A remarkable number of Children’s National Hospital-affiliated participants will present at this year’s Pediatric Academic Societies meeting. The meeting will take place in Washington, D.C., from April 27-May 1, 2023. For information on the over 200 presentations, please refer to this chart.
Are you attending the 2022 Pediatric Academic Societies meeting this week? There will be over 20 Children’s National Hospital-affiliated participants at this year’s meeting. We have compiled their sessions into a mini schedule below.
| Name | Department | Role | Topic | Date | Time |
| Kristen Sgambat, Ph.D., R.D. | Center for Translational Research | Speaker | Fueling our patients for success: Optimizing nutritional support for kids with kidney disease | 4/22/2022 | 2:30 PM |
| Priti Bhansali, M.D., M.Ed. | Child Health Advocacy Institute | Co-speaker | APA Division Directors/Faculty Development Combined SIG | 4/23/2022 | 8:00 AM |
| Karen Smith, M.D., M.Ed. Neha Shah, M.D., M.P.H. |
Workshop co-leaders | Don’t Struggle In Solitude: Recovery and Peer Support after Unanticipated Outcomes, Errors, and Difficult Conversations | 4/23/2022 | 8:00 AM | |
| Ian Chua, M.D., M.H.P.E. Gabrina Dixon, M.D., M.Ed. Margarita Ramos, M.D., M.S. |
Workshop co-leaders | Finding the DEI in LGBTQIA: Incorporating LGBTQIA diversity in your environment | 4/23/2022 | 8:00 AM | |
| Kevin M. Cook, Ph.D. | Co-presenter | Early exposure to the extra-uterine environment in premature infants is associated with altered functional brain connectivity compared to in-utero age-matched fetuses | 4/23/2022 | 8:15 AM | |
| Gabrina Dixon, M.D., M.Ed. Terry Kind, M.D., M.P.H. |
Workshop co-leaders | Changing the system: Best practices in supporting and advancing underrepresented in medicine (UIM) medical students | 4/23/2022 | 10:00 AM | |
| Yao Wu, Ph.D. | Oral abstract presenter | Impaired prenatal brain growth predicts adverse neurodevelopmental outcomes in infants with congenital heart disease | 4/23/2022 | 10:00 AM | |
| Lee S. Beers, M.D. | General and Community Pediatrics | Moderator | Scholarship in the Domain of Child Health Advocacy: Making It Work in the Academic Medical Center | 4/23/2022 | 10:00 AM |
| Chaya Merrill, Dr.P.H. | Center for Translational Research | Speaker | Using data to advance advocacy in the academic medical center | 4/23/2022 | 10:00 AM |
| Yuan-Chiao Lu, Ph.D. | Oral abstract presenter | Delayed Fetal Cortical Maturation Predicts 18-Month Neurodevelopment in Infants with Congenital Heart Disease | 4/23/2022 | 10:15 AM | |
| Olanrewaju O. Falusi, M.D., M.Ed. | Child Health Advocacy Institute | Speaker | Generating currency for advancement and professional development in the domain of advocacy | 4/23/2022 | 10:15 AM |
| Subechhya Pradhan, Ph.D. | Oral abstract presenter | Abnormal in-vivo brain biochemistry in fetuses with complex congenital heart disease | 4/23/2022 | 10:30 AM | |
| Lenore R. Jarvis, M.D., M.Ed. | Emergency Medicine and Trauma Services | Speaker | Academic advocacy for the subspecialist | 4/23/2022 | 10:30 AM |
| Jillian E. Nickerson, M.D., M.S. | Emergency Medicine and Trauma Services | Presenter | Utilizing an Online Module Platform to Teach Newborn Delivery and Resuscitation Skills to Pediatric Emergency Medicine Providers | 4/23/2022 | 10:30 AM |
| Lee S. Beers, M.D. | General and Community Pediatrics | Presenting Author | Leadership in legislative advocacy at the national level | 4/23/2022 | 11:00 AM |
| Kevin M. Cook, Ph.D. | Oral abstract presenter | Relative neighborhood disadvantage is associated with increased functional network segregation in fetal brains | 4/23/2022 | 11:15 AM | |
