News Briefs

Yanxin Pei awarded St. Baldrick’s Foundation Research Grant for Childhood Cancer

Yanxin Pei, Ph.D., assistant professor at the Children’s Research Institute, was a recipient of a $100,000 grant that is being named the “Benicio Martinez Fund for Pediatric Cancer Research Grant” from the St. Baldrick’s Foundation, the largest private funder of childhood cancer research grants in the United States.

Dr. Pei studies medulloblastoma – one of the most common malignant brain tumors in children – and has identified a subpopulation of tumor cells that contribute to metastasis after radiotherapy. Her lab is now determining whether targeting these cells can eliminate or prevent the spread of medulloblastoma, thereby improving the outcome of patients with this disease.

In their latest round of funding, the St. Baldrick’s Foundation awarded 76 grants totaling more than $19.1 million to support physician-scientists studying innovative treatment options in the pediatric cancer space. The grants from St. Baldrick’s deliver on its commitment to support the most promising childhood cancer research and work to provide the best solutions possible for kids. The next St. Baldrick’s grant cycle will be announced in fall 2018.

“At St. Baldrick’s, we focus on funding research that has the best potential of giving kids the healthy childhoods they deserve,” said Kathleen Ruddy, CEO of the St. Baldrick’s Foundation.  “I’m proud to say that we have now funded more than a quarter billion dollars since 2005 to support lifesaving childhood cancer research.

Randi Streisand

Randi Streisand, Ph.D., appointed Chief of Psychology and Behavioral Health at Children’s National Health System

Randi Streisand

Children’s National Health System announces that Randi Streisand, Ph.D., will become the chief of Psychology and Behavioral Health within the Center for Neuroscience and Behavioral Medicine. Dr. Streisand is a behavioral scientist, child health researcher and certified diabetes educator. She is a tenured professor of Psychology and Behavioral Health, and Pediatrics at The George Washington University School of Medicine and Health Sciences, and serves as the director of Psychology Research for Children’s National Health System.

“Dr. Streisand’s acceptance of this leadership position will play an integral role in our approach to improve research methods and providing comprehensive approaches to psychological treatments” says Roger J. Packer, M.D., senior vice president of the Center for Neuroscience and Behavioral Medicine.

As chief, Dr. Streisand will lead our team of nationally recognized educators, research leaders and specialists who are experts in the care of children and teens with emotional and behavioral disorders. She will also continue to lead an extensive research portfolio, focusing on parent-child adjustment to chronic disease, behavioral interventions to prevent and control disease and treatment complications and adherence to pediatric medical regimens.

Before joining the faculty at Children’s National in 2000, Dr. Streisand received her doctorate in clinical psychology from the University of Florida, completed her internship at Brown University and a fellowship at the Children’s Hospital of Philadelphia. She has written numerous publications in the areas of child health and serves on several grant review committees through Children’s National, NIH and the American Diabetes Association. At Children’s National, she is an active participant in the psychology training program, and mentors undergraduates, graduate students, interns, fellows and junior faculty members.

audience members at the 2018 Gluten Free Expo keynote

Dispelling gluten-free myths and patient education headline the 2018 Washington DC Gluten-Free Education Day and Expo

audience members at the 2018 Gluten Free Expo keynote

On June 10, 2018, some of the brightest minds in the field gathered at the 2018 Washington DC Gluten-Free Education Day and Expo to discuss opportunities and challenges associated with living a gluten-free life.

The one-day expo focused on how the food we eat affects our brains, how to dispel gluten-free myths and how to think outside the box with new recipes and cooking demonstrations from local restaurants, bakeries and chefs.

Keynote speakers for this year’s symposium included Benny Kerzner, M.D., medical director, Celiac Disease Program at Children’s National, Jocelyn Silvester, M.D., director of Research, Celiac Disease Program at Boston Children’s Hospital and Ian Liebowitz, M.D. from Pediatric Specialists of Virginia.

Additionally, Edwin Liu, M.D., from Colorado Children’s Hospital and Ilana Kahn, M.D., from Children’s National gave a joint keynote on the autoimmune connection, focusing on conditions related to celiac disease and the gut-brain connection.

Teen mentors gave a panel discussion for the 13+ age group attending the conference in a session called “For Teens from Teens!” during which they discussed the challenges of navigating a gluten-free lifestyle as a teen.

In addition to the useful educational sessions, attendees visited many of the 57 vendor tables with gluten-free product samples voting for the best sweet and savory winners.

The Celiac Disease Program at Children’s National Health System started in 2009 to improve the way pediatric celiac disease is diagnosed and treated. Working in partnership with concerned members of our community, our Celiac Disease Program brings together a team of expert physicians, nurses, nutritional consultants and professional counselors dedicated to developing a national model for detecting and treating celiac disease in children.

Tonya Kinlow

Children’s National Health System hosts School Health Symposium

Tonya Kinlow

The Child Health Advocacy Institute at Children’s National Health System held its first School Health Symposium, designed to strengthen relationships between the education and health care sectors. Led by Tonya Vidal Kinlow, M.P.A., vice president of Community Engagement, Advocacy and Community, Children’s National welcomed more than 150 regional health and education partners, community members and Children’s National staff to support the mission of helping kids grow up stronger.

In a day of panel discussions and breakout sessions, education, government and health professionals tackled the many societal challenges children face. The panel discussions at this year’s symposium focused on the following topics:

  • Caring for the whole child using a trauma-informed approach
  • Children’s National regional school-based programs
  • Local government role in school health
  • How a health system advocates for school health
  • How organizations are working with schools to address the social determinants of health

Participants also had the option to attend one of the following breakout sessions:

  • Mental wellness & self-care for school and health care professionals
  • School-based research: engaging families, empowering students
  • How an anchor institution is addressing the social determinants of health
  • School health legislation update

Outreach programs focused on strong community partnerships were recognized for serving diverse communities including infants and their caregivers, primary care clinicians, high school students, child care providers and teachers. Three programs were chosen as recipients for the Community Health Improvement Award through an application process where a panel of judges with expertise in public health and policy evaluated against an established criteria set.

