Meetings

Attendees at the inaugural symposium on AI in Pediatric Health and Rare Diseases

AI: The “single greatest tool” for improving access to pediatric healthcare

Attendees at the inaugural symposium on AI in Pediatric Health and Rare Diseases

The daylong event drew experts from the Food and Drug Administration, Pfizer, Oracle Health, NVIDIA, AWS Health and elsewhere to start building a community aimed at using data for the advancement of pediatric medicine.

The future of pediatric medicine holds the promise of artificial intelligence (AI) that can help diagnose rare diseases, provide roadmaps for safer surgeries, tap into predictive technologies to guide individual treatment plans and shrink the distance between patients in rural areas and specialty care providers.

These and dozens of other innovations were contemplated as scientists came together at the inaugural symposium on AI in Pediatric Health and Rare Diseases, hosted by Children’s National Hospital and the Fralin Biomedical Research Institute at Virginia Tech. The daylong event drew experts from the Food and Drug Administration, Pfizer, Oracle Health, NVIDIA, AWS Health and elsewhere to start building a community aimed at using data for the advancement of pediatric medicine.

“AI is the single greatest tool for improving equity and access to health care,” said symposium host Marius George Linguraru, D.Phil., M.A., M.Sc., principal investigator at the Sheikh Zayed Institute for Pediatric Surgical Innovation. “As a population, kids are vastly underrepresented in scientific research and resulting treatments, but pediatric specialties can use AI to provide medical care to kids more efficiently, more quickly and more effectively.”

What they’re saying

Scientists shared their progress in building digital twins to predict surgical outcomes, enhancing visualization to increase the precision of delicate interventions, establishing data command centers to anticipate risks for fragile patients and more. Over two dozen speakers shared their vision for the future of medicine, augmented by the power of AI:

  • Keynote speaker Subha Madhavan, Ph.D., vice president and head of AI and machine learning at Pfizer, discussed various use cases and the potential to bring drugs to market faster using real-world evidence and AI. She saw promise for pediatrics. “This is probably the most engaging mission: children’s health and rare diseases,” she said. “It’s hard to find another mission that’s as compelling.”
  • Brandon J. Nelson, Ph.D., staff fellow in the Division of Imaging, Diagnostics and Software Reliability at the Food and Drug Administration, shared ways AI will improve diagnostic imaging and reduce radiation exposure to patients, using more advanced image reconstruction and denoising techniques. “That is really our key take-home message,” he said. “We can get what … appear as higher dose images, but with less dose.”
  • Daniel Donoho, M.D., a neurosurgeon at Children’s National, introduced the audience to the potential of “Smart ORs”: operating rooms where systems can ingest surgery video and provide feedback and skill assessments. “We have to transform the art of surgery into a measurable and improvable scientific practice,” he said.
  • Debra Regier, M.D., chief of Genetics and Metabolism at Children’s National, discussed how AI could be used to diagnose and treat rare diseases by conducting deep dives into genetics and studying dysmorphisms in patients’ faces. Already, Children’s National has designed an app – mGene – that measures facial features and provides a risk score to help anyone in general practice determine if a child has a genetic condition. “The untrained eye can stay the untrained eye, and the family can continue to have faith in their provider,” she said.

What’s next

Linguraru and others stressed the need to design AI for kids, rather than borrow it from adults, to ensure medicine meets their unique needs. He noted that scientists will need to solve challenges, such as the lack of data inherent in rare pediatric disorders and the simple fact that children grow. “Children are not mini-adults,” Linguraru said. “There are big changes in a child’s life.”

The landscape will require thoughtfulness. Naren Ramakrishnan, Ph.D., director of the Sanghani Center for Artificial Intelligence & Analytics at Virginia Tech and symposium co-host, said that scientists are heading into an era with a new incarnation of public-private partnerships, but many questions remain about how data will be shared and organizations will connect. “It is not going to be business as usual, but what is this new business?” he asked.

Panel members at the NIAID symposium

CN-NIAID Symposium seeks ways to promote child health amid challenges

Panel members at the NIAID symposium

More than 30 million children seek emergency care each year, but 80 percent of these visits happen at hospitals that aren’t designed for pediatrics — a daunting figure during pandemics and other crises in healthcare. This considerable hurdle is one of many challenges that leaders in pediatric health came to discuss during a two-day symposium on promoting child health, hosted by Children’s National Hospital, the National Institute of Allergy and Infectious Diseases and the Pediatric Pandemic Network (PPN).

The symposium laid out a multitude of issues facing children and their doctors: growing mental health diagnoses, shrinking access to care in rural areas, asthma and eczema, winter respiratory surges and more.

Joelle Simpson, M.D., chief of emergency medicine at Children’s National and PPN principal investigator, said the network is drawing on expertise from 10 pediatric hospitals to ensure communities are better prepared for whatever challenges lie ahead, through training and support, collaboration among pediatric specialists, education on best practices and the promotion of equity and inclusion.