| Jung-Hoon Kim, Ph.D. | Presenting Author | Gestational age-related changes in the fetal functional connectome: in utero evidence for the global signal | 4/23/2022 | 1:00 PM | |
| Ioannis Koutroulis, M.D., Ph.D., M.B.A. | Emergency Medicine and Trauma Services | Oral abstract presenter | Immunometabolism in septic encephalopathy: a novel therapeutic target | 4/23/2022 | 1:00 PM |
| Terry Kind, M.D., M.P.H. | General and Community Pediatrics | Workshop co-leaders | Making Meaning from the Data: Exploring Coding in Qualitative Research | 4/23/2022 | 1:00 PM |
| Josepheen D. Cruz, M.D., Ph.D. | Oral abstract presenter | Cortical thickness changes in fetuses exposed to heightened maternal psychological distress | 4/23/2022 | 1:30 PM | |
| Monika Goyal, M.D., M.S.C.E. | Emergency Medicine and Trauma Services | Moderator | Adolescent Medicine II | 4/24/2022 | 8:00 AM |
| Binny Chokshi, M.D., M.Ed. Yael Smiley, M.D. |
Workshop co-leaders | Applying The Collective Impact Model to Pediatric Health Interventions | 4/24/2022 | 8:00 AM | |
| Aisha Barber, M.D. M.Ed. | Hospital Medicine | Workshop co-leaders | Demystifying DEI in Recruitment: Strategies for Creating a Diverse and Inclusive Residency and Fellow Training Environment | 4/24/2022 | 8:00 AM |
| Panagiotis Kratimenos, M.D., Ph.D. | Neonatology | Oral abstract presenter | Maternal Immune Activation and Hypoxia Induces Cerebellar Injury | 4/24/2022 | 8:45 AM |
| Monika Goyal, M.D., M.S.C.E. | Emergency Medicine and Trauma Services | Co-moderator | Emergency Medicine I | 4/24/2022 | 10:00 AM |
| Priti Bhansali, M.D., M.Ed. | Hospital Medicine | Workshop co-leaders | Making the Most of Peer Mentors within a Diverse Developmental Network: Supporting Scholarship and Academic Advancement | 4/24/2022 | 10:00 AM |
| Ian Chua, M.D., M.H.P.E. Gabrina Dixon, M.D., M.Ed. Karen Smith, M.D., M.Ed. |
Hospital Medicine
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Workshop co-leaders | The Art of Negotiation: Applying Negotiation Frameworks to Get More of What You Want in Your Academic Career | 4/24/2022 | 10:00 AM |
| Matthew Magyar, M.D. | Hospital Medicine | Oral abstract presenter | The association between social needs and unscheduled healthcare utilization among a nationally representative sample of children with asthma | 4/24/2022 | 10:00 AM |
| Lena A. Saleh, M.D., M.P.H. | Oral abstract presenter | Machine Learning to Predict the Need for Intensive Care for Pediatric Asthma Exacerbation | 4/24/2022 | 10:30 AM | |
| Christina R. Rojas, M.D. | Emergency Medicine and Trauma Services | Oral abstract presenter | Pediatric Emergency Department Undertriage for Patients with Limited English Proficiency | 4/24/2022 | 10:30 AM |
| Ololade Okito, M.D. | Neonatology | Workshop co-leaders | Best Practices in DEI Recruitment: Holistic Review and Addressing Systemic Bias | 4/25/2022 | 8:00 AM |
| Jennifer H. Klein, M.D. | Presenter | Geography of pediatric health: Using geospatial analysis tools in pediatric care | 4/25/2022 | 8:00 AM | |
| Anand Gourishankar, M.B.B.S., M.R.C.P., M.A.S. | Hospital Medicine | Presenter | Geospatial analysis in pediatric health: Principles, pitfalls, and practice | 4/25/2022 | 8:00 AM |
| Sarah D. Schlatterer, M.D., Ph.D. | Neurology | Oral abstract presenter | Autonomic Dysfunction and Hemodynamic Instability Precedes Cardiac Arrest in Infants with Congenital Heart Disease | 4/25/2022 | 8:15 AM |
| Chaya Merrill, Dr.P.H. | Presenter | Mapping neighborhood-level inequities using the Childhood Opportunity Index | 4/25/2022 | 8:20 AM | |
| Jennifer H. Klein, M.D. | Speaker | Geospatial distribution of congenital heart disease | 4/25/2022 | 8:40 AM | |