“Our Community Health Improvement Awards recognize all efforts to conduct community outreach programs and shape public policies that benefit children and families in the Washington D.C.  area,” says Kurt Newman, M.D., president and CEO of Children’s National. “The award also recognizes the physicians and clinicians here at Children’s who go above and beyond to provide quality care to kids and their families.”

This year’s recipients actively play a role in contributing to school health:

The School Health Symposium was followed by a networking reception to allow participants an opportunity to connect with colleagues and discuss the sessions.

photos used for facial analysis technology

Facial analysis technology successful in identifying Williams-Beuren syndrome in diverse populations

photos used for facial analysis technology

Image Credit: Darryl Leja, NHGRI.

In an international study led by the National Human Genome Research Institute (NHGRI), researchers have successfully identified Williams-Beuren syndrome in diverse populations using clinical information and objective facial analysis technology developed by the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National.

The technology, which was featured by STAT as an ‘Editor’s Pick’ finalist in their recent competition to find the best innovation in science and medicine, enables users to compare the most relevant facial features characteristic of Williams-Beuren syndrome in diverse populations.

Williams-Beuren syndrome affects an estimated 1 in 7,500 to 10,000 people, with the most significant medical problems being cardiovascular, including high blood pressure. Though the syndrome is a genetic condition, most cases are not inherited. Signs and symptoms include intellectual disability and distinctive facial features including puffiness around the eyes, a short nose with a broad tip, full cheeks and a wide mouth with full lips.

Using the facial analysis technology, the researchers compared 286 African, Asian, Caucasian and Latin American children and adults with Williams-Beuren syndrome with 286 people of the same age, sex and ethnicity without the disease. They were able to correctly identify patients with the disease from each ethnic group with 95 percent or higher accuracy.

“Our algorithm found that the angle at the nose root is the most significant facial feature of the Williams-Beuren syndrome in all ethnic groups and also highlighted facial features that are relevant to diagnosing the syndrome in each group,” said Marius George Linguraru, D.Phil., developer of the facial analysis technology and an investigator in the study from Children’s National.

Linguraru and his team are working to create a simple tool that will enable doctors in clinics without state-of-the-art genetic facilities to take photos of their patients on a smartphone and receive instant results.

The technology was also highly accurate in identifying Noonan syndrome according to a study published in Sept. 2017, DiGeorge syndrome (22q11.2 deletion syndrome) in April 2017 and Down syndrome in Dec. 2016. The next study in the series will focus on Cornelia de Lange syndrome.

Rebecca Zee

Children’s urology fellow wins best basic science award

Rebecca Zee

Rebecca Zee, a Children’s urology fellow, was awarded the best basic science prize at the Societies for Pediatric Urology annual meeting for her abstract describing a novel treatment to prevent ischemia reperfusion injury following testicular torsion.

Occurring in 1 in 4,000 males, testicular torsion occurs when the testis twists along the spermatic cord, limiting blood supply to the testicle. Despite prompt surgical intervention and restoration of blood flow, up to 40 percent of patients experience testicular atrophy due to a secondary inflammatory response, or ischemia reperfusion injury. Cytisine, a nicotine analog that the Food and Drug Administration approved for smoking cessation, recently has been found to activate a novel anti-inflammatory cascade, limiting the post-reperfusion inflammatory response.

“Administration of cytisine was recently found to limit inflammation and preserve renal function following warm renal ischemia,” Zee says. “We hypothesized that cytisine would similarly prevent ischemia reperfusion injury and limit testicular atrophy following testicular torsion.”

Using an established experimental model, Zee and colleagues induced unilateral testicular torsion by anesthetizing the adult male experimental models and rotating their right testicles by 720 degrees for two hours. In the treatment arm, the preclinical models were given cytisine as a 1.5 mg/kg injection one hour before or one hour after creating the testicular torsion. Eighteen hours after blood flow was restored to the right testis, total leukocyte infiltration and inflammatory gene expression were evaluated. Thirty days later, the researchers measured testicular weight and evaluated pro-fibrotic genes.

“We found that the administration of cytisine significantly decreases long-term testicular atrophy and fibrosis following testicular torsion,” says Daniel Casella, M.D., a urologist at Children’s National Health System and the study’s senior author. “What is particularly exciting is that we found similar long-term outcomes in the group that was given cytisine one hour after the creation of testicular torsion. This scenario is much more clinically applicable, given that we would not be able to treat patients until they present with testicular pain,” Dr. Casella adds.

Additional research is needed to determine the optimal cytisine dosing and administration regimen, however the researchers are hopeful that they can transition their findings to a pilot clinical trial in the near future.

In addition to Zee and Dr. Casella, the multi-institutional team included Children’s co-authors Nazanin Omidi, Christopher Bayne, Michael Hsieh, M.D., and Evaristus Mbanefo, in addition to Elina Mukherjee and Sunder Sims-Lucas, Ph.D., from the University of Pittsburgh.

Financial support for this work was provided by the Joseph E. Robert Jr. Center for Surgical Care.

Laura Sanapo

Children’s fetal medicine fellow named ‘Outstanding graduate student’

Laura Sanapo

Laura Sanapo, M.D., M.S.H.S., told the graduating class that two guiding themes defined her experience as a GW student: diversity and momentum.

