2025 Summer Student Research Program - Poster Day

2025 SUMMER STUDENT POSTER DAY

Welcome to the 2025 Summer Student Research Program Poster Day!

We’re excited to welcome you to the 2025 Summer Student Research Program Poster Day! Each year, this event showcases the unique and innovative research carried out by undergraduate and medical students on the Oak Street Campus during the summer months.

This year’s program includes:

130

registered students, represeting 17 universities world-wide

$180,000+ studentship awards

45+ hours

of professional development designed to build research skills, support academic growth, and enhance professional life skills

Did you know?

Over the past three decades, 2,000+ undergraduate and medical students have participated in the BC Children’s Hospital Research Institute Summer Student Research Program!

BCCHR offers students a truly integrated “bench to bedside” experience. Since its launch in 1987, the Summer Student Research Program has provided students with meaningful opportunities to contribute to research focused on child and family health.

The scope of research at BCCHR is truly remarkable, spanning foundational sciences, clinical studies, and population health research. Poster Day offers a glimpse into the interdisciplinary work our students are engaged in, and the impactful careers many of them will pursue as future scientific and clinical leaders.

We are incredibly proud of our students and are committed to supporting their development as the next generation of innovators in health research.

Thursday, July 24, 2025 All are welcome to join us as we celebrate the achievements of our summer students

9:00 am – 10:30 am

Poster Presentations, Online Session #1: Posters #1 to 7A www.bcchr.ca/posterday Poster Presentations, BCCHR Atrium Session #2: Posters #8 to 16 Session #3: Posters #17 to 24 Session #4: Posters #25 to 32

11:00 am – 12:30 pm

2:00 pm – 3:30 pm

Poster Presentations, BCCHR Atrium Session #5: Posters #33 to 40 Session #6: Posters #41 to 48 Session #7: Posters #49 to 56 Session #8: Posters #57 to 64 Poster Presentations, BCCHR Atrium Session #9: Posters #65 to 72 Session #10: Posters #73 to 80 Session #11: Posters #81 to 89 Session #12: Posters #90 to 97

4:00 – 4:15 pm

Awards – Best Poster Recipients BCCHR Auditorium OR Online www.bcchr.ca/posterday

Celebrating excellence within our talented research community 2025 Poster Presentations Participant

Title

Nabiha Ahmed

The Effect of Mucin Glycans on Candida Albicans Mucin Degradation

Kimia Ameri

Uncovering the Impact of Hypopigmented Conditions in Adolescents with Darker Skin of Colour: A Survey Study

Mark Ashamalla

The Role of Cannabis in Recurrent Adolescent Gynecomastia: A Case Series

Phoenix Au-Yeung

Improving Lives, One Flush at a Time: The Impact of Transanal Irrigation on Continence and Quality of Life in Children with Neurogenic Bowel Dysfunction due to Spinal Cord Injury Autism and Diverse Identity Documentation Practices at the BC Children’s Hospital Complex Pain Service

Victoria Belway

Anshvir Bhangoo

A Review of Potential Maternal Risk Factors that Can Increase the Incidence of Cerebral Palsy (CP) in Offspring

Katherine Cai

Beyond Questionaries, Sleep & Neurobehaviours: Preparations for a Crash Course

Kawami Cao

Risk factors for prolonged length of stay following posterior spinal fusion in adolescent idiopathic scoliosis

Kaylia Chan

Standardizing Avascular Necrosis Classification in Pediatric Hip Conditions: A Scoping Review

Reid Chase

Insights from Exomics: Identification of New Genes in Paediatric Vasculitis

Timothy Cheng

Paint Me a Picture: Illustrating the Psychosocial Impact of Different Juvenile Idiopathic Arthritis Categories. Results from the CAPRI Registry Epigenetic Markers of Cardiovascular Risk in Type 1 Diabetes

Serin Cheun

Presentation Session #11 | Poster #81 2:00 pm – 3:30 pm BCCHR Atrium Session #1 | Poster #1 9:00 am – 10:30 am Remote – Website Session #12 | Poster #90 2:00 pm – 3:30 pm BCCHR Atrium Session #12 | Poster #91 2:00 pm – 3:30 pm BCCHR Atrium Session #3 | Poster #23 9:00 am – 10:30 am BCCHR Atrium Session #2 | Poster #8 9:00 am – 10:30 am BCCHR Atrium Session #11 | Poster #82 2:00 pm – 3:30 pm BCCHR Atrium Session #1 | Poster #2 9:00 am – 10:30 am Remote – Website Session #2 | Poster #9 9:00 am – 10:30 am BCCHR Atrium Session #5 | Poster #33 11:00 am – 12:30 pm BCCHR Room 2108 Session #9 | Poster #65 2:00 pm – 3:30 pm BCCHR Room 2108 Session #7 | Poster #49 11:00 am – 12:30 pm BCCHR Atrium

Participant

Title

Presentation

Lauren Chew

Understanding the Role of Culture in Immigrant Youth Health

Emily Chilton

The Role of Clinician-Patient-Family Communication in Facilitating F-Words Integration in Pediatric Care

Daniel Choi

Retrospective Study of Smart Spot, a Bluetooth Low‑Energy Real‑Time Location System supporting Quality Improvement Efforts in Uganda Rectus Sheath Block and Coadministration of Intravenous Dexamethasone for Analgesia after Pediatric Laparoscopic Appendectomy – A Pilot Study Defining the chemical profile of brain connections in children with chemical messenger problems

Session #3 | Poster #17 9:00 am – 10:30 am BCCHR Atrium Session #6 | Poster #41 11:00 am – 12:30 pm BCCHR Atrium Session #3 | Poster #18 9:00 am – 10:30 am BCCHR Atrium Session #7 | Poster #50 11:00 am – 12:30 pm BCCHR Atrium Session #9 | Poster #66 2:00 pm – 3:30 pm BCCHR Room 2108 Session #4 | Poster #25 9:00 am – 10:30 am BCCHR Atrium Session #1 | Poster #3 9:00 am – 10:30 am Remote – Website Session #6 | Poster #42 11:00 am – 12:30 pm BCCHR Atrium

Carmen Choo

Grace Clarke

Georgia Clay

Rena Daniel

Genesis De Jesus Plancarte

Novel Methods to Quantify the Impact of Eplet-Level Donor HLA Mismatch on Early Acute Rejection and Graft Outcome after Pediatric Kidney Transplantation Identifying Genetic Predictors of Extreme Opioid Responses in Children with Cancer Outcomes for Newborns With Hypoxic-Ischemic Encephalopathy: A Retrospective Cohort Study From a Canadian Neonatal Intensive Care Unit

The BC Children’s Hospital research community would like to acknowledge the following organizations for supporting training opportunities on the Oak Street Campus

• BC Children’s Hospital Foundation • Canucks for Kids Fund Childhood Diabetes Laboratories • Community Child Health Endowment • Sunny Hill Health Centre Research Group BCCHR Research Themes & Teams: • Brain, Behaviour & Development • Childhood Diseases • Healthy Starts • Inclusion, Diversity, Equity, Allyship & Anti-Oppression Team

Participant Aaryan Dwivedi

Sara Ehling

Title

Presentation

To Scan or Not To Scan: A Systematic Review on Imaging Protocols for Children with Hearing Loss Related to Bacterial Meningitis Evaluating Fecal Lipocalin-2 as a Potential Biomarker for Intestinal Inflammation

Session #12 | Poster #92 2:00 pm – 3:30 pm BCCHR Atrium Session #11 | Poster #83 2:00 pm – 3:30 pm BCCHR Atrium Session #3 | Poster #19 9:00 am – 10:30 am BCCHR Atrium Session #7 | Poster #51 11:00 am – 12:30 pm BCCHR Atrium Session #9 | Poster #67 2:00 pm – 3:30 pm BCCHR Room 2108 Session #10 | Poster #73 2:00 pm – 3:30 pm BCCHR Atrium

Maddie Evora

Cognitive Mode Detectable with Task-Based fMRI: Initiation (INIT)

Scarlett Farrar

Single Leg Hop Test for Post ACLR Assessment – What Matters Most: Height or Symmetry?

Connor Flynn

Prophylactic Use of Salbutamol for Pediatric Exercise-Induced Bronchoconstriction

Danica Fontana

An exploration of the delays in diagnosis of Developmental Dysplasia of the Hip, Slipped Capital Femoral Epiphysis, and Legg-Calvé-Perthes Disease in British Columbia: The Patient Journey The Prevalence of Food Insecurity Amongst Children with Developmental Concerns Seeking Care at a Canadian Pediatric Hospital Navigating Nocturnal Nurturing: A narrative literature review of the relationship between environmental stressors and sleep in pregnancy Characterizing Wilms' Tumour (WT) Morphology using Spatial MALDI Mass Spectrometry

Jia Gandhi

Taima Gheriani

Saiya Gill

Ivan Guan

Non-Linguistic Assessment of Cochlear Implant Candidacy

Rachel Guo

Optimizing an Enzyme-linked Immunosorbent Assay to Measure a Novel Prohormone Biomarker in Type 1 Diabetes

Isabelle Hadad

Evaluation of the antibody response to Klebsiella infection to inform vaccine design against Klebsiella

Yoonsoo Ham

Exploring the genetic underpinnings of morphine ineffectiveness in children with cancer

Ali Hawkins

Upper Extremity Model for Detection of Pre-Operative Co-contraction in Pediatric Posttraumatic Elbows: A Pilot Study

Session #2 | Poster #10 9:00 am – 10:30 am BCCHR Atrium Session #2 | Poster #11 9:00 am – 10:30 am BCCHR Atrium Session #6 | Poster #43 11:00 am – 12:30 pm BCCHR Atrium Session #4 | Poster #26 9:00 am – 10:30 am BCCHR Atrium Session #9 | Poster #68 2:00 pm – 3:30 pm BCCHR Room 2108 Session #2 | Poster #12 9:00 am – 10:30 am BCCHR Atrium Session #8 | Poster #58 11:00 am – 12:30 pm BCCHR Atrium Session #4 | Poster #27 9:00 am – 10:30 am BCCHR Atrium

Participant Michelle Ho

Kaya Horii

Title Preventable by Choice: A Longitudinal Analysis of Risk Perception, Injury Prevention Attitudes, and Behavioural Change in British Columbians Aged 25–54 Intersubject Synchronization of Heart Rate and Skin Conductance During Music Listening in Youth

Johnny Huang

Investigating the Role of Region-Specific Intestinal Mucus in Citrobacter rodentium Growth

Renee Hui

Assessing H3K27me3 Restoration in a Humanized Mouse Embryonic Stem Cells (mESC) Model of Weaver Syndrome After CRISPR-Based Correction A literature Search to Support the Pilot Study: Post-operative Changes in Children with Severe Neurological Impairment

Patricia Humer

Michaela Ironside

Prevalence of body image dissatisfaction among youth with limb differences

Armaan Jaffer

Pediatrician Knowledge and Perspectives on Barriers and Facilitators to Social Prescribing: A Qualitative, Exploratory Study The Living Lab at Home: Feasibility of Multi-Modal In-Home Data Collection Among Children and Youth with Severe Neurological Impairment Barriers to physical activity and sleep in children with intestinal failure

Max Jasinski

Jamie Jeon

Iliyan Jiwani

“Baby Love”: The Power of Dyadic Care in Reducing Neonatal Abstinence Syndrome (NAS) (Exploring the Value of a Holistic, Family-Integrated Approach to NAS Management)

Presentation Session #7 | Poster #52 11:00 am – 12:30 pm BCCHR Atrium Session #11 | Poster #84 2:00 pm – 3:30 pm BCCHR Atrium Session #8 | Poster #59 11:00 am – 12:30 pm BCCHR Atrium Session #1 | Poster #4 9:00 am – 10:30 am Remote – Website Session #12 | Poster #93 2:00 pm – 3:30 pm BCCHR Atrium Session #1 | Poster #5 9:00 am – 10:30 am Remote – Website Session #11 | Poster #85 2:00 pm – 3:30 pm BCCHR Atrium Session #2 | Poster #13 9:00 am – 10:30 am BCCHR Atrium Session #1 | Poster #6 9:00 am – 10:30 am Remote – Website Session #1 | Poster #7 9:00 am – 10:30 am Remote – Website

Participant Kinsley-Marlie Jura

Chanjoo Kim

Title Long-Term Seizure Outcome With or Without Vagal Nerve Stimulation Therapy in Pediatric Drug-Resistant Epilepsy: A Single Site Study Survival Time of Neonates with Severe Hypoxic-Ischemic Encephalopathy after Cessation of Intensive Care

Simran Kooner

Enhancing Brain Waves Educational Materials: Updates for Improved Brain Injury Awareness and Prevention

Kristina Kurvits

The BC-GEN Project: how the families of children with chronic rheumatic illnesses feel about genetic testing

Lucas Kwong

Clinical Interpretation of VoUS in Epigenetic Syndromes Using Drosophila

Vivienne Le

A Pipeline for Reclassifying Variants of Uncertain Significance in Genetic Epilepsy

Alysha Lee

Equity of Access to Whole Exome Sequencing for Pediatric Epilepsy Patients: A Mixed Methods Study

Justin Lee

PICU Interventions and Outcomes in Healthy Children Following Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study of North American PICUs Database A Cross-Cultural Analysis of Parenting Resource Suitability for Chinese-Canadian Families

Kaitlyn Leung

Reeve Liew

Coblation Intracapsular Tonsillotomy: Postoperative Bleeding Rates at BC Children’s Hospital

Brooklyn Liu

KidSpace: Uncovering Hidden Barriers to Hand Hygiene in Pediatric Mental Health Care

Floria Lu

Revealing Hidden Insights: Deep Learning Recovery of SWI Data to Explore Brain Iron Levels and Neurodevelopment in Preterm Infants Is there an association between distance from the discharging hospital and risk of post-discharge mortality in children under 5 admitted with sepsis?

Matthew Lu

Presentation Session #6 | Poster #44 11:00 am – 12:30 pm BCCHR Atrium Session #11 | Poster #86 2:00 pm – 3:30 pm BCCHR Atrium Session #10 | Poster #74 2:00 pm – 3:30 pm BCCHR Atrium Session #3 | Poster #20 9:00 am – 10:30 am BCCHR Atrium Session #11 | Poster #87 2:00 pm – 3:30 pm BCCHR Atrium Session #10 | Poster #75 2:00 pm – 3:30 pm BCCHR Atrium Session #6 | Poster #45 11:00 am – 12:30 pm BCCHR Atrium Session #5 | Poster #34 11:00 am – 12:30 pm BCCHR Room 2108 Session #4 | Poster #28 9:00 am – 10:30 am BCCHR Atrium Session #6 | Poster #46 11:00 am – 12:30 pm BCCHR Atrium Session #3 | Poster #21 9:00 am – 10:30 am BCCHR Atrium Session #5 | Poster #35 11:00 am – 12:30 pm BCCHR Room 2108 Session #7 | Poster #53 11:00 am – 12:30 pm BCCHR Atrium

Participant Kaitlyn Lumby

Jessie Luo

Olivia Mackenzie

Zeanne Madda

Wesley Mah

Title

Presentation

Exploratory Analysis of Placental Growth Factor as a Marker of Fetal Growth Restriction in Pregnant Individuals in Vancouver CAR-T cell therapy as an early intervention in pediatric B-cell acute lymphoblastic leukemia

Session #10 | Poster #76 2:00 pm – 3:30 pm BCCHR Atrium Session #10 | Poster #77 2:00 pm – 3:30 pm BCCHR Atrium Session #4 | Poster #29 9:00 am – 10:30 am BCCHR Atrium Session #8 | Poster #60 11:00 am – 12:30 pm BCCHR Atrium Session #5 | Poster #36 11:00 am – 12:30 pm BCCHR Room 2108 Session #10 | Poster #78 2:00 pm – 3:30 pm BCCHR Atrium Session #5 | Poster #37 11:00 am – 12:30 pm BCCHR Room 2108 Session #5 | Poster #38 11:00 am – 12:30 pm BCCHR Room 2108 Session #2 | Poster #14 9:00 am – 10:30 am BCCHR Atrium Session #8 | Poster #61 11:00 am – 12:30 pm BCCHR Atrium Session #8 | Poster #62 11:00 am – 12:30 pm BCCHR Atrium Session #5 | Poster #39 11:00 am – 12:30 pm BCCHR Room 2108 Session #7 | Poster #54 11:00 am – 12:30 pm BCCHR Atrium Session #2 | Poster #15 9:00 am – 10:30 am BCCHR Atrium

Post-discharge mortality among HIV-positive children younger than 5 admitted with suspected sepsis in Uganda: an analysis of a prospective multisite observational study Cracking the Chemical Code: Comparing Biomarker Properties to Advance Understanding of Inborn Errors of Metabolism Lost in Transition: Understanding Food Allergy Immunotherapy Dropout in Adolescents and Young Adults

Artemis Melville-Bowser

Investigating Microbe-Mucus interactions in Ulcerative Colitis

Saray Membreno

Perceptions of Early Intervention Services for Pediatric Eating Disorders: Co-Developing a Community-Engaged Deliberative Dialogue Mother-Daughter Provision of Services For The Prevention of Cervical Cancer: A Scoping Review

Hana Miller

Noah Miller

Investigating the Impact of the L305I Mutation of RSV Post-Fusion F Protein on Antibody Binding Affinity

Nathan Millward

Establishing a human microglial cell line model to elucidate roles of adenosine deaminase 2 (ADA2) in cerebrovascular health Quantification of complement component genes in cingulate cortex of individuals with depressive and psychotic symptoms

Faithful Olarinde

Evelyn Olson

Selina Park

Florella Peng

Evaluating BEAM (Building Emotional Awareness and Mental Health): A review of postpartum mental health intervention outcomes Behind the Shot: Social factors influencing parental decisions for HPV immunization for their children Using Co-Design Methods to Improve Injury Prevention Knowledge Translation: A Usability Evaluation of the Active & Safe Platform

Participant

Title

Maia Poon

School Exclusion of Neurodivergent Children and Youth in a Community-Based Clinical Outreach Partnership

Kathryn Reilly

Lower Limb Surgical Intervention for Ambulatory Children with Cerebral Palsy: The Effects of Tendo-Achilles Lengthening on the Transverse Plane

Nurin Izzati Saiful Baharin

Understanding variability in sleep and blood glucose control among children and teens with type 1 diabetes

Aman Sharma

Epidemiological assessment and evidence summary of care for pediatric appendicitis in BC

Noah Shew

Feasibility of a Pilot Community-Based Rowing Program for Adolescents with Cerebral Palsy

Flora Su

Biomarker Indicators for Nutrition and Growth Outcomes (BINGO)

Ashiana Sunderji

Clinical characteristics and treatment outcomes of pediatric central nervous system tumours treated with targeted therapies in British Columbia Contributions and recognition of patient partners in pediatric health research: a rapid scoping review

Benedict Sutanto

Nicholas Tjandra

Advancements in Hepatocyte Preservation: In Vitro Strategies to Enhance Viability and Function

Presentation Session #12 | Poster #94 2:00 pm – 3:30 pm BCCHR Atrium Session #12 | Poster #95 2:00 pm – 3:30 pm BCCHR Atrium Session #11 | Poster #88 2:00 pm – 3:30 pm BCCHR Atrium Session #1 | Poster #7A 9:00 am – 10:30 am Remote – Website Session #5 | Poster #40 11:00 am – 12:30 pm BCCHR Room 2108 Session #10 | Poster #79 2:00 pm – 3:30 pm BCCHR Atrium Session #12 | Poster #96 2:00 pm – 3:30 pm BCCHR Atrium Session #9 | Poster #69 2:00 pm – 3:30 pm BCCHR Room 2108 Session #8 | Poster #63 11:00 am – 12:30 pm BCCHR Atrium

Participant

Title

Presentation

Taylor Traaseth

Impact of Planned Cesarean Delivery With No Clinical Indication on Neonatal and Maternal Length of Stay in Hospital

Vanessa Tran

A multivariate analysis of depression symptoms and adverse outcome risks in justice-involved youth

Leia Tsao

Evaluating the Impact of SmartParent: A Retrospective Cohort Study on SMS-Based Prenatal Education and Infant Health Outcomes Lineage Tracing of Msx1-Positive Cells in the Mouse Cerebellum

Session #6 | Poster #47 11:00 am – 12:30 pm BCCHR Atrium Session #9 | Poster #70 2:00 pm – 3:30 pm BCCHR Room 2108 Session #9 | Poster #71 2:00 pm – 3:30 pm BCCHR Room 2108 Session #3 | Poster #22 9:00 am – 10:30 am BCCHR Atrium Session #12 | Poster #97 2:00 pm – 3:30 pm BCCHR Atrium Session #11 | Poster #89 2:00 pm – 3:30 pm BCCHR Atrium Session #4 | Poster #30 9:00 am – 10:30 am BCCHR Atrium Session #8 | Poster #57 11:00 am – 12:30 pm BCCHR Atrium

Aieshini Udumullage

Lauren Ung

Abdominal Mass Virtual Huddle: Optimizing Diagnostic Tissue Adequacy in Pediatric Abdominal Tumours

Lara Vaziri

Cultural Considerations in Pediatric Eating Disorders Treatment: Insights from Racialized Youth and Families

Kayla Wen

Cellular modelling of a novel nonsense mutation in SYNCRIP associated with intellectual disability and autism spectrum disorder Feasibility of using a commercially available mindfulness app to reduce symptom burden in teenagers with Dysautonomia

Anna Wiese

Participant

Title

Presentation

Alyssa Wong

What is it like to PIVOT from Hospital to Home? Experiences of Caregivers in the BC Children’s Hospital Pediatric IV Outpatient Therapy (PIVOT) Program

Amber Wong

Exploring the Trajectory of Analgesia and Sedation Exposure in the Neonatal Intensive Care Unit

Kevin Wong

Comparative Phenome, Genome, and Pathway Analyses of Genes Associated with Both Cancer and Autism Spectrum Disorder

Kevan Wu

Modulation of Autophagy in Experimental Models to Improve Liver Transplant Outcomes: Literature Review

Anik Xiong

Investigating the Protective Role of Progranulin (GRN) in Alcohol-Exposed Mice with a Focus on Cerebellar Cells

Nathan Yang

Database Infrastructure Creation for Clinical Neurological Markers of Small Vessel Disease in Dual Diagnosis Psychosis-Addiction Patients

Gabriel Zamma

Implementing the Pain Pathway in community pediatric practices: Content development of implementation strategies

Lisa Zhang

Building Connections: Caregivers of Children with Medical Complexity Facilitating Communication Training with Pediatric Residents

Gloria Zhuo

Investigating the role of MED15 in Neuroblastoma using CRISPR-Cas9

Session #3 | Poster #24 9:00 am – 10:30 am BCCHR Atrium Session #8 | Poster #64 11:00 am – 12:30 pm BCCHR Atrium Session #9 | Poster #72 2:00 pm – 3:30 pm BCCHR Room 2108 Session #7 | Poster #55 11:00 am – 12:30 pm BCCHR Atrium Session #4 | Poster #31 9:00 am – 10:30 am BCCHR Atrium Session #7 | Poster #56 11:00 am – 12:30 pm BCCHR Atrium Session #10 | Poster #80 2:00 pm – 3:30 pm BCCHR Atrium Session #6 | Poster #48 11:00 am – 12:30 pm BCCHR Atrium Session #4 | Poster #32 9:00 am – 10:30 am BCCHR Atrium

Finding a Poster: BCCHR Atrium

Sessions 5 & 9

Patio

Room 2108 Sessions 2, 6, 11

Registration

Sessions 3, 7 & 10

Refreshments

Chan Centre for Family Health Education

Main Entrance

Reception

Sessions 4, 8 & 12

*This drawing is intended for visual reference only, it is not to scale

Presentations: 9:00 – 10:30 am Session #2 | Posters – #8 to 16 Session #3 | Posters – #17 to 24 Session #4 | Posters – #25 – 32 Presentations: 11:00 am – 12:30 pm Session #5 | Posters – #33 to 40 Session #6 | Posters – #41 to 48 Session #7 | Posters – #49 to 56 Session #8 | Posters – #57 to 64

Presentations: 2:00 – 3:30 pm Session #9 | Posters – #65 to 72 Session #10 | Posters – #73 to 80 Session #11 | Posters – #81 to 89 Session #12 | Posters – #90 to 97

SESSION 1 Thursday, July 24, 2025 9:00 – 10:30 am Online: bcchr.ca/posterday

Participants Kimia Ameri Kawami Cao Rena Daniel Renee Hui Michaela Ironside Jamie Jeon Iliyan Jiwani Aman Sharma

Kimia Ameri

Medical Student, University of British Columbia | Lam Research Team BC Children’s Hospital Research Institute Equity, Diversity & Inclusion Summer Studentship Recipient

Uncovering the Impact of Hypopigmented Conditions in Adolescents with Darker Skin of Colour: A Survey Study

Session 1 | Poster 1

Kimia Ameri, Yaseen Mandoub, Wingfield Rehmus, Joseph Lam Introduction: Hypopigmented skin conditions are often more visible on darker skin, potentially leading to greater psychosocial distress and diagnostic delays. Despite this, few studies have explored the experiences of adolescents with hypopigmented conditions, particularly those with skin of colour (SoC).

Objectives: This study aims to assess the psychological impact and quality of life faced by adolescents with hypopigmentation conditions, and to explore whether these experiences differ between Fitzpatrick skin types.

Methods: Adolescents with hypopigmentation conditions were recruited from the BC Children’s Hospital Dermatology clinic and completed two surveys: (1) a demographic and experience-based questionnaire and (2) the Dermatology Life Quality Index (DLQI) or Children’s DLQI. Fitzpatrick skin type, race, and ethnicity were self-reported.

Results: Data collection is ongoing. Sixteen participants completed the survey (9 female, 7 male). The average age was 13.9 years. Reported Fitzpatrick scores were: Type V (n=4), Type IV (n=8), Type III (n=2), Type II (n=1), and Type I (n=1). Races included South Asian (n=8), East Asian (n=5), White (n=3), Indigenous (n=2), and Latin American (n=1). Diagnoses were vitiligo (n=10), hypopigmented pityriasis lichenoid chronica (n=2), pityriasis alba (n=1), pigmentary mosaicism (n=1), and two undiagnosed but likely tinea versicolor.

Among SoC participants (Fitzpatrick IV–VI, n=12), 33% (n=4) felt their condition was misdiagnosed or diagnosed late due to skin type/colour, compared to zero fair-skinned participants (Types I-III, n=4).

Inappropriate treatment based on skin type/colour was reported by 33% (n=4) of SoC and 25% (n=1) of fair-skinned participants. Overall, 25% of participants (n=4) reported feeling quite a lot of anxiety (3 SoC, 1 fair-skinned), and 38% (n=6) reported quite a lot or very much lowered self-esteem or confidence (4 SoC, 2 fair-skinned). Among those under 16 years (n=12), 25% (n=3) experienced teasing or bullying in the past week “only a little” (2 SoC, 1 fair-skinned), 8% (n=1, fair-skinned) “quite a lot”, and 8% (SoC) “very much”.

Conclusion: Preliminary findings suggest that adolescents with hypopigmentation conditions may experience psychosocial challenges and barriers to care. Notably, all reports of diagnostic delay due to skin type/colour came from SoC participants. Other outcomes appeared more evenly distributed; ongoing recruitment will allow for deeper analysis.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

Table of Contents

Kawami Cao

Medical Student, Queen’s University | Simmonds Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Risk factors for prolonged length of stay following posterior spinal fusion in adolescent idiopathic scoliosis

Session 1 | Poster 2

Kawami Cao, Ali Eren, Emily Schaeffer, Morgan Tidler, Andrea Simmonds Background: Adolescent idiopathic scoliosis (AIS) is the most prevalent form of pediatric scoliosis, occurring in approximately 1-5 out of 100 children and adolescents. Posterior spinal instrumentation and fusion (PSIF) remains the gold standard for thoracic and double major curves, which comprise the majority of AIS cases. In the context of PSIF, prolonged length of stay (LOS) has been linked to higher rates of 90-day complications and reoperations and may increase psychological stress on patients and families, further disrupting recovery trajectories. Given the implications of prolonged LOS following PSIF, there has been increasing emphasis on understanding risk factors to minimize LOS. Objective: To systematically review all literature on risk factors affecting patient LOS following PSIF to treat AIS and to perform a meta-analysis of pooled data to quantify the association between factors and LOS. Methods: Three online databases (EMBASE, Ovid MEDLINE, Scopus) were searched using a combination of keywords and subject headings related to AIS, PSIF, risk factors, and length of stay.

The primary outcome is the effect of risk factors on mean LOS following PSIF. A meta-analysis of studies may be conducted if sample sizes and heterogeneity allow. Themes will be tabulated, and results will be presented through narrative synthesis where a meta-analysis is not performed.

Preliminary Results: Initial literature review identified trends in existing literature regarding common risk factors for extended LOS in children with AIS following PSIF. Preoperative patient characteristics that have been found to be associated with LOS include patient sex and ethnicity. Intraoperative factors such as operative time, number of levels fused, blood loss, and analgesic modality have also been identified to influence LOS. Implications: To date, no systematic review has assessed predictors of prolonged LOS following PSIF in AIS patients. Synthesis of these studies will identify the most consistent and clinically relevant risk factors of extended hospitalization, which may facilitate preoperative preparation and postoperative management for pediatric patients identified to be at risk and refine emerging clinical care pathways designed to reduce LOS. Mitigating extended hospital LOS offers an opportunity to improve postoperative outcomes and minimize resource expenditure.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

Table of Contents

Rena Daniel

Undergraduate Student, University of British Columbia | Loucks Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Identifying Genetic Predictors of Extreme Opioid Responses in Children with Cancer

Session 1 | Poster 3

Rena M. Daniel, Erika N. Scott, Bruce C. Carleton, Colin J.D. Ross, S. Rod Rassekh, Catrina M. Loucks Background: Opioids like morphine, hydromorphone, fentanyl and oxycodone are often used in pediatric oncology patients to manage highly-distressing pain resulting from cancer itself, life-saving treatments and/or necessary surgeries. However, patients show variable responses to these opioids. Most patients experience effective pain relief without adverse effects at recommended doses (typical responses).