| Ioannis Koutroulis, M.D., Ph.D., M.B.A. | Emergency Medicine and Trauma Services | Panelist | APA Urgent Care SIG | 4/25/2022 | 10:00 AM |
| Priti Bhansali, M.D., M.Ed. | Hospital Medicine | Workshop co-leaders | From Mediocre to Masterly: Using Cognitive Interviewing to Improve the Validity of Your Survey | 4/25/2022 | 10:00 AM |
| Beth A. Tarini, M.D., M.S. | General and Community Pediatrics | Speaker | SPR Presidential Plenary: “Transforming the Culture of Pediatric Research: We Are the Problem and the Solution | 4/25/2022 | 10:00 AM |
| Deena Berkowitz, M.D., M.P.H. | Emergency Medicine and Trauma Services | Speaker | 2. UC fellowships and accreditation: the APA pipeline | 4/25/2022 | 10:30 AM |
| John T. Kulesa, M.D. | Hospital Medicine | Oral abstract presenter | A Descriptive Model for Prioritization and Resource Allocation in Academic Global Health Partnerships | 4/25/2022 | 10:30 AM |
| Ariella Slovin, M.D. | General and Community Pediatrics | Speaker | APA Well-being and Vitality SIG | 4/25/2022 | 1:00 PM |
| Melissa Baiyewu, M.H.A., C.H.E.S. Lin Chun-Seeley, M.A. Desiree D. de la Torre, M.P.H., M.B.A. Olanrewaju O. Falusi, M.D., M.Ed. Chaya Merrill, Dr.P.H. |
General and Community Pediatrics | Workshop co-leaders | Training Faculty Members to Model and Teach Health Equity: A New Faculty Development Curriculum | 4/25/2022 | 1:00 PM |
| Ariella Slovin, M.D. | General and Community Pediatrics | Speaker | Wellness and Vitality SIG: Overview of endeavors to date and status report on well-being of APA Members | 4/25/2022 | 1:30 PM |
| Beth A. Tarini, M.D., M.S. | General and Community Pediatrics | Speaker | Navigating Research Careers Through the Currents of Policy and Politics | 4/25/2022 | 1:36 PM |
| Rebecca S. Lundberg, M.D. | Oral abstract presenter | Early parenteral nutrition support and preterm cerebellar metabolic maturation | 4/25/2022 | 2:00 PM | |
| Aisha Barber, M.D., M.Ed. | Hospital Medicine | Workshop co-leader | Moving with the Tide: Taking Steps Toward Anti-Racism and Equity | 4/233/22 | 1:00 PM |
The 2021 Pediatric Academic Societies (PAS) Virtual meeting hosted live-streamed events, on-demand sessions with live Q+A, a virtual exhibit hall, poster presentations and networking events that attracted pediatricians and healthcare providers worldwide. Among the physician-scientists, there were over 20 Children’s National Hospital-affiliated participants at this year’s meeting, adding to the conversation of pediatric research in specialty and sub-specialty areas.
Children’s National experts covered a range of topics, including heart disease, neurology, abnormal glycemia in newborns and antibiotic use in hospitalized children.
The “Neurological Implications of Abnormal Glycemia in Neonatal Encephalopathy and Prematurity” was a hot topic symposium presented by a panel of experts, including Sudeepta Basu, M.B.B.S., M.S., neonatologist at Children’s National.
The experts addressed the importance of recognizing early blood glucose disturbances in newborns with encephalopathy following birth asphyxia and its likely impact on brain injury and long-term outcomes. Although whole body cooling for newborns with encephalopathy after birth asphyxia is now standard of care in most advanced centers like Children’s National, many newborns still die or have neurological impairments. Dr. Basu emphasized on the need of continued advances in newer therapies and optimizing intensive care support for these vulnerable newborns immediately after birth. Dr. Basu’s presentation focused on the association of not only low blood glucose (hypoglycemia) but also high blood glucose (hyperglycemia) with abnormal motor, visual and intellectual outcomes in surviving newborns.