Laura Sanapo, M.D., M.S.H.S., a fetal medicine fellow at Children’s Fetal Medicine Institute, was named “Outstanding graduate student” at The George Washington University School of Medicine & Health Sciences (GWSMHS) and was among two student speakers to address fellow graduates during the ceremony held May 19, 2018.

Dr. Sanapo was selected from a competitive field of top-tier graduate students from an array of academic programs, says Samar A. Nasser, Ph.D., M.P.H., PA-C, director of Clinical and Translational Research and Clinical Health Sciences at GWSMHS, who nominated her for the award. “She is one of the brightest students I have encountered. Because of her exceptional background, I recruited Dr. Sanapo to become an adjunct professor in our Clinical and Translational Research program and I look forward to co-teaching a course with her this fall.”

“I am extremely humbled and honored by this recognition for my ongoing research,” Dr. Sanapo says. “It is a privilege to join the GW faculty and contribute to the growth of an outstanding academic team and diverse group of students. I feel energized by such a collegial and dynamic environment.”

She told the graduating class that two guiding themes defined her experience as a GW student: diversity and momentum. Diversity, she told the group “means the spark that generates new ideas and growth” and momentum is the feeling of being “propelled forward by being part of a university that feels like a lively workshop of ideas.”

Prior to joining Children’s National Health System in 2014, Dr. Sanapo served with distinction at the University of Maryland School of Medicine and Thomas Jefferson University School of Medicine, conducting original research and frequently publishing in peer-reviewed journals.

Under the mentorship of Adré J. du Plessis, M.B.Ch.B., M.P.H., chief of Children’s Division of Fetal and Transitional Medicine, Dr. Sanapo investigated the role of advanced ultrasound techniques in assessing fetal vasoreactivity in pregnancies complicated by such conditions as intrauterine growth restriction, Dr. Nasser wrote in the nomination letter. In that study, the research team is trying to better understand how a healthy fetus controls blood flow throughout the body, including to the lungs and brain.

In addition to evaluating and counseling in high-risk pregnancies complicated by complex fetal malformations, Dr. Sanapo performed research and clinical ultrasounds daily. What’s more, Dr. Sanapo often scheduled appointments after-hours for patients unable to complete ultrasounds during normal business hours and was an integral part of the team that counseled women through difficult pregnancies.

“‘These women are especially vulnerable and they deserve 100 percent of my time, knowledge, energy and empathy,’  ” Dr. Nasser recalls Dr. Sanapo explaining. “Laura often goes above and beyond her responsibilities as a fellow to assist these women in need.”

Dr. du Plessis notes that Dr. Sanapo has been a valued clinical leader at Children’s Fetal Medicine Institute, shepherding a multidisciplinary team that includes genetic counselors, specialists in maternal-fetal medicine, radiologists, pediatric neurologists and nurses.

“When Children’s National and Inova announced a three-year, $2.8 million research and education collaboration in maternal, fetal and neonatal medicine last January, Laura’s contributions were pivotal in ensuring the research collaboration’s early success,” Dr. du Plessis adds.

Gerard Gioia

Concussion prevention and better management of youth concussions headline Sports Neuropsychology Society Concussion Symposium

Gerard Gioia

Gerard Gioia, Ph.D., an internationally recognized expert in pediatric concussion management, was named president of the Sports Neuropsychology Society at the conclusion of this year’s meeting.

“We know how critical it is to identify and appropriately treat every concussion, particularly when they happen early in an athlete’s career,” Children’s National President and CEO Kurt Newman, M.D.,  told a crowd of nearly 300 sports concussion experts gathered in Washington, D.C. for the Sports Neuropsychology Society’s (SNS) 6th Annual Concussion Symposium.

Children’s National served as a title sponsor of the conference, which serves as the annual meeting for SNS. Each year, members from around the world meet to share best practices in sports-related concussion management through presentation of evidence-based studies on a wide range of related topics. This year’s presentations included topics such as:

  • Sex differences in sport-related concussion: Incidence, outcomes and recovery
  • Concussion Clinical Profiles and Targeted Treatments: Building the Evidence
  • Legislative advocacy and the sports neuropsychologist
  • Treatment of concussion in kids: What we know, what we think we know, and what we need to learn

“This meeting and its agenda, held in D.C. where we’ve done so much work on understanding concussion management for children, is particularly meaningful for me because it really drives home our key message of a link between active participation in sports, appropriate recognition, management of youth concussions and the developing  athlete’s brain health,” says Gerard Gioia, Ph.D., division chief of neuropsychology and director of the Safe Concussion Outcome, Recovery and Education (SCORE) program at Children’s National.

Dr. Gioia, an internationally recognized expert in pediatric concussion management, was named president of the society at the conclusion of this year’s meeting, which was held in Washington, D.C. from May 3-5, 2018. During his two year term, he will work with members to advance the mission of SNS, which seeks to advance the field of neuropsychology to generate and disseminate knowledge regarding brain-behavior relationships as it applies to sports, and to promote the welfare of athletes at all levels.

“The way we can really help our youth athletes is by understanding how we can maximally prevent concussions in sports, and how we can manage those earliest concussions more effectively to minimize the negative long term consequences,” says Dr. Gioia.

Susannah Jenkins

Guiding a new path for emergency medical care training

Susannah Jenkins

Susannah Jenkins, PA-C, guides a new training program for physician assistants.

Susannah Jenkins, PA-C, lead physician assistant with the emergency medicine and trauma services department at Children’s National Health System, celebrates three years at Children’s National this September and she’s glad she transitioned from an adult surgical environment to the fast-paced, dynamic environment of working in pediatric emergency medicine (PEM).

With 25 years of health care experience, 13 years as a physician assistant and 12 years as a nurse, Jenkins has worked in a variety of settings, inclusive of adult neurosurgery and high-risk OBGYN care.