Other patients have ineffective pain relief or experience adverse effects, such as respiratory depression and sedation, despite receiving these same recommended doses (extreme responses). These extreme responses can have long-term consequences for children with cancer as a lack of safe and effective analgesia can lead to chronic pain and altered brain development. Additionally, opioid adverse effects add to the treatment burden of these children who are already undergoing intensive chemotherapy. Notably, genetic variations in several genes (e.g., the pain/opioid-related COMT gene) have been shown to affect the level of pain relief, and/or the likelihood of adverse effects, in opioid-treated children. This suggests that individual genetic factors can help identify optimal pain management strategies for each child.

Objectives: To characterize opioid responses in pediatric oncology patients and identify genetic predictors of variable responses.

Methods: Case/control designation criteria have been developed to classify opioid responses as extreme (cases) and typical (controls). Using these criteria, responses to morphine, hydromorphone, fentanyl and oxycodone are being characterized. Once characterization of opioid responses is complete, case-control analyses will be conducted using logistic regression through PLINK while adjusting for demographic/ clinical factors as well as genetic ancestry.

Results: Characterization of opioid responses is ongoing. Recruited cases so far: morphine (n=57), hydromorphone (n=13), fentanyl (n=10), and oxycodone (n=4).

Conclusions: Given that extreme opioid responders are most likely to carry genetic factors with large impacts, this work will facilitate the identification of strong genetic predictors of opioid response.

Ultimately, this will allow for the development of genetic screening strategies to help avoid opioid-induced harm and ineffectiveness in pediatric oncology patients

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

Table of Contents

Renee Hui

Undergraduate Student, University of British Columbia | Gibson Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Assessing H3K27me3 Restoration in a Humanized Mouse Embryonic Stem Cells (mESC) Model of Weaver Syndrome After CRISPR-Based Correction

Session 1 | Poster 4

Renee Hui, Tess Lengyell, Makenna Cameron, Andrea Korecki, Ladan Kalani, Angela M Devlin, Elizabeth M Simpson, William T Gibson

Background: Weaver syndrome is a childhood overgrowth and intellectual disability disorder caused by partial loss-of-function (pLoF) mutations in EZH2 gene. EZH2 protein methylates lysine 27 on histone H3, enabling chromatin condensation. pLoF variants in EZH2 decrease its trimethylation of H3 (H3K27me3).

The Gibson and Simpson labs developed a partially humanized mouse embryonic stem cell (mESC) line by replacing exon 18 of mouse Ezh2 with the canonical exon 18 of human EZH2 (He18). mESCs were subsequently edited to create a missense pathogenic Weaver syndrome patient variant (p.Arg684Cys).

Weaver syndrome currently has no cure; this project investigates whether targeted genetic correction could serve as a viable therapeutic strategy.

Objective: To compare H3K27me3 levels across three genotypes of partially humanized mESCs: canonical human exon 18 (B6129F1-He18+/He18+), patient variant (B6129F1-He18-/He18-), and CRISPR corrected from patient variant back to canonical (B6129F1-He18cor+/He18cor+).

Hypothesis: H3K27me3 levels will be reduced in the patient variant cells relative to the canonical cells, and corrected cells will have H3K27me3 levels restored back similar to canonical levels.

Significance: Successful restoration of H3K27me3 levels in the corrected line would suggest that CRISPR therapy can benefit human patients.

Methods: The EpiQuik™ Total Histone Extraction Kit was tested on practice samples at three different dilutions, to optimize protein loading and antibody concentration. Kit was used again to extract histone from study samples. A titration western blot was done. After optimization, two western blots will be run in separate gels with H3K27me3 and H3 antibodies to compare H3K27me3 levels across three genotypes of study samples, normalizing H3K27me3 to total H3 levels.

Results: Western blotting of H3K27me3 and total H3 in B6-He18+/He18+ practice cells confirmed successful histone extraction and detection, validating the protocol. However, when applied to the experimental samples (B6129F1), H3K27me3 signal was undetectable across all genotypes, whereas total H3 bands were present. This suggests a potential issue with sample loading or antibody sensitivity specific to H3K27me3 detection. Further optimization is currently in progress.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

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Michaela Ironside

Undergraduate Student, University of Victoria | Cooper Research Team Office of Pediatric Surgical Evaluation and Innovation and UGME SSRP Recipient

Prevalence of body image dissatisfaction among youth with limb differences

Session 1 | Poster 5

Michaela Ironside, Anthony Cooper, Carrie Kollias, Paweena Sukhawathanakul, Harpreet Chhina Background: Body image refers to the thoughts, perceptions, and attitudes an individual holds about their body and appearance. Body image dissatisfaction during adolescence presents a significant risk for the development of poor psychological outcomes, including disordered eating, low self-esteem, depression, and interpersonal relationships. Youth with lower limb differences may be particularly susceptible to the development of poor body image, predisposing them to these adverse consequences.

Objectives: This project aims to investigate the relationship between limb-specific concerns (specifically leg appearance and functional ability of the leg) and overall body image satisfaction.

Method: Quantitative data will be collected using the validated LIMB-Q Kids questionnaire, which measures patient reported limb-specific appearance, physical function, and psychological well-being.

The statement, ‘I feel good about how I look’ from the psychological function section of LIMB-Q Kids will serve as the key indicator of patient body image satisfaction. Analysis of these scores will provide insight into the relationship between leg-appearance, function and overall body image concerns. A subset of participants with low scores in relevant sections from LIMB-Q Kids will be invited to participate in semi-structured interviews. These interviews will explore themes related to appearance, psychosocial challenges, and eating behaviours. As a secondary interview objective, all participants who have completed the LIMB-Q Kids questionnaire will be asked to fill out a short, validated eating disorder questionnaire to provide further insight into any disordered eating behaviours.

Significance: Identifying key contributing factors to the development of poor body image in this population would allow for the implementation of early intervention strategies. Interventions would be aimed at improving psychological outcomes and overall quality of life in youth undergoing limb reconstruction surgery. By addressing body image concerns proactively, the potential for disordered eating patterns, which have particularly harmful effects on bone health in this population, may be mitigated.

This project would create the opportunity to enhance clinical care practices by promoting a more holistic approach to treatment in youth with limb differences.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

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Jamie Jeon

Medical Student, University of British Columbia | Piper Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Barriers to physical activity and sleep in children with intestinal failure

Session 1 | Poster 6

Jamie E. Jeon, Sela Grays, Debby S. Martins, Hannah Piper

Background: Intestinal failure (IF) is a chronic gastrointestinal pathology that reduces functioning gut mass of patients, who become dependent on additional sources of nutrition. Pediatric IF patients have been reported to have difficulty growing with altered body composition (i.e. decreased lean body mass and increased fat mass). Several studies have indicated that children with IF have decreased physical activity levels compared to their healthy counterparts, and some researchers have found a significant association between physical activity and body composition. In Canada, the 24-Hour Movement Guidelines include age-specific recommendations for daily physical activity and sleep targets, which can be used as a reference for comparison. Identifying ways to increase daily activity level in this patient population can be beneficial to their overall health and growth, as they may face unique barriers to physical activity and sleep.

Aims: 1. Characterize physical activity and sleep patterns of children with IF and compare to the Canadian 24-Hour Movement Guidelines; and 2. Administer a survey to the caregivers of eligible patients to determine barriers to regular physical activity and uninterrupted sleep for their children with IF. Methods: Approximately 30 patients (at least 12 months old) will be recruited through Children’s Intestinal Rehabilitation Program (CHIRP) at BC Children’s Hospital. Clinical and nutrition data will be collected to find correlations with physical activity levels and/or sleep patterns. A REDCap survey will be created and administered to the caregivers of enrolled patients. Patients will be put into two groups and analyzed based on their ages (1-4 years and 5-18 years) to compare to the national guidelines. Challenges to physical activity and sleep will be grouped and described.

Significance: With barriers identified, further research can contribute to finding effective strategies that are tailored to pediatric patients with IF to support age-appropriate physical activity and sleep. This has been an under-studied area, and this study will bring critical changes to enhance the physical and emotional well-being of the patients and their caregivers.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

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Iliyan Jiwani

Undergraduate Student, University of Western Ontario | Moodley Research Team “Baby Love”: The Power of Dyadic Care in Reducing Neonatal Abstinence Syndrome (NAS) (Exploring the Value of a Holistic, Family-Integrated Approach to NAS Management)

Session 1 | Poster 7

Iliyan Jiwani, Anithadevi Moodley Background: Neonatal Abstinence Syndrome (NAS) affects newborns exposed to opioids in utero, often resulting in withdrawal symptoms shortly after birth. While traditional management has relied on around the clock pharmacologic treatment and NICU care, emerging evidence highlights the impact of holistic, dyadic models, centring the relationship between baby and mother.

Objective: To evaluate how managing the baby-to-mom dyad using a trauma-informed, family-integrated approach improves maternal and neonatal outcomes in NAS-affected dyads.

Methodology: Narrative literature review of peer-reviewed studies and guidelines from CPS, WHO, ACOG, NIDA, and Canadian clinical frameworks (e.g., Fraser Health). Focused on non-pharmacologic interventions, maternal support, ESC (Eat, Sleep, Console), and culturally safe practices.

Key Interventions: • Rooming-in, skin-to-skin contact, and breastfeeding • Mental health and substance use screening • Medication-Assisted Treatment (MAT) • Use of ESC over Finnegan scoring • Indigenous liaison and community support Outcomes Measured: Maternal: • Stabilized drug use (via MAT) • Increased breastfeeding rates • Reduced maternal-infant separation • Higher rates of infants discharged home with mother Neonatal: • Shortened hospital length of stay • Reduced need for opioid medications • Improved neurodevelopment regulation • Lower NICU admissions Conclusion: A “baby love” approach, grounded in empathy, equity, and evidence, improves outcomes for both mother and infant. Shifting from symptom-focused NICU care to a dyadic, family-integrated model is not only safer and more effective, but also preserves the mother-infant bond and promotes long-term wellness.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote Table of Contents

Aman Sharma

Medical Student, University of British Columbia | Baird Research Team UBC MS Connect Summer Studentship Recipient

Epidemiological assessment and evidence summary of care for pediatric appendicitis in BC

Session 1 | Poster 7A

Aman Sharma, Robert Baird

Introduction: Appendicitis is an inflammation of the appendix, most commonly resulting from luminal obstruction, which, if not treated promptly, can progress to necrosis and perforation. Pediatric appendicitis is the most common cause of surgical emergency in children, with the rate of complicated appendicitis higher in younger patients. Though there have been continued advances in the diagnosis and management of pediatric appendicitis, studies still suggest a significant difference in management and care disparities between urban and rural hospitals as well as pediatric and non-pediatric institutions.

It is currently unclear whether differences in care and outcomes exist in BC between pediatric appendicitis patients that are cared for within or outside BCCH. Objective: To characterize pediatric appendicitis care in BC comparing outcomes in BCCH compared to other hospitals in the province, and to generate a pragmatic scoping review with best-evidence summaries for care providers that is easily accessible across care contexts.

Methods: A literature search was performed using PubMed and MEDLINE libraries for pediatric appendicitis studies in English between Jan 2020 and Jun 2025. The results were screened by one author for relevant articles in the following domains: clinical evaluation, diagnostic imaging, antibiotic stewardship, operative and non-operative treatment pathways, post-operative clinical course, and complicated appendicitis. The search terms included “appendicitis or appendectom*” including mesh terms under “appendicitis”, combined with “child* or adolescent* or teen* or infant* or newborn* or neonat* or pediatric* or paediatric* or juvenile*”.

The BC Discharge Abstract Database (DAD) will be queried to fetch pediatric patients with a diagnosis of appendicitis in the last 5 years. A logistic regression analysis on R will be run to find differences between BCCH and other BC hospitals for the total length of stay in hospital, length of stay in ICU, and the presence of complicated appendicitis.

Significance: Given the prevalence of pediatric appendicitis, this project will have an important impact on the quality of appendicitis care provided within BC, especially for treatment providers who may not be trained pediatric subspecialists but care for children with appendicitis.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | Remote

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SESSION 2 Thursday, July 24, 2025 9:00 – 10:30 am In-Person, BCCHR Atrium

Participants Anshvir Bhangoo Kaylia Chan Jia Gandhi Taima Gheriani Isabelle Hadad Max Jasinski Noah Miller Florella Peng

Anshvir Bhangoo

Undergraduate Student, University of British Columbia | Mishaal Research Team Sunny Hill Health Centre Research Summer Studentship Recipient

A Review of Potential Maternal Risk Factors that Can Increase the Incidence of Cerebral Palsy (CP) in Offspring

Session 2 | Poster 8

Anshvir Bhangoo, Rozen Naama, Ram Mishaal Background: Cerebral palsy (CP) is an umbrella term that describes a group of movement disorders resulting from non-progressive brain injury around the time of birth, before birth or in early infancy, causing abnormal neural connections. Early diagnosis and rehabilitation have a profound impact on improving functional outcomes, particularly during infancy when neuroplasticity is at its peak. Current clinical guidelines and assessments enable a timely diagnosis of cerebral palsy (CP) as early as 3-4 months, however the average CP diagnosis age in British Columbia (BC), Canada was ~25 months up until 2021. With the implementation of the CP early diagnosis clinic at Sunny Hill Health center, at BC Children’s Hospital in 2021, the age of diagnosis decreased from 25 months to 7 months corrected age for children with medical risk factors. The earlier the diagnosis the better the likelihood of preventing adverse outcomes. Since the diagnosis age has been brought down to 7 months this paper will examine maternal risk factors to track at risk individuals in utero to lower the diagnostic age and help prevent late diagnosis for cerebral palsy.

Objective: The goal of this work is to investigate the influence of maternal health status and autoimmune condition on the incidence of CP in offspring.

Data Sources: This narrative review examined articles (primary research studies, systematic reviews, meta-analysis) discussing how autoimmune conditions, obesity and preeclampsia influence CP risk in offspring. The databases used were PubMed, Ovid Medline, and Ovid Embase.

Study Selection: Twenty-six studies were identified for this narrative synthesis. Studies that were chosen to discuss how preeclampsia, autoimmune conditions and obesity impact CP risk directly or indirectly.

Conclusion: This review found that maternal morbid obesity is associated with an increase in CP risk for offsprings. Preeclampsia is a risk factor for CP due to the increase in pre-term birth however in full-term births preeclampsia is not a significant risk factor. Autoimmune conditions are found to be risk factors for the development of CP, particularly multiple autoimmune diseases.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Kaylia Chan Undergraduate Student, University of Toronto | Mulpuri Research Team Standardizing Avascular Necrosis Classification in Pediatric Hip Conditions: A Scoping Review Kaylia Chan, Danica Fontana, Cate Foy, Mehara Seneviratne, Bryn Zomar, Rachel Phord-Toy,

Session 2 | Poster 9

Emily Schaeffer Background: Avascular necrosis (AVN) of the femoral head is a degenerative bone condition caused by disrupted blood supply, leading to bone cell death and joint dysfunction. It is a critical treatment complication in pediatric hip conditions like developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), and cerebral palsy (CP), which can significantly impact joint function and quality of life. Despite its importance, there is no universally accepted classification system for AVN, with studies using various methods influenced by factors such as patient age and underlying conditions.

This variability complicates efforts to compare findings across studies and hinders the development of standardized approaches to diagnosis and treatment.

Objective: This scoping review aims to address the variability in AVN classification systems and assessment methods in pediatric hip conditions, providing evidence-based insights to help orthopedic surgeons adopt a standardized and consistent approach for improved diagnosis and management.

Inclusion Criteria: Studies will be included if they involve populations diagnosed with AVN, osteonecrosis, or proximal femoral growth disturbance secondary to a pediatric hip disorder such as DDH, SCFE, CP-related hip displacement, femoroacetabular impingement (FAI), or traumatic hip injuries.

Eligible studies must provide details on AVN classification systems, grading methods, or diagnostic criteria, with a focus on reliability and validity.

Methods: A comprehensive search strategy including MeSH terms and keywords was developed on MEDLINE (Ovid), and translated to PubMed, Embase, Web of Science Core Collection, and CINAHL (EBSCO). Relevant studies were retrieved up to July 7, 2024, and uploaded to Covidence for duplicate removal. Two independent reviewers screened titles, abstracts, and full texts based on inclusion criteria.

Results: After removing duplicates, 3,712 articles were identified for title and abstract screening.

Of these, 1,109 articles were included for full-text review, which is currently ongoing.

Conclusion: This scoping review sets a precedent for addressing the variability in AVN classification systems by providing evidence-based insights to guide orthopedic surgeons in adopting standardized approaches. The findings will be submitted to a peer-reviewed, open-access journal to ensure broad accessibility, and future studies will focus on achieving consensus and validation to enhance clinical relevance and diagnostic accuracy.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Jia Gandhi

Undergraduate Student, University of British Columbia | Smile Research Team Community Child Health Endowment Summer Studentship Recipient

The Prevalence of Food Insecurity Amongst Children with Developmental Concerns Seeking Care at a Canadian Pediatric Hospital

Session 2 | Poster 10

Jia Gandhi, Sharon Smile Background: Food insecurity (FI)—defined as the lack of reliable access to sufficient, affordable, and nutritious food—is a growing public health crisis in Canada. In 2024, over 25% of Canadians, including 2.5 million children, lived in food-insecure households. In British Columbia, the rate is even higher, affecting nearly one in three children (32.6%). FI disproportionately impacts racialized and immigrant communities and is strongly associated with poor physical and mental health outcomes. For children, inadequate access to food can result in malnutrition, stunted growth, anxiety, depression, lower IQ, and academic challenges. For those with developmental concerns, these consequences can be even more severe, leading to poorer health, increased emergency department visits, and more frequent missed or delayed medical appointments.

Objective: This study aims to assess the prevalence of FI and describe the characteristics of affected families attending Sunny Hill Health Centre, a developmental pediatrics outpatient clinic at BC Children’s Hospital, in order to inform screening practices and targeted supports.

Method: To inform the study design, a scoping review of Canadian pediatric literature and international data (n = 18) was conducted. The Hunger Vital Sign—a validated two-question FI screener—was selected, and a caregiver survey was developed to collect additional demographic information, including household income, immigration status, and family composition. A review of local B.C.-based food access programs (n = 14) was also completed, resulting in three key resources being included in a handout provided to all participants. All study materials were co-developed with input from clinicians and caregiver partners and underwent multiple rounds of refinement. The survey will be available in both digital (REDCap) and paper formats. The goal is to survey approximately 500 families by December 2025.

The study is currently under expedited review by the Behavioural Research Ethics Board.

Significance: Findings will establish the prevalence and key risk factors of FI among children with developmental concerns and support the implementation of routine FI screening in pediatric developmental care. Results will also inform quality improvement initiatives and hospital policies related to social determinants of health—ensuring earlier identification and connection to support for food-insecure families.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Taima Gheriani Undergraduate Student, University of British Columbia | Tomfohr-Madsen Research Team

Navigating Nocturnal Nurturing: A narrative literature review of the relationship between environmental stressors and sleep in pregnancy

Session 2 | Poster 11

Taima Gheriani, Ariana Martinez, Camille Mori, Lianne Tomfohr-Madsen Background: Sleep is essential for maternal and fetal health; however, sleep disturbances tend to increase over the course of pregnancy due to various complex physiological changes. Concurrently, characteristics of the urban environment are receiving growing recognition as significant determinants of health and sleep quality in the general population, especially in a global context of climate change and growing urbanization. Understanding how environmental indicators influence maternal sleep, therefore, is critical for mitigating health deteriorating factors and promoting well-being within populations for which there are increased vulnerabilities to disrupted sleep. This review aims to synthesize the existing literature on associations between relevant environmental factors and sleep outcomes during pregnancy.

Methods: This literature review was conducted via comprehensive searches across databases, including PsycINFO, PubMed, Scopus, Web of Science, Science Direct, and Google Scholar. Our search strategy focused on the following environmental factors: noise, temperature, greenspace, PM2.5/10, ozone, and smoke, in relation to sleep outcomes (sleep disturbances, quality, etc.) during pregnancy. Direct, indirect, and pre and postnatal effects were identified in the included studies.

Results: Our search yielded 18 studies that examined the impacts of environmental indicators on sleep during pregnancy. A review of the studies demonstrated a direct link between ambient particulate matter (PM2.5/PM10) and worsening maternal sleep quality, whereas greater greenspace exposure was associated with improved maternal sleep and psychological well-being. Indirect relationships highlighted the positive influence of greenspace on perinatal mental health, which further impacted maternal sleep.

Notably, research examining direct associations to maternal sleep was scarce for noise, temperature extremes, ozone, and smoke exposure. Racial/ethnic disparities in maternal sleep highlighted the critical interaction between health outcomes and structural environmental inequities.

Significance: Understanding environmental influences is essential for maternal and fetal health and shaping public health strategies, especially with rising climate concerns and urbanization. This review highlights significant ecological links to maternal sleep quality and identifies critical gaps in the literature.

Future directions include the need for more research on varied environmental exposure impacts on maternal sleep, specifically in the perinatal period. Further, helpful additions to the literature would include longitudinal studies that utilize objective sleep measures, examine cumulative exposures, and account for environmental inequities.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Isabelle Hadad

Undergraduate Student, Columbia University | Sadarangani Research Team Evaluation of the antibody response to Klebsiella infection to inform vaccine design against Klebsiella Isabelle Hadad, Kaitlin Winter, Ken H. Chu, Arissa Tejani, Selina Cai, Wei Ling Kuan, Natalie Wilks,

Session 2 | Poster 12

Liam Mullins, Tony Harn, Emily Mason, Mandy Lo, Manish Sadarangani Background: The rise of antimicrobial resistance has become one of the most urgent crises of this century. Klebsiella pneumoniae (Kp), an encapsulated gram-negative organism, is a leading cause of community- and hospital-acquired infections in both healthy and immunocompromised children and adults worldwide. This pathogen causes a wide variety of infections including pneumonia, meningitis, intra-abdominal abscesses, and urinary tract infections. The high mortality rate indicates the necessity to protect the global population from Klebsiella infections through preventative immunization measures.

There is currently no Klebsiella vaccine available on the market and protective mechanisms against infection remain unclear. In this study, we examined whether prior exposure to Kp is protective against a lethal challenge in mice, allowing us to explore the immunological mechanisms underpinning protection against disease.

Methods: Six-to-eight week old BALB/c mice were injected intraperitoneally with a sublethal dose of Kp. Serum was collected by saphenous bleed 4 weeks after challenge. Anti-Kp serum IgG was evaluated by an endpoint enzyme-linked immunosorbent assay (ELISA). Four weeks after the sublethal Kp exposure, mice were challenged with a lethal dose of Kp administered intraperitoneally. Mice were scored based on weight, appearance, and symptoms 3 times daily for 48h post infection. Survival curves were analyzed by two statistical methods (Mantel-Cox Test and Gehan-Breslow Wilcoxon Test) using Prism.

Results: Sublethal exposure elicited detectable IgG titers against Kp (21000 vs. 2377 IgG Endpoint Titer).

In our challenge, exposure provided substantial protection to mice (63% survival vs. 25% in controls).

There was a statistically significant difference by the Gehan-Breslow Wilcoxon Test (p-value = 0.0213).

The mice subjected to the sublethal exposure exhibited less weight loss following infection.

Significance: These findings suggest that a sublethal infection with Kp elicits a protective immune response in mice. Further investigation into the mechanism of the protective responses will allow us to inform successful Kp vaccine design. The development of an effective vaccine is imperative in order for future generations of individuals to receive protection against this illness, whose impacts are felt both globally and in our local community.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Max Jasinski

Undergraduate Student, McGill University | Boerner Research Team American Psychological Association – Summer Undergraduate Psychology Experience in Research Fellowship Recipient

Session 2 | Poster 13

The Living Lab at Home: Feasibility of Multi-Modal In-Home Data Collection Among Children and Youth with Severe Neurological Impairment Max Jasinski, Leora Pearl-Dowler, Veronica Dudarev, Jessica Luu, Jane Shen, Harold Siden, Liisa Holsti, Katelynn E. Boerner, Tim F. Oberlander Background: Traditional laboratory-based health research is generally inaccessible for children and youth with severe neurological impairment (SNI), who often have cognitive and motor impairments resulting in complex everyday and medical needs. Failing to accommodate youth with SNI in child health research risks homogenizing their unique needs, further contributing to health inequities. In-home research methods used to understand everyday behaviours cocreated with families may reduce the barriers to participating in child health studies, ensuring that methods used are tailored to individuals’ needs and reflect lived experiences.

Objective: Investigate the feasibility and acceptability of codesigned in-home data collection methods among children and youth with SNI and their families to inform future in-home children’s health research practices.

Methods: 7 young people with SNI and their families participated in a pilot feasibility study of an in-home multimodal data collection protocol used to assess everyday behaviours, designed with family input.

Across a 14-day data collection period youth wore an accelerometer, collected salivary cortisol samples, and family/caregiver networks answered smartphone-based Ecological Momentary Assessment (EMA) questionnaires. Post-study interviews were conducted with participants regarding their experiences.

Continued reciprocity with families throughout the research process was paramount, and methods were adjusted mid-study to account for family inputs. Summary statistics and reflexive thematic analysis will be used to assess the feasibility of methods, and the quantity and quality of data.

Significance: In-home multimodal data collection may be a feasible alternative for children and youth with SNI and their families to participate in health research without the constraints of traditional research methodologies. By developing codesigned, accessible, in-home research methods with families we can capture more ecologically valid data on those who have been systemically excluded from child health research, ultimately reducing inequities in healthcare affecting children and youth with SNI.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Noah Miller

Undergraduate Student, McGill University | Lavoie Research Team BioTalent Canada Student Work Placement Program Recipient

Investigating the Impact of the L305I Mutation of RSV Post-Fusion F Protein on Antibody Binding Affinity

Session 2 | Poster 14

Noah Miller, Blandine Dang, Pascal Lavoie, Aleksandra Stojic, David Marchant Background: Globally, Respiratory Syncytial Virus (RSV) causes an estimated 1.4 million lower respiratory tract infection (LRTI) hospitalizations, and 45,700 deaths in children under 6 months annually.

Palivizumab, a monoclonal antibody targeting RSV, has been the main prophylaxis in Canada until Nirsevimab’s approval in April 2023. Clesrovimab is another prophylaxis still under review in Canada.

These three monoclonal antibodies bind distinct epitopes of the pre-fusion (preF) and post-fusion (postF) conformations of the RSV F protein. 101F, the model antibody used in this study, binds similarly to Clesrovimab.

As a single-stranded RNA virus, RSV exhibits high mutation rates. Population-level monoclonal antibody rollout programs introduce selection pressures, potentially leading to the emergence of RSV variants with higher resistance, causing public health concerns in vulnerable populations. The mutation L305I in RSV F protein emerged under antibody-driven selection in a directed evolution assay. Protein modelling and docking validates this mutation can induce a protein-wide conformational change.

Previous research has shown that despite these conformational changes, binding affinity to preF is unchanged, but antibody neutralization is reduced for reasons unknown. This study aims to examine affinity differences between wild type and mutated variants of the RSV postF protein against Palivizumab and Clesrovimab.

Objectives: To determine how the L305I mutation in the RSV postF protein affects antibody binding affinity and kinetics, to explain the role of postF in lowered neutralization.

Methods: The L305I mutation was introduced into the RSV postF protein plasmid using site-directed mutagenesis, followed by E.coli transformation (strain DH5α). Wild-type and L305I mutant postF proteins were expressed in the HEK293F cell line and purified using His-tag affinity chromatography. Surface Plasmon Resonance (SPR) will quantify real-time binding kinetics for monoclonal antibody interaction with both protein variants.

Significance: This study addresses the lack of evidence on L305I’s impact on postF antibody binding, and provides reasoning for reduced neutralization levels. Quantitative analysis will clarify how a single amino acid change can induce major conformational shifts, potentially affecting antibody binding.

These findings will inform future prophylaxis development, guiding the design of more robust and mutation-resistant prophylactic antibodies and vaccines to maintain protection against RSV.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Florella Peng

Undergraduate Student, Queen’s University | Ezzat Research Team Using Co-Design Methods to Improve Injury Prevention Knowledge Translation: A Usability Evaluation of the Active & Safe Platform

Session 2 | Poster 15

Florella Peng, Shelina Babul, Hasana Bilal, John Jacob, Ian Pike, Allison Ezzat Background: Digital interventions are increasingly recognized as powerful tools for delivering accessible, scalable health education. Launched in 2017, the Active & Safe platform (https://activesafe.ca/) is one such tool providing evidence-based sport injury prevention education on 51 different sports targeted to various community members (active individuals, parents, coaches and teachers, sport officials and administrators, and health professionals). The Active & Safe educational content was updated with a best-evidence synthesis in 2024. However, there is a need to refresh the digital experience to reflect current best practices in digital usability. As the preliminary step in a multi-stage, iterative, co-design process this study aims to assess the usability of the Active & Safe platform and explore opportunities for user-informed enhancements.

Methods: Using a convergent mixed methods study design, we will collect qualitative and quantitative data to assess the usability of the Active & Safe platform. We will recruit 20 participants representing the platform’s target user groups to participate in think aloud qualitative interviews and quantitative surveys.

Quantitative data will be obtained from validated questionnaire: the System Usability Scale, User Engagement Scale and a Net Promoter Score-style question. Qualitative data will be transcribed and analyzed using a pragmatic thematic approach. Quantitative data will be descriptively summarized.

Mixed methods data integration will generate comprehensive results to support future stages of the co-design process to enable broader widespread platform modernization and evaluation.

Results: We have successfully obtained ethics approval from UBC Children’s & Women’s Research Ethics Board and participant recruitment is underway.

Anticipated Outcomes: We expect to identify key areas for improvements, (navigation, content clarity, and visual appeal) and opportunities to enhance design features that influence user engagement, trust, satisfaction, and interest (video clips, quizzes, etc).