“Recognizing the problem is the first step for further advancement,” Dr. Basu said. “The scientific community needs to recognize the importance of early glucose status as an early marker for disease severity and risk of brain injury.” To sum up, Dr. Basu drew attention to recent newborn resuscitation guidelines from the International Liaison Committee on Resuscitation (ILCOR), which recommends close monitoring of blood glucose levels and optimizing supportive care to maintain it within normal range. Dedicated clinical trials are the need of the hour to guide what are “normal” glucose levels in newborns with encephalopathy and what treatment options are most beneficial.
Rana F. Hamdy, M.D., M.P.H., M.S.C.E., director of the Children’s National Antimicrobial Stewardship Program, delved into the increased number of children receiving care for acute conditions – like acute respiratory tract infections – from urgent care centers and direct-to-consumer (DTC) telemedicine companies during her session “Implementing Antibiotic Stewardship in Telemedicine and Urgent Care Settings.”
Telemedicine, in this case, refers to DTC telemedicine companies—not to be confused with the telemedicine established with primary care providers, like the services provided by Children’s National.
There has been little research focused on promoting good antibiotic stewardship in urgent care settings that tend to overprescribe antibiotics compared to a primary care setting. In addition to her work focusing on improving antimicrobial use within Children’s National, Dr. Hamdy has led collaborative quality improvement work nationally in both the pediatric urgent care and DTC telemedicine settings.
“What we’ve learned from our work with the DTC telemedicine setting is that leadership commitment coming from the company is a necessary core element,” Dr. Hamdy said. “There may be unique opportunities in the telemedicine setting to employ the home-grown computer systems for antimicrobial stewardship interventions, for example, incorporating clinical decision support or feedback reports into the electronic health record systems or displaying a commitment letter in the virtual waiting room.”
In the urgent care setting, Dr. Hamdy’s team recruited approximately 150 pediatric urgent care providers to participate in the national quality improvement initiative. Communication training modules for pediatric urgent care providers with scripted language for target infectious conditions — acute otitis media, pharyngitis and otitis media with effusion — were among the successful intervention approaches that led to improved appropriate antibiotic prescribing practices, according to her team’s findings.
“Understanding the prescribing practices in the urgent care setting is important to knowing where and how to focus on target conditions and to be able to support with education and resources,” Dr. Hamdy said. “And understanding the perceived barriers to judicious antibiotic prescribing can help to identify the highest yield interventions.”
This also reflects the approach taken by the outpatient antibiotic stewardship team at the Children’s National Goldberg Center, led by Ariella Slovin, M.D., primary care pediatrics provider at Children’s National Hospital. Dr. Slovin’s oral abstract entitled “Antibiotic Prescribing Via Telemedicine in the Time of COVID-19,” examined the effect that a shift to telemedicine due to the COVID-19 pandemic had on antibiotic use for acute respiratory tract infections. Overall, her team found a decrease in the proportion of acute respiratory tract infections prescribed antibiotics and concluded that the shift to telemedicine did not adversely affect judicious antibiotic prescribing for acute respiratory tract infections.
Other participants from Children’s National included: Taeun Chang, M.D.; Yuan-Chiao Lu, Ph.D.; Chidiogo Anyigbo, M.D., M.P.H.; Panagiotis Kratimenos, M.D.; Sudeepta Basu, M.B.B.S., M.S.; Ashraf Harahsheh, M.D., F.A.C.C., F.A.A.P.; Rana F. Hamdy, M.D., M.P.H., M.S.C.E.; John Idso, M.D.; Michael Shoykhet, M.D., Ph.D.; Monika Goyal, M.D.; Ioannis Koutroulis, M.D., Ph.D., M.B.A.; Josepheen De Asis-Cruz, M.D., Ph.D.; Asad Bandealy, M.D., M.P.H.; Priti Bhansali, M.D.; Sabah Iqbal, M.D.; Kavita Parikh, M.D.; Shilpa Patel, M.D.; Cara Lichtenstein, M.D.
