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Billie Lou Short and Kurt Newman at Research and Education Week

Research and Education Week honors innovative science

Billie Lou Short and Kurt Newman at Research and Education Week

Billie Lou Short, M.D., received the Ninth Annual Mentorship Award in Clinical Science.

People joke that Billie Lou Short, M.D., chief of Children’s Division of Neonatology, invented extracorporeal membrane oxygenation, known as ECMO for short. While Dr. Short did not invent ECMO, under her leadership Children’s National was the first pediatric hospital to use it. And over decades Children’s staff have perfected its use to save the lives of tiny, vulnerable newborns by temporarily taking over for their struggling hearts and lungs. For two consecutive years, Children’s neonatal intensive care unit has been named the nation’s No. 1 for newborns by U.S. News & World Report. “Despite all of these accomplishments, Dr. Short’s best legacy is what she has done as a mentor to countless trainees, nurses and faculty she’s touched during their careers. She touches every type of clinical staff member who has come through our neonatal intensive care unit,” says An Massaro, M.D., director of residency research.

For these achievements, Dr. Short received the Ninth Annual Mentorship Award in Clinical Science.

Anna Penn, M.D., Ph.D., has provided new insights into the central role that the placental hormone allopregnanolone plays in orderly fetal brain development, and her research team has created novel experimental models that mimic some of the brain injuries often seen in very preterm babies – an essential step that informs future neuroprotective strategies. Dr. Penn, a clinical neonatologist and developmental neuroscientist, “has been a primary adviser for 40 mentees throughout their careers and embodies Children’s core values of Compassion, Commitment and Connection,” says Claire-Marie Vacher, Ph.D.

For these achievements, Dr. Penn was selected to receive the Ninth Annual Mentorship Award in Basic and Translational Science.

The mentorship awards for Drs. Short and Penn were among dozens of honors given in conjunction with “Frontiers in Innovation,” the Ninth Annual Research and Education Week (REW) at Children’s National. In addition to seven keynote lectures, more than 350 posters were submitted from researchers – from high-school students to full-time faculty – about basic and translational science, clinical research, community-based research, education, training and quality improvement; five poster presenters were showcased via Facebook Live events hosted by Children’s Hospital Foundation.

Two faculty members won twice: Vicki Freedenberg, Ph.D., APRN, for research about mindfulness-based stress reduction and Adeline (Wei Li) Koay, MBBS, MSc, for research related to HIV. So many women at every stage of their research careers took to the stage to accept honors that Naomi L.C. Luban, M.D., Vice Chair of Academic Affairs, quipped that “this day is power to women.”

Here are the 2019 REW award winners:

2019 Elda Y. Arce Teaching Scholars Award
Barbara Jantausch, M.D.
Lowell Frank, M.D.

Suzanne Feetham, Ph.D., FAA, Nursing Research Support Award
Vicki Freedenberg, Ph.D., APRN, for “Psychosocial and biological effects of mindfulness-based stress reduction intervention in adolescents with CHD/CIEDs: a randomized control trial”
Renee’ Roberts Turner for “Peak and nadir experiences of mid-level nurse leaders”

2019-2020 Global Health Initiative Exploration in Global Health Awards
Nathalie Quion, M.D., for “Latino youth and families need assessment,” conducted in Washington
Sonia Voleti for “Handheld ultrasound machine task shifting,” conducted in Micronesia
Tania Ahluwalia, M.D., for “Simulation curriculum for emergency medicine,” conducted in India
Yvonne Yui for “Designated resuscitation teams in NICUs,” conducted in Ghana
Xiaoyan Song, Ph.D., MBBS, MSc, “Prevention of hospital-onset infections in PICUs,” conducted in China