“My passion is helping everyone heal, but I particularly enjoy working with children,” notes Jenkins. “Children have an extraordinary ability to bounce back after a fall and recover from a bout of seasonal, flu-like illness. A dose of medication or the correct diagnosis, paired with the right treatment, can sometimes make everything better, almost instantaneously, which is one of the most rewarding parts of working in this field. You get to help and see children heal.”

In addition to providing treatment for a range of pediatric patients, Jenkins works with Deena Berkowitz, M.D., M.P.H., a pediatric emergency medicine physician and assistant professor of pediatrics and emergency medicine at Children’s National and the George Washington University School of Medicine and Health Sciences, to train physician assistants, or PAs, to respond to urgent care needs within a Level 1 trauma center. With the encouragement and guidance of Dr. Berkowitz and Robert J. Freishtat, M.D., M.P.H., chief of emergency medicine at Children’s National, Jenkins expanded on an emergency medicine training program for PAs, which started at Children’s National in 2012.

Jenkins presents the 12-month module at the American Academy of Physician Assistants 2018 Annual Conference in New Orleans on Saturday, May 19, 2018.

Jenkins’ poster presentation, coauthored by Dr. Berkowitz, details the objectives, timeline, curriculum components and results that correspond with providing eight PAs with a 12-month training program to treat low-acuity pediatric patients at a Level 1 trauma center.

The eight PAs who completed the 12-month program in 2017-18 saw 14 percent of the emergency care department’s low-acuity pediatric patients – patients seeking treatment for basic care, such as ear infections, conjunctivitis or strep throat – after 12 months of exhibiting competency in the program. The structured curriculum includes a two-month orientation followed by a 10-month provisional training module, inclusive of CME submissions, scientific literature reviews, journal discussions, case studies, chart reviews, team-based care and competency reviews.

“This is all about education,” notes Jenkins. “We’re here to support the PA and we aim to answer questions they have about education goals, competency goals and practice goals in an institutional setting. This template provides the foundation to bridge the gap between post-graduation studies with the skills PAs need and are eager to develop throughout their career.”

Jenkins is currently working with Dr. Berkowitz to develop guidelines for PAs treating medium-acuity patients, inclusive of patients seeking a higher level of primary care, such as for appendicitis, and for PA-training-programs that extend past one year. Jenkins notes the 12-month program she presents at the American Academy of Physician Assistants 2018 Annual Conference is a template that can be applied to any PA subspecialty and is a desirable program for both employers and PA applicants.

“Ultimately, I sought to provide a guide that answered all of my questions I had as a new graduate and as a seasoned PA entering the new subspecialty of pediatric emergency medicine,” says Jenkins. “This program blends the academic science with clinical case studies and practice competencies, making it a modifiable learning platform that’s beneficial for everyone – but specifically designed for PAs. Remember, they enter the field with the desire to support physicians and their patients.”

Her guiding question isn’t on the final test but it helps her with the program design: How can we train PAs to provide the kind of care we want for our children, for our families and for our neighbors?

“I am proud of all of the PAs in this program and of all of the PAs I work with,” Jenkins concludes. “I actively refer them to family members and friends seeking urgent pediatric care. I am confident in the abilities of my group. They represent the type of provider I would send my family and my friends to see, and ultimately your family and friends to see, if they were in need.”

Dr. Berkowitz agrees and is happy with the success the program has had in preparing an average of six to eight PAs each year with the tools they need to launch their career.

Download a copy of “Bridging the post-graduation gap: A 12 month curriculum for PAs entering Pediatric Emergency Medicine.”

Dorothy Bulas

Dorothy Bulas, M.D., receives the Society for Pediatric Radiology’s highest honor

Dorothy Bulas

Dorothy Bulas, M.D. F.A.C.R., F.A.I.U.M., F.S.R.U., chief of diagnostic imaging and radiology in the Division of Diagnostic Imaging and Radiology at Children’s National Health System, is being recognized at the 2018 Society for Pediatric Radiology Annual Meeting with their most distinguished honor, the Gold Medal.

The Society of Pediatric Radiology (SPR) Gold Medal is awarded to pediatric radiologists who have contributed greatly to the SPR and their subspecialty of pediatric radiology as a scientist, teacher, personal mentor and leader.

Initially, Dr. Bulas completed her residency in pediatrics. During a pediatric radiology rotation at John Hopkins University, she realized how much she loved problem solving and using emerging imaging modalities and went on to complete her radiology residency at Albert Einstein Hospital. Soon after, Dr. Bulas moved to Washington, D.C. to complete a pediatric radiology fellowship at her professional home, Children’s National.

Since the completion of her fellowship, Dr. Bulas views her role in the advancement of fetal imaging as her most significant professional contribution. She has published 131 papers, one of her most recent as a co-author on “Neuroimaging findings in normocephalic infants with Zika virus” in Pediatric Neurology. Dr. Bulas is also a co-author of the textbook entitled Fundamental and Advanced Fetal Imaging and has authored 35 book chapters.

She has served as program director of the Radiology Fellowship Program at Children’s National since 2005 where she has impacted medical students, residents and fellows from the United States and abroad.

As a previous chair member for numerous organizations, Dr. Bulas currently co-chairs the American College of Radiology’s pediatric radiology education committee. She is a founding member of the Image Gently Alliance, where she chaired the outreach campaign to parents and wrote brochures, web material and articles. Dr. Bulas is also a founder of the World Federation of Pediatric Imaging.

Dr. Bulas was honored as an outstanding teacher with the Edward Singleton-Hooshang Taybi Award for Excellence in Education from the SPR and this past fall and as the Outstanding Educator in 2017 by the Radiological Society of North America.