To view the PAS phase I mini session list and the various areas of expertise at Children’s National, visit: https://innovationdistrict.childrensnational.org/childrens-national-hospital-at-the-2021-pediatric-academic-societies-meeting/
Attending the 2021 Pediatric Academic Societies meeting this week? There will be over 20 Children’s National Hospital-affiliated participants at this year’s meeting. We have compiled their sessions into a mini schedule:
| Name | Program/Department | Session and role | Date | Time |
| Taeun Chang, M.D. | Neonatal Neurology and Neurocritical Care Program | PAS Postgraduate Course: Neonatal Neurology: HIE-focused Project-Based (Chair) | Friday, 30 April
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9:00 AM – 4:00 PM CT |
| Taeun Chang, M.D. | Neonatal Neurology and Neurocritical Care Program | PAS Postgraduate Course: Neonatal Neurology: HIE-focused Project-Based (Presenter) | Friday, 30 April | 9:30 AM – 10:00 AM CT |
| Yuan-Chiao Lu, Ph.D. | Developing Brain Research Laboratory | Cardiology Poster: Care of the Fetus and Newborn with CHD (Presenter) | Saturday, May 1 | 4:30 PM – 4:45 PM CT |
| Chidiogo Anyigbo, M.D., M.P.H. | General and Community Pediatrics | Poster: Health Services Research I (Presenter)
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Saturday, May 1 | 5:15 PM – 5:30 PM CT |
| Panagiotis Kratimenos, M.D. | Neonatology | Platform (moderator) | Saturday, May 1 | 4:30 PM – 6:00 PM CT |
| Sudeepta Basu, MBBS, MS | Neonatology | Hot Topic Symposia: The Neurological Implications of Abnormal Glycemia in Neonatal Encephalopathy and Prematurity (Chair) | Sunday, May 2 | 9:00 AM – 12:00 PM CT |
| Sudeepta Basu, MBBS, MS | Neonatology | Hot Topic Symposia: The Neurological Implications of Abnormal Glycemia in Neonatal Encephalopathy and Prematurity (Presenter) | Sunday, May 2 | 9:55 AM – 10:15 AM CT |
| Ashraf Harahsheh, M.D., F.A.C.C., F.A.A.P.
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Cardiology | Cardiology: Heart Disease in the Older Child | Sunday, May 2 | 10:00 AM – 12:00 PM CT |
| Rana F. Hamdy, M.D., MPH, MSCE | Infectious Diseases
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Expanding Outpatient Antibiotic Stewardship: Practical Strategies, Novel Settings, and Sociobehavioral Influences (Presenter) | Sunday, May 2 | 10:15 AM – 10:30 AM CT |
| Rana F. Hamdy, M.D., MPH, MSCE | Infectious Diseases
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Hot Topic Debates: Antibiotic Use in Hospitalized Children (Chair) | Sunday, May 2 | 1:00 PM – 3:00 PM CT |
| John Idso, M.D. | Critical Care Poster: Resuscitation and Potpourri (presenter) | Sunday, May 2 | 2:20 PM – 2:30 PM CT |
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| Michael Shoykhet, M.D., Ph.D. | Critical Care Medicine
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Critical Care Poster: Resuscitation and Potpourri (presenter) | Sunday, May 2 | 2:20 PM – 2:30 PM CT |
| Panagiotis Kratimenos, M.D. | Neonatology | Neonatal Neurology: Basic & Translational I (moderator) | Sunday, May 2
|
4:30 PM – 6:00 PM CT |
| Monika Goyal, M.D. | Emergency Medicine and Trauma Services | Injury Prevention (moderator) | Sunday, May 2 | 10:00 AM – 12:00 PM CT |
| Ioannis Koutroulis, M.D., Ph.D., M.B.A. | Genetic Medicine Research
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Emergency Medicine III (moderator) | Tuesday, May 4 | 2:00 PM – 4:00 PM CT |
| Sudeepta Basu, MBBS, MS | Neonatology | Neonatal Neurology: Clinical: HIE and Other Insults (moderator) | Tuesday, May 4 | 4:30 PM – 6:00 PM CT |
| Josepheen De Asis-Cruz, M.D., Ph.D. | Center for the Developing Brain | Neonatal Neurology: Clinical: HIE and Other Insults (presenter) | Tuesday, May 4 | 4:30 PM – 4:45 PM CT |
