Category: Translational
International Component or Travel: No

Research Project Description:
Human hemoglobinopathies, such as sickle cell disease (SCD) and beta-thalassemia, are by far the most common (1 in 600) monogenic diseases worldwide, and are among the likely candidates for their potential treatment provided that pluripotent hematopoietic stem cells (HSCs) can be stably transduced, and long-term, regulated expression of a functional b-globin gene in the erythroid progenitor cells can be achieved. Although lentiviral vectors have been shown to be effective in animal models, their safety remains to be established since clonal expansion in a human clinical trial with a patient with b-thalassemia was reported recently. Thus, we believe that further development of alternative vector systems, such as the adeno-associated virus (AAV), needs to be pursued for their potential ability to achieve high efficiency transduction of HSCs, given the proven safety and efficacy of AAV vectors in clinical trials in gene therapy of Leber’s congenital amaurosis and hemophilia B. We have developed optimized AAV vectors that are capable of high-efficiency transduction in general, and HSCs in particular. Medical students will be involved in using these optimized AAV anti-sickling beta-globin vectors in hematopoietic stem cell transplantation and phenotypic correction of SCD in mouse models. Funding for the project is provided by the National Institutes of Health and the George H. Kitzman Endowment.

M. Tan, K. Qing, S. Zhou, M.C. Yoder, and A. Srivastava. Adeno-associated virus 2-mediated transduction and erythroid lineage-restricted long-term expression of the human b-globin gene in hematopoietic cells from homozygous b-thalassemic mice. Molecular Therapy, 3: 940-946, 2001.

N. Maina, L. Zhong, X.Li, W. Zhao, Z. Han, D. Bischof, G, Aslanidi, S, Zolotukhin, K. Weigel-Van Aken, A. Rivers, W.B. Slayton, M.C. Yoder, and Srivastava, A. Optimization of recombinant adeno-associated virus serotype vectors for human b-globin gene transfer and transgene expression. Human Gene Therapy, 19: 365-375, 2008.

L. Song, M.A. Kauss, E. Kopin, M. Chandra, T. Ul-Hasan, E. Miller, G.R. Jayandharan, A.E. Rivers, G.V. Aslanidi, C. Ling, B. Li, W. Ma, X. Li, L.M. Andino, L. Zhong, A.F. Tarantal, M.C.Yoder, K.K. Wong, Jr., M. Tan, S. Chatterjee, and A. Srivastava. Optimizing the transduction efficiency of capsid-modified AAV6 vectors in primary human hematopoietic stem cells in vitro and in a xenograft mouse model in vivo. Cytotherapy, 15: 986-998, 2013.

L. Song, X. Li, G.R. Jayandharan, Y. Wang, G.V. Aslanidi, C. Ling, L. Zhong, G. Gao, M.C. Yoder, C. Ling, M. Tan, and A. Srivastava. High-efficiency transduction of primary human hematopoietic stem cells and erythroid lineage-restricted expression by optimized AAV6 serotype vectors in vitro and in a murine xenograft model in vivo. PLoS One, 8(3): e58757, 2013.

C. Ling, K. Bhukhai, Z. Yin, M.Q. Tan, M.C. Yoder, P. Leboulch, E. Payen, and A. Srivastava. High-efficiency
transduction of primary human CD34+ hematopoietic stem/progenitor cells by AAV6 serotype vectors: Strategies for overcoming donor-variation and implications in genome editing. Scientific Reports, 6, 35495, 2016.

H. Yang, K. Qing, G.D. Keeler, L. Yin, M. Mietzsch, C. Ling, B.E. Hoffman, M. Agbandje-McKenna, M. Tan, W. Wang, and A. Srivastava. Enhanced transduction of human hematopoietic stem cells by AAV6 vectors: Implications in gene therapy and genome editing. Molecular Therapy-Nucleic Acids. 20: 451-458, 2020.