Ninth Annual Research and Education Week Poster Session Awards

Basic and Translational Science
Faculty:
Adeline (Wei Li) Koay, MBBS, MSc, for “Differences in the gut microbiome of HIV-infected versus HIV-exposed, uninfected infants”
Faculty: Hayk Barseghyan, Ph.D., for “Composite de novo Armenian human genome assembly and haplotyping via optical mapping and ultra-long read sequencing”
Staff: Damon K. McCullough, BS, for “Brain slicer: 3D-printed tissue processing tool for pediatric neuroscience research”
Staff: Antonio R. Porras, Ph.D., for “Integrated deep-learning method for genetic syndrome screening using facial photographs”
Post docs/fellows/residents: Lung Lau, M.D., for “A novel, sprayable and bio-absorbable sealant for wound dressings”
Post docs/fellows/residents:
Kelsey F. Sugrue, Ph.D., for “HECTD1 is required for growth of the myocardium secondary to placental insufficiency”
Graduate students:
Erin R. Bonner, BA, for “Comprehensive mutation profiling of pediatric diffuse midline gliomas using liquid biopsy”
High school/undergraduate students: Ali Sarhan for “Parental somato-gonadal mosaic genetic variants are a source of recurrent risk for de novo disorders and parental health concerns: a systematic review of the literature and meta-analysis”

Clinical Research
Faculty:
Amy Hont, M.D., for “Ex vivo expanded multi-tumor antigen specific T-cells for the treatment of solid tumors”
Faculty: Lauren McLaughlin, M.D., for “EBV/LMP-specific T-cells maintain remissions of T- and B-cell EBV lymphomas after allogeneic bone marrow transplantation”

Staff: Iman A. Abdikarim, BA, for “Timing of allergenic food introduction among African American and Caucasian children with food allergy in the FORWARD study”
Staff: Gelina M. Sani, BS, for “Quantifying hematopoietic stem cells towards in utero gene therapy for treatment of sickle cell disease in fetal cord blood”
Post docs/fellows/residents: Amy H. Jones, M.D., for “To trach or not trach: exploration of parental conflict, regret and impacts on quality of life in tracheostomy decision-making”
Graduate students: Alyssa Dewyer, BS, for “Telemedicine support of cardiac care in Northern Uganda: leveraging hand-held echocardiography and task-shifting”
Graduate students: Natalie Pudalov, BA, “Cortical thickness asymmetries in MRI-abnormal pediatric epilepsy patients: a potential metric for surgery outcome”
High school/undergraduate students:
Kia Yoshinaga for “Time to rhythm detection during pediatric cardiac arrest in a pediatric emergency department”

Community-Based Research
Faculty:
Adeline (Wei Li) Koay, MBBS, MSc, for “Recent trends in the prevention of mother-to-child transmission (PMTCT) of HIV in the Washington, D.C., metropolitan area”
Staff: Gia M. Badolato, MPH, for “STI screening in an urban ED based on chief complaint”
Post docs/fellows/residents:
Christina P. Ho, M.D., for “Pediatric urinary tract infection resistance patterns in the Washington, D.C., metropolitan area”
Graduate students:
Noushine Sadeghi, BS, “Racial/ethnic disparities in receipt of sexual health services among adolescent females”

Education, Training and Program Development
Faculty:
Cara Lichtenstein, M.D., MPH, for “Using a community bus trip to increase knowledge of health disparities”
Staff:
Iana Y. Clarence, MPH, for “TEACHing residents to address child poverty: an innovative multimodal curriculum”
Post docs/fellows/residents:
Johanna Kaufman, M.D., for “Inpatient consultation in pediatrics: a learning tool to improve communication”
High school/undergraduate students:
Brett E. Pearson for “Analysis of unanticipated problems in CNMC human subjects research studies and implications for process improvement”

Quality and Performance Improvement
Faculty:
Vicki Freedenberg, Ph.D., APRN, for “Implementing a mindfulness-based stress reduction curriculum in a congenital heart disease program”
Staff:
Caleb Griffith, MPH, for “Assessing the sustainability of point-of-care HIV screening of adolescents in pediatric emergency departments”
Post docs/fellows/residents:
Rebecca S. Zee, M.D., Ph.D., for “Implementation of the Accelerated Care of Torsion (ACT) pathway: a quality improvement initiative for testicular torsion”
Graduate students:
Alysia Wiener, BS, for “Latency period in image-guided needle bone biopsy in children: a single center experience”

View images from the REW2019 award ceremony.