| Asad Bandealy, M.D., MPH Priti Bhansali, M.D. Monika Goyal, M.D. Sabah Iqbal, M.D. Kavita Parikh, M.D. Shilpa Patel, M.D. |
Workshop. ThisIsSTILLOurLane: Protect Kids, Not Guns | Monday, May 10 | 9:00 AM – 11:00 AM CT |
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| Cara Lichtenstein, M.D. | General and Community Pediatrics | APA Injury Control/Advocacy Training Combined SIG (SIG Chair) | Monday, May 10 | 1:00 PM – 3:00 PM CT |
| Terry Kind, M.D., MPH | General and Community Pediatrics
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APA Women in Medicine / Qualitative Research Combined SIG (SIG Chair) | Wednesday, May 12 | 9:00 AM – 11:00 AM CT |
Phase I: April-30-May 4 and Phase II: May 10-June 4
PAS 2021 Virtual Schedule
“Because the majority of patients in our analyses were injured through accidental shootings, this particular risk factor can help to inform policy makers about possible interventions to prevent future firearm injury, disability and death,” says Katie Donnelly, M.D.
Firearm injuries disproportionately impact African American young men living in Washington’s Wards 7 and 8 compared with other city wards, with nearly one-quarter of injuries suffered in the injured child’s home or at a friend’s home, according to a hot spot analysis presented during the Pediatric Academic Societies 2019 Annual Meeting.
“We analyzed the addresses where youths were injured by firearms over a nearly 12-year period and found that about 60 percent of these shootings occurred in Ward 7 or Ward 8, lower socioeconomic neighborhoods when compared with Washington’s six other Wards,” says Monika K. Goyal, M.D., MSCE, assistant chief of Children’s Division of Emergency Medicine and Trauma Services and the study’s senior author. “This granular detail will help to target resources and interventions to more effectively reduce firearm-related injury and death.”
In the retrospective, cross-sectional study, the Children’s research team looked at all children aged 18 and younger who were treated at Children’s National for firearm-related injuries from Jan. 1, 2006, to May 31, 2017. During that time, 122 children injured by firearms in Washington were treated at Children’s National, the only Level 1 pediatric trauma center in the nation’s Capitol:
Of all injuries suffered by children, injuries due to firearms carry the highest mortality rates, the study authors write. About 3 percent of patients in Children’s study died from their firearm-related injuries. Among surviving youth:
“Regrettably, firearm injuries remain a major public health hazard for our nation’s children and young adults,” adds Katie Donnelly, M.D., emergency medicine specialist and the study’s lead author. “Because the majority of patients in our analyses were injured through accidental shootings, this particular risk factor can help to inform policy makers about possible interventions to prevent future firearm injury, disability and death.”
Pediatric Academic Societies 2019 Annual Meeting poster presentatio
Katie Donnelly, M.D., emergency medicine specialist and lead author; Shilpa J. Patel, M.D., MPH, emergency medicine specialist and co-author; Gia M. Badolato, co-author; James Jackson, co-author; and Monika K. Goyal, M.D., MSCE, assistant chief of Children’s Division of Emergency Medicine and Trauma Services and senior author.
Other Children’s research related to firearms presented during PAS 2019 includes:
April 27, 8 a.m.: “Protect kids, not guns: What pediatric providers can do to improve firearm safety.” Gabriella Azzarone, Asad Bandealy, M.D.; Priti Bhansali, M.D.; Eric Fleegler; Monika K. Goyal, M.D., MSCE; Alex Hogan; Sabah Iqbal; Kavita Parikh, M.D.; Shilpa J. Patel, M.D., MPH; Noe Romo; and Alyssa Silver.