Implications: This study will support the co-design of Active & Safe platform. Results will inform the development of a refreshed platform that is better aligned with user needs. The results may also offer broader insights for the development of future digital health education platforms targeting injury prevention and beyond.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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SESSION 3 Thursday, July 24, 2025 9:00 – 10:30 am In-Person, BCCHR Atrium

Participants Lauren Chew Daniel Choi Maddie Evora Kristina Kurvits Brooklyn Liu Aieshini Udumullage Victoria Belway Alyssa Wong

Lauren Chew

Undergraduate Student, University of British Columbia | Hou Research Team Understanding the Role of Culture in Immigrant Youth Health

Session 3 | Poster 17

Lauren Chew, Sharon Hou, Sophia Guan, Lara Ivaziri Background: Existing literature on immigrant youth health in Canada has predominantly centred on the most prevalent ethnic groups, including Chinese, Black and South Asian communities. Less is known regarding the health experiences and outcomes of underrepresented and minoritized immigrant groups.

Additionally, while much of the research has emphasized social determinants of child health and factors contributing to health disparities, less attention has been paid to the cultural strengths and resilience of immigrant youth and families, especially those living with serious and life-threatening illnesses, that may positively influence their healthcare experiences and engagement.

Objectives: To identify gaps in current knowledge regarding the cultural strengths and resilience of immigrant youth in Canada, who are living with serious and life-threatening conditions, with a focus on immigrant youth who are from underrepresented immigrant communities.

Methods: A rapid review will be conducted to examine how cultural influences, such as migration status, acculturation, cultural identity, and values play a role in the health and well-being of immigrant youth and their families. The review protocol will be pre-registered with Open Science Framework and managed by Covidence.

Significance: Findings from this review will inform the development of culturally tailored resources and tools to support improved healthcare experiences and outcomes for immigrant youth and their families.

In addition, the review will also inform future research priorities that aim to contribute to a more inclusive healthcare experience for diverse immigrant populations living in Canada.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Daniel Choi

Undergraduate Student, University of British Columbia | Ansermino Research Team BC Children’s Hospital Research Institute Healthy Starts Summer Studentship Recipient

Retrospective Study of Smart Spot, a Bluetooth Low-Energy Real-Time Location System supporting Quality Improvement in Uganda

Session 3 | Poster 18

Daniel Choi, Ediketh Tugume, Aine Ivan Aye Ishebukara, Charly Huxford, Yashodani Pillay, J Mark Ansermino, Dustin Dunsmuir Background: Real-time location systems (RTLS) are used to track the movement of assets and individuals. In clinical settings within high-income countries, they have improved patient flow. However, their use in low- and middle-income countries (LMICs) remains limited. Smart Spot, a low-cost Bluetooth Low-Energy (BLE) RTLS integrated within the Smart Triage quality improvement (QI) platform, was deployed in the outpatient department of Uganda Martyrs’ Ibanda Hospital.

Objective: To determine if Smart Spot (i) captures patient flows that align with expected clinical pathways, and (ii) can be used to compare median time spent in key areas before and after Smart Triage implementation.

Methods: At triage, parents or children (<12 years) received a BLE beacon attached to a color-coded lanyard that indicated risk priority. Strategically located gateways detected these beacons throughout each visit until discharge or admission. BLE data were converted into timestamped location records.

Data were collected during a 4‑month baseline phase (589 visits; Feb–May 2022) and a 12‑month intervention phase following Smart Triage implementation (1,319 visits; June 2022–May 2023). A data cleaning algorithm was developed to reduce noise and generate reliable location stamps. The time spent per patient in the assessment area, emergency room, laboratory, and throughout the entire visit was calculated. Patient journeys were visualized, and median differences between phases were analyzed using quantile regression.

Results: Data cleaning improved the matching to the expected patient flow from 15% to 85%. Compared to baseline, the intervention showed significant reductions in median time spent in the assessment area (−75.6 min [47.5%]; CI= -93.9 to -62.4), emergency room (−44.7 min [82.2%]; CI= -57.1 to -28.7), and total visit duration (−113.3 min [59.3%]; CI= -127.4 to -99.1), all p < 0.001. The 1.1-minute reduction in median laboratory time was not statistically significant (p = 0.43).

Conclusion: Data cleaning significantly improved tracking compared to raw Smart Spot data. The cleaned data confirmed that the study intervention reduced overall time spent in the outpatient department and provided more detailed information on improvements in specific locations.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Maddie Evora

Undergraduate Student, University of British Columbia | Woodward Research Team Cognitive Mode Detectable with Task-Based fMRI: Initiation (INIT)

Session 3 | Poster 19

Maddie Evora, Todd S. Woodward In the context of task-based functional magnetic resonance imaging (fMRI), cognitive modes can be defined as task-general cognitive/sensory/motor processes which reliably elicit specific blood-oxygenlevel-dependent (BOLD) signal pattern configurations. A number of cognitive modes are detectable with task-based fMRI, and here we focus on initiation (INIT), an early-trial peaking cognitive mode.

This cognitive mode has shown dependence on cognitive load among various tasks, wherein a pattern of increased activation is observed as cognitive load is increased in different task conditions, representing a direct relationship. The task-induced BOLD signal changes associated with INIT are modulated by a range of tasks, and we present five here. For each task, we report: (1) highly specific pattern- based (as opposed to coordinate-based) anatomical details essential for distinguishing INIT from other BOLD-based cognitive modes, and (2) task-induced BOLD signal changes associated with INIT across a range of task conditions. In order to facilitate recognition, we nick-named the anatomical patterns specific to INIT as follows: (1) Raised Eyebrows, (2) De Divina Proportione Front Guy, and (3) When I’m 64. Evidence for INIT was derived from the timing and magnitude of task-induced BOLD signal changes for the following tasks: verbal working memory (three versions), spatial working memory, and thought generation.

Inspection of the task-induced BOLD signal changes associated with INIT, over the range of tasks mentioned above, and compared to similar modes such as multiple demand (MD), consistently supported the cognitive mode interpretation of restarting/initiating cognitive processes involving visual stimuli after brief, undemanding periods following a series of cognitive operations.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Kristina Kurvits

Undergraduate Student, University of British Columbia | Tucker Research Team UBC Faculty of Medicine Summer Studentship Recipient

The BC-GEN Project: how the families of children with chronic rheumatic illnesses feel about genetic testing

Session 3 | Poster 20

Kristina Kurvits, Nick McPhate, Erica Won, Lori B. Tucker Background: Genetic testing can be an important tool contributing to the diagnosis of children with rare pediatric rheumatic conditions, and identification of a specific genetic diagnosis can be critical in providing personalized directed treatments.

With expanded availability of genetic testing there is increased awareness of the importance of meaningful conversations with patients and families about genetic testing around the implications for their medical situation.

Objective: To investigate the level of general knowledge and perceptions related to genetic testing, among families with chronic rheumatic diseases followed in the pediatric rheumatology clinics at BC Children’s Hospital.

The overarching goal for the Division of Rheumatology is to incorporate the voices of children and their families into a consensus pipeline to increase access to and availability of genetic testing for children with rare rheumatologic conditions in BC. Methods: A survey (22 items) was developed based on a literature review and rheumatology health care provider expert opinions. The items are grouped into 2 sections: knowledge of genetic testing (6 items, yes/no answers) and patient/ family perceptions and concerns about genetic testing for themselves (15 items; 5-point Likert scale). One open text question asked how families would prefer to receive the results of their genetic test.

Families seen in the pediatric rheumatology clinic at BCCH were invited to participate; one parent per family and patients over 13 yrs were invited to complete the questionnaire. The parent and patient questionnaires were completed separately and not linked for analysis. Families whose child had known genetic comorbidities or those who could not complete the survey in English were excluded.

Quantitative data was analyzed using descriptive statistics and calculated in R. Qualitative data were analyzed using a content analysis.

Results: 164 participants were approached over the 7-week period; 141 agreed to participate and 123 completed the questionnaire – 30% patients (n=37), 70% parents (n=86) – only 10.5% had previous genetic testing through the clinic (n=13).

Initial results indicate a generally positive view of genetic testing but some clear gaps in general knowledge.

Conclusion: The high participation rate and overall positive perceptions of genetic testing indicates that genetic testing is a subject of interest for families in the Pediatric Rheumatology clinic but that current knowledge gaps should be addressed in future planning.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium Table of Contents

Brooklyn Liu

Undergraduate Student, Queen’s University | Li Research Team KidSpace: Uncovering Hidden Barriers to Hand Hygiene in Pediatric Mental Health Care

Session 3 | Poster 21

Brooklyn Liu, Mavis Chan, Yalda Hosseini, Aneesa Din, Carole Rodger, Miguel Imperial, Lynne Li Background: Hand hygiene (HH) is a cornerstone of infection prevention and control (IPAC), yet adherence remains a challenge in pediatric psychiatric settings where traditional protocols are difficult to implement. The Healthy Minds Centre, a pediatric psychiatric unit at BC Children’s Hospital, was found to have significantly low HH rates during a routine audit conducted by Health Canada. The unit features an open-concept layout that allows children to move freely throughout the space, which creates uncertainty among healthcare workers (HCWs) about when HH should be performed. In addition, alcohol-based hand rub (ABHR) dispensers are intentionally limited due to patient safety concerns, with only two located in a secured staff office.

Methods: To better understand these challenges, the Kidspace Project was launched in collaboration with the IPAC team. A mixed-methods approach was used, where an in-person survey was administered to HCWs, gathering both quantitative and qualitative data about their perceptions, routines, and HH-related challenges. Participants were asked to identify common barriers and respond to scenario-based questions to assess HH decision-making. At the same time, a sensor was installed on the unit’s ABHR dispenser to collect baseline usage data.

Intervention: The planned interventions will be multimodal and aim to address both environmental and behavioural barriers to hand hygiene. These will include one-on-one interviews with staff to further explore obstacles to HH adherence, as well as a short educational video developed by the IPAC team. The video will highlight common HH challenges and demonstrate appropriate practices within a dynamic and non-standard care environment. Following the video rollout, the same survey will be re-administered to evaluate changes in perception and HH decision-making.

Significance: This project aims to close the gap between ideal hand hygiene practices and the real-world limitations present in pediatric mental health settings. By identifying environmental and behavioural barriers, the Kidspace Project seeks to inform future IPAC strategies that are not only effective but also adaptable to complex care environments.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Aieshini Udumullage

Undergraduate Student, University of British Columbia | Goldowitz Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Lineage Tracing of Msx1-Positive Cells in the Mouse Cerebellum

Session 3 | Poster 22

Aieshini Udumullage, Michael Ke, Joanna Yeung, Daniel Goldowitz The cerebellum is a major integration center of the brain, coordinating motor, sensory, and cognitive processes. Developmental defects in the cerebellum are observed in disorders such as autism spectrum disorder, ADHD, and medulloblastoma (the most common pediatric brain cancer). Therefore, understanding the molecular mechanisms underlying cerebellum development can be key to further understanding these conditions and has the potential for novel therapeutic interventions.

Cells of the cerebellum arise from two germinal zones. One of these germinal zones is the rhombic lip, which has the progenitors that give rise to the glutamatergic lineage. Atoh1 expression initiates the differentiation and migration of these cells from the rhombic lip. However, as these cells differentiate and migrate away, a distinct population of progenitors must replenish the rhombic lip progenitor pool.

It is hypothesized that Msx1-expressing cells may represent this progenitor pool and contribute to glutamatergic lineage development in the cerebellum.

To test whether Msx1-expressing cells, at an early timepoint during development, give rise to the entire glutamatergic lineage, we employed lineage tracing; a method used to follow the developmental fate of specific cells over time. Msx1CreERT2/+; R26RtdTomato/+ mice allow for the permanent labeling of Msx1expressing cells and all their progeny with red fluorescent protein (RFP, tdTomato-expression) after a tamoxifen injection. Tamoxifen was injected at embryonic day 9.5, activating Cre recombinase and labeling cells for 24–36 hours. Cerebella were collected at E18.5, when all glutamatergic cell types can be observed.

Preliminary results examining E18.5 cerebellums show that all glutamatergic cell types emerge from Msx1-expressing progenitors in the rhombic lip. tdTomato-expressing cells are co-expressed with TBR2 (unipolar brush cells), PAX6 (granule cells), and TBR1 (cerebellar nuclear neurons), markers of the three glutamatergic cell types, respectively. Interestingly, although these cell types arise at discrete time points during development, the RFP-labelled cells (Msx1-expressing cells) in the early rhombic lip gives rise to all three of them, persisting through development.

Msx1-expressing progenitors play a seminal role in the development of the glutamatergic neurons of the cerebellum. Continuing to understand this role has broad implications for various neurodevelopmental disorders and medulloblastoma.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Victoria Belway

Undergraduate Student, Simon Fraser University | Boerner Research Team American Psychological Association – Summer Undergraduate Psychology Experience in Research Fellowship Recipient

Autism and Diverse Identity Documentation Practices at the BC Children’s Hospital Complex Pain Service

Session 3 | Poster 23

Victoria J. Belway, Katelynn E. Boerner, Erin C. Moon Background: Marginalized groups are commonly represented in youth seeking treatment for chronic pain. For example, autistic individuals report increased prevalence of pain disorders, as autism is associated with both biological and psychosocial pain risk factors. Given that demographic and identity-related data is not collected systematically by most pain clinics, the prevalence of various marginalized social identities in this population is unclear.

Method: To understand current identity-related data collection practices and explore possible areas for improvement, we are conducting a retrospective chart review of patients from the Complex Pain Service (CPS) at BC Children’s Hospital. From a sample of 50 charts, we will extract data relating to socialidentity factors, including neurodiversity, gender/sex diversity, diverse sexual orientation, minoritized race/ ethnicity, disability, immigration status, language diversity, socioeconomic status, body size, religion/ spirituality, and age. Further, we will note the professions of charting clinicians and subsections of the charts in which relevant information is recorded. We will calculate descriptive statistics and based on patterns of available versus missing data, we will explore how each identity factor is being collected.

Significance: Equity-based research and clinical quality improvement efforts can be facilitated by systematic demographic data collection that includes a wide range of social-identity factors. Considering how neurodivergence, and specifically autism, are identities relevant to an individual’s experience of pain and overall well-being, we aim to highlight neurodevelopmental diagnoses and neurodiverse identities as important demographic factors that can impact patient care. We further aim to develop a systemized approach to demographic data collection at the CPS based on this exploratory study.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Alyssa Wong

Undergraduate Student, University of British Columbia | McLaughlin Research Team What is it like to PIVOT from Hospital to Home? Experiences of Caregivers in the BC Children’s Hospital Pediatric IV Outpatient Therapy (PIVOT) Program

Session 3 | Poster 24

Alyssa Wong, Jessie Luo, Elizabeth Kalenteridis, Julie Robillard, Tom McLaughlin Background: Children with serious infections often require prolonged intravenous (IV) antibiotics, traditionally administered in hospitals or clinics by healthcare professionals. Previous findings suggest that caregiver-administered IV antibiotics at home can be equally safe and effective, yielding comparable outcomes to inpatient care. BC Children’s Hospital has (BCCH) implemented the Pediatric IV Outpatient Therapy (PIVOT) Program, which trains caregivers to administer IV antibiotics to their children at home using simplified devices. The program leverages virtual care and local partnerships to support families across British Columbia and Yukon. Early data show PIVOT reduces inpatient length of stay, lowers healthcare costs, and maintains clinical safety. However, caregiver experiences with home IV administration remain unexplored.

Objectives: This study explores the experiences of caregivers administering IV antibiotics through BCCH’s PIVOT Program. It assesses caregiver stress and quality of life, stratified by the distance of the family’s residence from BCCH. Methods: This mixed-methods prospective study combines surveys and semi-structured interviews.

Primary caregivers complete a demographic questionnaire and up to three follow-up surveys after discharge, depending on their child’s treatment duration. Surveys use 5-point Likert scales to measure stress, decision-making, and quality of life. A subset of caregivers also participates in semi-structured interviews, with transcripts analyzed using content analysis.

Results: We report in-progress findings from 32 participants, with response rates of 81% at the start of treatment, 57% mid-treatment, and 67% at the end of treatment. Preliminary data show high caregiver satisfaction with the PIVOT Program. Quantitative results highlight challenges such as pharmacy and supply delivery, limited weekend support, and concerns about complications at home. Despite this, many caregivers preferred home-based IV therapy. Qualitative themes reveal increased mental and physical stress from caregiving responsibilities and risks, balanced by appreciation for strong PIVOT team support, educational resources, and the belief that home care was best for the family.

Conclusions: Preliminary results suggest that caregivers value home-based care despite the added responsibility. Caregiver-identified stressors point to areas for improvement, including expanding weekend support, improving pharmacy logistics, and better communication between the PIVOT team and community hospitals. Ongoing analysis will examine how caregiver experiences vary by demographics to guide program refinements.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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SESSION 4 Thursday, July 24, 2025 9:00 – 10:30 am In-Person, BCCHR Atrium

Participants Georgia Clay Ivan Guan Ali Hawkins Kaitlyn Leung Olivia Mackenzie Kayla Wen Anik Xiong Gloria Zhu

Georgia Clay

Undergraduate Student, McGill University | Blydt-Hansen Research Team BC Children’s Hospital Research Institute Childhood Diseases Summer Studentship Recipient

Novel Methods to Quantify the Impact of Eplet-Level Donor HLA Mismatch on Early Acute Rejection and Graft Outcome after Pediatric Kidney Transplantation

Session 4 | Poster 25

Georgia Clay, Amy Thachil, Tom Blydt-Hansen Background: Kidney transplantation is the preferred treatment for pediatric end-stage renal disease, offering improved survival and quality of life compared to dialysis. However, it introduces lifelong immunosuppression which carries significant risks, including infection, malignancy, and drug toxicity.

Despite these interventions, acute rejection, particularly T cell mediated rejection, remains a major challenge for graft survival and long-term outcomes. A key driver of rejection is the immunological mismatch between donor and recipient at the level of Human Leukocyte Antigens (HLA). Traditional HLA matching considers only broad antigen mismatches and fails to account for molecular differences that shape the immune response. Tools like HLA Matchmaker and PIRCHE-II assess mismatches at the epitope level for B cell and T cell responses, respectively.

Objectives: This study aims to evaluate whether higher eplet mismatch loads, quantified by HLA Matchmaker and PIRCHE-II scores, are associated with an increased risk of acute rejection within the first year in pediatric kidney transplant recipients. We will monitor graft outcome through three measures: graft rejection confirmed by surveillance biopsy results, graft rejection indicated by inflammatory markers like CXCL10, and kidney function assessed by glomerular filtration rate (GFR) within the first-year posttransplant.

Methods: We conducted a retrospective analysis including pediatric patients who underwent kidney transplant at BC Children’s Hospital between July 2005 and October 2024. Patients were included if they were age 19 and under at the time of transplant and if high-resolution molecular HLA typing had been collected for both the donor and recipient (n=162). Patients were excluded if they did not receive at least 3 surveillance biopsies within the first 12 months after transplant (n=80).

Significance: This project could improve donor-recipient matching by validating the predictive value of HLA Matchmaker and PIRCHE-II tools in pediatric kidney transplant recipients. It aims to confirm whether associations observed in adult populations between molecular HLA mismatches and rejection are also found in pediatric populations, ultimately contributing to more personalized and effective transplant management.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Ivan Guan

Undergraduate Student, Queen’s University | Tobia Research Team Otolaryngology Studentship Recipient

Non-Linguistic Assessment of Cochlear Implant Candidacy

Session 4 | Poster 26

Ivan Guan, Doug Sladen, David Horn, Destinee Halverson, Amjad Tobia, Mark Felton Background: A cochlear implant (CI) is an auditory prosthetic that provides partial hearing restoration for individuals with moderate to profound hearing loss. The gold standard of CI candidacy assessment involves English-language speech tests, which presents difficulties when evaluating non-English-speaking immigrants with hearing loss. Translating speech perception tests into English is possible, but still requires a translator to score responses, who may or may not use the same dialect. Children who are d/Deaf and hard of hearing (DHH) also often have distortions in their speech productions, adding an additional layer of difficulty in evaluating responses from the child. As such, non-linguistic assessments of spectral ripple discrimination and reversed/distorted words have been used among those with hearing loss, and are likely candidates as alternative, non-linguistic assessments of CI candidacy.

Objectives: 1. To compare performance on conventional speech testing (monosyllabic words) to a SRD task 2. To compare performance on conventional speech testing (monosyllabic words) to a reversed/ distorted speech task Results from the experimental tasks (SRD and reversed/distorted words) will be compared to the gold standard (monosyllabic word recognition) to create ROC curves and determine sensitivity and specificity values.

Methods: 35 English-speaking children (age 5-18 years) will be recruited who will complete the standard battery of English speech tests for CI candidacy, in addition to experimental non-linguistic measures – spectral ripple detection (SRD) tasks and/or reversed and distorted monosyllabic words. All hearing tests will be conducted in aided hearing conditions (with a hearing aid on) presented at equivalent loudness levels in a sound booth chamber. Results of conventional speech testing and non-linguistic measures will be compared via Pearson correlation analysis, linear regression modelling, and receiver operator characteristic (ROC) curves analysis to define the sensitivity and specificity of the experimental tasks for accurately identifying CI candidacy.

Significance: By using non-linguistic measures instead of English speech tests, non-English-speaking cochlear implant candidates can be assessed. This allows for better equity, diversion, and inclusion for those families involved in this particular cochlear implant process. This project improves almost every long-term outcome on the overall health, quality of life, and ability to thrive of children with hearing disabilities and their families.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Ali Hawkins

Undergraduate Student, University of British Columbia | Bhatnagar Research Team Upper Extremity Model for Detection of Pre-Operative Co-contraction in Pediatric Posttraumatic Elbows: A Pilot Study

Session 4 | Poster 27

Ali Hawkins, Dan Engel, Jake Harris, Diane Wickenheiser, Tim Bhatnagar, Jeffrey Pike Elbow contractures, or stiffness of the elbow, develop in 3-6% of children following supracondylar fractures, and 33-100% of children following distal radius fractures (1). Loss of elbow and forearm range of motion (ROM) can greatly inhibit regular functioning; thus, treatment of posttraumatic stiffness is of utmost importance. The continuous passive motion machine is a rehabilitative device that can facilitate ROM in the painful post-operative period (2), but there is only one available to rent for pediatrics in Canada. With advanced notice required for rental, efficient detection of abnormal muscle activation patterns pre-operatively in stiff posttraumatic elbows is needed to create precise, individualized post-operative rehabilitation plans. Researchers have correlated post-operative elbow stiffness in the adult population with a co-contraction pattern of the biceps and triceps, as identified through control studies utilizing electromyography (EMG) (3,4). To date, no studies have explored the potential correlation between posttraumatic elbow stiffness and co-contraction in pediatrics. Therefore, this study aims to investigate the efficacy of an upper extremity motion capture model and EMG technology in identifying pre-operative indications for stiffness following intervention in pediatric posttraumatic elbows. Participants were at least 3 months post-injury and were being seen at BC Children’s Hospital Orthopedic Clinic for management of posttraumatic elbow contracture. Seventeen passive reflective motion capture markers and four wireless surface EMG sensors are placed on participants’ bilateral upper extremities and trunk.

Motion capture was used to evaluate bilateral elbow flexion-extension and muscle activation timing.

Participants completed two activities to identify co-contraction: 1) metronome-controlled elbow flexion and extension and 2) clinician and patient-controlled proprioception neuromuscular facilitation of biceps and triceps. One out of five participants have been recruited for the pilot study at time of abstract submission.

Elbow angle was plotted against time and synchronized with the EMG data. This determined when co-contraction occurred over the elbow ROM during the activities. The outcomes of this pilot will inform the protocol of a larger prospective clinical trial.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Kaitlyn Leung

Undergraduate Student, University of British Columbia | Mah Research Team A Cross-Cultural Analysis of Parenting Resource Suitability for Chinese-Canadian Families

Session 4 | Poster 28

Kaitlyn Leung, Janet Mah Mental health in childhood is a significant predictor of lifelong outcomes, and positive parenting practices play a causal role in shaping emotional and behavioural child wellbeing. In recent decades, there has been a substantial increase in parent usage of web-based resources that offer guidance on child-rearing practices. While web-based resources offer conveniently accessible and freely distributable information, there are limited online evidence-based resources that are culturally tailored to families of Chinese heritage. This disadvantages hundreds of thousands of Chinese caregivers raising children in the Canadian context. This study evaluates the credibility and suitability of existing online parenting resources for Chinese-Canadian caregivers, and compares resources that were either (1) developed in China, Taiwan or Hong Kong, or (2) developed in North America. We included text- and video-based online resources on the two top priorities previously identified by this community: (1) child emotional control and (2) child disobedience. This search was conducted on the search engines (e.g., Google, Baidu) and social media platforms (e.g., Twitter, Facebook, Douyin) with the highest monthly rates of usage in Chinese and North American contexts. Using search terms provided by Chinese-Canadian caregivers, we identified a sample of 132 resources, which will be evaluated using the QUality Evaluation Scoring Tool (QUEST) and Suitability Assessment of Materials (SAM) rating scales. A 2x2 between-subjects, fixed-effects ANOVA will assess whether the credibility or suitability of resources differs significantly across cultures and resource topics. We predict that these two factors will interact in a manner consistent with cultural values, such that emotion-related resources from North American platforms will yield higher credibility and suitability scores, as will disobedience-related resources from Asia. Findings will inform strengths and limitations of current resources to guide the development of content-relevant, feasible, and culturally-grounded resources that improve mental health literacy and treatment seeking for Chinese-Canadian families.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Olivia Mackenzie

Undergraduate Student, University of British Columbia | Kissoon Research Team Post-discharge mortality among HIV-positive children younger than 5 admitted with suspected sepsis in Uganda: an analysis of a prospective multisite observational study

Session 4 | Poster 29

Olivia Mackenzie, Niranjan Kissoon, Matthew O. Wiens, Cherri Zhang Background: Children living with HIV account for a disproportionate portion of post-discharge mortality among those under five in low-income countries. The purpose of this study is to explore the factors contributing to this group’s heightened vulnerability following hospital discharge.

Methods: This study was a secondary analysis of two multisite observational studies in Uganda, involving 8,813 children under five admitted with suspected sepsis between 2012 and 2020. At admission, clinical and sociodemographic data were collected and follow-up assessments were conducted by phone at 2 months and 4 months after discharge, and in person at 6 months. The subjects were categorized based on their HIV status: positive, exposed but uninfected, and unexposed. Differences between cohorts were explored using risk ratios and cumulative hazard curves.

Main Findings: The post-discharge mortality rate was higher in HIV positive children compared to their HIV-negative peers, with rates of 12.9% (n=34) compared to 5.8% (n=402), respectively. Most of these deaths occurred at home. Severe malnutrition, anemia, and lower respiratory infections were associated with greater risk among HIV-positive children. Furthermore, HIV-positive children tended to have lower readmission rates to hospitals, and they experienced a higher mortality rate after being readmitted.

Interpretation: Children living with HIV were commonly malnourished, anemic, and more likely to die at home. These findings indicate that follow-up care for HIV-positive children is suboptimal. To improve outcomes for this group, discharge preparation and post-discharge care must address the clinical, environmental, and social factors that contribute to this group’s heightened risk of mortality.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Kayla Wen

Undergraduate Student, University of British Columbia | Pouladi Research Team BC Children’s Hospital Research Institute Childhood Diseases Summer Studentship Recipient

Cellular modelling of a novel nonsense mutation in SYNCRIP associated with intellectual disability and autism spectrum disorder

Session 4 | Poster 30

Kayla Wen, Sophie C. Gjervan, Katherine Van Belois, Oguz K. Ozgoren, Glen L. Sequiera, Jia Feng, Jan M. Friedman, Mahmoud A. Pouladi Background: Neurodevelopmental disorders are the most common chronic condition encountered in paediatric primary care, with autism spectrum disorder (ASD) being a particularly prevalent and complex subset. ASD is a neurodevelopmental disorder characterized by social communication impairment and repetitive behaviours, often co-occurring with intellectual disability (ID) and global developmental delay (DD). While many genetic variants have been identified through large-scale sequencing efforts, the precise mechanisms by which these variants lead to neurodevelopmental phenotypes are still being elucidated.

SYNCRIP is a conserved RNA-binding protein involved in mRNA transport, editing, translation, and degradation. It is essential for brain development, influencing neuronal and muscular growth, neuritogenesis, synapse formation, and plasticity. A ~3-year male patient presented at BC Children’s Hospital with global DD, suspected ID, and diagnosed ASD. Exome sequencing revealed a de novo heterozygous nonsense variant in the SYNCRIP gene. The variant is absent from gnomAD and DECIPHER databases, with a high CADD score of 38, supporting its potential pathogenicity.

Objective: This project will functionally characterize the novel nonsense variant in SYNCRIP using isogenic human induced pluripotent stem cells (hiPSC) and HEK293 cells.

Methods and Preliminary Results: The SYNCRIP nonsense variant was introduced into the PGP1 hiPSC line using CRISPR/Cas9. Single-cell sorting was subsequently performed to isolate individual clones harbouring the variant. Wildtype (WT) and nonsense SYNCRIP variant protein expression will be quantified in hiPSC-derived neural progenitor cells (NPC), neurons, and neural organoids. Preliminary results show differences in SYNCRIP isoform expression in NPCs and changes in neurite outgrowth in neurons. Immunofluorescence staining will be used to quantify NPC and neural marker expression and assess SYNCRIP localization. Differentiation of cerebral organoids is still ongoing.

Preliminary results from HEK293 cells, transiently transfected with the nonsense variant or WT SYNCRIP constructs, showed decreased protein levels and lower molecular weight in the nonsense variant compared to WT. Immunofluorescence imaging demonstrated nuclear localization in both WT and nonsense variant cells, but with lower SYNCRIP expression observed in nonsense variant cells.

Conclusions: Our preliminary data demonstrate that the SYNCRIP nonsense variant results in decreased protein expression and altered neuronal development, suggesting a loss-of-function mechanism.