Potential Gene Therapy of Human Liver Cancer

Faculty Mentor’s Name: Dr. Arun Srivastava
Email: aruns@peds.ufl.edu
Phone Number: (352) 273-8259
Project Category: Translational
International Component or Travel: No

Research Project Description:
Two of the most common liver cancers include hepatoblastoma (HB) in children, and hepatocellular carcinoma (HCC) in adults. HB is the most frequent pediatric liver cancer in the United States. HCC is one of the five most common cancers involving solid tumors, and is highly fatal. HCC is rapidly emerging as a clinically important disease in developed countries and of grave concern is its increasing incidence to epidemic proportions in certain areas of the world. An alarming trend in its increase has been recently observed: 18,000 new cases of HCC are expected every year. Projected new cases in the coming years are likely to rise even more dramatically, based on the increasing number of hepatitis-C infected Americans (~4 million). Furthermore, the increasing incidence in the United States of obesity and diabetes, which have also been linked to the development of chronic liver disease and HCC, is likely to further augment the number of Americans afflicted with HCC. Thus, a novel therapeutic approach for the treatment of HB and HCC is warranted, which may involve the use of target-specific genes. We have had a long-term interest in a non-pathogenic human parvovirus, the adeno-associated virus (AAV), which has gained attention as a potentially safe vector for gene therapy, and has recently shown efficacy in Phase I clinical trials in patients with Leber’s congenital amaurosis and hemophilia B. We have observed that of the 10 AAV serotypes, AAV3 vectors transduce human HB and HCC cell lines and primary human hepatocytes extremely well, and also target human liver tumors in mouse xenograft models extremely efficiently. Medical students will be involved in using these optimized AAV3 vectors carrying therapeutic genes to potentially eradicate human liver tumors in mouse xenograft models. Funding for the project is provided by the National Institutes of Health and the George H. Kitzman Endowment.

C. Ling, Y. Lu, B. Cheng, K.E. McGoogan, S.W.Y. Gee, W. Ma, B. Li, G.V. Aslanidi, and A. Srivastava. High-efficiency transduction of liver cancer cells by recombinant adeno-associated virus serotype 3 vectors. J. Vis. Exp., 49. Pii: 2538, doi: 10.3791/2538, 2011.

B. Cheng, C. Ling, Y. Dai, L.G. Glushakova, Y. Lu, S.W.Y. Gee, K.E. McGoogan, G.V. Aslanidi, M. Park, P.W. Stacpoole, D. Siemann, C. Liu, Srivastava, and C. Ling. Development of optimized AAV3 serotype vectors: Mechanism of high-efficiency transduction of human liver cancer cells. Gene Therapy, 19: 375-384, 2012.

C. Ling, Y. Wang, Y. Zhang, A. Ejjigani, Z. Yin, Y. Lu, L. Wang, M. Wang, J. Li, Z. Hu, G.V. Aslanidi, L. Zhong, G. Gao, A. Srivastava, and C. Ling. Selective in vivo targeting of human liver tumors by optimized recombinant AAV3 vectors in a murine xenograft model. Human Gene Therapy, 25: 1023-1034, 2014.

Y. Zhang, L, Wang, Y. Lu, G.V. Aslanidi, A. Srivastava, C. Ling, and C. Ling. Cytotoxic genes from traditional Chinese medicine inhibit tumor growth both in vitro and in vivo. J. Int. Medicine, 12: 483-494, 2014.

L. Yin, G.D. Keeler, Y. Zhang, B.E. Hoffman, C. Ling, K. Qing, and A. Srivastava. AAV3-miRNA vectors for growth suppression of human hepatocellular carcinoma cells in vitro and human liver tumors in a murine xenograft model in vivo. Gene Therapy, https://doi.org/10.1038/s41434-020-0140-1, 2020.

CMV Newborn Screening

Faculty Mentor’s Name: Dr. Frances Saccoccio
Email: fsaccoccio@peds.ufl.edu
Phone Number: (352) 294-8847
Project Category: Clinical
International Component or Travel: No

Research Project Description:
Congenital CMV is the most common non-genetic cause of hearing loss. Newborn screening of high risk infants is recommended to improve outcomes of infected babies. The UF nursery is screening babies that fail their hearing screen prior to discharge for CMV. This goals of this project are:
1. Improve the screening work flow in the nursery for both the nursery staff and the Pediatric Infectious Diseases Division
2. Expand screening to the NICU
3. Develop educational material for patients and medical staff on the impact of congenital CMV both at UF and with community pediatricians

The medical student researcher would be expected to gain an understanding of the epidemiology and pathogenesis of congenital CMV, the impact of newborn screening on infected infants, and the risks and benefits of treatment. The student would be expected to help develop educational material such as flyers and power point presentations for both patients and medical providers on the above information. The student would also be involved in helping improve the process of screening thru the PDSA method. This project is registered in QIPR. The project does not have funding.