April 29, 5:45 p.m.: “Emergency department visits for pediatric firearm-related injury: By intent of injury.” Shilpa J. Patel, M.D., MPH; Gia M. Badolato; Kavita Parikh, M.D.; Sabah Iqbal; and Monika K. Goyal, M.D., MSCE.
April 29, 5:45 p.m.: “Assessing the intentionality of pediatric firearm injuries using ICD codes.” Katie Donnelly, M.D.; Gia M. Badolato; James Chamberlain, M.D.; and Monika K. Goyal, M.D., MSCE.
April 30, 9:45 a.m.: “Defining a research agenda for the field of pediatric firearm injury prevention.” Libby Alpern; Patrick Carter; Rebecca Cunningham, Monika K. Goyal, M.D., MSCE; Fred Rivara; and Eric Sigel.
“As a community-focused health system, one of our central missions is to train a new generation of residents to create successful community partnerships and integrate public health concepts into the everyday practice of medicine to improve the health of underserved communities,” says Cara Lichtenstein, M.D., MPH.
The Children’s National Community Health Track (CHT) has been recognized by the Academic Pediatric Association with its prestigious Teaching Program Award. The honor was made public at the Pediatric Academic Societies (PAS) annual meeting on May 7, 2018 in Toronto, Ontario. The purpose of the award is to foster interest in the teaching of general pediatrics by giving national recognition to an outstanding general pediatric program. The PAS selection committee chose Children’s CHT for demonstrating excellence in educational teaching methods, acceptance by the community, its adaptability and the outstanding quality of residents trained in the program.
“As a community-focused health system, one of our central missions is to train a new generation of residents to create successful community partnerships and integrate public health concepts into the everyday practice of medicine to improve the health of underserved communities,” says Cara Lichtenstein, M.D., MPH and director of Children’s Community Health Track.
Children’s CHT focuses on underserved populations and the development of skills in health policy, advocacy and community healthcare delivery. Residents spend their outpatient time learning to use public health techniques to identify and address community health needs, becoming a physician advocate and learning more about the sociocultural determinants of health and health disparities. Training for CHT is integrated with Children’s overall pediatrics residency program to ensure excellence in attainment of clinical skills, and to allow residents the opportunity to work with Children’s top-rated primary care, specialty and hospital-based physicians and care teams.
This is the third time in recent years that Children’s National has been honored by the Academic Pediatric Association. In 2013, Mary Ottolini, M.D., MPH and vice chair of medical education was recognized for her leadership of Children’s Master Teacher Leadership Development program. In 2009, Denice Cora-Bramble, M.D., MBA accepted the APA Health Care Delivery Award for the Goldberg Center for Community Pediatric Health at Children’s National.
Children’s offers up to eight residency positions each year designated as Community Health Track positions. The goals of the track are centered on the core competencies of community pediatrics as described by the American Academy of Pediatrics. Primarily to train residents to:
The fundamental difference in this track compared to the more traditional Categorical Track lies in the outpatient experiences that occur in all three years of training. The CHT utilizes these outpatient experiences to help residents to attain a well-rounded community pediatrics experience.
“Washington, D.C. is an incredibly diverse community with large numbers of vulnerable children and families from D.C. and all over the world. Given our location in our nation’s capital, residents and faculty have the unique opportunity to work with national professional and advocacy organizations that are influencing policy – both locally and nationally – as it relates to children, families and health care,” says Mark Weissman, M.D., chief of general pediatrics and community health at Children’s National. “We’re thrilled to be recognized with the Academic Pediatric Association’s Teaching Program Award and grateful to Dr. Lichtenstein for her leadership and commitment to improving the health of D.C.’s children and training the next generation of pediatricians and advocates.”
A speech by outgoing American Pediatric Society President Mark L. Batshaw, M.D., explored the impact of a single clinical trial on the entire field.
Gene therapy – delivering genetic material into patients’ cells as a way to treat or cure their diseases – has immense promise to alleviate or end many lifelong and deadly conditions. This treatment has so much potential that it was a heavy focus of research and research dollars around the world in the 1980s and 1990s.