Brian Stone with baby

Collaborative approach to NICU care leads to improved quality and safety across hospitals

Brian Stone with baby

Parents with sick or premature newborns want and need the best care possible, making quality and safety in the neonatal intensive care unit (NICU) a top priority. Over the past decade, Children’s National Health System has provided top quality NICU care to the Washington, D.C. community and surrounding areas. As part of this commitment, the institution developed an extensive network of partnerships in the Mid-Atlantic region where Children’s National neonatologists and advanced practice providers collaborate with other hospitals in the region to share best practices in the NICU.

Together, Children’s National and partner hospitals aim to improve NICU care for patients and families. To carry out this commitment, Children’s National neonatologists fully integrate themselves into local community hospitals to provide services such as neonatal care, delivery room attendance, consultations to obstetricians and local pediatricians, and serve as educators to the hospital team.

Integrating pediatric specialists into community hospitals that treat both adults and children helps strengthen the infrastructure and refine practices to specifically understand pediatric biology and development to enhance existing care. Using the Dyad leadership model, the team forms interdisciplinary care committees, led by a physician and nursing champion, to empower everyone who interacts with the NICU and has a stake in a child’s care. All policies and procedures are vetted by these committees to ensure high-quality, cohesive care for the patient.

Through this collaboration, Children’s National neonatologists oversee newborn care for more than 10,000 births per year. Outcomes include:

  • Partner NICUs consistently perform in the top quartile for key performance benchmarking measures in national networks.
  • Partner NICUs have lower than predicted rates of morbidity, infection, lung disease and necrotizing enterocolitis which are major determinants in overall neonatal outcome.

Based on this success, Children’s National created the Division of Pediatric Outreach in 2017, led by Brian Stone, M.D., M.B.A. This division focuses on ensuring that neonatal and pediatric patients have access to and can receive expert care from Children’s National specialists in their local community birth hospital. Additionally, the division works closely with local obstetricians and maternal-fetal-medicine specialists to develop birth and post-natal plans for high-risk pregnancies to ensure that newborns have the best possible start.

“Over the years, we have been able to leverage our internal expertise as reflected in our current number one ranking in U.S. News & World Report and extend the same high level of care to patients born within our extended network to improve population health as a whole within the region,” said Dr. Stone.

Cara Lichtenstein

Children’s Community Health Track receives prestigious APA Teaching Program Award

Cara Lichtenstein

“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:

  • Grasp the breadth of diversity inherent in the pediatric population and be familiar with health-related implications of cultural beliefs and practices of groups represented in the community.
  • Recognize the role of the pediatrician in identifying needs and facilitating access to resources for patients, families and communities.
  • Be aware of the risks to health and barriers to care for underserved children in Washington, D.C., and demonstrate skill in improving access to continuous comprehensive health maintenance.
  • Appreciate key issues related to the pediatrician’s role and interactions with local community agencies and advocacy groups.
  • Value the role of schools and childcare settings in supporting the educational and psychosocial development of children and adolescents.
  • Apply key principles about health promotion and disease prevention for children and adolescents over a set period of time.
  • Observe, interpret and report observations about the communities in which they serve.

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.”

Presidnet's Award for Innovation in Research

President’s Award highlights innovative work by early-career researchers

Presidnet's Award for Innovation in Research

As part of Research and Education Week 2018, two Presidential awardees were recognized for their research contributions, Catherine “Katie” Forster, M.D., M.S., and Nathan Anthony Smith, Ph.D.

Catherine “Katie” Forster, M.D., M.S., and Nathan Anthony Smith, Ph.D., received the President’s Award for Innovation in Research honoring their respective research efforts to explore an understudied part of the microbiome and to shed light on an underappreciated player in nerve cell communication.

Drs. Forster and Smith received their awards April 19, 2018, the penultimate day of Research and Education Week 2018, an annual celebration of the excellence in research, education, innovation and scholarship that takes place at Children’s National Health System. This year marks the fifth time the President’s Award honor has been bestowed to Children’s faculty.

Dr. Forster’s work focuses on preventing pediatric urinary tract infections (UTIs). Frequently, children diagnosed with illnesses like spina bifida have difficulty urinating on their own, and they often develop UTIs. These repeated infections are frequently treated with antibiotics which, in turn, can lead to the child developing antibiotic-resistant organisms.

“The majority of the time if you culture these children, you’ll grow something. In a healthy child, that culture would indicate a UTI,” Dr. Forster says. “Children with neurogenic bladder, however, may test positive for bacteria that simply look suspect but are not causing infection. Ultimately, we’re looking for better ways to diagnose UTI at the point of care to better personalize antibiotic treatment and limit prescriptions for children who do not truly need them.”

Powered by new sequencing techniques, a research group that includes Dr. Forster discovered that the human bladder hosts a significant microbiome, a diverse bacterial community unique to the bladder. Dr. Forster’s research will continue to characterize that microbiome to determine how that bacterial community evolves over time and whether those changes are predictable enough to intervene and prevent UTIs.

“Which genes are upregulated in Escherichia coli and the epithelium, and which genes are upregulated by both in response to each other? That can help us understand whether genes being upregulated are pathogenic,” she adds. “It’s a novel and exciting research area with significant public health implications.”

Smith’s work focuses on the role of astrocytes, specialized star-shaped glial cells, in modulating synaptic plasticity via norepinephrine. Conventional thinking describes astrocytes as support cells but, according to Smith, astrocytes are turning out to be more instrumental.