Emily Niu

Osteochondritis dissecans: Deciding the best candidates for nonoperative treatment

Emily Niu

“When patients come to see me with this condition, they’re often at their lowest point. But then I get to watch them go through this transformation as they’re getting better,” says Emily Niu, M.D. “It’s really wonderful to see someone’s personality blossom over the course of treatments.”

The adage of “practice makes perfect” is true for young competitive athletes; however it also puts them at risk for overuse injuries. One of these injuries is a condition called osteochondritis dissecans (OCD), in which repeatedly overloading joints causes increased stress to certain areas of bone. This area of bone can lose its blood supply, become unhealthy and ultimately end up fragmented. In the late stages, this area of bone can break off from the surrounding healthy bone and as a result, the overlying cartilage (which relies on the bone for a foundation) can become prone to damage. This process can be likened to the formation of potholes in a road. Typically, individuals affected can have pain, limited range of motion or even arthritis down the line.

This condition can happen at different locations throughout the body, including the knees, ankles and elbows. Baseball players and gymnasts are particularly prone to getting OCD of the capitellum, or the outside of the elbow, from throwing or tumbling.

If this injury is unstable, with bone and cartilage already fragmenting, it’s typically treated with surgery, explains Emily Niu, M.D., a Children’s National orthopaedic surgeon. Stabilizing the fragment and drilling tunnels in the affected bone surface allows new bone to grow and repair the defect. But for stable OCD, the treatment path is unclear.

Sometimes nonoperative treatments, such as rest, physical therapy or bracing the joint, can allow it to fully heal over time; however, she says, some patients treated nonoperatively may not be able to heal and will still require surgery later.

What distinguishes these two groups has thus far been unclear. Dr. Niu adds that there are few studies that have looked at what characteristics might make patients better candidates for a surgical or nonoperative route. The studies that do exist are limited to very small groups of patients.

To help doctors and their patients make more informed decisions, Dr. Niu and her colleagues performed a retrospective review of 89 patients aged 18 years old and younger treated at Boston Children’s Hospital for stable OCD of the capitellum. The vast majority of these 49 male and 40 female patients were baseball players and gymnasts. Most had just a single elbow affected; four patients (all gymnasts) experienced this problem in both elbows.

Each of these patients was initially treated nonoperatively, with activity restriction, physical therapy and progressive return to activity at the discretion of the treating physician. During this time, all of the athletes had elbow radiographs, elbow MRIs or both to image the injury and follow its healing process.

The researchers report in the November 2018 that just over half of these 93 elbows healed successfully with nonoperative treatments, taking an average of about eight months for symptoms to subside and imaging to show that the bone had healed properly.

When Dr. Niu and her colleagues looked for characteristics that might have influenced whether nonoperative treatments worked or didn’t, they didn’t find any difference in the two groups with age, bone maturity, sex, hand dominance or sport. However, the healing group had symptoms for an average of four months shorter than the non-healing group before they sought treatment. Those patients with bone lesions without clear margins visible on MRI were more likely to heal than those with clear margins, as were those without cyst-like lesions on their bones – both signs of a more advanced process. In addition, those whose bone lesions were relatively small were more likely to heal than those with larger lesions compared to the size of their bones.

Dr. Niu notes that OCD can be a devastating injury for young athletes, interrupting their participation in sports on average for a minimum of six months and significantly longer if nonoperative treatments fail and surgery becomes necessary. Being able to shave some time off that schedule with better knowledge of which type of treatment is most likely to work, she says, can help her patients get back to doing what they love significantly faster.

“When patients come to see me with this condition, they’re often at their lowest point. But then I get to watch them go through this transformation as they’re getting better,” Dr. Niu says. “It’s really wonderful to see someone’s personality blossom over the course of treatments. It’s such a relief for both of us when they’re back where they want to be.”