Continued characterization using the cellular models established will further clarify the contribution of the nonsense variant in SYNCRIP to neurodevelopmental disorders.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Anik Xiong

Undergraduate Student, University of British Columbia | Goldowitz Research Team Investigating the Protective Role of Progranulin (GRN) in Alcohol-Exposed Mice with a Focus on Cerebellar Cells

Session 4 | Poster 31

Anik Xiong, Maryam Rahimi Balaei, Benjamin E. Life, Alissandra de M, Gomes, Blair R. Leavitt, Daniel Goldowitz Background: Fetal Alcohol Spectrum Disorder (FASD) is one of the most preventable neurodevelopmental conditions, affecting 1-5% of the population in Canada. FASD is caused by prenatal ethanol exposure and is associated with symptoms such as facial dysmorphology, growth deficiencies, and learning and behavioral impairments. One biological feature of FASD is increased apoptosis in cerebellar Purkinje cells and granule neurons. Despite its prevalence, there are currently no FASDspecific therapeutics. Progranulin (GRN), a protein previously shown to protect neurons against apoptosis in conditions like stroke, hypoxia, and acidosis, is our potential target in preventing ethanol-induced apoptosis in cerebellar neurons.

Purpose: This project employs ethanol exposed progranulin wildtype (Grn+/+) and knockout (Grn-/-) C57BL/6 mice to investigate the potential neuroprotective effects of progranulin against ethanol-induced cell death.

Methods: Mouse pups (n=10 Grn+/+ and n=10 Grn-/-) at postnatal day (P) 5 were divided into two groups (n=5 in 2 groups per genotype, for a total of 4 groups). Ethanol (dose=5g/kg, divided into two separate doses of 2.5g/kg) or vehicle (saline) were administered (via SQ injection) twice in a 2-hour interval to each group. Brain samples were collected and fixed in 4% PFA 5 hours post the second injection. This is followed by paraffin embedding, sectioning, and staining using a TUNEL assay, to detect apoptotic cells (TUNEL+) in the cerebellar area. The number of TUNEL+ cells will be assessed microscopically.

The counted TUNEL+ cells will be divided over the total area of the region to give TUNEL+/mm2 and compared between groups.

Preliminary Results: To date, n=3 Grn+/+ and n=3 Grn-/- mice have been stained. This study is ongoing, and we will continue to increase sample size to n=5 for both genotypes and quantify our results. If our hypothesis is correct, we expect increased apoptosis in ethanol-treated mice compared to saline controls within each genotype, in GRN-/- mice compared to GRN+/+ under saline conditions, and in GRN-/- versus GRN+/+ mice following ethanol exposure.

Significance: This research provides insight that may assist and uncover new therapeutic strategies to mitigate FASD-related effects like apoptosis in brain cells.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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Gloria Zhuo

Undergraduate Student, University of British Columbia | Taubert Research Team Investigating the role of MED15 in Neuroblastoma using CRISPR-Cas9

Session 4 | Poster 32

Gloria Zhuo, Sara Cristiano, Chiaki Shuzenji, Stefan Taubert Background: Cancer is the leading cause of death by disease in children, with neuroblastoma (NB) being the most common solid tumor in infants. NB originates from neural crest-derived cells that undergo defective differentiation due to genomic/epigenomic alterations. Molecularly, transcription factors (TFs), which are controlled by various co-regulators including Mediator, are frequently dysregulated in these cancers. Interestingly, MED15, a subunit of the Mediator complex, is highly expressed in many cancers and associated with shorter patient survival.

To study MED15 in cancer, our lab generated MED15 knockout (KO) models in lung adenocarcinoma cells, which led to the downregulation of oxidative stress response, cell cycle, and pro-inflammatory immune genes and proteins. This signifies a role for MED15 in these cancer cells; however, it is not known if MED15 may play a similar role in other cancers, including NB. Therefore, this project aims to investigate the role of MED15 in NB. Objectives: 1. To generate stable MED15KO NB cell lines.

2. Future Direction: Examine the role of MED15 in oxidative stress response and pro-inflammatory immune response in NB. Methods: To study the role of MED15 in NB, I will use CRISPR-Cas9 genome editing to generate MED15 exon 5 KOs in two NB cell lines, IMR-32 (male) and SK-N-AS (female). After generating single colonies, I will genotype the MED15 locus using PCR to identify homozygous mutant clones. I will use these NB MED15KOs to assess the expression of oxidative stress and immune genes/proteins using qRT-PCR and Western Blots.

Expected Results: 1. I will successfully generate stable homozygous MED15KO NB cell lines using CRISPR-Cas9 genome editing.

2. As previously mentioned, our lab identified the downregulation of various genes/proteins in MED15KO lung cancer cells. I expect to observe similar findings, including the downregulation of oxidative stress and immune response genes/proteins in the generated NB MED15KO cells.

Significance: Many childhood cancers, including NB, remain deadly and are in need of new treatments.

This project has the potential to identify MED15 as a new therapeutic target in NB. Importantly, the MED15-TF interface is targetable with small molecules, making MED15 a potential therapeutic target in pediatric cancers.

Presentation: Thursday, July 24, 2025 | 9:00 am – 10:30 am | BCCHR Atrium

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SESSION 5 Thursday, July 24, 2025 11:00 am – 12:30 pm In-Person, BCCHR Atrium

Participants Reid Chase Justin Lee Floria Lu Wesley Mah Saray Membreno Hana Miller Evelyn Olson Noah Shew

Reid Chase

Undergraduate Student, University of British Columbia | Capon Research Team Henrietta Ehlers Estate Endowment for Medicine

Insights from Exomics: Identification of New Genes in Paediatric Vasculitis

Session 5 | Poster 33

Reid Chase, Francesca Capon Background: Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) refers to a group of severe autoimmune diseases, caused by inflammation of small and medium-sized blood vessels. While clinically heterogeneous, these conditions typically present with lung and kidney damage, so that they are potentially life-threatening. Although vasculitis is considered a multifactorial disease resulting from gene-gene and gene-environment interactions, paediatric forms caused by single-gene defects have been described.

Objectives: The aim of the study is to investigate the genetic determinants of AAV by analysing DNA profiles generated through whole-exome sequencing, and to identify the most likely disease mutations in well-characterised paediatric cases.

Methods: Whole-exome sequencing was used to analyse thirty paediatric patients diagnosed with AAV. Initial filtering removed common and synonymous variants. Rare variants observed at high-frequency in the study cohort were further removed to eliminate sequencing artefacts. To focus the analysis, an earlyonset patient subset (n=4) was created. Computational tools (e.g., CADD, AlphaMissense, and SpliceAI) were applied within this subset to evaluate variant pathogenicity and remove changes predicted to be benign. The remaining variants were ranked using literature-based evaluation performed by AMELIE, and genes mutated at higher frequency in the cohort were further prioritised. Finally, the most likely disease mutation was identified for each patient in the subset, based on predicted pathogenicity, coding region size, and genetic constraint.

Results: Four variants were identified as the most likely disease mutations in the early-onset subset of patients: a heterozygous missense mutation in SEMA6A, a heterozygous frameshift deletion in CLCN2, a heterozygous missense mutation in GATA3, and a homozygous stopgain insertion in GPRC6A. Significance: Understanding the genetic bases of AAV can reveal novel pathogenic pathways, improve diagnostic capabilities, and inform targeted therapeutic approaches. These insights support earlier diagnoses and more personalized treatments, ultimately improving patient outcomes.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Justin Lee

Undergraduate Student, University of British Columbia | Skippen Research Team UBC Faculty of Medicine Elsie May Hogg Fund in Medicine Award Recipient

PICU Interventions and Outcomes in Healthy Children Following Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study of North American PICUs Database

Session 5 | Poster 34

Justin Lee, Cheuk Chung Au, Peter Skippen Background: Out-of-hospital cardiac arrest (OHCA) in healthy children represents a rare, unexpected and devastating medical emergency with high mortality rates and poor neurological outcomes. Pediatric OHCA are most commonly caused by non-cardiac causes, such as hypoxic respiratory failures, multisystem trauma, submersion injury, sepsis, infections, and cardiac disorders. Although pediatric OHCA epidemiology and optimization of individual intervention strategies have been documented, only a few have explored how the level of care patients received in the pediatric intensive care unit (PICU) impacts outcomes in otherwise healthy children.

Aim: Therefore, this study aims to address this gap by (a) describing the etiology of pediatric OHCA in PICU and (b) comparing characteristics of PICU interventions between good and poor neurological outcomes. Consequently, it is hypothesized that patients with good neurological outcomes have received more aggressive interventions in the PICU than those with poor outcomes, where “aggressive interventions” indicate a higher number of interventions performed, and/or longer duration of intervention performed.

Methods: A retrospective analysis is conducted using data from the Virtual Pediatric Systems, LLC (VPS), a large North American database that collects data from more than 130 hospitals. Analysis will describe healthy patients </= 18 years old who suffered OHCA with no underlying conditions before the arrest.

Association of individual PICU interventions and an Aggressive Index, which quantifies the vigorous interventions patients received in PICU, will be evaluated with favourable neurological outcomes, rated as 1-3 in Pediatric Cerebral Performance Category.

Significance: The suddenness of OHCA in healthy children with no underlying conditions can have a profound impact on the pediatric patients, their families, and the healthcare team, even after vigorous resuscitation. The PICU thus becomes a place of uncertainty, emotional strain, and hope. By describing current PICU practices and identifying clinical interventions and factors associated with neurological outcomes, the findings of this study can provide insight into difficult discussions about post-resuscitation care between families and healthcare teams. Furthermore, this study can provide hospitals with knowledge to prioritize resources and develop evidence-based guidelines that improve pediatric patient outcomes.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Floria Lu

Undergraduate Student, University of British Columbia | Weber Research Team UBC Faculty of Medicine Summer Studentship Recipient

Revealing Hidden Insights: Deep Learning Recovery of SWI Data to Explore Brain Iron Levels and Neurodevelopment in Preterm Infants

Session 5 | Poster 35

Floria Lu, Alexander Weber Background: Infants born very preterm (<32 weeks gestation) experience a period of critical brain development in the neonatal intensive care unit (NICU), where they are vulnerable to brain injuries and environmental stressors that may impact long-term neurodevelopment. Susceptibility Weighted Imaging (SWI) is a routine clinical MRI scan sensitive to blood, iron, and calcium, often used to detect brain bleeds and injuries associated with calcification or iron deposition. However, the final images from SWI are qualitative in nature, meaning they cannot be used to determine the amount of iron deposition, for example. This is because clinical SWI scans automatically ‘filter’ the acquired data and discard the unfiltered data. If there were a way to recover this unfiltered data, researchers could retrospectively analyze the data from hundreds of thousands of clinical scans to better understand iron levels at birth and later neurodevelopmental outcomes.

Objective: To apply a deep learning (DL) algorithm to recover unfiltered SWI data and generate Quantitative Susceptibility Mapping (QSM) images, and ultimately investigate the relationship between deep grey matter iron levels and later neurodevelopmental outcomes in children born very preterm.

Methods: This project analyzed imaging data from approximately 60 infants born <32 weeks gestation, scanned at BC Children’s Hospital between 2015 and 2019. A DL-based unfiltering algorithm “HomodyneNet” was applied to filtered SWI images to reconstruct unfiltered data. QSM images were then generated using a rapid two-step dipole inversion method.

Expected Results: Based on prior literature, it is expected that reduced susceptibility values in deep grey matter regions (e.g., basal ganglia, thalamus), suggestive of lower iron content, will be associated with lower cognitive and motor scores later in life. Previous studies have shown that iron plays a vital role in myelination, neurotransmission, and neurodevelopment, and that iron deficiency in infants is linked to poorer motor and cognitive outcomes, especially in preterm populations.

Significance: This project could demonstrate the feasibility of using DL-based unfiltering on clinical SWI scans, enabling retrospective QSM analysis in neonatal cohorts, and potentially generating new insights in the neurobiological mechanisms underlying preterm brain injury and development.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Wesley Mah

Undergraduate Student, University of British Columbia | Mak Research Team Canadian FAIT Foundation Summer Student Research Grant Recipient

Lost in Transition: Understanding Food Allergy Immunotherapy Dropout in Adolescents and Young Adults

Session 5 | Poster 36

Wesley Mah, Raymond Mak, Edmond Chan, Jennifer Tong, Ravinder Dhaliwal, Lianne Soller Background: The transition from adolescence to young adulthood is a critical period for maintaining continuity in allergy immunotherapy. BC Children’s Hospital has successfully supported many adolescents with food allergies through structured programs, such as sublingual immunotherapy (SLIT) and oral immunotherapy (OIT), which have shown to reduce allergic reactivity and improve quality of life. However, a decline in adherence is commonly observed as patients transition to adult care. We sought to determine the dropout rate and reasons for dropout in a cohort of patients on SLIT or OIT during transition to Vancouver General Hospital.

Methods: Patient chart notes from BC Children’s and Vancouver General Hospitals were qualitatively reviewed, and factors for treatment discontinuation were recorded and categorized to identify recurring trends in adherence during the transition to adult care. Adherence was defined as long-term participation, while discontinuation referred to treatment cessation.

Results: Between Sept/2023 and June/2025, 30 patients were followed through transition, with 13 (aged 16-21 years) discontinuing treatment (43.3%). Patients were followed for 2 to 4 years, from the start of treatment to their first visit with the adult allergist, with a median age of 18. Without parental involvement in daily dosing, busy schedules and shifting priorities made it difficult for university students to prepare SLIT doses or source ingredients for OIT, accounting for 7 of 13 (53.8%) dropouts. Three of 13 (23.1%) who discontinued were lost to follow-up, reporting confusion about treatment duration, follow-up expectations, and responsibility for ongoing allergy management. Another 3 of 13 (23.1%) discontinued due to frequent illness or side effects like severe eczema, bradycardia, and chest pain.

Conclusions: The transition to adult care is a critical period where decreased adherence in young adults can lead to dropouts. Empowering adolescents earlier in their treatment and producing more efficient dosing methods and better communication may help sustain adherence and preserve long-term outcomes.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Saray Membreno

Undergraduate Student, University of British Columbia | Coelho Research Team UBC Department of Psychiatry Undergraduate Research Assistantship Recipient

Perceptions of Early Intervention Services for Pediatric Eating Disorders: Co-Developing a Community-Engaged Deliberative Dialogue

Session 5 | Poster 37

Saray Membreno, Audrey Tung, Julia Kaufmann, Sharon Hou, Jennifer S Coelho Background: There is a strong need for early intervention (EI) for children and youth with eating disorders, yet there is limited availability of EI models across Canada. To promote EI development in British Columbia (BC), and engage interest holders in setting a research agenda, a hybrid event titled “Promoting Early Access, Care, and Workforce Expansion for Eating Disorders” will be held in October, 2025 in Vancouver, BC. There, clinicians, researchers, decision-makers, and individuals with lived/ living experience from across BC and Canada will participate online or in-person to share personal and professional knowledge on eating disorders and EI expansion. A smaller in-person group will then deliberate on barriers and facilitators in developing early eating disorder care and identify research priorities relating to the eating disorders workforce.

Methods: A pre-event survey will be sent to event registrants (n = 200). Information collected includes demographics, eating disorder research and/or care involvement, and perceptions and barriers to implementing EI. The survey will be administered via REDCap, and data may be disaggregated.

Individuals who disclose that they have lived/living experience will be invited as a working group alongside decision-makers, clinicians, and researchers to interpret the survey results to further event planning.

Anticipated Results: Collecting demographics will capture a diverse, representative sample and understand how participants’ intersectional identities shape experiences in and perceptions of eating disorder research/care. Survey results will identify common barriers and strategies to address those barriers for EI. Data will be analyzed using quantitative methods and then disaggregated while protecting personal identities by refraining from reporting results from groups of less than five participants.

Responses will inform the event’s interactive discussion known as a deliberative dialogue, where a diverse group of interest holders collaborate to advance decision-making initiatives (Godhwani, 2025).

Conclusion: This event utilizes a community-engaged methodology where registrants are encouraged to discuss the current state of the eating disorders workforce, and what gaps in the research continue to persist. By collating these different attitudes and perceptions towards EI and eating disorders via a survey, the interactive deliberative dialogue can facilitate the co-development of a research agenda to expand EI across BC and Canada.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Hana Miller

Undergraduate Student, McGill University | Ogilvie Research Team BC Children’s Hospital Research Institute Healthy Starts Summer Studentship Recipient

Mother-Daughter Provision of Services For The Prevention of Cervical Cancer: A Scoping Review

Session 5 | Poster 38

Hana Miller, Grace McCloskey, Candice Ruck, Amy Booth, Laurie Smith, Gina Ogilvie Introduction: Cervical cancer (CC) is the fourth most common cancer in women worldwide, with the highest incidence rates in low- and middle-income countries (LMIC). This concentration is largely driven by low uptake of CC screening and HPV vaccinations, both of which are effective in preventing CC. To address low uptake of both, combining cervical screening for mothers and HPV vaccination for daughters into one service has been suggested, however there is limited existing research. This scoping review aims to collate the existing evidence on the integration of mother-daughter provision of cervical cancer prevention services, and to identify the current themes and gaps in the literature.

Methods: PubMed was systematically searched. Studies were included if they were published in English between 2000-2025, included adolescents/pre-adolescents, and involved mother-daughter integrated services. Two authors independently screened titles, abstracts, and full-texts. Relevant papers were extracted.

Results: The search resulted in 151 initial papers, of which, 9 were identified for full text review, and 6 papers, all from LMICs, were included in the scoping review. Three categories of integration methods were identified: 1) HPV vaccination programs used to recruit mothers for cervical screening; 2) co-recruitment of mother-daughter pairs with independent service delivery; and 3) joint delivery of HPV vaccination and cervical screening at a single site. Four studies reported high uptake rate of HPV vaccinations and cervical screening, however, the method of measurement for screening and vaccine uptake varied. Self-collection was the most commonly used cervical screening method. The quadrivalent HPV vaccine was the most commonly administered vaccine.

Discussion: There is a limited but growing body of evidence on mother-daughter service provision to enhance cervical cancer prevention. Despite heterogeneity in outcome measures across the six studies, the available evidence suggests that integrated mother-daughter service delivery could enhance engagement in CC prevention. Future research should consider comparing integrated service provision to the more common approach of independent screening and vaccination.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Evelyn Olson

Undergraduate Student, University of Alabama | Tomfohr-Madsen Research Team BC Children’s Hospital Research Institute Brain, Behaviour & Development Summer Studentship Recipient

Evaluating BEAM (Building Emotional Awareness and Mental Health): A review of postpartum mental health intervention outcomes

Session 5 | Poster 39

Evelyn Olson, Makayla Freeman, Lianne Tomfohr-Madsen Background: Postpartum depression and anxiety are common, affecting nearly one in four pregnant people in Canada. Although early intervention is important, many parents face barriers to accessing mental health support after childbirth. These include time constraints, stigma, limited resources, and childcare demands. BEAM (Building Emotional Awareness and Mental Health) is a 12-week, app-based intervention that offers mental health psychoeducation, peer coaching, and a social support forum. This project aimed to synthesize all available literature evaluating BEAM, with a focus on its impact on postpartum mental health.

Methods: A literature search was conducted across APA PsycInfo, APA PsycArticles, and MEDLINE using the term “Building Emotional Awareness and Mental Health.” Studies were included if they reported empirical findings related to the BEAM program, included caregivers of children aged 0–71 months, and were either peer-reviewed or available as pre-prints. Ten studies were included: randomized controlled trials, pilot trials, qualitative studies, and protocols. Study selection was verified by the BEAM research team.

Results: Findings on depression symptoms were mixed. One study found that 60% of participants experienced clinically significant improvements, while others found symptom improvement without statistically significant effects. In contrast, anxiety symptoms showed more consistent reductions across studies. Some reported greater improvements in the BEAM group compared to control groups. Parenting stress and anger also mostly decreased following BEAM participation, especially among parents with higher depression and anxiety scores at enrollment.

Feedback from participants suggested high usability and appreciation for having videos, forums, and coaching in one place. Barriers to engagement included slow-loading videos and forum design. Studies found higher engagement among older participants and higher-income families and less in first-time parents, indicating a need for more targeted support.

Future Directions: Recommendations include adapting BEAM content for fathers and underserved communities, improving cultural responsiveness and accessibility, updating video formatting and mobile compatibility, enhancing forum features, and conducting larger, long-term trials.

Conclusion: BEAM is a promising intervention program for improving postpartum mental health and parenting for parents of young children.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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Noah Shew

Undergraduate Student, University of Guelph | Bhatnager Research Team Sunny Hill Health Centre Research Summer Studentship Recipient

Feasibility of a Pilot Community-Based Rowing Program for Adolescents with Cerebral Palsy

Session 5 | Poster 40

Noah Shew, Tim Bhatnager, Karen Davies Background: Adolescents with CP have been reported to be perceived differently than their peers, leading to isolation, potentially adversely affecting their mental health. Cerebral Palsy (CP) is characterized by impaired posture control, muscle coordination, and altered muscle tone. To increase physical abilities and participation in sport, a learn-to-row program for adolescents with CP was introduced. Row to Grow is a 3-year pilot program that started in 2024 between The Motion Lab, Sunny Hill Health Centre at BC Children’s Hospital and BC rowing clubs to determine the feasibility of a learn-to-row program for adolescents with CP. Objectives: Evaluate the feasibility of a learn-to-row program for youth with CP and the coach and club experience of this program.

Methods: Coaches maintained a log for each participant, including session duration, adverse events, and activities conducted. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework acted as a template to help determine the feasibility of this program. Semi-structured interviews and surveys for clubs and coaches, and coach logs informed us of adoption by clubs, implementation strategies, and successful maintenance.

Preliminary Results: In the first year of the program, there were 8 participants, 5 clubs, and 8 coaches.

Surveys showed that coaches enjoyed participating in this program. Coaches expressed a need for more equipment, administrative, and in-session support (n=2). Clubs had some difficulties with weather conditions such as heat, wind, or rain (n=4). A suitable session duration for clubs ranged from 90 to 120 minutes. Data collection is ongoing at the time of submission of the abstract.

Significance: Preliminary findings suggest a focus on the amount of in-session and administrative support is needed. Weather will need to be accounted for to ensure safety measures are met. Coach and club satisfaction and enjoyment are essential for maintenance of the program. Future work will include analyzing results from the 3-year pilot program and working with community rowing clubs, provincial, and national organizations.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Room 2108

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SESSION 6 Thursday, July 24, 2025 11:00 am – 12:30 pm In-Person, BCCHR Atrium

Participants Emily Chilton Genesis De Jesus Plancarte Saiya Gill Kinsley-Marlie Jura Alysha Lee Reeve Liew Taylor Traaseth Lisa Zhang

Emily Chilton

Medical Student, Queen’s University | Ip Research Team BC Children’s Hospital Research Institute Brain, Behaviour & Development Summer Studentship Recipient

The Role of Clinician-Patient-Family Communication in Facilitating F-Words Integration in Pediatric Care

Session 6 | Poster 41

Emily Chilton, Denise Somuah-Asamoah, Kim Szeto, Angie Ip Background: One in twelve children aged six to ten in British Columbia live with neurodevelopmental differences, also called neurodisabilities. Historically, care for neurodiverse children has followed the biomedical model, focused on diagnosing and treating impairments. While a diagnosis remains essential for accessing services, it often does not fully capture a child’s unique strengths and support needs.

To address this, researchers and clinicians now advocate for a more function-focused, biopsychosocial approach to childhood neurodisability. One such framework is Rosenbaum and Gorter’s “F-Words for Child Development”, or “F-words”, which provide an accessible, strengths-based scaffold to highlight child functioning across six key domains: functioning, family, fitness, fun, friends, and future. Despite enthusiasm from families and service providers worldwide, uptake and integration into clinical practice is still underway.

Objective: This project aims to examine the use of the F-words and function-focused approaches within two public diagnostic pathways for childhood neurodisability in British Columbia: the BC Autism Assessment Network (BCAAN) and the Complex Developmental and Behavioural Conditions (CDBC) clinic. We aim to highlight how the F-words can be leveraged to enhance communication among clinicians, patients, and families, thereby improving patient- and family-centered care.

Methods: We used a semi-structured observation approach to characterize how the F-words and function-focused thinking were represented during clinical appointments across seven disciplines within BCAAN and CDBC: case management, nurse practitioner, occupational therapy, developmental pediatrics, psychology, social work, and speech and language pathology. Using purposive sampling, we selected a representative set of appointments reflecting key stages in the BCAAN and CDBC patient and family journeys, including intake, assessments, and family conferences. Detailed field notes were recorded during the appointments, then coded in NVivo using deductive content analysis guided by the F-words framework.

Significance: The F-words for Child Development framework empowers clinicians, patients, and families to view childhood neurodisability through a holistic, strengths-based lens. Findings from this project will be used to inform recommendations to embed the F-words into multidisciplinary clinical practice to strengthen patient- and family-centered care at BCAAN and CDBC.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Genesis De Jesus Plancarte

Medical Student, University of British Columbia | Siden Research Team

Session 6 | Poster 42

UBC Faculty of Medicine Summer Studentship Recipient

Outcomes for Newborns With Hypoxic-Ischemic Encephalopathy: A Retrospective Cohort Study From a Canadian Neonatal Intensive Care Unit Genesis De Jesus Plancarte, Gail Andrews, Katherine Boone, Emily Kieran, Hal Siden Background: Hypoxic-ischemic encephalopathy (HIE) is the leading cause of brain injury in newborns, with outcomes ranging from normal neurodevelopment to severe impairment or death. Despite improved survival with therapeutic hypothermia (TH)—the standard of care for moderate to severe HIE—prognosis remains highly variable.

Objectives: To evaluate HIE outcomes at discharge from a Canadian neonatal intensive care unit (NICU), with the analysis supported by a literature review on long-term outcomes of HIE in high-income countries.

Methods: A retrospective chart review was conducted for newborns with documented HIE born between 2014 to 2024 who received care at BC Women’s NICU. A MEDLINE literature search was conducted for studies published between 2014 and 2025 reporting HIE outcomes from NICUs in high-income countries with at least 12-month follow-up.

Results: Of 422 patients identified, 346 had clearly defined stages of HIE (mild/moderate/severe) and were included for retrospective chart review. Incidence of moderate HIE was highest (44%, n=151), followed by mild (33%, n=114) and severe (23%, n=81). Nearly all newborns with mild and moderate HIE survived to discharge (98% [n=112] and 100% [n=151], respectively), compared to 28% (n=23) for severe HIE. Among survivors, 12% (n=14) of the mild group and 38% (n=57) of the moderate group were discharged with adverse presentation (requiring ongoing respiratory support, tube feeding, pharmacological seizure management, and/or having failed auditory/visual tests), which is less than half that of severe HIE survivors (78%, n=18).

From a literature review of 15 studies, moderate HIE similarly had the highest incidence while mild HIE had the lowest (15%), likely due to the exclusion of patients that did not receive TH. 10-15% of newborns with moderate-to-severe HIE died—mostly before discharge—while 10-25% had severe neurodevelopmental delay at follow-up (median 24 months). Newborns with severe HIE were approximately four times more likely to experience death or major disability than those with moderate HIE, which is comparable to the relative risk of short-term adverse outcomes determined in the cohort study.

Significance: These results provide an updated look at short- and long-term outcomes for newborns with HIE in the NICU, highlighting the variable prognoses between different HIE stages.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium Table of Contents

Saiya Gill

Medical Student, University of Galway | Bush Research Team Characterizing Wilms’ Tumour (WT) Morphology using Spatial MALDI Mass Spectrometry

Session 6 | Poster 43

Saiya Gill, Joshua Dubland, Jonathan Bush Background: Wilms’ Tumour (WT) or Nephroblastoma is the most common malignant renal neoplasm seen in children. While the pathogenesis remains unclear, 5-15% of cases present syndromically, suggesting other molecular factors may be involved. WT is characterized histologically by a triphasic composition of blastemal, stromal and epithelial elements. The clinical behaviour of WT subtypes varies, with epithelial predominant WTs often responding beneficially with surgery, whereas blastemal predominant WTs are associated with higher recurrence and poorer prognosis. Mass spectrometry (MS), specifically MALDI (matrix-assisted laser desorption/ionization) imaging mass spectrometry (IMS) allows for spatial proteomic analysis. This process provides insight into tumour heterogeneity by linking molecular profiles to histologic subtypes.

Objectives: This pilot study explores the application of mass spectrometry, specifically MALDI-IMS, to uncover morphological molecular differences within Wilms’ Tumour and its relationship with the surrounding tumour microenvironment.

Methods: Ten formalin-fixed, paraffin-embedded Wilms’ Tumour (WT) samples were selected and transferred to Vanderbilt University to be analyzed using MALDI-IMS. Digital pathology overlays were used to annotate regions of interest (ROIs) containing WT histological subtypes: epithelial, blastemal, stromal and normal renal parenchyma. The data was analyzed with a 5% FDR (False Discovery Rate) threshold to identify ions mutually exclusive to tumour regions and normal kidney tissue.

Significance & Conclusion: IMS is a powerful tool used to identify molecular differences within Wilms’ Tumour (WT). In this pilot study, IMS was successful in identifying 55 distinct ions within a single sample (n=1 of analysis), which may be useful in categorizing tumour vs non-tumour tissue. These findings signify the potential of using IMS in both tumour classification and biomarker discovery.

Future Steps: • Expand analysis to 9 additional Wilms’ Tumours • Use a custom protein database to assign identities to detected ions • Increase ROI coverage to allow finer morphologic subtyping • Validate candidate markers using IHC to assess clinical utilization/relevance

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Kinsley-Marlie Jura Medical Student, University of British Columbia | Singhal Research Team UBC Faculty of Medicine Summer Studentship Recipient

Long-Term Seizure Outcome With or Without Vagal Nerve Stimulation Therapy in Pediatric Drug-Resistant Epilepsy: A Single Site Study

Session 6 | Poster 44

Kinsley-Marlie Jura, Madeline Elder, Annika Weir, Samantha Nalliah, Mary Connolly, Ash Singhal Background: Vagal Nerve Stimulation (VNS) has been an adjuvant therapy for drug-resistant epilepsy for more than 25 years. However, the long-term seizure outcomes of continued VNS stimulation compared to the discontinuation of VNS stimulation in pediatric patients is unknown.