Norepinephrine, a neurotransmitter that plays an essential role in attention and focus, is released by a process known as volume transmission, which is a widespread release of a neurotransmitter at once, says Smith, a principal investigator in Children’s Center for Neuroscience Research. Astrocytes, which outnumber neurons in the brain, are strategically and anatomically located to receive this diffuse input and translate it into action to modulate neural networks.

“We hypothesize that astrocytes are integral, functional partners with norepinephrine in modulating cortical networks,” Smith adds. “Since astrocytes and norepinephrine have been implicated in many central nervous system functions, including learning and attention, it is critical to define mechanistically how astrocytes and norepinephrine work together to influence neural networks. This knowledge also will be important for the development of novel therapeutics to treat diseases such as attention deficit hyperactivity disorder and epilepsy.”

Dr. Jackson and colleagues with D.C. City Council

Shining a light on child abuse, how to prevent it and help kids recover

Dr. Jackson and colleagues with D.C. City Council

Dr. Jackson and colleagues from Children’s National Health System and the District’s Multidisciplinary Team join resolution sponsor Councilmember Vincent Gray and the D.C. City Council for the presentation of the Child Abuse Prevention Month Recognition Resolution of 2018.

In recognition of Child Abuse Prevention Month, Children’s National Health System joined the DC City Council on Tuesday, April 10, 2018, to present the Child Abuse Prevention Month Recognition Resolution of 2018. According to Councilmember Vincent Gray, who sponsored it, the unanimous resolution “recognizes all the community partners who work to prevent the tragedy of child abuse before it happens, and who keep the children of the District of Columbia as safe as we can.”

He mentioned the many years that the District of Columbia fell in the top five for child abuse victims per capita, and that, while the city still ranks highly, the number of victims per  1,000 children has declined significantly since 2009. He attributes this decline to the communities and agencies who work together to protect children and strengthen families.

Allison Jackson, M.D., MPH, chief of the Child and Adolescent Protection Center at Children’s National, expressed her sincere appreciation for all the people who care for and protect children.

“Every day we see the scores of children who have experienced maltreatment,” she says. “We are so thankful for the recognition of the small voices, and grateful to Councilman Gray and the other supportive councilmembers for helping us to remove the veil of secrecy that burdens so many children and families who have experienced child abuse.”

The Child and Adolescent Protection Center at Children’s National Health System was started in the mid-1970s to provide medical care, forensic medical evaluations by pediatric trained forensic professionals, and mental health treatment for children. Dr. Jackson notes that in the 1990s, the District established a multi-disciplinary team to implement the trauma-informed response framework across all agencies in the District addressing these issues.

She also cites that years of research into adverse childhood events have shown that childhood abuse, exploitation, and neglect has long term medical and brain health consequences that last throughout life and can shorten lives, as well.

However, that research also shows that trauma-informed care and interventions can reduce the exposure to maltreatment, and also reduce the long lasting impacts of maltreatment on a child.

“Child abuse can be prevented if we can all commit to promoting safe, stable and nurturing relationships for children and youth,” Dr. Jackson points out. “I encourage each of you to learn how to recognize child abuse and the appropriate response if you suspect it. Parenting is difficult, so support and encourage parents and caregivers.  Remember that ‘discipline’ means ‘to teach,’ so find constructive ways to teach children right from wrong. And SPEAK UP for children and families.”

The presentation occurs at 33:00 minutes of the 22nd Legislative Meeting of the D.C. City Council.

Monika Goyal

Monika Goyal M.D., M.S.C.E., consultant on $5M NIH grant to reduce pediatric firearm injuries

Monika Goyal

Monika Goyal M.D., M.S.C.E., director of research in Children’s Division of Emergency Medicine and Trauma Services, has been named a consultant on a new $5 million National Institutes of Health research grant that represents the agency’s largest funding commitment in more than two decades to reduce pediatric firearm injuries.

“I am honored that Children’s National Health System is among the 12 universities and health systems around the nation selected to work collaboratively to identify solutions to lower pediatric deaths and injuries due to firearms,” Dr. Goyal says. “This grant will expand the nation’s research capacity on this important subject area and will power the next wave of research to inform policy at the state and national level.”

Dr. Goyal is a member of Children’s firearms research work group which has published or presented at academic meetings on topics that include efforts to reduce pediatric firearm-related injuries and the pivotal role pediatricians can play in reducing the burden of firearm-related injuries among children.

Faculty from Ann & Robert H. Lurie Children’s Hospital of Chicago/Northwestern University, Arizona State University, Brown University, Children’s National Health System, Columbia University, Harvard University, Medical College of Wisconsin, Michigan State University, University of Colorado, University of Michigan, University of Pennsylvania and University of Washington make up the Firearm-Safety Among Children & Teens Consortium (FACTS). The initiative is co-led by Rebecca Cunningham, M.D., and Marc Zimmerman, Ph.D., of the University of Michigan.

In addition to tapping the expertise of scientists and researchers who specialize in criminal justice, emergency medicine, pediatrics, psychology, public health and trauma surgery, FACTS will include a stakeholder group that includes teachers, parent groups, gun owners, firearm safety trainers and law enforcement partners.

The five-year grant will produce a number of deliverables, including:

  • A research agenda for the field of pediatric firearm injury
  • Generating preliminary data through five small pilot projects that focus on topics such as the epidemiology of pediatric firearm injuries and prevention of firearm injuries
  • A data archive on childhood firearm injury
  • Training for the next generation of researchers, including postdoctoral trainees and graduate students

Financial support for this research was provided by the National Institute of Child Health & Human Development under award number R24HD087149.

Robin Steinhorn

Children’s National senior vice president elected to American Pediatric Society leadership

Robin Steinhorn

Robin Steinhorn, M.D., Senior Vice President of Center for Hospital-Based Specialties at Children’s National Health System, was elected by her peers to become vice president and president-elect of the American Pediatric Society (APS) beginning May 2018 at the annual Pediatric Societies Meeting in Toronto, Canada. Dr. Steinhorn will serve in this role for one year and will then become the Society’s president in May 2019 for a one-year term.