Built on a Health Resources and Services Administration grant, the network is focusing on four key areas: infectious disease and disease outbreaks, emergency and disaster management, mental and behavioral health, and health equity and community engagement. “This year, we know we are boiling the ocean as we come together,” Simpson said.

Miss the symposium? Check out the recordings available on YouTube, including the closing Q&A with many of the panelists and Sheryl Gay Stolberg, health policy reporter with the New York Times.

Day 1 of the 6th Annual Children’s National Hospital – NIAID Symposium

Day 2 of the 6th Annual Children’s National Hospital – NIAID Symposium

 

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Children’s National Hospital at the 2023 Pediatric Academic Societies meeting

PAS LogoA 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.

William Sheehan

Allergist taps into biologics to treat asthma



6th Annual Children’s National Hospital – NIAID Symposium
Promoting Child Health: From Environmental Challenges to Pandemic
April 27 – 28, 2023 | Children’s National Research & Innovation Campus | 7144 13th Pl NW, Washington, DC 20012



 

William SheehanWilliam Sheehan, M.D., joined Children’s National Hospital in 2017 as a board-certified allergist and immunologist with a passion for helping patients with asthma, allergies, eczema and immunodeficiency. During his fellowship at Children’s Hospital of Boston, he investigated the impact of inner-city and school environments on children’s asthma, and he found reward in helping children breathe easier. Dr. Sheehan will be discussing the impact of the environment on childhood asthma at the upcoming CNH-NIAID Symposium on Promoting Child Health: From Environmental Challenges to Pandemic. He shared with Innovation District an overview of his research and his hope for using biologics to treat asthma.

Q: Could you talk about the research you have been involved in?

A: Since my fellowship, my work has been specifically targeting the interaction between environmental exposures in school and asthma. By intervening in the school environment, we could help dozens of children with asthma. In recent years and here at Children’s National, I have become interested in research regarding using biological medicines to treat inner-city children with asthma. These antibody medications, given by injection, target cells that cause inflammation and are used in children who have severe asthma that is not responding to conventional therapies.

Q: What is new about biologics for treating childhood asthma? How are researchers at Children’s National contributing to the field?

A: The first biologic medicine for treating asthma, called Omalizumab, was approved in 2003. In the last five years, four more biologics have been approved for treating childhood asthma, with more in the pipeline. At Children’s National, we have been trying to identify which biologic therapy is most effective for a particular child with asthma by looking at specific biomarkers. We also are examining new biomarkers that may be beneficial. Specifically, we are looking at the levels of regulatory B cells, an immune cell that acts as a brake to control allergic inflammation.  We have shown that these cells are lacking in children with severe asthma and may make these children better candidates for biologic therapies.

Q: How prevalent are young patients in the asthma population in D.C., and do you believe environmental factors associated with living in a city contribute to the higher incidence of asthma in this population?

A: D.C. is a challenging city for pediatric asthma. Not only is asthma prevalence higher here, but we also see higher rates of severe asthma requiring emergency visits, hospitalizations and even admissions to the Pediatric Intensive Care Unit.

While environmental factors such as pollution, second-hand smoke and exposure to mice and cockroaches can contribute to childhood asthma, I don’t think it’s the sole factor in D.C. There might be multiple factors at play, including social structures that make it difficult for families to access and maintain asthma care and medications. Additionally, there seems to be a genetic component as Black and Hispanic children tend to suffer from worse asthma than white children, regardless of the environment.

Q: What specific research areas or topics interest you for future study?

A: We have made significant progress in controlling asthma with biologics, but prevention is the next frontier. Current studies are focusing on treating vulnerable children at a very young age with the goal of preventing the development of asthma later in childhood. If we can’t prevent asthma, we should strive to achieve asthma “remission” through the use current medications and biologic therapies. The goal would be for individuals to go through their year without any symptoms or exacerbations, essentially living as though they don’t have asthma at all.

images of baby's legs and casts

Innovation in clubfoot management using 3D anatomical mapping

Idiopathic clubfoot is one the most common congenital deformities of the lower extremity. Its incidence is reported to be 1-2 cases per 1000 live births.

While clubfoot is relatively common and the treatment is highly successful, the weekly visits required for Ponseti casting can be a significant burden on families. Researchers at Children’s National Hospital are looking for a way to relieve that burden with a new study that could eliminate the weekly visits with a series of 3D-printed casts that families can switch out at home. The study, presented at the SPIE Medical Imaging Conference 2022, uses a novel photogrammetry method to gather 3D surface images of infant clubfoot anatomy and assess the foot position and correction.

Even better, this approach captures the images without additional radiation exposure.

“We’re not changing the gold standard of Ponseti casting, we’re adding to it,” says Sean Tabaie, M.D., orthopaedic surgeon at Children’s National and one of the study’s authors. “The more families we have in this study the greater the potential to move this field forward.”

Read more about the study, Development of a novel photogrammetry method for acquiring 3D surface models of infant clubfoot anatomy.