However, many of these efforts came to a screeching halt in 1999 when a teenaged patient named Jesse Gelsinger died in a gene therapy trial aimed at curing a disease called ornithine transcarbamylase deficiency, a urea cycle disorder. Gelsinger’s death triggered a number of investigations, halted gene therapy trials in the United States, and severely restricted financial support from federal, foundation and industry funders.
The tragedy also spurred Mark L. Batshaw, M.D., one of the clinical trial investigators and newly named Chief Academic Officer at Children’s National Health System, to turn in his resignation. The chief executive at the time declined to accept it, instead naming an outside panel to investigate Dr. Batshaw’s role in a study marred by conflicts of interest, delays in updating patient consent forms, lack of adherence to the study protocol and ineffective team leadership.
As Dr. Batshaw passed the gavel to the next president of the American Pediatric Society during the Pediatric Academic Societies’ annual meeting this spring, he told attendees of his Presidential Address that “not a day goes by that I don’t think of Jesse Gelsinger and his family and hope that the work our team has continued will honor him by eventually achieving success with gene therapy.” In an act of altruism, 18-year-old Jesse Gelsinger had joined the trial with the aim of helping other kids suffering from metabolic disorder.
Dr. Batshaw recognizes that his is an unusual choice, speaking about his “greatest professional failure” when predecessors have used their addresses to speak exclusively about scientific accomplishments.
“Because I was a principal, I think telling this story first of all says, hey look, this guy who is president of this organization, who has had a significant career, is willing to talk openly about a failure and how he dealt with it and how the field dealt with that failure,” Dr. Batshaw says. “Secondly, the field of gene therapy right now is starting to explode. It’s telling two different stories in an integrated way: One is of a great personal failure – and failure of an entire field. And the recovery from that, and what the future will be for a technology that holds great promise.”
More than 1,000 gene therapy trials are currently underway, 23 of them at Phase III, the pivotal stage that makes or breaks approval by the Food and Drug Administration (FDA). Dr. Batshaw estimates about a dozen of those are likely to demonstrate robust enough results to progress to a formal application for FDA approval. “After a period of virtually no growth in gene therapy trials from 2000 to 2013, there has been a marked upswing in the past two to three years,” he says.
Children’s National is a study site for one of those clinical trials, a Phase I/II adenoassociated virus (AAV)-mediated gene therapy for late-onset ornithine transcarbamylase (OTC) deficiency. Children with urea cycle disorders have enzyme deficiencies that leave them unable to adequately dispose of waste nitrogen. Often as newborns, they develop severely elevated ammonia in their brains leading to encephalopathy, an often fatal condition. The Phase I work will test escalating doses in three patients for safety. The Phase II work will explore whether the gene therapy improves outcomes like lowering ammonia levels and improving patients’ ability to convert ammonia to urea. (A precursor study in an experimental model was among the most impactful research papers published by Children’s National authors in 2016.)
“So, for both our group’s program – and viral-delivered gene therapy in general – there has been a rebirth after the disastrous outcome of the initial adenovirus trial in OTC deficiency,” Dr. Batshaw said in his prepared remarks. “This resurgence has likely been fueled by improved viral vectors, especially AAVs, and an improved economy and industry investment. The future of gene therapy is likely to be enhanced by new genetic therapy platforms including RNA interference as a means of vertically transmitted gene regulation and the CRISPR gene-editing technology. It will also be impacted by the results of the trials that will be completed in the next few years, especially those using AAV vectors in hemophilia A and B, spinal muscular atrophy and leukemia.”
Looking forward 10 years, Dr. Batshaw is hopeful that gene therapy will become part of the therapeutic tools routinely used to help patients who suffer from rare disease and cancer. Making that next leap forward will be powered by innovative research, including work by colleagues at Children’s National. Among the presenters at PAS2017, the world’s largest pediatric research meeting, were more than 100 Children’s presenters, speakers and moderators.
“It makes me very proud that there are so many clinicians who are also scientists who are not satisfied with simply doing things the way they have always been doing it but constantly questioning how can we do things better for our children?” Dr. Batshaw says. “Our whole focus at Children’s National is caring for children, and that means caring for them the very best way possible and not being satisfied with current therapy if it’s not curative.”