Dr. Steinhorn is a globally recognized physician-leader, researcher and clinician in the fields of neonatal perinatal medicine and fetal pulmonary development. She was elected to the APS Council in 2015 and currently holds a seat on the American Board of Pediatrics’ Board of Directors.

“Dr. Steinhorn has devoted her professional career to advancing the field of pediatrics through exemplary leadership in related societies, as well as editorial oversight of cutting-edge research,” says David Wessel, M.D., executive vice president and chief medical officer of Hospital and Specialty Services at Children’s National. “This elevated role with the APS will enable her to further share her expertise to benefit children on a national and international level.”

Dr. Steinhorn serves as associate editor of the Journal of Pediatrics and is also a contributing editor for NEJM Journal Watch’s Pediatric and Adolescent Medicine.  Additionally, she sits on the editorial boards of Pediatric Critical Care Medicine and Pulmonary Circulation. Dr. Steinhorn is an elected fellow of the American Heart Association and a member of both the Perinatal Research Society and the American Thorasic Society.

Founded in 1888, the American Pediatric Society is the oldest and most prestigious academic pediatric organization in North America. Members are elected to APS based on their accomplishments as academic leaders in pediatrics and goal to shape the future of academic pediatrics. Mark L. Batshaw, M.D., physician-in-chief and chief academic officer of Children’s National preceded Dr. Steinhorn as APS President from 2016-2017.

“This is a tremendous honor, and it is a special privilege to follow Dr. Batshaw’s sound leadership. I look forward to leveraging the collective leadership and research accomplishments by our members to improve the health of infants and children throughout the U.S.,” said Dr. Steinhorn.

Dr. Steinhorn joined Children’s National in 2015 after a successful tenure as professor and chair of the department of pediatrics at the University of California, Davis (UCD) School of Medicine and as physician-in-chief, UCD Children’s Hospital. Previously, she was vice chair of the department of pediatrics and chief of the division of neonatology at Northwestern University and the Ann & Robert H. Lurie Children’s Hospital of Chicago.

Dr. Steinhorn’s clinical and academic interests have focused primarily on fetal and neonatal pulmonary vascular development. Her translational work has spanned from in vitro studies, to experimental models and clinical trials. In addition to her own translational research program, she has participated in numerous multicenter trials that have helped define the clinical treatment of pulmonary hypertension during the neonatal period. Her clinical research work also has addressed other topics, such as harmonization of electronic health records for clinical research and telemedicine support of neonatal care in small rural hospitals.

Additionally, Dr. Steinhorn is particularly passionate about mentoring faculty and supporting the growth and career development of young neonatologists and scientists, with several having developed their own research laboratories and assumed division leadership positions. She was selected as a “Top Doctor” by Northern Virginia  Magazine in 2018.

Adora Lin

Funding will help uncover immune system differences that trigger food allergies

Adora Lin

“When it comes to food allergies, we really don’t know how they develop. We don’t know how to best differentiate between a child who can safely eat a potential allergen, like peanuts, compared with a child who cannot safely eat peanuts.” says Adora A. Lin, M.D., Ph.D.

Adora A. Lin, M.D., Ph.D., an attending physician in Children’s department of Allergy and Immunology, was awarded $240,000 to improve understanding of how children’s immune systems tolerate or react to certain food allergens – sometimes triggering a cascade of side effects that can be fatal.

The three-year American Academy of Allergy, Asthma & Immunology (AAAAI) Foundation award will underwrite Dr. Lin’s ongoing research into the regulation of the antibody Immunoglobulin E (IgE), which plays a pivotal role in these allergic responses.

“Our immune system maintains a delicate balance, working just enough to ward off potential invaders and pathogens, but not so much that it triggers problems of its own making,” Dr. Lin says. “When it comes to food allergies, we really don’t know how they develop. We don’t know how to best differentiate between a child who can safely eat a potential allergen, like peanuts, compared with a child who cannot safely eat peanuts.”

Food allergies have become a growing problem and affect about 1 in 13 U.S. children, or about two per classroom. Food items such as eggs, milk, peanuts, tree nuts, soy and wheat trigger allergic reactions that can include itching, swelling, hives and difficulty breathing. As children’s immune systems react to exposure to such allergens, their B-cells produce IgE antibodies.

Apart from avoiding these foods and carrying rescue medications, which must be used immediately after accidental exposure, there is no way to treat food allergies effectively. That makes it essential to better understand how the immune system works in order to innovate new and better food allergy treatments and diagnostics.

Dr. Lin’s work involves isolating immune cells from blood samples, culturing them and stimulating an immune response to known food allergy triggers. B-cells make IgE, but additional clarity is needed about what turns on the “make IgE” signal as well as which signals indicate it’s time to stop making IgE. Ultimately, the aim is to identify biomarkers that are akin to the “check engine” light that illuminates to warn of a potential problem long before a car stalls in traffic.

“I’m very excited about this funding,” Dr. Lin adds. “Our field has done an exceptional job with clinical work to help children with food allergies. This award recognizes the importance of the mechanistic side of the equation. I’m excited to help make that contribution to the research.”

As it stands now, blood tests are sensitive to food-related IgE, but are not specific. Only 30 to 55 percent of children who have IgE to common food allergens have an allergic reaction after eating the food, which means that 45 to 70 percent are merely sensitized and could tolerate eating the food. Current tests cannot distinguish between sensitized and allergic children.