Objective: In this study, we aimed to evaluate and compare long-term seizure reduction in pediatric patients with long-term VNS stimulation (VNS-on) with those who discontinued VNS (VNS-off).

Methods: A retrospective chart review of pediatric patients with drug-resistant epilepsy who underwent VNS implantation at BCCH from 1992 to 2024 was performed. Demographic data including VNS status (ON/OFF) and all seizure frequency per month (ASF) was documented at 8-years follow-up. We assessed between-group differences (VNS-on vs VNS-off) in ASF reduction at the same time point.

Results: Fifty patients were included; at 8-years follow-up, 64.0% (16/25) VNS-on patients had >50% reduction in ASF, whereas 88.0% (22/25) VNS-off patients had >50% reduction in ASF. In the VNS-on group, the median ASF decreases significantly from 75 (IQR = 218.75) to 19 (IQR = 87.79). In the VNS-off group, the median ASF decreases significantly from 90 (IQR = 129.6) to 14 (IQR = 28.70).

Conclusion: Both VNS-on and VNS-off groups had significant reduction in seizure frequency at 8-year follow-up compared with pre-VNS seizure frequency. This suggests that other factors, such as natural disease course and other treatments, affect epilepsy control over time, apart from active VNS treatment.

Our results are of importance to both medical practitioners and families in facilitating informed decisionmaking regarding epilepsy surgery.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Alysha Lee

Medical Student, Royal College of Surgeons in Ireland | Adam Research Team BC Children’s Hospital Research Institute Equity, Diversity & Inclusion Summer Studentship Recipient

Equity of Access to Whole Exome Sequencing for Pediatric Epilepsy Patients: A Mixed Methods Study

Session 6 | Poster 45

Alysha Lee, Shelin Adam, Michelle Demos Background: Epilepsy is a disorder of the brain characterized by an ongoing predisposition to epileptic seizures. Approximately 30% of pediatric epilepsies have a genetic etiology and require genetic testing, such as Whole Exome Sequencing (WES), for targeted treatment. Genetically mediated complex epilepsy in children is thought to be equally distributed, yet anecdotal reports from BC Children’s Hospital (BCCH) have noticed a lack of diversity in families accessing WES. Thus, we aim to identify if WES is equitably distributed and what factors affect uptake of testing.

Methods: In Phase I, a retrospective chart review was completed on 352 BCCH patients who received WES in 2021-2023. Demographic variables were collected: patients’ ethnicity, language spoken by parents, and city of residence. The 2021 Community Health Service Area data was used to identify socioeconomic status and deprivation levels within their neighbourhood. As a comparison, a Z-test will be done between our cohort and the 2021 BC Census. In Phase II, we will conduct semi-structured interviews with 12-15 rural families to understand barriers and facilitators to accessing WES. The qualitative data will be analyzed using inductive coding and thematic analysis.

Results: The chart review of all 352 patients shows that 92% of parents in our cohort speak English, compared to 79% of the BC population who speak English at home. Out of the collected ethnicities (n=221), 48% were Caucasian/Mixed Caucasian, 39% were Visible Minorities, and 13% were Indigenous.

We also found that 54% of our families came from the most urban areas, while 15% came from rural locations. The deprivation index revealed only 8% of families came from regions with the lowest socioeconomic status.

Conclusion: Results from Phase I indicate our families were more English-speaking and of higher socioeconomic status than the BC population; however, the distribution of ethnicities and urban to rural locations seems to reflect the province as a whole. We anticipate that Phase II will provide deeper insight on the experience of accessing WES, which will enable us to identify ways to improve future uptake of genomic testing in the Division of Neurology.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Reeve Liew

Medical Student, University of British Columbia | Pianosi Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Coblation Intracapsular Tonsillotomy: Postoperative Bleeding Rates at BC Children’s Hospital

Session 6 | Poster 46

Reeve Liew, Fainess Mwakisimba, Kiersten Pianosi Background: Tonsillectomy is a frequently performed surgery in pediatric settings for the treatment of obstructive sleep apnea and recurrent tonsillitis. Coblation intracapsular tonsillotomy (CIT) utilizes lowtemperature plasma to precisely remove affected tonsillar tissue while preserving the fibrous capsule separating it from the underlying muscle. CIT aims to reduce the risks of serious complications such as postoperative bleeding compared to traditional tonsillectomy methods. While numerous studies in the UK and USA have reported favourable results, outcomes of CIT in Canadian pediatric populations have not been extensively studied, and concerns remain regarding the potential for the preserved tonsillar tissue to regrow and require revision surgery in the future.

Objectives: The aim of this study is to evaluate the primary and secondary postoperative bleeding rates following CIT in a pediatric population at a tertiary care centre in Canada. The rate of revision surgery, such as in the case of tissue regrowth or recurrent symptoms, will be evaluated as a secondary outcome.

Methods: A retrospective chart review will be conducted to analyze medical records of all pediatric patients who underwent CIT at BC Children’s Hospital between January 2019 and December 2024.

Data will be collected on demographics, surgical details, and postoperative outcomes, including length of hospital stay, emergency department visits, hospital re-admissions, postoperative bleeding, and revision surgery. Rates of primary bleeding (<24h postoperatively), secondary bleeding (>24h postoperatively), and revision surgery will be calculated and compared with the existing literature. Data collection is ongoing at the time of abstract submission.

Significance: The choice to proceed with tonsillectomy requires careful consideration of its benefits and risks, yet the significant gap in research on the outcomes of CIT in Canadian pediatric populations leaves healthcare providers and families with limited regional-specific data to inform this decision. The frequency of pediatric tonsillectomies and risks of life-threatening complications further highlight the urgent need for evidence-based guidelines. By providing localized insights into the safety and efficacy of pediatric CIT, the results of this study will support the development of such guidelines and inform future recommendations to improve surgical outcomes.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Taylor Traaseth

Medical Student, Queen’s University | Hutcheon & Liauw Research Teams BC Children’s Hospital Research Institute Summer Studentship Recipient

Impact of Planned Cesarean Delivery With No Clinical Indication on Neonatal and Maternal Length of Stay in Hospital

Session 6 | Poster 47

Taylor Traaseth, Jennifer Hutcheon, Jessica Liauw Background: Use of Cesarean delivery without a clinical indication (“maternal request”) is a controversial topic in Canada, and an understanding of its costs to the healthcare system is important for informing policies on its use. Numerous studies have examined hospital length of stay (LOS) – a key driver of hospital costs – by actual mode of delivery (vaginal vs Cesarean). This comparison, however, is misaligned with the information available at the time of antenatal decision-making, as a planned vaginal delivery could result in either an actual vaginal delivery or an emergency intrapartum Cesarean.

Objectives: To estimate maternal and neonatal LOS in hospital following a planned Cesarean delivery with no clinical indication (“maternal request”), compared with planned vaginal delivery.

Methods: We conducted a population-based retrospective cohort study of all singleton term births from nulliparous pregnancies in British Columbia from 2004 to 2017 using the British Columbia Perinatal Data Registry. Infants were classified as those delivered following a planned Cesarean delivery without a clinical indication (proxied by breech presentation) or planned vaginal delivery. The primary outcomes were neonatal and maternal total LOS in hospital, in days. Differences in mean differences were tested using a t-test.

Results: The planned Cesarean group comprised 10,558 women and the planned vaginal group comprised 242,505 women (27.0% emergency Cesarean). The rate of emergency Cesareans among singleton term births increased from 25.6% in 2004 to 30.1% in 2017. The planned Cesarean group had significantly longer maternal LOS (3.2 vs 2.8 days, p<0.001) and neonatal LOS (3.2 vs 2.4 days, p<0.001) than those in the planned vaginal group.

Conclusion: Planned Cesarean delivery with no clinical indication was associated with significantly longer maternal LOS and neonatal LOS, compared to planned vaginal delivery. These findings provide evidence to inform the development of policies surrounding “maternal request” Cesareans.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Lisa Zhang

Medical Student, University of British Columbia | Lee Research Team UBC Faculty of Medicine Summer Studentship Recipient

Building Connections: Caregivers of Children with Medical Complexity Facilitating Communication Training with Pediatric Residents

Session 6 | Poster 48

Lisa Zhang, Judy So, Mimi Kuan, Jenna Lew-Cooke, Cynthia Vallance, Esther Lee Background: Children with medical complexity (CMC) account for 37% of all pediatric hospitalizations.

For pediatric residents (PR) training primarily at a pediatric tertiary care centre, this means a third of their patients will be CMC. Despite this, a survey study in Boston found PR’s mean self-entrustment was at or below ‘somewhat confident’ for all clinical activities in complex care. Residents also described a lack of comfort in responding to the psychosocial needs of families of CMC. This must be addressed, as studies have shown physician lack of confidence/skill in caring for patients with disabilities is a driver of disabilitybased discrimination in healthcare.

Objectives: To enhance first- and second-year pediatric residents’ skills in (1) communicating effectively with CMC and their families and (2) recognizing and addressing ableism in pediatric healthcare.

Methods: Using quality improvement (QI) methodology, a novel curriculum was co-developed over six months through monthly Zoom meetings with caregivers of CMC (family partners) and delivered during an academic half-day session for first- and second-year pediatric residents in June 2025 at BC Children’s Hospital. The session was facilitated by family partners, a complex care pediatrician, and a patient and family engagement advisor from Sunny Hill. Curriculum evaluation includes pre- and post-workshop surveys assessing residents’ self-entrustment in addressing the psychosocial needs of families of CMC, analyzed using descriptive and inferential statistics. Narrative analysis of workshop transcripts is ongoing to identify common themes and inform improvements for future sessions.

Significance: This QI initiative addresses a critical training gap in disability-informed practice for pediatric residents—an area often overlooked in formal education and left to the “hidden curriculum”. Strengthening resident communication skills and reducing implicit bias may improve health outcomes for CMC and decrease caregiver medical traumatic stress. For CMC—who often experience frequent hospitalizations— positive early interactions can shape lifelong perceptions of healthcare. The same is true for their caregivers, whose well-being is closely tied to the quality of clinical encounters.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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SESSION 7 Thursday, July 24, 2025 11:00 am – 12:30 pm In-Person, BCCHR Atrium

Participants Serin Cheun Carmen Choo Scarlett Farrar Michelle Ho Matthew Lu Selina Park Kevan Wu Nathan Yang

Serin Cheun

Undergraduate Student, University of Toronto | Devlin Research Team Canucks for Kids Fund Childhood Diabetes Laboratories Summer Studentship Recipient

Epigenetic Markers of Cardiovascular Risk in Type 1 Diabetes

Session 7 | Poster 49

Serin Cheun, Ladan Kalani, Zoe Lofft, Angela Devlin Background: Cardiovascular complications are the leading cause of mortality in individuals with Type 1 Diabetes (T1D). With the affected pathways of vascular damage remaining poorly understood, we aimed to understand how gene expression in early stages of the disease contributes to long-term complications.

Epigenetic modifications (e.g. histone methylation) orchestrate persistent changes in gene expression.

In this study, we used two mouse models to investigate how prenatal nutrition and early metabolic dysfunction induce epigenetic modifications that predispose to metabolic and vascular disease: (1) a high folate maternal diet model to study effects on pancreatic development in offspring, and (2) the Akita (Ins2+/Akita) mouse model to examine early vascular dysfunction.

Objective: To determine how early-life nutritional and metabolic stressors impact epigenetic modifications in endocrine and vascular tissue.

Methods: 1. Pregnant dams were fed a control or high-folate diet. Offspring liver and pancreas were isolated at post-natal day 14 and nuclei was isolated from liver for H3K4 methylation (H3K4me) via immunoblotting.

2. Aorta and kidney were harvested from onset and post-onset Akita mice and analyzed for H3K4me and H3K9 acetylation (H3K9ac) via immunoblotting.

Results: Preliminary findings suggest that a high folate maternal diet increases H3K4me in offspring, consistent with folate’s role in methyl donation. H3K4me is known to mark actively transcribed genes, which are expected to increase in high folate diets and metabolically stressful conditions. Over time, this may lead to long-term activation of pro-inflammatory pathways in the offspring, increasing disease susceptibility.

For the Akita mice, we expect an epigenetic upregulation of genes related to reactive oxidative species (ROS), such as NFkB and Serpine 1. Chronic hyperglycemia is known to increase ROS in endothelial cells, activating NFkB-driven inflammatory responses that contribute to endothelial dysfunction.

Conclusion: Identifying early epigenetic markers of vascular dysfunction can predict, prevent, and potentially reverse vascular complications in T1D.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Carmen Choo

Undergraduate Student, University of British Columbia | Krishnan Research Team Rectus Sheath Block and Coadministration of Intravenous Dexamethasone for Analgesia after Pediatric Laparoscopic Appendectomy – A Pilot Study

Session 7 | Poster 50

Carmen Choo, Rory Blackler, Hannah Piper, Steffanie Fisher, Katherine Mason, Prakash Krishnan Introduction: A laparoscopic appendectomy is a surgical procedure where the appendix is removed through small incisions in the abdominal wall. It is the most common emergent surgery performed in children. Despite being minimally invasive, the majority of children require opioid medications at some point during their recovery. Increased pain after surgery can delay healing, prolong hospitalization and lead to chronic pain. While opioids can provide appropriate analgesia, there are considerable side effects including sedation, respiratory depression, nausea, and constipation. Therefore, there is a need to minimize opioid use in children recovering from laparoscopic appendectomy.

There are currently two standard approaches to pain management during the surgery. The first is a regional approach using a rectus sheath block with intravenous dexamethasone, that targets medication deeper into the abdomen wall nerves. The second, is a local approach where anesthetic is infiltrated around the incision sites. It remains unclear which method provides superior pain control.

Objectives: The goal of this study is to determine the best approach for post-operative pain control for children undergoing laparoscopic appendectomy by comparing two methods of anesthetic delivery: 1) rectus sheath block with intravenous dexamethasone and 2) local anesthetic infiltration. This pilot study will determine the feasibility of a larger randomized control trial.

Methods: All cases of non-perforated appendicitis at BC Children’s Hospital will be considered for recruitment for this study. If eligible, patients are randomized into one of the two groups. The patient and their families will be informed which method of anesthesia they will receive by the anesthesiologist and the potential risks of the approach will be explained. Patients will be consented for the use of their data following their procedure. Thirty-two patients will be recruited and asked to complete a parent satisfaction survey. Post-operative pain management will be assessed using pain scores, opioid usage, and parent satisfaction.

Results: Data collection is ongoing.

Significance: Identifying the most effective method for pain control after laparoscopic appendectomy may improve patient outcomes, reduce medication use, and support faster recovery. This study may help guide clinical decisions, support evidence-based practice, and enhance overall perioperative care.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Scarlett Farrar

Undergraduate Student, University of British Columbia | Bhatnagar Research Team Single Leg Hop Test for Post ACLR Assessment – What Matters Most: Height or Symmetry?

Session 7 | Poster 51

Scarlett Farrar, Ali Hawkins, Farah Azim, Timothy Bhatnagar, Lise Leveille The Athletic Motion Analysis (AMA) program at The Motion Lab (TML) at Sunny Hill Health Centre assesses participants’ readiness to return to sport following anterior cruciate ligament reconstruction (ACLR). Graft failure of ACLR in pediatric patients can range between 9.6 to 29%. Thus, it is important that participants only return to sport when their body is physically ready, reducing the risk of reinjury.

Motion capture technology is used to evaluate the biomechanics of patients post-operatively as they perform several tests according to the PRiSM Sports protocol, this includes the single leg hop (SLH).

SLH is currently assessed using the limb symmetry index (LSI), which is a ratio of the affected limb’s hop distance to the unaffected limb’s hop distance. A recent study of the adult population has shown that single leg hop distance normalized to height (SLHDH) should be considered to determine the appropriate hop distance threshold. The current study compares the SLHDH to the LSI as a threshold to evaluate adolescent participants’ readiness for return to athletic activity following ACLR. We hypothesise that there will be a greater number of participants who pass the LSI threshold compared to the SLHDH. Participants (n=48, males = 16, mean age = 17.06 yrs) are referred to TML 8-16 months post-operatively for AMA evaluation by their orthopaedic surgeon. SLHs were collected and analyzed using a motion capture system according to the PRiSM Sports protocol. The SLH involves jumping and landing on the same foot and maximizing distance. LSI is calculated by dividing the affected limbs’ single leg hop distance (SLHD) by the unaffected SLHD. SLHDH is calculated by dividing SLHD by height. Each subject will then have their LSI and SLHDH compared to the standard thresholds for the respective metric (90% and 70%) found from previous literature. Ensuring a patient only returns to sport when ready reduces the risk of reinjury.

If the results depict discrepancies in the two metrics, TML should consider including both metrics as part of routine care.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Michelle Ho

Undergraduate Student, University of British Columbia | Pike Research Team BC Injury Research and Prevention Unit Summer Studentship Recipient

Preventable by Choice: A Longitudinal Analysis of Risk Perception, Injury Prevention Attitudes, and Behavioural Change in British Columbians Aged 25–54

Session 7 | Poster 52

Michelle Ho, Alex Zheng, Samantha Bruin, Ian Pike Background: Injuries are the primary cause of death among British Columbians aged 1 to 44, exceeding chronic illnesses such as cancer and heart disease. While often considered accidents, many injuries are preventable through small, deliberate actions. Preventable, a non-profit organisation established in 2009, addresses this issue by shifting public attitudes and behaviours through targeted awareness campaigns.

These campaigns instil a culture of conscious injury prevention and encourage safer choices, particularly in everyday situations lacking explicit warnings. Their strategy emphasises personal responsibility using timely reminders and behaviour-change messaging. However, it has become increasingly difficult to reach the younger demographic (ages 25–34) through Preventable’s social marketing campaigns.

Objective: This study examines changes in public attitude and beliefs, self-reported behaviours, and campaign recall across two demographics: (i) ages 25–34 and (ii) 35–54, over the course of the campaign. Special focus is placed on trends in the 25–34 age group to understand how their preferences have changed over time and improve engagement strategies for this difficult-to-reach cohort.

Methods: Survey data from campaign years (2009, 2012, 2016, 2022) were analysed in R for descriptive statistics. A literature review was also conducted to assess how social marketing to 25–34-year-olds has evolved, comparing those in this age group in 2009 (Generation X) and in 2022 (Generation Z).

Results: Preliminary analysis shows similar public attitudes and behaviours between the two age groups over time. The belief that injuries only happen to other people declined, while daily consideration for preventing injuries rose. Self-reported behaviours on preventable injuries follow similar trends between the age groups. Recall of campaign ads was higher among older generation than the younger generation.

The younger generation found the campaign easier to believe, but less interesting and insightful than the older generation. Literature suggests Generation Z prefers peer and influencer-created, entertaining video content rather than traditional public service announcements. Conversely, Generation X responds better to informative messaging and show higher behavioural change when exposed to preventive health information via trusted sources.

Conclusion: To maximise impact, injury prevention campaigns should align with generational preferences—using peer-driven, dynamic content for Generation Z, and research-based, informative messaging for Generation X.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Matthew Lu

Undergraduate Student, Queen’s University | Wiens Research Team BC Children’s Hospital Research Institute Healthy Starts Summer Studentship Recipient

Is there an association between distance from the discharging hospital and risk of post-discharge mortality in children under 5 admitted with sepsis?

Session 7 | Poster 53

Matthew Lu, Matthew Wiens Background: Currently, nearly 3 million children under the age of 5 die from sepsis annually, most of which occur in low- and middle-income countries (LMICs). Many of these deaths occur during the post-discharge period. While geography has been identified as a barrier to accessing care in some studies, its independent effect during the post-discharge period remains unexplored.

The multi-center Smart Discharges study examined the epidemiology of post-discharge mortality among children admitted with sepsis in Uganda and developed prediction models to identify children at risk of mortality during the post-discharge period. Leveraging this large cohort of children, we seek to elucidate the independent impact of distance of residence from both the admitting health facility and the nearest health facility, on post-discharge mortality and readmission.

Objective: To investigate the independent effect of distance to hospitals from home on post-discharge mortality and readmission among under-5 children with sepsis, while accounting for common geographyrelated sociodemographic confounders that may influence both access to care and mortality risk.

Methods: Using the dataset from the Smart Discharges cohort study, we performed a secondary analysis to determine the impact of euclidean distance on the outcome of mortality and the outcome of first readmission, within 6 months of discharge. Patient home coordinates (latitude and longitude), the location of their discharge hospital, alongside readmission and vital status during the 6-month follow-up were used to identify exposure and outcome status. A preliminary analysis was conducted to identify key confounders associated with both the outcome and exposure of mortality. Confounders included maternal education, household size, marital status, use of a mosquito net, and the purity of drinking water (i.e. boiling, filtering, disinfecting of drinking water). Using R, the euclidean distance was calculated for each child, and a multivariable Cox proportional hazards model was conducted to determine the association of distance on mortality.

Results: Our preliminary analysis included 3,679 children who were discharged alive, of whom 159 died during the 6 month post-discharge period. In the unadjusted analysis, we observed a trend towards a decrease in the risk of mortality as distance increased (HR per 10 km: 0.993; 95% CI: 0.985–1.001; p = 0.093). After adjusting for confounders, the association reversed (aHR per 10 km: 0.991; 95% CI: 0.983–1.000; p = 0.048). Our adjusted model suggests that longer distance from hospital does not independently increase the risk of post-discharge mortality.

Conclusion: Our adjusted model suggests that longer distance from hospital does not independently increase the risk of post-discharge mortality and may in fact contribute to lower mortality rates, though a more thorough examination of potential confounders may be warranted.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Selina Park

Undergraduate Student, Queen’s University | Bettinger Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Behind the Shot: Social factors influencing parental decisions for HPV immunization for their children

Session 7 | Poster 54

Selina Park, Lo Lee, Julie A. Bettinger Background: Human papillomavirus (HPV) is among the most prevalent sexually transmitted infections globally. Evidence supporting the efficacy of HPV vaccine is rapidly accumulating, with studies demonstrating nearly a 90% reduction rate in cervical cancer incidence among vaccinated populations.

In pursuit of eliminating cervical cancer, the World Health Organization (WHO) has set a target to achieve full HPV vaccination coverage in over 90% of adolescents by 17 years of age. Yet, vaccination rates in British Columbia (BC) remain suboptimal. As of 2023, only 60% of female and 57.7% of male students had received two recommended doses of the vaccine. This uptake is lower by over 25% than other school-based immunizations, such as the hepatitis B vaccine. Given that parental consent is required when the HPV vaccine is given in school, understanding the factors influencing parental decision-making is essential.

Objectives: To identify the social and contextual factors that influence parental decisions to accept or decline HPV vaccination for their children.

Methodology: Five interview transcripts were randomly selected from the ACE-PROVE project database.

Parents of children in grades 6-8, were interviewed about their knowledge, attitudes, and decision-making processes regarding the HPV vaccine. Interviews conducted via Zoom were transcribed, de-identified, and reviewed for accuracy prior to analysis. Deductive coding approaches were applied using the established codebook from the Vaccine Evaluation Center, and the codes were analyzed using thematic analysis.

Results: Of the five interview transcripts selected, three participants had yet to vaccinate their child with the HPV vaccine while two had completed the vaccinations. All participants expressed positive views on vaccines, including the HPV vaccine. During the interviews, they discussed internal and external factors that influenced their decision-making processes. Through thematic analysis, four themes were identified: (1) community influence and social responsibility, (2) role of parents, school, and child involvement, (3) sex and cultural norms, and (4) information environment and misinformation.

Significance: This project aims to contribute to the understanding of social factors contributing to HPV vaccine decision-making to increase rates of uptake.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Kevan Wu

Undergraduate Student, University of British Columbia | Oldani Research Team Modulation of Autophagy in Experimental Models to Improve Liver Transplant Outcomes: Literature Review

Session 7 | Poster 55

Kevan Wu, Mina Kolahdouzmohammadi, Graziano Oldani Background: Liver transplantations, the only effective treatment for end-stage liver disorders, face significant challenges due to its growing need and graft loss problems. Driven by factors such as alcohol consumption and an aging population, liver diseases are becoming increasingly prevalent worldwide, resulting in a severe organ shortage. With transplants, graft loss can be a challenge due to donor organ rejection and ischemia/reperfusion injury. Autophagy, a cellular process that degrades and recycles damaged components to maintain cellular homeostasis, is found in a recent study to have an important role in addressing these concerns. Autophagy is critical in regulating apoptosis, antigen presentation, necrosis, and metabolic adaptation— essential for successful transplantations. The following research aimed to examine the role autophagy plays in post-transplantation organ preservation and recovery, additionally investigating its potential role in immune response regulation and increasing graft survival.

Furthermore, autophagy was studied in the context of xenotransplantation, a potential solution to the organ shortage crisis.

Methods: A literature review was conducted of existing research investigating autophagy regulation for organ preservation before liver transplantation and for graft survival and associated ischemia/reperfusion injury damage. Articles selected were published from 2016 to 2025 with key words, including ischemia/ reperfusion injury and autophagy, in reference to mouse and human contexts.

Results: For liver transplantation, autophagy has been shown to enhance organ preservation by regulating cellular self-repair and recycling damaged components. Moreover, autophagy is found to play important roles in modulating immunological rejection in xenotransplantation, enhancing xenograft viability. In regard to ischemia/reperfusion injury, autophagy has been observed to act as a protective mechanism maintaining cellular homeostasis.

Conclusion: By protecting against preservation injury, regulating immune responses, and mitigating ischemia/reperfusion injury, modulating autophagy demonstrates therapeutic potential in practical applications for liver transplantation.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Nathan Yang

Undergraduate Student, University of British Columbia | Lang Research Team Database Infrastructure Creation for Clinical Neurological Markers of Small Vessel Disease in Dual Diagnosis Psychosis-Addiction Patients

Session 7 | Poster 56

Nathan Yang, Donna Lang Background: In 2024, a new broad investigation of mental illness, addictions and head trauma in a socio-economically impoverished urban population, Vancouver’s Downtown Eastside (Downtown Eastside = DTES) was launched. Residents of the DTES are an acutely economically challenged population and experience a significantly elevated rate of both psychiatric disorders and addictions. Many residents in this neighbourhood struggle to get adequate health care (Honer et al., 2017). Within this context, it has been shown in our previous initial investigations that this population also experiences a very high rate of head injuries (O’Connor et al., 2022).

Objective: The objective is to assess signs of cerebrovascular disease in the DTES cohort as part of identifying predictive biomarkers of accelerated clinical and cognitive decline over time.

Exploratory Hypotheses: It is expected that participants will have elevated rates of white matter hyperintensities (a sign of small vessel disease) on imaging.

Methods: Participants: 300 residents (age 19-65) of the DTES are actively recruited; currently, 220 have been enrolled, and further enrolment will continue over the next 12 months. Participants’ eligibility includes the ability to provide full written consent in English and the ability to participate in cognitive assessments, clinical interviews, and MRI scanning.

MRI Scans: Neuroimaging is being conducted annually for each participant upon completion of initial cognitive and clinical assessments. All neuroimaging is undertaken on the UBC 3T Phillips Elition Scanner at the UBC MRI Research Centre. T1-weighted anatomic images,T2-weighted anatomic images, T2-weighted MR Angiography scans and T2-weighted Fluid Attenuated Inversion Recovery (FLAIR) scans have been conducted.

MRI Qualitative Assessments: A full clinical qualitative research rating of brain morphology and potential incidental findings was performed by a qualified neuroradiologist. Additionally, a qualitative rating of cerebrovascular deficits (small vessel disease) based on the Fazekas Scale (Fazekas et al., 1987) was performed by trained raters using FLAIR scans.

Significance: The interaction of these factors and their long-term consequences is not clear. Clinical, cognitive and psycho-social measures are regularly ascertained over 5 years so that we can explore predictive markers of clinical trajectories and outcomes for the DTES population.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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SESSION 8 Thursday, July 24, 2025 11:00 am – 12:30 pm In-Person, BCCHR Atrium

Participants Anna Wiese Yoonsoo Ham Johnny Huang Zeanne Madda Nathan Millward Faithful Olarinde Nicholas Tjandra Amber Wong

Anna Wiese

Undergraduate Student, Queen’s University | Armstrong Research Team Community Child Health Endowment Summer Studentship Recipient

Feasibility of using a commercially available mindfulness app to reduce symptom burden in teenagers with Dysautonomia

Session 8 | Poster 57

Anna Wiese, Astrid De Souza, Melanie Kardel, Pearl Waraich, Kathryn Armstrong Background: Dysautonomia of Adolescence (DAOA) is a condition that affects as many as 1 in 3 adolescents and results from an imbalance in the Autonomic Nervous System (ANS). Patients with DAOA experience symptoms affecting multiple organ systems including: tachycardia, dyspnea, chest pain, dizziness, nausea, stomach pain, muscle/joint pain and brain fog. Mindfulness strategies may help manage symptoms and improve quality of life (QoL); however, little research has been done to explore the effectiveness of mindfulness interventions in this population. The purpose of this project is to use a mindfulness app (Open), which has a 21-day nervous system reset program to: (1) determine the feasibility and acceptability of the Open app and (2) determine if the use of the Open app reduces symptom burden in adolescents with DAOA. Methods: Ten adolescents (ages 13–18) followed in the BC Children’s Hospital DAOA Clinic will be identified through a clinic list and contacted via email. Participants will download and sign up for the ’21 Day Nervous System Reset’ on the Open app. Prior to starting the program participants will complete the PedsQL and Symptom Burden questionnaires which assess QoL and symptom severity prior to and after using the Open app. Participants will complete daily 15-minute mindfulness sessions which will include meditation, breathing exercises or sound awareness for 21 days. Compliance will be tracked through daily text or email check-ins, with most participants using the text messaging platform WelTel. Weekly messages will also monitor participant well-being.