Physical Fitness Mini-clinic Database

Faculty Mentor’s Name: Dr. Angelina Bernier
Email:angelina@ufl.edu
Phone Number: (508) 558-0475
Project Category: Translational
International Component or Travel: No

Research Project Description:
An American Heart Association scientific statement released in 2020 strongly supports the use of cardiorespiratory testing during clinic visits as a screen to predict current and future disease risk in children, but acknowledges the access challenges and cost of this testing. Guided by this statement and our own published research, we moved beyond traditional clinical framework and established a free physical fitness mini-clinic within the existing UF Pediatric Metabolic & Obesity Program. Our multidisciplinary team from the Departments of Pediatrics and Physical Medicine and Rehabilitation has implemented time-efficient, predictive fitness-related health assessments that help patients and families identify SMART goals for lifestyle change. As part of this translational process of implementing fitness assessments in clinic, we aim to demonstrate how this new intervention affects the health trajectory of our patient population. In order to do so, we will create a redcap data registry for tracking the assessments, recommendations and follow up metrics to determine potential efficacy.
We anticipate that mini-clinic will improve the quality of the care experience by directly engaging children at risk for future diseases and disability in three ways: 1) providing equal access to evidence-based predictive tests for disease risk; 2) engages children as young as 5 years of age in understanding the importance of exercise; and 3) assists children and families in identifying opportunities for better health through physical activity-oriented SMART goals. Tracking of follow-up response will help determine which recommendations are successful for the child and whether better lifestyle choices are being made to increase fitness.

Turner Syndrome Data Registry

Faculty Mentor’s Name: Dr. Elizabeth Fudge
Email: efudge@ufl.edu
Phone Number: (352) 265-7337
Project Category: Clinical
International Component or Travel: No

Research Project Description:
Our Turner Syndrome clinic at UF will participate in a multi-institutional, collaborative research registry to collect patient data that will allow us to learn more about TS. The InsighTS Registry will consent and enroll patients from multiple clinics in a REDCap format. This will allow data to be pooled and used to drive new and exciting research on TS. Once enough data is collected, there will be opportunity for clinical research projects.

The Effect of the Covid19 Pandemic on Weight in Pediatric Patients

Faculty Mentor’s Name: Dr. Carolyn Carter
Email: cartcg@shands.ufl.edu
Phone Number: (352) 733-1770
Project Category: Clinical
International Component or Travel: No

Research Project Description:
The Covid19 pandemic has altered the eating, sleeping and activity behaviors of children and adolescents in a manner that promotes weight gain for most individuals. How much weight gain and if weight levels are improving as schools reopen has not been studied. On the other end of the spectrum, very limited research has explored the impacts of the COVID-19 pandemic on weight loss or eating disorders (EDs) in children and adolescents. Psychosocial stressors resulting from the pandemic including isolation may exacerbate ED-related triggers and present challenges for individuals already struggling with ED tendencies. The purpose of this project is to look at the weight gain or loss of children and adolescents seen in the UF Health General Pediatric Clinics during the pandemic from March 1, 2020 to March 1, 2022.

This project can support 1-2 students. There is no current funding for this project.
1) Has the Covid pandemic affected the growth velocity of children’s (6-18 yo) weight in a negative fashion, looking at those with a normal BMI (< 85th%tile) and abnormal BMI (>95th %tile), with either excessive weight gain or weight loss?
a. Development and approval of an IRB to support their research project.
b. Development of a research database through REDCap (Research Electronic Data Capture)
c. Perform chart review of UF Pediatric Primary Care patient medical records assessing the change in weight over the previous year.
d. Perform literature review on the effects of the covid19 pandemic on pediatric patients weight.
e. Manuscript publication and presentation of findings (i.e an article discussing how the pandemic has affected children and adolescents’ eating patterns).

Dates of study: March 1, 2019 (a year prior to the pandemic) to March 1, 2022.

Disclaimer: The images on this page were taken prior to the national guidelines of face coverings and social distancing.