“Our hope is to identify biomarkers that would serve as the ‘check engine’ light that tell us in advance which child’s immune system will react strongly to that food. Right now, there is no way to tell. This project will help uncover those differences,” she says.

Dr. Lin was one of three recipients of the AAAAI Foundation’s faculty development award, which was presented during a March 3, 2018, award ceremony held during the organization’s business meeting.

Shireen Atabaki

Innovative care using health IT lands Children’s National a 2017 HIMSS Enterprise Davies Award

Shireen Atabaki

A new diagnostic tool led by Shireen Atabaki, M.D., M.P.H., helps prescribers determine if CT scans are necessary for children with head injuries through a checklist protocol.

Opportunities to improve the lives of children are increasingly found at the intersection of health and technology, a sweet spot for enhancing care in today’s connected world. A team of experts at Children’s National Health System launched several initiatives using health information technology to improve care delivery, earning the institution the prestigious 2017 HIMSS Enterprise Davies Award. Recognizing outstanding achievements of organizations that have utilized health IT to significantly improve patient outcomes while also achieving a return on investment, Children’s National received the award based on three case studies in particular:

  • Decreasing use of CAT scans by 44 percent – A new diagnostic tool led by Shireen Atabaki, M.D., M.P.H., emergency medicine specialist, incorporated into the electronic health record helps prescribers determine if CT scans are necessary for children with head injuries through a checklist protocol. The new tool reduced the rate of CT scan utilization by 44 percent – decreasing unnecessary radiation exposure for children and resulting in first-year cost savings of more than $875,000.
  • Innovative unit-based quality boards – These electronic boards provide health care teams and families with real-time quality and safety information. By having patient information readily available in one location, the boards improved medication reconciliation by 13 percent, decreased the time to patient consent by 49 percent, and reduced duration of urinary catheters by 11 percent.
  • Improved clinician documentation – To improve outcomes and reduce costs,

Children’s National transitioned from dictation/transcription-driven notes to electronic/voice recognition notes in ambulatory specialty clinics. This allowed for the immediate availability of notes to all care providers and a significant reduction in transcription costs.

These initiatives demonstrate the life-changing quality and safety efforts under way at Children’s National that put patient safety first. Brian Jacobs, M.D., vice president, chief medical information officer and chief information officer, accepted the award on behalf of Children’s National at the HIMSS Awards gala at the Wynn in Las Vegas in March.

Vittorio Gallo

Perinatal brain injury headlines American Society for Neurochemistry

Vittorio Gallo

Dr. Gallo’s research could have major implications for overcoming the common behavioral and developmental challenges associated with premature birth.

Children’s National Chief Research Officer Vittorio Gallo, Ph.D., recently had the honor of presenting a presidential lecture at the 48th Annual Meeting of the American Society for Neurochemistry (ASN). The lecture focused on his lifelong investigations of the cellular and molecular mechanisms of white matter development and injury, including myelin and glial cells – which are involved in the brain’s response to injury.

Specifically, he outlined the underlying diffuse white matter injury observed in his lab’s pre-clinical model of perinatal hypoxia, and presented new, non-invasive interventions that promote functional recovery and attenuate developmental delay after perinatal injury in the model. Diffuse white matter injuries are the most frequently observed pattern of brain injury in contemporary cohorts of premature infants. Illuminating methods that might stimulate growth and repair of such injuries shows promise for potential noninvasive strategies that might mitigate the long-term behavioral abnormalities and developmental delay associated with premature birth.

Dr. Gallo’s work in developmental neuroscience has been seminal in deepening understanding of cerebral palsy and multiple sclerosis. During his tenure as center director, he transformed the Center for Neuroscience Research into one of the nation’s premier programs.

ASN gathers nearly 400 delegates from the neurochemistry sector each year, including bench and clinical scientists, principal investigators, graduate students and postdoctoral fellows all actively involved in research from North America and around the world.

Jennifer Porter

Jennifer L. Porter receives the 2018 National Minority Quality Forum 40 under 40 Award for Leaders in Minority Health

Jennifer Porter

Jennifer L. Porter, MPH, MCHES, 2018 NMQF 40 Under 40 Award Winner.

Jennifer L. Porter, government affairs specialist in the Child Health Advocacy Institute, has been selected as one of the 2018 National Minority Quality Forum 40 leaders under 40 in minority health for her achievements in advocacy and research on behalf of Children’s National Health System. The 2018 National Minority Quality Forum Leadership Summit on Health Disparities and Spring Health Braintrust will be held in Washington, D.C on April 16-17, 2018.

After receiving hundreds of applications from health care professionals across the country, 40 individuals were chosen to represent the next generation of thought leaders working to reduce health disparities and decrease health inequality for minority communities.

This award acknowledges Jennifer’s approach to bringing fresh ideas to help those suffering from poor access to quality health care and focuses on a wide range of adolescent sexual issues including: economic influences of medical adherence for HIV positive adolescents, structural barriers, HIV prevention for youth and pregnancy prevention outcomes.

Throughout her career, Mrs. Porter has been a tireless health advocate and has held a number of volunteer leadership positions in local, regional and national community service organizations. She currently serves as a commissioner for the District of Columbia Commission for Women; the National Health Policy Conference Advisory Committee and serves on the National Policy Advisory Group for Girls, Inc.

“When it comes down to advocacy, this award validates the importance of these types of roles where you never see the work behind the scenes,” says Porter. “Whether it’s research or advocacy, my mission is to make a positive impact on the changing health care landscape and to tell these people’s story with dignity and context.”

Along with U.S. Rep. John Lewis, Rep. Maxine Waters and Merck CEO Kenneth Frazier, Porter will accept her award during the leadership summit on April 16-17, 2018 in Washington, D.C. Congratulations again Jennifer for receiving this award!