Expected Outcomes: We expect that adolescents with DAOA will find the Open app both accessible and helpful, and that regular mindfulness practice will lead to a reduction in symptom burden. Given the strong connection between the ANS and the mind-body connection, we hypothesize that DAOA patients who complete the 21 days of guided mindfulness will reduce their physical symptoms. We anticipate that will result in high participant retention, strong compliance, and prove a good resource for future use.

If successful, this pilot study will lay the groundwork for larger-scale research on the role of mindfulness in managing DAOA symptoms.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Yoonsoo Ham

Undergraduate Student, University of British Columbia | Loucks Research Team UBC Faculty of Medicine Summer Studentship Recipient

Exploring the genetic underpinnings of morphine ineffectiveness in children with cancer

Session 8 | Poster 58

Yoonsoo Ham, Graeme Ernest-Hoar, Erika N Scott, Jia He Zhang, Rena M Daniel, Colin JD Ross, S Rod Rassekh, Bruce C Carleton, Brock Grill, Catharine Rankin, Catrina M Loucks Background: Morphine is commonly used to manage pain in children with cancer, yet its effectiveness varies. Genetic differences likely contribute to this variability, but research in pediatrics is limited. This project aims to identify genetic variants associated with morphine ineffectiveness and explore associated gene function using a Caenorhabditis elegans model.

Objectives: 1. Identify genetic variants associated with poor pain relief from morphine in children with cancer using a case-control pharmacogenomic analysis.

2. Investigate the functional relevance of variant-containing genes by examining morphine sensitivity in C. elegans strains with mutations in orthologous genes.

Methods: 1. Genetic analyses in children: Using genomic data from 204 children with cancer (57 with poor morphine-based pain relief and 147 with adequate pain relief), genetic variation in morphine-related genes will be examined. Genes identified as harbouring variants significantly associated with morphine ineffectiveness will be functionally validated in C. elegans.

2. Functional validation in C. elegans: C. elegans expressing a mammalian μ-opioid receptor will be used to assess morphine sensitivity. Worms with mutations in identified genes will be recorded in assay buffer ± morphine, and morphine-induced locomotory inhibition will be quantified using specialized worm-tracking software.

Results: Given that dopamine-related genes have been previously implicated in human pain and pain relief-related processes, preliminary analyses focused on C. elegans loss-of-function dopaminergic mutants. Analyses showed that C. elegans SLC6A2 (dat-1) mutants with enhanced dopamine signaling exhibited greater locomotory inhibition in buffer compared to wild-type. Conversely, TH (cat-2) mutants with decreased dopamine signalling displayed similar behavior to wild-type.

Significance: Using C. elegans as a model provides functional insight into the roles of pharmacogenomic variants/genes. This work supports the potential of integrating genetic testing into pediatric pain management to employ precision medicine strategies on morphine therapy to improve pain relief.

Future Directions: Further C. elegans locomotion assays will compare movement in buffer alone versus morphine-containing buffer to assess whether morphine enhances locomotory inhibition in different genetic strains. Additionally, a genome-wide association study is planned to uncover novel genetic associations with morphine ineffectiveness beyond known variants/genes, especially in ancestrally diverse populations represented in Canada.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium Table of Contents

Johnny Huang

Undergraduate Student, University of British Columbia | Vallance Research Team Investigating the Role of Region-Specific Intestinal Mucus in Citrobacter rodentium Growth

Session 8 | Poster 59

Johnny Huang, Qiaochu Liang, Bruce Vallance Background/Objective: Citrobacter rodentium is a murine pathogen commonly used as a model to study human enteric infections. Infection starts in the cecum, and spreads to the distal colon, using mucus-derived components as nutrients to enable infection. The distal colon has known differences from the proximal colon, particularly in mucus content and goblet cells. Resistin-like molecule beta (Relm-ß), an antimicrobial peptide (AMP) secreted into the mucus, may contribute to regional differences in host defense. This study investigates whether C. rodentium colonizes the distal colon over the proximal colon because of the spatial differences in goblet cells and secreted mucus.

Methods: Streptomycin-resistant C. rodentium was grown in Luria-Burtani (LB) broth with shaking at 37°C overnight, pelleted by centrifugation, washed, and resuspended in M9 media. Cultures were diluted 1:50 in M9 media supplemented with 0.2% glucose or 1% murine mucus from the proximal, mid, or distal colon. Samples were incubated at 37 °C with rocking. CFU counts was assessed at 3, 5, 6.5, and 24 hours on LB-streptomycin plates. Each experiment included at least two biological replicates.

Paraffin-embedded tissue sections of mouse proximal and distal colon were deparaffinized, cleared with xylene, rehydrated, subjected to antigen retrieval in sodium citrate buffer (pH 6.0), and blocked. Tissues were stained with rabbit anti-mRelm-ß followed by Alexa Fluor 488-conjugated donkey anti-rabbit IgG. Slides were mounted with ProLong Gold Antifade reagent containing DAPI and imaged using a Zeiss AxioImager microscope and an AxioCam HRm camera operating through Zen software.

Results: C. rodentium grew best in media supplemented with glucose, with no significant differences among mucus samples. Growth stagnated between 6.5 hours to 24 hours in all mucus conditions.

Fluorescent staining showed higher Relm-β expression in the proximal colon compared to the distal colon.

Conclusions/Discussion: C. rodentium does not appear to preferentially use mucus from a specific region as a nutrient source. These results suggest that nutrient availability is not the main factor that drives C. rodentium localization in mouse infections. Rather, regional differences in AMP expression such as Relm-ß, likely play a more significant role in regulating host-pathogen epithelium interactions.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Zeanne Madda Undergraduate Student, University of British Columbia | Wasserman Research Team

Cracking the Chemical Code: Comparing Biomarker Properties to Advance Understanding of Inborn Errors of Metabolism

Session 8 | Poster 60

Zeanne Madda, Cindy Zhang, Brad Winter, Wyeth Wasserman Inborn errors of metabolism (IEMs) are genetic disorders that disrupt normal metabolic processes.

Biomarkers are molecules (chemical or biochemical) for which the presence or concentration is indicative of a characteristic of interest. These compounds play a central role in the diagnosis and monitoring of these IEMs. IEMbase is an expert-curated knowledge database for IEMs that contains biomarker information for most IEMs. IEMs often exhibit overlapping biomarkers. The objective of this project is to develop a compound similarity index that allows for the comparative analysis of any two biomarker compounds from the IEMbase through user input. Using the Python programming language, we are developing a tool that quantifies compound similarity by evaluating the following descriptors: hydrophobicity (via LogP, the log of the octanol-water partition coefficient), polarity (via Topological Polar Surface Area), and hydrogen-bond donor/acceptor count. Compounds will also be assessed for structural similarity via Morgan fingerprinting and Tanimoto similarity analysis. This method quantifies molecular similarity through the comparison of chemical fingerprints - a binary representation of the presence or absence of certain substructures (i.e. element count, ring system type, etc). All analyses will be conducted using open-source Python libraries. The primary libraries relevant to this investigation are PubChemPy and RDKit. PubChemPy interacts with the PubChem database to retrieve the Simplified Molecular Input Line Entry System (SMILES) representation of the compounds, given their names. RDKit provides the tools required for the quantification of the descriptors outlined above. For interpretability, the results of the similarity index will be visualized in three ways: 1) line-bond structures of each compound, 2) a radar plot, and 3) a feature table (containing the raw, numeric values). This investigation highlights the role of cheminformatics in rare disease research. By systematically comparing biomarkers of IEMs using molecular similarity metrics, we can create a reproducible similarity index to explore intra- and inter- disorder connections, potentially uncovering shared metabolic pathways or other functional overlaps between IEMs. Recognizing these patterns can help researchers and clinicians gain a deeper understanding of IEMs, informing more nuanced approaches to the diagnosis and treatment of these important metabolic disorders.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Nathan Millward

Undergraduate Student, University of British Columbia | Brown Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Establishing a human microglial cell line model to elucidate roles of adenosine deaminase 2 (ADA2) in cerebrovascular health

Session 8 | Poster 61

Nathan Millward, Sarah M. Bowers, Kelly L. Brown Background: Deficiency of adenosine deaminase 2 (DADA2) is a rare disease caused by pathogenic, predominantly missense, variants in the ADA2 gene. DADA2 typically presents in childhood and is often characterized by systemic vasculitis with cerebrovascular complications, including recurrent ischemic strokes and intracranial hemorrhages. The ADA2 protein is secreted as a homodimer, primarily by monocytes and macrophages, and may function as an extracellular enzyme and/or growth factor to support vascular endothelial cell development and integrity. DADA2 patients’ peripheral blood monocytes skew towards pro-inflammatory TNF-secreting M1 macrophages, and TNF inhibition therapy is effective in preventing recurrent strokes. Effects of pathogenic ADA2 variants on microglia — the tissue-resident macrophages of the central nervous system (CNS) and key regulators of CNS homeostasis — and potential contributions to cerebrovascular manifestations of DADA2 have not been investigated.

Objective: To engineer a human microglial cell line (HMC3) for stable over expression of wild-type and variant forms of ADA2. This overexpression system will enable analysis of cell-intrinsic effects mediated by different pathogenic ADA2 variants in microglia.

Methods: A FRT site for Flp recombinase-mediated site-specific integration was introduced to the genome of HMC3 cells by nucleofection of a pFRT/lacZeo plasmid, followed by antibiotic (Zeocin) selection for successful integrants. Single FRT site integration in a transcriptionally active site was confirmed by β-galactosidase activity (Mammalian β-Galactosidase Assay) and gene copy number (TaqMan Copy Number Assay). Pathogenic missense variants associated with DADA2 were generated through site-directed mutagenesis of wild-type ADA2 in the pcDNA5/FRT plasmid. Chosen variants differ in ADA2 domain localization and associated clinical features, including G47R (dimerization domain; vasculitis and stroke), R9W (signal sequence; vasculitis), L351Q (catalytic domain; stroke and hematologic deficiency), and R169Q (putative receptor binding domain; systemic inflammation). Basal and induced ADA2 expression (semi-quantitative RT-PCR) and enzyme activity (Diazyme ADA Activity Assay) were assessed in HMC3 cells.

Outcomes: Mechanisms underlying cerebrovascular manifestations of DADA2 are incompletely understood, in large part, because roles of ADA2 remain unclear. Successful integration of the genomic FRT site and optimized culture, maintenance, and transfection protocols establish a foundation to study these functions and investigate variant-specific contributions to cerebrovascular manifestations in DADA2.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Faithful Olarinde

Undergraduate Student, University of British Columbia | Beasely Research Team Canadian Institutes of Health Research Undergraduate Student Research Award Recipient

Quantification of complement component genes in cingulate cortex of individuals with depressive and psychotic symptoms

Session 8 | Poster 62

Faithful Olarinde, Clare Beasley, Li Shao Background: Major depressive disorder (MDD) has a lifetime prevalence of around 11%, and is associated with significant burden, both for the affected individual, but also their family. The cause of MDD is thought to be multifactorial, including genetic, environmental, and psychosocial factors, although the exact etiology and pathophysiology underlying the disorder remain unknown. However, a growing body of literature implicates the immune system and inflammation in MDD, suicide and psychosis.

The cingulate cortex is the extensive area of the limbic system that overlies the corpus callosum and is involved in emotional and cognitive function which traditionally has been viewed as the part of the brain circuit involved in experience and expression of emotion (Papez, 1937). The complement system is a crucial part of the immune system acting as a line of defense to protect against pathogens. Various proteins of the complement system act in conjunction to play a role in immune response and inflammation.

Recent evidence has associated dysregulation of the complement system with the pathophysiology of MDD, and complement genes are associated with suicide risk across different psychiatric disorders (Ebrahimi et al., 2024).

Methods: Post-mortem brain samples containing cingulate cortex were previously obtained from 24 individuals with MDD and 12 matched controls without psychiatric disorder. mRNA expression of complement system genes was quantified using real-time PCR. Expression will be compared between MDD and control groups. Secondary analyses will examine whether mRNA expression is altered in MDD subjects who also experienced psychotic symptoms (n = 12), or died by suicide (n = 17).

Significance: Greater understanding of the relationship between the complement system and depressive, psychotic and suicidal symptoms could lead to improved medications, as such directly improving the lives of people with depressive disorders and their families.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Nicholas Tjandra

Undergraduate Student, Simon Fraser University | Oldani Research Team Advancements in Hepatocyte Preservation: In Vitro Strategies to Enhance Viability and Function

Session 8 | Poster 63

Nicholas Tjandra, Mina Kolahdouzmohammadi, Kevan Wu, Graziano Oldani Background: Hepatocyte preservation and expansion are critical to improving outcomes in liver transplantation, advancing liver disease research, and enhancing drug toxicity testing. However, isolated primary hepatocytes often lose viability, metabolic function, and differentiation capacity rapidly in vitro, limiting their clinical and research applications.

Objective: This literature review aimed to identify and summarize recent in vitro strategies reported to enhance healthy primary hepatocyte viability, function, and long-term expansion, highlighting promising approaches for future translational applications.

Methods: We conducted a literature search in PubMed and Medline databases for studies published within the past decade. Titles and abstracts were screened according to predefined inclusion criteria, followed by full-text review and data extraction. Eligible studies evaluated in vitro methods involving chemical modulation, genetic manipulation, or biomechanical innovations to improve hepatocyte maintenance, proliferation, or differentiation. Studies were excluded if they used exclusively immortalized hepatic cell lines rather than healthy primary hepatocytes. Data extraction was performed to summarize the types of strategies, culture techniques, signaling pathways involved, reported outcomes, and limitations identified by each study.

Progress: To date, our screening has identified several emerging strategies reported in the literature.

Cytokine-based culture approaches, including those that combine factors such as interleukin-6, oncostatin M, and tumor necrosis factor-alpha, have been used to promote hepatocyte proliferation and sustain functional markers in vitro. Small-molecule inhibition of signaling pathways (e.g., ROCK, Wnt, TGF-beta, PI3K, ERK). Genetic modifications such as Foxa3 and Hnf4a overexpression; and culture environments leveraging three-dimensional scaffolds or hydrogels. Furthermore, research highlights the importance of autophagy modulation in reducing cellular stress and enhancing cell viability. Innovations in microfluidics and organ-on-a-chip technologies have also shown potential in preliminary assessments for extending hepatocyte functionality and metabolic performance in vitro.

Significance: This review, upon completion, will provide comprehensive insights into promising hepatocyte preservation techniques and identify areas requiring further investigation. Effective in vitro strategies are crucial for improving the predictive accuracy of drug screening platforms, advancing liver transplantation strategies, and ultimately enhancing liver disease management. Future findings from this review will suggest research priorities toward translating these methodologies into clinically and industrially relevant solutions.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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Amber Wong

Undergraduate Student, University of British Columbia | Charlton Research Team UBC Faculty of Medicine Summer Studentship Recipient

Exploring the Trajectory of Analgesia and Sedation Exposure in the Neonatal Intensive Care Unit

Session 8 | Poster 64

Amber Wong, Julia Charlton Background: Infants with congenital anomalies can spend weeks in the Neonatal Intensive Care Unit (NICU), often undergoing frequent invasive procedures. Given the intensity of NICU care, compelling evidence supports the need to administer pain relief to these infants to prevent neurodevelopmental harm related to brain growth, motor function, and hypothalamic-pituitary-adrenal axis development. However, while morphine, fentanyl, and dexmedetomidine are commonly used to manage procedural pain, concerns remain that these analgesics may contribute to brain injury and long-term neurodevelopmental impairment.

Objective: This study aims to characterize the normal variation of analgesic and sedative exposure for infants in their first 8 weeks of life in the NICU and identify risk factors affecting exposure.

Methods: We are conducting a retrospective observational cohort study of eligible infants admitted to the BC Women’s Hospital NICU between April 2022 and April 2025 who underwent surgery within their first 8 weeks of life. Their electronic medical records are reviewed to extract data on each infant’s primary diagnosis, weight over time, and cumulative exposure to morphine, fentanyl, and dexmedetomidine.

Descriptive statistics are used to summarize the interquartile range of cumulative analgesic exposure, while associations with clinical factors such as sex, gestational age, sedative exposure, and primary diagnosis are analyzed using chi-squared tests and regression models.

Outcomes: Understanding infants’ analgesic and sedative exposure levels and associated risk factors can help guide neonatal care practices and support the development of standardized protocols that minimize high-risk exposure and optimize pain management. Results will be shared with neonatology staff at BCWH and UBC and submitted for publication in a peer-reviewed medical journal. Future studies should evaluate the long-term neurodevelopmental outcomes associated with varying analgesic exposures and assess the impacts of standardized sedation protocols.

Presentation: Thursday, July 24, 2025 | 11:00 – 12:30 pm | BCCHR Atrium

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SESSION 9 Thursday, July 24, 2025 2:00 – 3:30 pm In-Person, BCCHR Atrium

Participants Timothy Cheng Grace Clarke Connor Flynn Rachel Guo Benedict Sutanto Vanessa Tran Leia Tsao Kevin Wong

Timothy Cheng

Undergraduate Student, University of British Columbia | Guzman Research Team Paint Me a Picture: Illustrating the Psychosocial Impact of Different Juvenile Idiopathic Arthritis Categories. Results from the CAPRI Registry

Session 9 | Poster 65

Timothy Cheng, Amieleena Chhabra, Karen Hodge, Kristin Houghton, Sarah James, Jeanine McColl, Dax Rumsey, Heinrike Schmeling, Christiaan Scott, Lori Tucker, Marinka Twilt, Jaime Guzman Background: Juvenile idiopathic arthritis (JIA) affects 1/1000 Canadian children, making it the most common chronic inflammatory rheumatic condition of childhood. There are 7 JIA categories that differ in clinical presentation, but much remains to explore about their relation to psychosocial function.

Objective: To describe the impact of different JIA categories on the psychosocial well-being of children within 3 months of diagnosis and at one-year follow-up; and to identify associated factors.

Methods: We included patients enrolled within 3 months of JIA diagnosis in the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) Registry. JIA category was assigned by the treating rheumatologist using International League of Associations for Rheumatology (ILAR) classification criteria.

Psychosocial impact was measured using the psychosocial items of the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) at registry enrollment and one year later. Kruskal-Wallis tests compared JAQQ-psychosocial scores across JIA categories (from 1=no difficulties to 7=difficulties all the time), Spearman correlation coefficients explored factors associated with JAQQ-psychosocial scores, and hierarchical clustering grouped patients and JAQQ-psychosocial items to produce heatmaps.

Results: The preliminary analysis included 1072 children at enrollment and 474 at one year.

At enrollment, we observed statistically significant differences in JAQQ-psychosocial scores across JIA categories, highest in children with RF-positive polyarthritis (median 3.2; IQR 1.8-4.4) and lowest in children with oligoarthritis (1.8; 1-3), p<0.001 by Kruskal-Wallis test. By one year, median JAQQpsychosocial scores improved in five of seven categories, and the difference across JIA categories was no longer statistically significant (p=0.432). JAQQ-psychosocial scores correlated moderately with pain intensity (rs=0.43), pain interference (rs=0.52), fatigue (rs=0.56), and physical function measured by CHAQ disability index (rs=0.52) and Kids Disability Screen (KDS) (rs=0.50). All correlation strengths were maintained at one year except for KDS (rs=0.36). Heatmaps generated with hierarchical clustering showed an overall decrease in psychosocial impact by one year but persistent impact in a small subset of children, regardless of their JIA category. Heatmaps clustered JAQQ-psychosocial items roughly into three groups: internalizing/externalizing behaviours, interpersonal relationships, and difficulties at school/leisure.

Conclusion/Implications: JIA psychosocial impact is highest shortly after diagnosis, varies based on JIA category, and decreases by one year. Unfortunately, a minority of children continue to experience substantial psychosocial impact, irrespective of their JIA category. The grouping of psychosocial items suggests potential areas for psychosocial intervention. Our results underscore the need for early, tailored, psychosocial support to complement medical treatment for JIA.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Grace Clarke

Undergraduate Student, University of British Columbia | Horvath Research Team Defining the chemical profile of brain connections in children with chemical messenger problems

Session 9 | Poster 66

Grace Clarke, Gabriella Horvath, Dakota Peacock Background: Secondary neurotransmitter disorders are a group of neurological problems that can cause frequent seizures, abnormal movements, and developmental delays. They are characterized by abnormal patterns of neurotransmitter metabolites in the cerebrospinal fluid (CSF). The lack of a pathophysiological mechanism challenges the discovery of a disease-modifying treatment. This study proposes to define the chemical profile at the synapse among children with secondary neurotransmitter disorders.

Objectives: • Characterize the metabolome of the perisynaptic space in children with secondary neurotransmitter disorders.

• Map abnormal metabolite concentrations to relevant cellular pathways.

• Identify candidate aberrant physiological processes associated with secondary neurotransmitter disorders.

Methods: The BCCH Biochemical Genetics Lab database was reviewed for all CSF NT analyses performed between 2009-2023. Samples with abnormal neurotransmitter levels were extracted, excluding those with substandard collection methodology or patients taking neurotransmitter supplements.

Samples from patients with a diagnosed primary NT disorder were used as a control group. Clinical data was collected from patient charts. Patient demographics, clinical and genetic diagnoses, development information, and imaging results were extracted. Included CSF samples will be sent to the Wishart lab at the University of Alberta for targeted metabolomic analysis. The resulting list will be subjected to metabolite set enrichment analysis (MSEA) and pathway analysis. If multiple differentially expressed metabolites are identified, supervised dimensionality reduction will proceed to create a model separating disease and control groups. Partial least-squares discriminant analysis (PLS-DA) will allow us to identify variables contributing most significantly to the separation.

Conclusion/Implications: The results of MSEA, pathway analysis, and PLS-DA will be considered together with known biological function to inform hypothesis generation and future targets of experimental studies. This project will identify cellular processes which may explain the physiology of secondary neurotransmitter disorders. This physiological understanding represents the next step in identifying biomarkers of disease, which are necessary for developing novel disease-modifying treatments for these children with severe neurological impairment.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Connor Flynn

Undergraduate Student, University of British Columbia | Goldman Research Team UBC Faculty of Medicine Summer Studentship Recipient

Prophylactic Use of Salbutamol for Pediatric Exercise-Induced Bronchoconstriction

Session 9 | Poster 67

Connor Flynn, Ran D. Goldman Background: Exercise-induced bronchoconstriction (EIB) is a common, temporary narrowing of the lower airways during or after physical activity, that restricts airflow into the lungs. It is typically diagnosed with an exercise challenge test, using spirometry to measure forced expiratory volume in one second (FEV₁) before and after exercise. A post-exercise fall in FEV₁ of 10-15% is the standard threshold for diagnosis.

Approximately 9% of youth experience EIB, though the average prevalence rises to 46% in children with asthma. Left untreated, EIB can hinder participation in physical activity, negatively impacting physical and mental health. Salbutamol, a short-acting β₂-agonist, relaxes airway smooth muscle through β₂-adrenoceptor stimulation, leading to bronchodilation that counteracts exercise-induced airway narrowing. Its use for both prevention and relief of EIB is supported by strong clinical evidence.

Objective: The aim of this study is to determine if salbutamol should be recommended for prevention of exercise-induced bronchoconstriction in children. This narrative review assessed existing evidence for efficacy and safety of salbutamol, to inform an evidence-based recommendation for clinical use in children.

Methods: Literature searches were conducted using PubMed and Google Scholar, with keywords such as “salbutamol,” “exercise-induced bronchoconstriction,” and “pediatric.” Relevant studies were identified through screening of titles, abstracts, and reference lists. We included relevant papers published after 1990. We extracted information on study methodology, participants’ illness (asthma or not), participants’ age, time of drug administration before exercise, and post-exercise change in FEV₁.

Preliminary Findings: A total of 11 randomized controlled trials (RCTs) that examine the efficacy of salbutamol for prevention of EIB were included, with salbutamol administered 15 to 30 minutes before exercise. In seven pediatric RCTs, mean post-exercise changes in FEV₁ ranged from +1.9%, to -18%.

Four RCTs performed in adults reported FEV₁ changes ranging from -4% to -15.4%. Existing clinical trials strongly support the short-term effectiveness of salbutamol for EIB prevention in children and adolescents, when taken between 15 to 30 minutes before exercise. Treatment was generally tolerated by children, and the safety profile of using salbutamol was favorable. Salbutamol is an appropriate drug for the prevention of EIB, when given less than once per day on average.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Rachel Guo

Undergraduate Student, University of British Columbia | Verchere Research Team Canucks for Kids Fund Childhood Diabetes Laboratories Summer Studentship Recipient

Optimizing an Enzyme-linked Immunosorbent Assay to Measure a Novel Prohormone Biomarker in Type 1 Diabetes

Session 9 | Poster 68

Rachel Z. Guo, Lindsay P. Pallo, C. Bruce Verchere Background: Type 1 diabetes (T1D) is characterized by autoimmune destruction of insulin-producing beta cells, resulting in lifelong insulin dependence. While over 300,000 Canadians currently live with T1D, reliable biomarkers of residual beta cell function remain limited. Pro-islet amyloid polypeptide (proIAPP), the precursor of the beta cell peptide hormone, IAPP, is a promising biomarker of beta cell function in T1D. IAPP is initially synthesized as an inactive prohormone, proIAPP1-67 that is cleaved by prohormone convertase (PC) 1/3 into an intermediate form, proIAPP1-48, and subsequently by PC 2 into mature IAPP for co-secretion with insulin. Our lab previously reported disproportionately elevated ratios of circulating proIAPP1-48 to total IAPP species in individuals with T1D compared to non-diabetic individuals. These findings highlight the potential of proIAPP:IAPP ratios to improve T1D prediction and response to therapy.

However, current in-house ELISAs for proIAPP1-48 and mature IAPP exhibit high cross-reactivity with other IAPP species, resulting in inaccurate quantification of proIAPP1-48 and IAPP. Objective: To develop and optimize a sandwich ELISA for accurate and specific measurement of proIAPP1-48 and IAPP in human plasma samples.

Methods: To identify assay formats with minimal cross-reactivity, we tested various combinations of capture and detection antibody pairs for proIAPP1-48 and IAPP quantification. Antibodies targeting the N-terminal region (#F024) and C-terminal amidated region (#F025) of mature IAPP and the N-terminal region of proIAPP that undergoes cleavage by PC 2 (#AA190) were evaluated. We then performed checkerboard assays to determine the optimal dilutions of capture and detection antibodies.

Results: We identified optimal antibody pairs and dilutions for specific measurement of proIAPP1-48 (capture: #AA190; detection: #F025) and mature IAPP (capture: #F024; detection: #F025). Crossreactivity with IAPP and proIAPP1-67 in the proIAPP1-48 assay, and with proIAPP forms in the mature IAPP assay was <15%. For both assays, antibody dilutions (AA190: 1/750; F024: 1/250; F025: 1/100) were optimized to achieve a limit of detection of ~2.0 pM. Conclusions: We improved the specificity of immunoassays that measure T1D biomarkers proIAPP1-48 and IAPP in human plasma. Further optimization of these assays will enable accurate measurement of proIAPP1-48:IAPP ratios, supporting their application in T1D clinical studies and trials.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Benedict Sutanto

Undergraduate Student, University of British Columbia | Siden Research Team Contributions and recognition of patient partners in pediatric health research: a rapid scoping review

Session 9 | Poster 69

Benedict Sutanto, Elaha Niazi, Gabriel Zamma, Candice Barrans, Colleen Pawliuk, Anne-Mette Hermansen, Danielle Pietramala, Dr. Hal Siden Introduction: Interest in Patient-Oriented Research (POR) has grown steadily in recent years as it can improve the relevancy and feasibility of research projects. In the context of this abstract, POR is a descriptor for the engagement of patients as collaborators in pediatric health research. By including patient-partners in the research process, they may meaningfully contribute throughout the lifecycle of a project and meet criteria for formal acknowledgement or authorship. However, it is often unclear where in the process patient-partners are contributing and how often they are formally recognized for their contributions.

Objectives: 1. Capture the prevalence of authorship or acknowledgement of patient-partners in pediatric health research.

2. Map the extent of patient-partners’ involvement throughout the research process.

3. Understand how patient-partner engagement is identified in searchable fields in databases.

Methods: We searched MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), and other sources of POR literature, following a set of inclusion and exclusion criteria. To expedite identification and data extraction of relevant sources, 25% of the references were screened and extracted by two independent reviewers, while the remaining screened by one reviewer. We are now completing full-text screening and completing data extraction using a data extraction tool that was developed by the research team.

Results: Our search yielded 20,299 articles. Title and abstract screening resulted in 5,948 articles for full-text review. Full-text screening and data extraction are in progress. Preliminary results from the data extraction will be presented.

Conclusions/Next Steps: While patient partnership and co-authorship is increasing, the contributions of patient-partners to the published research are not always reported. Inconsistencies remain with the identification of patient partners and the acknowledgment of their contributions in pediatric health research publications.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Vanessa Tran

Undergraduate Student, University of British Columbia | Woodward Research Team Vancouver Coastal Health Research Institute – Summer Program Advancing Research Knowledge and Skills (SPARKS) Recipient

A multivariate analysis of depression symptoms and adverse outcome risks in justice-involved youth

Session 9 | Poster 70

Vanessa V. Tran, Orli S. Hellerstein, Jodi L. Viljoen, Tonia L. Nicholls, Todd S. Woodward Background: Justice-involved youth are individuals aged 12-17 who have had contact with the criminal justice system (being convicted of criminal offences, arrested, etc). This population is disproportionately affected by depression, which is associated with greater risks for adverse outcomes (e.g. suicide), contributing to reoffending in adulthood. However, less is known about the associations between specific depression symptoms (e.g. feeling unhappy) and adverse outcome risks in justice-involved youth.

Objective: This study used iterative constrained principal component analysis (iCPCA) to explore whether depression symptoms could optimally predict adverse outcome risks in justice-involved youth.

Methods: Baseline questionnaire data were obtained from a longitudinal study of justice-involved youth (N = 87). A multivariate statistical analysis method, iCPCA, examined the optimal prediction of adverse outcome risks from self-reported depression symptoms. iCPCA provided a ‘component,’ which summarized the item-level correlations between the depression symptom and adverse outcome risk items.

Results: One significant component was extracted, accounting for 28.54% of the total variance in adverse outcome risks. Depression symptoms such as feeling miserable/unhappy, feeling lonely, and hating myself were all associated with future risks for suicide (r = 0.50), self-harm (r = 0.46), substance abuse (r = 0.27), and unauthorized leave (e.g. running away from home, missing/dropping out of school; r = 0.22).

Conclusions: One significant component linking adverse outcome risks and depression symptoms was identified. Feeling miserable/unhappy, feeling lonely, and hating oneself is related to self-injurious behaviour and violating rules. Our findings underscore the importance of considering depression symptoms when assessing adverse outcome risks, which may help clinicians tailor their treatment planning for rehabilitation in justice-involved youth.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Leia Tsao

Undergraduate Student, Queen’s University | Janssen Research Team Evaluating the Impact of SmartParent: A Retrospective Cohort Study on SMS-Based Prenatal Education and Infant Health Outcomes

Session 9 | Poster 71

Leia Tsao, Patricia Janssen Background: SmartParent is Canada’s first SMS-based prenatal education platform, programmed to deliver accessible, evidence-informed information to pregnant individuals. Prenatal education is known to improve pregnancy and infant outcomes; however, fewer than one-third of pregnant individuals in Canada attend prenatal classes due to barriers such as socioeconomic status, geographic isolation, younger age, and stigma, particularly among equity-deserving groups. In the absence of accessible, structured education, expectant parents are often directed to unreliable sources of information. SmartParent addresses this knowledge gap via three automated weekly text messages aligned with the participant’s gestational age and postpartum stage. The objective of this study is to investigate whether SmartParent enrollment is associated with improved perinatal outcomes, specifically whether participation in the program improves infant outcomes, including reduced risk of preterm birth and small for gestational age (SGA), cesarean birth rates, and higher apgar scores.

Methods: This retrospective cohort study includes 3617 participants (853 SmartParent users, 2764 control) in British Columbia who provided Personal Health Numbers (PHNs) for linkage to perinatal outcome data via Perinatal Services BC. To evaluate the association between program participation and perinatal health outcomes, group differences between factors such as maternal age, parity, gestational weight gain, prenatal care attendance, and infant outcomes between SmartParent users and non-users were assessed using chi-square tests and independent t-tests. Confounding factors were adjusted for using a logistic regression model.

Conclusion: Preliminary findings suggest SmartParent users have higher prenatal care attendance, exclusive breastfeeding rates, and lower rates of still births in comparison to standard pregnancy care subjects. SmartParent offers a scalable and low-cost approach to closing prenatal education gaps.

By promoting informed decision-making and supporting maternal health behaviors, SmartParent shows promise in reducing adverse infant outcomes and advancing health equity for children and families across Canada.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2108

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Kevin Wong

Undergraduate Student, Queen’s University | Lewis Research Team BC Children’s Hospital Research Institute Brain, Behaviour & Development Summer Studentship Recipient

Comparative Phenome, Genome, and Pathway Analyses of Genes Associated with Both Cancer and Autism Spectrum Disorder

Session 9 | Poster 72

Kevin Wong, Suzanne Lewis Background: Cancer and Autism Spectrum Disorder (ASD) are complex genetic disorders with multifactorial etiology involving genetic, environmental, and epigenetic factors. ASD is a neurodevelopmental disorder characterized by challenges in communication, social interaction, and repetitive behaviours. Twin and family studies estimate genetic contributions to ASD range from 50-90%, yet despite extensive research the precise genetic and environmental causes for many ASD children remain elusive. Interestingly, emerging evidence suggests that some genetic pathways and gene variations may overlap between ASD and cancer. Genetic studies have demonstrated certain oncogenes and tumor suppressor genes may also play a role in neurodevelopment. Understanding these connections could provide insights into shared biological mechanisms and potentially reveal novel therapeutic targets.

Objectives: 1. To identify overlapping genes implicated in both cancer and ASD. 2. To analyze clinical data to correlate de novo and inherited genetic variations related to the ASD phenotype and cancer histories in affected individuals and families.

Methods: For sample collection, exome and whole genome sequencing data was screened from a fully curated cohort of 600 psychometrically confirmed autistic probands and their parents (trios or more), found to carry either de novo or inherited gene variants also linked to risk susceptibility for distinct types of cancer and ASD. Pre-existing cancer and ASD genetic databases (e.g. The Cancer Genome Atlas and SFARI respectively) were screened to further identify overlapping genes. While analyses have yet to be completed, bioinformatics tools (e.g. ANNOVAR) will be used to align sequences, call variants, and annotate potential functional consequences. Additional pathway enrichment analysis will be conducted using enrichment analyses tools (e.g. GSEA, DAVID) to identify shared pathways and biological functions impacted by significant variants detected in both cancer and ASD. Significance: By identifying overlapping variants and pathways, we may identify novel risk factors for both conditions that could inform screening and therapeutic strategies. Understanding how these pathways converge could lead to innovative treatments targeting shared molecular mechanisms, improving patient outcomes for each disorder.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Room 2109

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S E S S I O N 10 Thursday, July 24, 2025 2:00 – 3:30 pm In-Person, BCCHR Atrium

Participants Danica Fontana Simran Kooner Vivienne Le Kaitlyn Lumby Jessie Luo Artemis Melville-Bowser Flora Su Gabriel Zamma

Danica Fontana

Undergraduate Student, Queen’s University | Mulpurui Research Team An exploration of the delays in diagnosis of Developmental Dysplasia of the Hip, Slipped Capital Femoral Epiphysis, and Legg-Calvé-Perthes Disease in British Columbia: The Patient Journey

Session 10 | Poster 73

Danica Fontana, Renee Boldut, Bennett Stothers, Aayush R Malhotra, Kishore Mulpuri, Emily Schaeffer Purpose of the Study: Developmental Dysplasia of the hip (DDH), Slipped Capital Femoral Epiphysis (SCFE), and Legg-Calvé-Perthes Disease (LCPD) are three prevalent pediatric hip conditions.

Delayed diagnosis can lead to various complications, indicating a need to improve screening and early identification. The objective of this study is to investigate the patient/family perspective in navigating their diagnostic journey, and to identify common trends in demographic or risk factors associated with delayed diagnosis.

Methods: Patients presenting to the BC Children’s Hospital (BCCH) Orthopaedic Clinic with a confirmed diagnosis were eligible for enrollment. Patients with DDH were considered if diagnosis occurred after six months, while all patients with SCFE or LCPD were considered. Following consent, a semi-structured interview (15-30 minutes) was conducted. Participants were asked demographic questions (e.g., about race, household income etc) and key inquiries relating to their diagnostic journey, such as: barriers to care, presence of a family doctor, etc. With data collection currently underway, our ultimate goal is to recruit 20 patients each with DDH, SCFE and LCPD, for a total of 60 patients. Mixed-methods analysis will be conducted and we aim to construct qualitative patient journey maps.

Summary of Results: To date, we have conducted semi-structured interviews with a total of 19 patients recruited thus far. Once participant quotas have been reached, quantitative data will be analyzed using the R statistical software version 4.1.0 (R Development Core Team). A combination of descriptive statistics to illustrate the study population, and comparative statistics to identify variables correlated with delayed diagnosis will be performed. Qualitative data will be analyzed in NVivo 12 (QSR International, Melbourne, Australia). Two independent reviewers will also code responses and categorize them into themes.

Conclusions: Patient-centered care empowers patients to assume an active role in their health-related decisions. Creating an environment where patient care serves as the focal point allows for a deeper understanding of patients’ diagnostic experiences, including the barriers they faced when seeking a diagnosis. As patient recruitment continues, the ongoing recognition of diagnostic trends will facilitate opportunities to improve patient care, centered around a more timely diagnosis for future cases.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Simran Kooner

Undergraduate Student, Simon Fraser University | Babul Research Team Enhancing Brain Waves Educational Materials: Updates for Improved Brain Injury Awareness and Prevention

Session 10 | Poster 74

Simran Kooner, Kate Turcotte, Shelina Babul Brain injury can have long-lasting impacts on child health and development. Educating children about how the brain works, and its role in how we perceive and interact with the world, is essential for fostering early awareness and promoting safe behaviours. Brain Waves, delivered by the BC Injury Research and Prevention Unit in collaboration with Parachute (the national charity for injury prevention), is a classroom-based program targeted to students in grades 4–6. Brain Waves materials include a presentation slide deck, hands-on activities, an activity booklet, and an instructor guide.

In 2025, Brain Waves presentations were conducted in Vancouver, Chilliwack, and Rossland, reaching over 441 students. Formal feedback was collected from teachers via surveys, while students provided informal feedback during the sessions and through brief Q&A periods following each presentation.

This feedback offered valuable insights into how the presentation and accompanying materials could be improved for greater clarity, impact, and ease of understanding. It also informed new strategies to boost student engagement and maintain their interest throughout the presentation, helping ensure effective knowledge delivery.

A comprehensive update of the Brain Waves presentation and its associated materials was undertaken, including the slide deck, activity booklet, and instructor guide. The updated materials now place a stronger emphasis on brain injury prevention overall, with particular attention to protecting highly vulnerable populations such as infants. They also feature a more detailed explanation of concussions and the sensory systems. Most notably, the activity booklet—previously dependent on live presentations to fill in knowledge gaps—has been redesigned as a stand-alone resource. This ensures that students who cannot attend live sessions still receive a complete and informative educational experience. The instructor guide was also revised to align with the updated content, equipping presenters with current and accurate information on brain function and injury prevention.

The recent updates to the Brain Waves program aim to improve educational outcomes, enhance the clarity and accessibility of brain injury prevention messaging, and empower students to make informed decisions about brain safety. Ultimately, this work contributes to fostering a safer, more informed generation.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Vivienne Le

Undergraduate Student, Queen’s University | Boelman Research Team A Pipeline for Reclassifying Variants of Uncertain Significance in Genetic Epilepsy

Session 10 | Poster 75

Vivienne Le, Cyrus Boelman, Alexander Freibauer Background: Epilepsy is a chronic neurological condition characterized by recurrent, unprovoked seizures. It is one of the most common neurological disorders in children and adolescents and can have a variety of causes, including structural brain abnormalities, infections, and genetic factors. Currently, over 825 genes are known to be implicated in epilepsy. Whole exome sequencing (WES) is used to identify genetic variants categorized as benign, pathogenic, or variants of uncertain significance (VUS).

Patients who are found to have pathogenic mutations can potentially benefit from personalized medicine to improve their outcomes. In contrast, VUSs have an unknown impact on clinical status, often complicating diagnosis and management. Among 409 children who had at least one VUS, 282 had WES results older than two years, only 48 of whom had undergone parental testing.

Objectives: This project aims to support the reclassification of variants of uncertain significance in epilepsy patients at BC Children’s Hospital using Franklin, a genomic interpretation platform.

The objective is to identify variants that may be eligible for reclassification.

Methods: Franklin applies criteria from the American College of Medical Genetics to interpret clinical and genetic data. Many of the WES tests in the cohort were conducted over two years ago and may be outdated. As more cases are studied, variants that were previously VUSs may now have clearer clinical interpretations. Each variant was also reanalyzed under the assumption of being de novo to assess whether the classification would change with parental testing. Chart reviews are being conducted for patients whose variant classification, when considered as de novo, changed from VUS to likely pathogenic. The patients’ clinical phenotypes are being compared to gene-associated phenotypes to evaluate whether the reclassification aligns with their clinical presentation.

Significance: The significance of the work revolving this project is to find new strategies to provide diagnostic clarity for patients with VUS. This project works to improve the interpretation of VUS using updated genomic evidence and clinical phenotyping. Streamlining the process of the analysis of VUS can help to provide further diagnostic clarity to patients with epilepsy and hopefully improve their clinical care.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Kaitlyn Lumby Undergraduate Student, University of British Columbia | Karakochuk Research Team

Exploratory Analysis of Placental Growth Factor as a Marker of Fetal Growth Restriction in Pregnant Individuals in Vancouver

Session 10 | Poster 76

Kaitlyn Lumby, Crystal Karakochuk, Kelsey Cochrane Background: Placental growth factor (PlGF) is a proangiogenic protein that supports pregnancy by promoting the development of blood vessels and trophoblast cells in the placenta. PlGF levels rise throughout pregnancy, peaking at ~30 weeks’ gestation. However, lower levels have been linked to complications such as pre-eclampsia and fetal growth restriction. This study aims to determine whether PlGF concentrations at 30 weeks’ gestation differ between two forms of prenatal folate supplementation: synthetic folic acid (0.6 mg/day) and natural (6S)-5-methyltetrahydrofolate (5-MTHF; 0.625 mg/day) in a cohort of 54 pregnant individuals enrolled in a randomized trial in Vancouver, Canada. We will also explore whether 5-MTHF supplementation reduces PlGF concentrations at 30 weeks, potentially indicating a risk of fetal growth restriction compared to folic acid. A secondary objective is to examine the association between PlGF levels and maternal red blood cell folate concentrations, and if this relationship is influenced by the form of folate supplement.

Methodology: PlGF levels will be measured using an immunoassay. Generalized linear regression models will be used to compare PlGF concentrations at ~30 weeks’ gestation between the two supplementation groups, to examine the relationship between PlGF levels and red blood cell folate concentrations, and to assess whether this relationship is affected by the form of folate supplement.

Results: Blood specimens have been collected and PlGF analyses are currently pending.

Significance: This study will contribute to the growing evidence supporting PlGF as a clinical biomarker in pregnancy and could provide additional insights into how folate levels and the type of folate supplement influence pregnancy outcomes, helping to shape future recommendations and support healthier starts for infants.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Jessie Luo

Undergraduate Student, University of British Columbia | Reid Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

CAR-T cell therapy as an early intervention in pediatric B-cell acute lymphoblastic leukemia

Session 10 | Poster 77

Jessie Luo, Tanmaya Atre, Mahlegha Ghavami, Zahra Savoji, Nakaw Young, Ali Farrokhi, Gregor Reid Background: B cell acute lymphoblastic leukemia (B-ALL) is the most common pediatric cancer and is often preceded by an extended clinically silent pre-leukemic phase. New treatment options for B-ALL include CD19-targeting chimeric antigen receptor T cell (CD19 CAR-T) therapy, which involves modifying a patient’s T cells to express receptors against CD19, an overexpressed cell surface antigen on pre-leukemic and leukemic B cells. While CD19 CAR-T therapy has shown remarkable success in treating pediatric B-ALL, its potential to eliminate pre-leukemic B cells remains untested.

Objective: To evaluate the cytotoxic efficacy of CD19 CAR-T cells against pre-leukemic B cells.

Methodology: CD19 CAR-T cells are generated from healthy BALB/c mice. To confirm their cytotoxic capacity in vitro, we perform killing assays using primary leukemic and pre-leukemic B cells isolated from the transgenic Eμ-Ret mouse model of B-ALL as targets. CAR-T cell cytotoxicity will be measured using flow cytometry. To assess in vivo persistence and cytotoxicity, CAR-T cells will be injected into immunodeficient RAG1-deficient Eμ-Ret mice. These mice generate pre-leukemic B cells and mimic the lymphodepleted state of patients prior to CAR-T cell infusion. We will monitor the mice for up to three weeks after CAR-T cell injection, then assess pre-leukemic cell burden in spleen, liver, and bone marrow.

Expected Results: We anticipate that our CAR-T cells will kill pre-leukemic and leukemic cells with equal efficiency in vitro and will significantly reduce the number of pre-leukemic B cells present in healthy Eμ-Ret mice.

Significance: Our findings will provide novel insights into the potential of CD19 CAR-T cell therapy for prevention and early intervention in pediatric B-ALL.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Artemis Melville-Bowser

Undergraduate Student, University of British Columbia | Vallance Research Team Investigating Microbe-Mucus interactions in Ulcerative Colitis

Session 10 | Poster 78

Artemis Melville-Bowser, Ashley Gilliand, Bruce Vallance Background: Inflammatory Bowel Disease (IBD) affects more than 320,000 Canadians and is increasing in incidence, particularly in children. One form of IBD, ulcerative colitis (UC) consists of chronic colonic inflammation and has no available cure. It has been hypothesized that the inflammation in UC patients is caused or exacerbated by commensals with pathogenic potential, known as pathobionts. Pathobionts can penetrate the defective mucus barrier in the UC patient colon, expand in the inflamed gut, and potentially exacerbate disease.

Gastrointestinal mucus consists primarily of mucin-2 (MUC2), a glycoprotein with O-linked glycans capped with terminal sialic acid or fucose residues. Previous data has shown structural differences between healthy and UC mucus, such as reduced thickness, reduced glycosylation, and hyper-sialyation.

It is currently unknown whether differences between healthy and UC mucus may influence pathobiont behavior.

Methods: We grew p19A in the presence of mucin sugars as well as whole mucus collected from patientderived organoids and monitored expression of virulence genes via qPCR. We infected organoids and air-liquid interface (ALI) monolayers with p19A in the presence of free mucin sugars, imaged using bright field and fluorescent microscopy, and quantified the inflammatory response via IL-8 ELISA. Results: Preliminary results suggest that the p19A toxin hemolysin-alpha is upregulated in the presence of sialic acid . ALI monolayer infection with P19A pre-induced with sialic acid showed increased monolayer disruption and IL-8 production. Future results will confirm changes in p19A toxin gene expression in response to mucin sugars or whole mucus and reveal the inflammatory response of organoids to p19A infection in the presence or absence of mucin sugars.

Significance: The data generated from this study will provide key insights into the signals and mechanisms used by bacterial pathobionts to cross the mucus barrier and induce inflammation. The goal of this study is to identify mucus-associated risk factors in the IBD patient population that may make them more susceptible to the actions of disease-promoting bacterial pathobionts.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Flora Su

Undergraduate Student, University of British Columbia | Peters Research Team UBC Faculty of Medicine Summer Studentship Recipient

Biomarker Indicators for Nutrition and Growth Outcomes (BINGO)

Session 10 | Poster 79

Flora Su, Kaitlin Berris, Nicolas Mourad, Nicholas West, Katherine Mason, Steven Rathgeber, Emily Tai, Amy Fotheringham, Ahamad Muhieldin, Andrew Campbell, Jeffrey Bone, Cheryl Peters Introduction: Congenital heart disease (CHD) affects approximately 1 in 80 to 100 children in BC, many of whom face complex medical challenges and will require surgical intervention. Pre-existing malnutrition is a significant risk factor that has been linked to adverse surgical outcomes, including chylothorax, infections, and prolonged hospital stays. Currently, there are no standardized preoperative nutrition guidelines to identify children who may be at high risk. Many may not be identified until after their procedure, at which point they would require specialized diets. Retrospective data from BC Children’s Hospital (BCCH) suggests that early declines in nutritional status, indicated by reductions in weightfor-age z-scores, may be associated with poorer outcomes. However, weight-based assessments can be unreliable in CHD patients due to fluid imbalance, therefore more accurate indicators are needed to identify and address nutritional risk prior to surgery.

Objectives: This study aims to evaluate whether the preoperative levels of surrogate nutrition blood biomarkers albumin and prealbumin are associated with postoperative complications and hospital length of stay. The secondary objective is to assess the feasibility of including these biomarkers in standard preoperative bloodwork. Findings from this study will inform the development of a standardized preoperative nutrition support guideline for pediatric patients undergoing cardiac surgery.

Methods: Patients aged 28 days to 17 years scheduled for cardiac surgery are actively being recruited during their Cardiac Pre-Anesthesia Clinic (CPAC) visit at BCCH. Albumin and prealbumin are added to the patients’ routine preoperative bloodwork. Clinical data including growth parameters, cardiac profile, and postoperative outcomes are extracted from their medical records. Data analysis will include summary statistics, visualizations, and generalized linear models to assess associations between preoperative albumin/prealbumin levels and clinical outcomes, adjusting for expert-identified confounders.

Results: Enrollment and data collection are ongoing.

Significance: Findings will inform the development of a preoperative nutrition intervention, where children with low biomarker levels will receive targeted nutritional supplementation before surgery. Ultimately, this project aims to improve surgical recovery outcomes through early nutrition support for at-risk patients.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Gabriel Zamma

Undergraduate Student, Simon Fraser University | Hou & Siden Research Teams Implementing the Pain Pathway in community pediatric practices: Content development of implementation strategies

Session 10 | Poster 80

Gabriel Zamma, Sharon Hou, Stephanie Glegg, Laesa Kim, Gail Andrews, Tim Oberlander, Caroline Sanders, Hal Siden Background: Children with severe neurological impairments often experience pain and irritability of unknown origin (PIUO), yet are unable to express “where it hurts.” The Pain Pathway was developed and tested to manage PIUO in children with SNI. To-date, the Pain Pathway has only been used by clinicians in tertiary care pediatric centres. Phase 2 of this work focuses on implementing the Pain Pathway in community pediatric practices in BC, expanding the reach of this care approach.

Objective: To develop and refine the implementation strategies that will be used to support the uptake of the Pain Pathway in community practices with a focus on content development of the education and training materials.

Methods: This work is part of a larger, multi-method, multi-phased hybrid implementation-effectiveness project. Content development of the education and training materials is based on a content analysis of results from earlier phases of this research, coupled with consultation with expert clinicians that bring previous experience using the Pain Pathway, and families of children with SNI that previously participated in the Pain Pathway. Specific strategies for implementing the Pain Pathway will be developed and guided by patient-oriented research (POR) methods, the Active Implementation Research Network and the RE-AIM framework.

Significance: Implementing the Pain Pathway in community practices will bring a standardized approach to treating PIUO to a broader community of children with SNI and their families. Our work is unique using a POR framework to ensure that lived expertise is integrated throughout content development – including the perspectives of clinicians, families of children with SNI, and researchers from earlier phases of this work. Next steps include the refinement of our implementation plan to guide the launch of the Pain Pathway in the community.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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S E S S I O N 11 Thursday, July 24, 2025 2:00 – 3:30 pm In-Person, BCCHR Atrium

Participants Nabiha Ahmed Katherine Cai Sara Ehling Kaya Horii Armaan Jaffer Chanjoo Kim Lucas Kwong Nurin Izzati Saiful Baharin Lara Vaziri

Nabiha Ahmed

Undergraduate Student, University of Toronto | Vallance Research Team The Effect of Mucin Glycans on Candida Albicans Mucin Degradation

Session 11 | Poster 81

Nabiha Ahmed, James Sousa, Bruce Vallance Background: Inflammatory bowel disease (IBD) is a disease characterized by chronic inflammation in the gastrointestinal tract. IBD pathobionts are opportunistic microbes that can worsen a patient’s IBD symptoms. The fungus Candida albicans is an IBD pathobiont, although the exact mechanism by which it exacerbates IBD is unknown. Patients with IBD have altered mucin glycosylation along their gastrointestinal tract, which may affect C. albicans’ ability to degrade mucins and lead to barrier disruption, exacerbating disease. For instance, the mucin glycan N-acetylglucosamine (GlcNAc) can induce virulence gene expression in C. albicans, which may promote its mucin degradation capabilities.

Objective: To study the effects of the mucin glycans GlcNAc, N-acetylgalactosamine (GalNAc), galactose, fucose, and sialic acid on the mucin degradation ability of C. albicans.

Methods: Growth curves were performed in YNB minimal yeast media supplemented with mucin glycans.

RNA was also extracted from the fungi grown in YNB media supplemented with porcine gastric mucin and mucin glycans, followed by qPCR to assess for virulence gene expression. Wet mount slides were created to assess the induction of the hyphal phenotype by the presence of mucins and mucin glycans. Lastly to assess mucin degradation, fungal colonies were plated on an agar plate assay containing mucins and mucin glycans, followed by staining with 0.1% amido black to assess for degradation.

Preliminary Results: GlcNAc induces the formation of the invasive phenotype, hyphae, and promotes mucin degradation, while sialic acid inhibits hyphal formation, yeast growth, and mucin degradation.

Significance: This project will improve our understanding of the mechanism by which Candida albicans’ mucin degradation capabilities changes in IBD patients to exacerbate IBD. Future directions of this research will involve testing IBD patient-derived mucus for increased sensitization to C. albicans mucin degradation.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Katherine Cai

Undergraduate Student, University of British Columbia | Ipsiroglu Research Team Beyond Questionaries, Sleep & Neurobehaviours: Preparations for a Crash Course

Session 11 | Poster 82

Natasha Patel, Katherine Cai, Suzanne Lewis, Glen Davies, Deepika Sheemar, Gerhard Klösch, Thomas Herdin, Thomas Czypionka, Theresa Bengough, David Wensley, Nadia Beyzaei, Osman Ipsiroglu Background: Sleep disturbances and disorders disproportionately affect children and adolescents with neurodevelopmental disorders (NDDs) such as autism spectrum disorder, attention-deficit hyperactivity disorder or prenatal alcohol exposure. Disturbed sleep impacts daytime functioning and can trigger challenging or disruptive behaviours, leading to family breakdowns. Despite this, sleep disturbances and disorders of children and adolescents with NDDs are often overlooked as community-based healthcare professionals (HCPs) receive little to no sleep health training on recognizing and managing behaviours.

Objective: To deliver the Sleep Health Crash Course, developed by the ChildRight2Sleep Initiative’s international team, to HCPs who provide care to children and adolescents with NDDs and to receive feedback on content applicability for refinement.

Methods: A 3-day unstructured sleep log, a 7-day structured sleep log (National Sleep Institute) and an “intake survey” will be used as a pre-course reflective tool to understand personal sleep patterns, goals and concerns, and to highlight core sleep medicine/psychology screening symptoms. The course will be hybrid, consisting of two 3.5-hour modules. The first module will use three case studies to understand the intersections between disturbed sleep and NDDs and how to manage behaviours; the second focuses on optimizing family support and building healthcare networks. An in-person focus group will be conducted both pre- and post-course. Further, post-course feedback will be collected through REDCap and analyzed using descriptive statistics.

Significance & Anticipated Outcomes: HCPs providing care to children and adolescents with NDDs are expected to build confidence in identifying disturbed sleep, facilitating referrals to the appropriate sleep health or medicine services, and supporting families with circumscribed first-line interventions/ treatments. Course feedback will be reviewed with health economists and policy makers to understand how sleep health could be integrated into medical and allied healthcare education. We aim to develop, in collaboration with the Pacific Family Autism Network, a Sleep Health Network with community-based HCPs who are equipped to support families in need more efficiently and overcome barriers to applying recommendations.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Sara Ehling

Undergraduate Student, McGill University | Sly Research Team Evaluating Fecal Lipocalin-2 as a Potential Biomarker for Intestinal Inflammation

Session 11 | Poster 83

Sara Ehling, Wei Jen Ma, Bing Cai, Susan Menzies, Laura Sly Background: Ulcerative Colitis (UC) and Crohn’s Disease (CD) are both inflammatory bowel diseases (IBD) characterized by inflammation of the digestive tract. Globally, IBD cases in children have been rising, with Canada seeing particularly high rates. Part of caring for these individuals involves monitoring inflammation of the gastrointestinal tract in order to determine progression of the disease as well as treatment efficacy. This often involves invasive procedures such as endoscopies and biopsies which can be particularly harmful for children and may lead to aggravation of inflamed areas. This is why it is important that we find sensitive and non-invasive biomarkers that can detect inflammation. Fecal lipocalin-2 (LCN-2) is thought to be one of these markers. LCN-2, also known as neutrophil gelatinaseassociated lipocalin (NGAL), is produced by various immune cells, such as neutrophils, and its elevated levels are associated with intestinal inflammation. By measuring LCN-2 levels in mouse fecal samples with ELISA we hope to evaluate the sensitivity of the protein as a biomarker for inflammation.

Objectives: 1. To determine whether LCN-2 serves as an effective biomarker for IBD in mouse models and shows progression/improvement of inflammation.

2. Compare the sensitivity and efficacy of LCN-2 to fecal calprotectin, the current standard for fecal testing.

Methods: Two preclinical mouse models, the SHIP-/- model of CD-like ileitis and T cell transfer colitis were used, and fecal samples were collected bi-weekly. Analysis of LCN-2 protein content was completed via sandwich ELISA to determine the concentration, in ng/g, of LCN-2 in each mouse sample at each time point. This data will then be compiled to show the trends of LCN-2 levels in IBD mice that are in untreated, treated, and vehicle control groups.

Results: Data analysis is ongoing at the time of abstract submission.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Kaya Horii

Undergraduate Student, University of British Columbia | Vanderwal Research Team Intersubject Synchronization of Heart Rate and Skin Conductance During Music Listening in Youth

Session 11 | Poster 84

Kaya Horii, Ahmad Samara, Daria Hammond, Tara Gaertner, Tamara Vanderwal Background: Heart rate variability (HRV) is the fluctuation in time intervals between heartbeats, and is a commonly utilized indicator of the body’s regulatory processes. Psychiatric disorders such as depression and anxiety are associated with decreased HRV, suggesting dysregulated cardiac autonomic function.

Similarly, skin conductance level (SCL), which depends on blood flow and sweat production, is considered an indicator of the body’s “fight-or-flight” response. Studies have shown that music listening increases HRV and decreases SCL in adults with and without psychiatric disorders. However, it is unclear whether music elicits similar effects in youth.

Objectives: This study aims to – • Examine the effects of music listening on HRV and SCL in youth.

• Determine whether specific music types synchronize HRV and SCL responses across participants.

Methods: Electrocardiogram (ECG) and SCL data were collected from 25 participants (17 female, average age 15.0 ± 1.8) during a 5-minute silent baseline followed by 5 auditory conditions.

The 5 conditions had varying emotional valence and arousal: relaxing, energizing, binaural beats (a phenomenon thought to increase relaxation), pink noise, and a participant-chosen song. To estimate HRV, heart rate was computed using a sliding window approach from the ECG recordings. Changes in SCL were analyzed for the relaxing, energizing, and binaural beats conditions. The other conditions did not have a standard stimuli to compare to and were omitted. Intersubject correlations in HRV and SCL were computed between all subject pairs separately for each condition. Statistical significance between conditions was assessed using ANOVA, then paired t-tests with Bonferroni correction for multiple comparisons.

Results: Intersubject correlation of HRV was highest during the relaxing condition (p = 0.020). Differences in intersubject correlations of SCL were statistically significant across the tested conditions (p < 0.02). The relaxing condition had the highest correlation (p < 0.001).

Discussion: We found that intersubject synchronization in skin conductance and heart rate varied based on the type of music participants listened to, with relaxing music yielding more synchronized responses.

Our findings suggest that music may evoke reliable physiological responses in youth. Further work is needed to better characterize these responses in youth with and without psychiatric conditions.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Armaan Jaffer

Undergraduate Student, Queen’s University | Carwana Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Pediatrician Knowledge and Perspectives on Barriers and Facilitators to Social Prescribing: A Qualitative, Exploratory Study

Session 11 | Poster 85

Armaan Jaffer, Ethan Fong, Shalaka Dixit, Britt Udall, Matthew Carwana Introduction: Social prescribing (SP) is an intervention where patients are referred to non-medical and community-based supports to address the determinants that can influence health. These activities can be wide-ranging and multifaceted, including exercise, counselling, housing, and food security. However, while SP tools and implementation are robust in some settings, there is less evidence of its application to children and young people in North America. Studies have highlighted pediatric SP’s effectiveness in supporting young people’s overall health, but they have not systematically explored facilitators and barriers pediatricians face when engaging in SP. Consequently, a large provider know-do gap exists between the praxis and practice of SP. The Theoretical Domains Framework (TDF) is an established, evidence-based implementation science approach to understanding barriers and facilitators to health practice changes.

Objective: Explore barriers and facilitators to pediatric SP amongst pediatric providers.

Methods: An interview guide that aligned with key domains of the TDF was developed. The project was approved by local Institutional Review Board. Pediatricians, child and adolescent psychiatrists, and pediatric neurologists from across British Columbia (BC), Canada were invited to participate in the study via passive and purposive recruitment strategies. Eighteen semi-structured interviews were conducted via Zoom, with verbatim transcription completed. Thematic analysis consisted of inductive and deductive approaches. Inductive themes were deductively coded under the TDF domains.

Results: 5 TDF domains (Skills, Social/Professional Role, Beliefs about Capabilities, Environmental Consequences and Resources, and Social Influences) were assigned to inductively coded facilitators and barriers. 7 facilitators were identified: proactive resource gathering; assessing social needs in clinical practice; commitment to holistic care; utilization of online resources; collaboration with families; peer collaboration and sharing; and community ties. 5 barriers were identified: unclear ownership of SP, time constraints and external limitations; feeling limited without support; lack of social workers; and lack of a coordinated system.

Conclusion: Findings suggest that a broad range of facilitators and barriers can influence the practice of pediatric SP in BC. At an individual-level, pediatrician knowledge and skills can be improved through training, a centralized resource directory and peer networks. At the same time, increased access to social workers, and revised fee codes can remove systems-level barriers. Both systems- and individual-level interventions are required to increase SP uptake.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Chanjoo Kim

Undergraduate Student, University of Victoria | Siden Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Survival Time of Neonates with Severe Hypoxic-Ischemic Encephalopathy after Cessation of Intensive Care

Session 11 | Poster 86

Chanjoo Kim, Katherine Boone, Emily Kieran, Harold Siden Introduction: Hypoxic-ischemic encephalopathy (HIE) is a birth injury caused by oxygen deprivation to the brain, and in severe cases, may not be compatible with life in neonates. Babies born with HIE often require intensive care, including artificial nutrition, hydration and ventilation. In severe cases, artificial ventilation and painful medical interventions can be ethically ceased for the comfort of the baby; however, survival time after cessation is uncertain and not well-reported in the literature. That lack of knowledge diminishes the ability of clinicians to provide accurate information to families of these infants. This study aims to identify the factors correlated with the baby’s survival time and the trajectory after cessation.

Method: This study employed a structured, retrospective medical record review. We reviewed all neonates born between 2014-2024 diagnosed with severe HIE who had undergone cessation of mechanical ventilation. The population consisted of late preterm and term neonates who had been admitted to BC Women’s Hospital NICU as part of their care. We examined clinical profiles, including survival time and gestational age, as well as ventilation cessation and comorbidities of neonatal asphyxia.

The correlation between the number of affected systems and the survival time after extubation was analyzed using Pearson correlation.

Results: We identified 82 neonates with severe HIE. At least 79 of them were intubated (3 were missing data on ventilation), and 56 died (69%). We could obtain the full charts of 45 of these babies, all of whom were intubated. Of those, 30 babies died (67%), and their median survival time after extubation was 87.5 minutes (range, 10 min – 6 days). There was no significant difference between those children who lived or died based on their number of comorbidities, gestational age, weight, or Apgar scores. There also does not appear to be a correlation between survival time and these covariates.

Conclusion: This points to the need for further research into potential covariates that will surface with a more detailed chart review. Preliminary data on survival rate and survival time for infants after cessation of ventilation in the context of HIE also suggest further research into predictors of outcome.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Lucas Kwong

Undergraduate Student, University of British Columbia | Gibson Research Team UBC Faculty of Medicine Summer Studentship Recipient

Clinical Interpretation of VoUS in Epigenetic Syndromes Using Drosophila

Session 11 | Poster 87

Lucas Kwong, William T. Gibson Background and Objectives: Clinical and population exome sequencing are routine, driving the need for well-calibrated functional assays of variant function. These assays play crucial roles, from establishing causal genes in novel syndromes to screening rare population variants for potential risk factors in common diseases. We’ve developed a cost-effective, scalable screening platform using Drosophila for variant functional assessment with clinical predictive value. The RBBP4 gene codes for a histone-binding protein of the PRC2, NuRD, and CAF-1 complexes. Recently, a cohort of 17 patients carrying 14 different mono-allelic RBBP4 variants was collected, all of whom have developmental delay, intellectual disability, and speech delay. Yet, the reclassification of RBBP4 as a novel syndromic gene remains unresolved.

Here, we present an assay where human RBBP4 expression in Drosophila can rescue severe loss-offunction phenotypes arising from the loss of its ortholog Caf1-55.

Methods: Using the eyGAL4 UAS-FLP (EGUF) method, we can generate homozygous Caf1-55 null eye tissue in an otherwise heterozygous animal. The homozygous null is lethal and causes a severe loss of eye tissue phenotype. Next, we express the human RBBP4 variants and assess the ability to which each of the variants rescues the loss-of-function phenotype in the eye. Bright-light and confocal microscopy will be used to image these variant eyes and assess their development. Additionally, the mutant eyes will be sectioned utilizing a cryostat and stained to look at rhabdomere formation and organisation.

Results & Significance: We have shown that human reference RBBP4 can successfully rescue loss of function phenotype from expression of Caf1-55 null. Additionally, we have successfully generated and tested flies carrying the patient variants. The majority of the variants tested show a partial loss of function compared to the reference. Overall, this approach will help classify whether the variants are likely to be disease-causing, which can improve patient diagnosis and our understanding of RBBP4 as a novel syndromic disorder.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Nurin Izzati Saiful Baharin Session 11 | Poster 88

Undergraduate Student, University of British Columbia Okanagan Voss Research Team | UBC Faculty of Medicine Summer Studentship Recipient Understanding variability in sleep and blood glucose control among children and teens with type 1 diabetes Nurin Izzati Saiful Baharin, Ty Sideroff, Trent Smith, Christine Voss Background: Type 1 diabetes (T1D) is one of the most common chronic conditions in children and teens, with over 2,000 children and teens living with diabetes in BC. Sleep is a vital regulator of physical health and emotional well-being, especially in this population. Constant management of blood glucose, including overnight monitoring and responding to alarms, can disrupt sleep and may impact overall quality of life.

Objectives: 1. To describe sleep patterns and nightly fluctuations in blood glucose levels, including variability and occurrences of hyperglycemic (≥15.0mmol/L) and hypoglycemic (≤3.9mmol/L) episodes.

2. To explore associations between sleep with variability in blood glucose levels.

Methods: Baseline data were drawn from a larger longitudinal study of physical activity in children and teens with T1D ages 5-17yrs from the BC Interior. Participants wore a Fitbit Charge for up to 28 days and shared detailed data (5 min epoch) from their continuous glucose monitor (CGM). Min-by-min Fitbit data, including sleep stages, were extracted to REDCap via custom-written API. Participants were included in analyses if they had at least one day with ≥1320 minutes/day of time-matched Fitbit and CGM data.

‘Time in range’ (TIR%) was calculated from CGM data using clinical glucose targets of 3.9-10.0mmol/L, with hypo- and hyperglycemic episodes defined as any single glucose reading below this range or above 15.0mmol/L, respectively. Statistical analyses were conducted on a person-night level dataset, using R. Results: Twenty-five participants (mean age 11.7±3.9yrs; 48% girls) were included. Children’s (5-13yrs) mean sleep duration was 8.3±0.7hrs/d, while teens (14-17yrs) averaged 7.1±1.3hrs/d. Only 7% of children and 10% of teens met age-specific sleep guidelines. The mean nightly TIR was 55.9±15.8%, with 20% of participants achieving >70% TIR. On average, participants spent 17.9% of the night in hyperglycemic and 1.8% in hypoglycemic episodes. A statistically significant but weak positive correlation was found between the number of awakenings and time spent in hyperglycemic episodes per night (r=0.14, p=0.03).

Next Steps: To examine within-person night-to-night variability in sleep and glycemic patterns and exploring potential gender and age differences.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Lara Vaziri

Undergraduate Student, University of British Columbia | Hou Research Team Cultural Considerations in Pediatric Eating Disorders Treatment: Insights from Racialized Youth and Families

Session 11 | Poster 89

Lara Vaziri, Sharon H.J. Hou, Tayla Bain, Julia Kaufmann, Hali Kil, Jennifer S. Coelho Background: Eating disorders are becoming increasingly prevalent among racialized youth. However, there is a limited understanding of how their cultural background, including cultural identities and values, influence their treatment experiences. Integrating cultural considerations into eating disorders treatment is essential, as recent research suggests significant cultural variability in eating disorders symptoms, risk factors, and treatment effectiveness.

Objectives: This study will investigate the experiences of racialized youth with eating disorders and their families engaging in care, in order to better understand key barriers and facilitators in the care journey and to determine how diverse perspectives shape treatment experiences and approaches.

Method: This study will use patient-oriented research (POR) to engage youth and families with lived experiences. Focus groups will be conducted with youth (14–25 years) who self-identify as racialized, have lived experience with an eating disorder, and have accessed treatment. Separate focus groups will be held with caregivers of racialized youth with eating disorders. Youth and families who have previously consented to future contact will be recruited from BC Children’s Hospital and Looking Glass Residence, in addition to recruitment through the community.

Implications: Findings from this study will elucidate culturally relevant factors that influence eating disorders care experiences and engagement in treatment, informing ways that care process can be more inclusive and relevant to diverse populations of youth. Additionally, results may help equip clinicians with the insight needed to meaningfully integrate cultural responsiveness into their clinical practice, fostering more effective care for racialized youth and their families.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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S E S S I O N 12 Thursday, July 24, 2025 2:00 – 3:30 pm In-Person, BCCHR Atrium

Participants Mark Ashamalla Phoenix Au-Yeung Aaryan Dwivedi Patricia Humer Maia Poon Kathryn Reilly Ashiana Sunderji Lauren Ung

Mark Ashamalla

Medical Student, University of British Columbia | Arneja Research Team UBC Faculty of Medicine Summer Studentship Recipient

The Role of Cannabis in Recurrent Adolescent Gynecomastia: A Case Series

Session 12 | Poster 90

Mark Ashamalla, Kathryn McDermid, Jugpal Arneja Background: Gynecomastia, the benign proliferation of male breast glandular tissue, is a multifactorial condition influenced by hormonal imbalances, medication effects, systemic diseases, and substance use.

Affecting 40-65% of adolescent males, gynecomastia typically peaks between ages 13 and 14 years.

A retrospective long-term follow-up study reported a 37.5% recurrence rate 10-19 years postoperatively.

Cannabis has attracted attention due to its widespread use and endocrine-disrupting effects, particularly following its decriminalization in Canada in 2018. However, evidence linking cannabis to gynecomastia remains conflicting. Understanding its association with postoperative recurrence is critical given the physical and psychological consequences of recurrent gynecomastia. This case series aims to explore the potential association between cannabis use and gynecomastia recurrence following surgical removal.

Methods: A retrospective case series was conducted involving adolescent males who reported cannabis use and underwent gynecomastia excision surgery by the senior author from May 2009 to May 2025 at BC Children’s Hospital. Patients reporting cannabis use who subsequently experienced gynecomastia recurrence requiring additional surgery were narratively described.

Results: Of 119 patients undergoing surgery for gynecomastia, 11 (9%) reported cannabis use.

Three of these patients reported cannabis use after the initial procedure and required additional surgery for recurrent gynecomastia. Case 1 underwent bilateral excision at 15 years of age and required revision for recurrent disease at 17. At 5-weeks following his revision, he disclosed cannabis use approximately once per week. Case 2 underwent unilateral excision at 17 years old and a revision at 19 years old after discontinuing THC use six months earlier. Case 11 received right-sided excision for unilateral gynecomastia at 16, and developed contralateral gynecomastia four years later. He underwent a second surgery at 20 years old. At presentation for his second surgery, he reported monthly cannabis use.

Conclusion: These findings suggest a potential association between cannabis use and recurrent gynecomastia in adolescents’ post-surgery. Limitations of this study included stigma around cannabis use and legal restrictions for minors, possibly resulting in underreporting. Future research is warranted to clarify the relationship between cannabis use and gynecomastia recurrence. Our results highlight the potential value of preoperative counseling on substance use for clinicians managing adolescent gynecomastia.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Phoenix Au-Yeung

Medical Student, University of British Columbia | Purtzki Research Team BC Children’s Hospital Research Institute Summer Studentship Recipient

Improving Lives, One Flush at a Time: The Impact of Transanal Irrigation on Continence and Quality of Life in Children with Neurogenic Bowel Dysfunction due to Spinal Cord Injury

Session 12 | Poster 91

Phoenix Au-Yeung, Christina Kim, Asli Ozer, Jeffrey Bone, Jacqueline Purtzki Background: Children with spinal cord injury (SCI), such as spina bifida or traumatic SCI, suffer from difficulty with bowel control, known as Neurogenic Bowel Dysfunction (NBD). NBD is associated with frustrating medical complications, including chronic constipation and fecal incontinence, secondary urinary tract infections, and abdominal pain. Without effective bowel management, NBD can significantly undermine children’s quality of life (QoL), education, and employment outcomes in the long run, and place a significant burden on caregivers. Current bowel management options range from suppositories to surgical intervention, but vary in effectiveness and invasiveness. Transanal irrigation (TAI; trade name Peristeen) is a commercially available alternative that can be used by the child independently to flush the lower part of the colon and the rectum with water, allowing for controlled and scheduled stool evacuation which prevents constipation and incontinence episodes. While TAI has been in use in Europe and the U.S. for over a decade, there is a scarcity of Canadian pediatric literature on its impact on QoL and the associated user perspectives.

Objective: To evaluate the impact of TAI on bowel management, medical complications, and QoL in children with NBD due to SCI, as well as ongoing support needs for both children and their caregivers.

Methods: This mixed methods study will include pediatric patients who have been followed by the BCCH Spinal Cord Clinic (SCC) and have currently or previously used TAI for at least 3 months for NBD. A retrospective review will be conducted on charts since 2023, evaluating for changes in primary NBD symptoms, secondary medical outcomes, and QoL questionnaires scores by modelling their trajectories since TAI use. Pediatric patients and their caregivers will also be interviewed to explore barriers, facilitators, and user perspectives of using TAI. Qualitative data analysis will employ an inductive thematic analysis approach.

Significance: To our knowledge, the BCCH SCC was the first in Canada to introduce TAI to pediatric patients as a treatment option. This study will fill a gap in literature on TAI use in the Canadian pediatric population, and help inform clinicians on ways to optimize bowel care plans for children affected by NBD.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Aaryan Dwivedi

Medical Student, University of British Columbia | Felton Research Team UBC Faculty of Medicine Summer Studentship Recipient

To Scan or Not To Scan: A Systematic Review on Imaging Protocols for Children with Hearing Loss Related to Bacterial Meningitis

Session 12 | Poster 92

Aaryan Dwivedi, Alexander Moise, Fainess Mwakisimba, Fred Kozak, Amjad Tobia, Mark Felton Background: Bacterial meningitis (BM) can cause sensorineural hearing loss in up to 30% of pediatric cases. Infection driven cochlear ossification can begin within weeks and progress for decades, steadily closing the window for effective cochlear implantation (CI). Imaging is thus needed to detect ossification early to ensure timely CI. Magnetic resonance imaging (MRI) delineates the membranous labyrinth and auditory nerve, whereas computed tomography (CT) depicts fine bony architecture of the inner ear.

However, despite these available modalities and the recognized importance of timely imaging, there is considerable uncertainty amongst clinicians regarding when to scan and how frequently to repeat imaging to optimize clinical outcomes for pediatric patients with BM. The conundrum arises from the fact that scanning patients too early may fail to effectively progressive ossification that might develop later, leading to repeated scans and potentially unnecessary exposure to imaging procedures which affects both patient quality of life and creates strain on publicly funded healthcare systems.

Study Aim: To synthesize current evidence on post-meningitic imaging and determine which clinical factors, imaging modalities (MRI, CT, or both) and schedules most accurately (1) detect cochlear ossification at the earliest practicable stage and (2) guide timely CI candidacy in children.

Methods: MEDLINE, Embase, CENTRAL and Web of Science were searched from inception to June 2025 using a comprehensive meningitis, hearing loss, and imaging string. The help of a UBC Medicine Librarian was used to further refine the search. Two reviewers will independently screen titles/abstracts in Covidence, assess full texts, and extract data on demographics, interval since infection, imaging timing, modality, ossification detection, and CI outcomes. Risk of bias will be conducted thereafter. Findings will be narratively and numerically synthesized. A PRISMA flow diagram will document study selection.

Significance: Given the progressiveness and chronicity of ossification associated hearing loss and the profound impact early intervention can have on language development and quality of life for pediatric patients, a standardized imaging protocol is warranted. Our review will help the creation of this protocol which would allow clinicians to significantly improve pediatric quality of life via timely CI and improved auditory rehabilitation.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Patricia Humer

Medical Student, University of British Columbia | Siden Research Team A literature Search to Support the Pilot Study: Post-operative Changes in Children with Severe Neurological Impairment

Session 12 | Poster 93

Patricia Humer, Elaha Niazi, Anne-Mette Hermansen, Liisa Holsti, Hal Siden Introduction: Anecdotal evidence from clinicians indicates that children with severe neurological impairment (SNI), such as cerebral palsy, experience post-operative functional changes. Additionally, our research team previously published qualitative data from parents indicating that their children experienced significant and prolonged functional decline after major surgery. Neuroinflammation has been proposed as the driving mechanism of post-operative cognitive dysfunction observed in elderly populations following surgery. Here we hypothesize that neuroinflammation is also a major contributing factor to the phenomenon of post-operative functional decline observed in children with SNI. With this feasibility project, we aim to further explore this phenomenon and are laying the foundation for a large-scale prospective study in future.

Current Study Design: Our current study will determine the feasibility and acceptability of 1) administering a set of functional questionnaires to a population of caregivers of children with SNI who are undergoing major surgeries (hip and spine) and 2) measuring pre- and post- operative neurological and systemic inflammatory biomarkers in these children and neurotypical control participants.

Literature Search: To assist in the progression of this project, a literature search was completed investigating 1) the general inflammatory profile of children with SNI; 2) post-operative generalized inflammation in children with SNI; 3) post-operative neuroinflammation in all patients; 4) and the ability to predict post-operative changes using neuro-inflammatory biomarkers. The literature review elucidated that roughly half of paediatric patients with cerebral palsy who are undergoing posterior spinal fusion surgery for neuromuscular scoliosis also develop systemic inflammatory response syndrome (SIRS).

Impact on Future Study Design: Based on these findings, the chart review form for the larger project was modified to include a section outlining the diagnostic requirements for SIRS. Review of medical charts of the recruited neurotypical control patients and patients with SNI, who have already undergone surgery, will demonstrate if the diagnostic requirements for SIRS were met and if the incidence of SIRS is higher in the SNI patient population as compared to the control patient population. Ultimately, this study design and literature review may have implications for improving pre-surgical counselling through better informing caregivers and guiding post-operative recovery through targeted rehabilitation.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Maia Poon

Medical Student, Western University Schulich School of Medicine | Salh Research Team | Sunny Hill Health Centre Research Summer Studentship Recipient School Exclusion of Neurodivergent Children and Youth in a Community-Based Clinical Outreach Partnership

Session 12 | Poster 94

Maia Poon, Denise Somuah-Asamoah, Gurpreet Salh In 2023, a partnership was formed between the Leq’á:mel Health and Wellness Centre, Mission Primary Care Network, and the Complex Developmental Behavioural Conditions program at Sunny Hill Health Centre. The partnership sought to address transportation, financial, and geographical barriers to accessing neurodevelopmental services for young people in the Fraser Valley Region by providing assessments closer to home. The present project builds upon this work and seeks to explore school exclusion faced by neurodivergent children and youth.

School exclusion encompasses the temporary or permanent removal of students from mainstream schooling, voluntarily or involuntarily. It often results in poor long-term outcomes in areas including education, employment, and mental health. Furthermore, school exclusion often requires that parents/ caregivers devote significant time and resources to their children’s education on top of caregiving and other responsibilities.

BCEdAccess Society, a charitable organization that supports families of complex learners, found that the highest-reported reason that students experienced school exclusion in 2022-2023 was inadequate support for learning. Several studies have found that exclusion disproportionately affects marginalized populations, including neurodivergent, socioeconomically-disadvantaged, and Indigenous students.

We will employ a community-based participatory action research (CBPAR) approach to ensure that the project is relevant and beneficial to the communities we work with. This involves ongoing collaboration with community members, including excluded students and their parents/caregivers, who will contribute their learned and lived experiences at every stage, from project conception to knowledge mobilization.

Through these collaborations, we will seek to understand how the study and results can enable better support for students and communities. Furthermore, we will follow the First Nations Principles of OCAP®, whereby Leq’á:mel First Nation will own and control the cultural knowledge, data, and information collected.

To understand the data available on school exclusion and neurodivergence, a literature review has been conducted. Given CBPAR’s inherently adaptive nature, a protocol is also being developed to ensure methods are appropriate for the communities involved. In conclusion, we aim to better understand neurodivergent students’ experiences with school exclusion while continually engaging with community members to direct research questions, design, and goals in ways that will best support the community.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Kathryn Reilly

Medical Student, University of British Columbia | Leveille Research Team UBC Faculty of Medicine Summer Studentship Recipient

Lower Limb Surgical Intervention for Ambulatory Children with Cerebral Palsy: The Effects of Tendo-Achilles Lengthening on the Transverse Plane

Session 12 | Poster 95

Kathryn Reilly, Luckshman Bavan, Tim Bhatnagar, Zoe Ng, Lise Leveille Children with Cerebral Palsy (CP) can experience progressive musculoskeletal conditions that affect gait and function. Orthopedic surgical intervention is commonly undertaken to improve gait and prevent progressive limitations in ambulation. Historically, surgical interventions were conducted in sequence, subjecting patients to multiple surgical events, anesthesia exposures, and rehabilitations periods. Recently, Single-Event Multi-Level Surgery (SEMLS), where patients receive multiple surgical interventions in one operative event, has been widely adopted as the gold standard of care. To effectively combine individual procedures in SEMLS, it is critical to understand the effects of isolated procedures. Three-dimensional gait analysis allows for the quantification of the effects of surgery on the sagittal, transverse, and coronal planes across the gait cycle. Transverse plane kinematics following orthopedic surgical intervention targeted at improving gait in children with CP are poorly characterized.

This preliminary study aims to characterize the effects of Tendo-Achilles Lengthening surgery (TAL) on transverse plane kinematics in gait. TAL is an orthopedic surgical intervention used to address equinus gait attributed to a spastic or shortened gastrocsoleus complex in children with CP. When indicated, lengthening the Tendo-Achilles allows for increased dorsiflexion and can improve foot position throughout the gait cycle. In this preliminary chart review, we identified 23 patients at BCCH who received an isolated TAL and underwent postoperative gait lab assessment. Twelve patients received a right TAL, eight patients received a left TAL, and three patients received TALs bilaterally. The average age at the time of the surgery was 9 years ±2 years and 4 months (6 years and 5 months to 16 years 4 months). The average time between surgery and postoperative assessment was 1 year ±3 months (7 months to 1 year 10 months). The next stage of this project is to compare pre-and postoperative kinematics to quantify the effects of TAL on foot progression angle throughout the gait cycle.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Ashiana Sunderji

Medical Student, University of British Columbia | Cheng Research Team UBC Faculty of Medicine Summer Studentship Recipient

Clinical characteristics and treatment outcomes of pediatric central nervous system tumours treated with targeted therapies in British Columbia

Session 12 | Poster 96

Ashiana Sunderji, Sylvia Cheng Background: Central nervous system (CNS) tumors are the most common solid tumors in children, with a global incidence of 2.28 per 100,000 individuals. These tumors are a leading cause of morbidity and mortality in pediatric populations, often causing seizures, visual and neurological deficits, hypopituitarism, and cognitive impairments. While advances in surgery have improved outcomes, gross total resection is not always possible. Traditional treatments, such as chemotherapy and radiotherapy, can result in longterm side effects. Targeted therapies, which inhibit specific molecular pathways involved in tumorigenesis, have emerged as a promising alternative, particularly for recurrent or progressive tumours. However, there is limited clinical trial and real-world data on their effectiveness and side effects in pediatric patients.

Objective: This study aims to describe the clinical and molecular characteristics of pediatric patients with CNS tumors treated with targeted therapies in British Columbia. Secondary objectives include evaluating therapeutic response, describing adverse events, examining therapy initiation timing, and identifying reasons for treatment discontinuation.

Methods: A retrospective chart review was conducted at BC Children’s Hospital for patients diagnosed between January 1, 2000, and December 31, 2023. Data collected included demographics, clinical diagnosis, molecular alterations, tumor location, prior treatments, and details of targeted therapy use.

Results: Fifty-four patients were included (61% male, 39% female). Common molecular alterations included BRAF alterations (BRAF fusions 19%, BRAF V600E mutations 17%), TSC (15%), and H3K27 alterations (4%). Eighteen patients had neurofibromatosis (NF1=14, NF2=4). Tumor locations varied, with ventricular (15%), diencephalic (7%), and optic pathway (7%) being most common. Targeted therapies were initiated primarily as second-line (26%) or first-line (24%) treatments. The most frequently used agents were Trametinib (35%), Dabrafenib + Trametinib (13%), and Everolimus (9%). At analysis, 61% of patients remained on targeted therapy.

Conclusion: This study provides the first provincial summary of targeted therapy use in pediatric CNS tumors. The findings highlight the growing role of molecularly guided treatment in pediatric neuro-oncology and emphasize the need for ongoing evaluation of real-world effectiveness and tolerability. These insights can guide clinical decision-making and improve outcomes for children with complex CNS tumor diagnoses.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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Lauren Ung

Medical Student, University of British Columbia | Deyell Research Team UBC Faculty of Medicine Summer Studentship Recipient

Abdominal Mass Virtual Huddle: Optimizing Diagnostic Tissue Adequacy in Pediatric Abdominal Tumours

Session 12 | Poster 97

Lauren Ung, Catherine Njeru, Manraj Heran, Stephen Ho, Robert Baird, Jonathan Bush, Rebecca Deyell Background: Abdominal solid malignancies, such as Wilms tumor, neuroblastoma, and hepatoblastoma represent a significant disease burden in the pediatric population. A definitive diagnosis is made through histologic examination of tumor tissue obtained via biopsy or surgical resection. Contemporary diagnosis requires the addition of cytogenetics and some molecular testing to risk stratify, tailor therapy and facilitate research participation. Accurate tissue diagnosis is essential for effective treatment, but sample adequacy can vary by procedure. Core needle biopsy (CNB) is preferred over open biopsy (OB) as it is less invasive, but it is unclear if CNB affects diagnostic tissue adequacy.

Objective: By implementing a “virtual huddle”, we aim to improve the overall tissue adequacy rate by more than 20% from the pre-intervention baseline among children with newly diagnosed abdominal tumors. Adequate tissue is defined as sufficient to achieve timely diagnosis with molecular characterization, facilitate research participation and provide ≥1 vial of fresh frozen tumor for future use.

Methods: Patients ≤19 years presenting with an abdominal mass at British Columbia Children’s Hospital (BCCH) from 2020 - 2024 were reviewed retrospectively. A multi-disciplinary virtual huddle process was implemented in October 2024 for prospective patients referred to interventional radiology for diagnostic CNB. This huddle facilitated pre-procedure discussion among the oncologist, surgeons, interventionalists and pathologists on biopsy approach and tissue needs.

Preliminary Results: Among 43 consecutive pre-intervention patients (age 1 week to 11 years), 49% underwent core needle biopsies (CNBs). Overall, 77% of cases met tissue adequacy criteria: 62% for CNB and 91% for open biopsy (OB). Post-intervention, 10 patients with abdominal masses were assessed prospectively. Virtual huddles were implemented prior to all CNB procedures (n=7; 70%).

Tissue adequacy in this cohort was 90% overall: 86% for CNB and 100% for OB. There were no repeat biopsies or procedural complications.

Conclusion: At BCCH, CNB is increasingly used to obtain diagnostic tumor tissue. Baseline data highlight the need to improve overall tissue adequacy rates, and suggest that implementing a virtual huddle may enhance CNB outcomes.

Presentation: Thursday, July 24, 2025 | 2:00 pm – 3:30 pm | BCCHR Atrium

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