Bear Institute PACK logo

Bear Institute Pediatric Accelerator Challenge for Kids winners announced

Bear Institute PACK logoIn December 2022, the Bear Institute, along with Children’s National Hospital and Oracle Health, hosted the second annual Bear Institute PACK (Pediatric Accelerator Challenge for Kids), a start-up competition aimed to foster pediatric digital health innovation.

Bear Institute PACK is inclusive of the entire pediatric health care community and addresses the large disparity in digital health innovation funding dedicated to children versus the rest of the population. “We have to do more for children, a population that can’t advocate for itself,” says Matt Macvey, M.B.A., MS, executive vice president and chief information officer at Children’s National Hospital. “Bear Institute PACK is an all-hands effort to provide increased support to those start-ups trying to bring new solutions to market for kids.”

Start-ups share their innovations and receive valuable feedback from expert judges while competing for a chance to win an on-site pilot and software development support. The competition features three rounds of judging: an initial review of applications from the Bear Institute PACK team, judging from participating pediatric healthcare providers and administrators and review from an expert panel of judges during finalist start-ups’ live pitches. This year’s start-up participants competed across four innovation tracks in the following areas of development: Early-Stage Innovation, Concept Validation, Early Commercialization and Growth Trajectory.

This 2022 winners, in four innovation tracks, are:

  • Early-Stage Innovation (“Even the biggest ideas start small”) Winner: PigPug Health
    Its solution uses neurofeedback, a non-invasive approach to treating brain-related conditions, and artificial intelligence to help children with ADHD and autism become more socialized.
  • Concept Validation (“Now it’s time to test it”) Winner: Global Continence, Inc.
    Its Soluu™, Bedwetting Mitigation Device, helps rapidly and permanently mitigate bedwetting with a neuromodulation process.
  • Early Commercialization (“Countdown to launch”) Winner: PyrAmes Inc.
    Its solution Boppli™ provides continuous, non-invasive blood pressure monitoring and streams data via Bluetooth to a mobile device.
  • Growth Trajectory (“The investment is growing”) Winner: maro
    Its full stack child development kit equips a child’s caretakers (at home, school and clinic) with easy access to tools and data needed to help them navigate tough conversations including mental health, diversity, empathy, and puberty and helps identify mental health at-risk students in schools.

“I was very impressed with this year’s start-up participants and their caliber of talent and passion for what they do. The finalist judges were tasked with selecting one winner in each innovation track, but the work each participant is doing for kids makes them all winners,” says Rebecca Laborde, Ph.D., chief scientist, vice president of Health Innovation and Scientific Advisory, Oracle Health. “Thank you to the entire pediatric healthcare community that comes together to help make this event a success. We believe that by bringing together like-minded individuals with the same goals, we can make a real difference in pediatric healthcare.”

More information on this year’s winners can be found on the Bear Institute PACK website.

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Children’s National at the Societies for Pediatric Urology Fall Congress

Providers from the Department of Urology at Children’s National Hospital attended the Societies for Pediatric Urology Fall Congress in October 2022 and shared a series of abstracts.

The abstracts look at unplanned healthcare use and missed visits among children with spina bifida, as well as factors associated with these outcomes. The team collected data from chart review and patient interviews to complete these projects. They considered clinical information, as well as demographic information and the childhood opportunity index, which is a composite measure that proxies social determinants of health, while accounting for how far a family lives from the emergency department.

Clinically, patients with more complex spina bifida (e.g., ventricular shunt or wheelchair use) were more likely to use the emergency department. Genitourinary and gastrointestinal problems were the most common reasons for emergency department use. Within the Spina Bifida Program at Children’s National, our providers are aggressively trying to reduce gastrointestinal complaints with a nurse practitioner dedicated to bowel management and working collaboratively with the Division of Colorectal and Pelvic Reconstruction.

A sobering finding from this research was that non-white patients with spina bifida at Children’s National were more likely to have had an emergency department visit between 2016-2020 after accounting for all other variables. This indicates a clear need for improving access, communication and quality of care for minority patients with spina bifida. We are increasingly developing our community partnerships with pediatricians and school nurses, and we are accessible by a direct phone line and email to allow for prompt support. We have also established clinics in Prince George’s County in Maryland which will bring the program closer to some minority communities.

The team also found that families of children with spina bifida scheduled for telemedicine visits were much more likely to miss a visit than a child without spina bifida or if the visit was in-person. This has led to changes in how we deploy telemedicine in this population, while still remaining nimble with the option of telemedicine or in-person visits. By screening the family’s ability and desire to use this modality, we hope to reduce missed visits overall.

View the abstracts

poster conclusions

echocardiogram

AI may revolutionize rheumatic heart disease early diagnosis

echocardiogram

Researchers at Children’s National Hospital have created a new artificial intelligence (AI) algorithm that promises to be as successful at detecting early signs of rheumatic heart disease (RHD) in color Doppler echocardiography clips as expert clinicians.

Researchers at Children’s National Hospital have created a new artificial intelligence (AI) algorithm that promises to be as successful at detecting early signs of rheumatic heart disease (RHD) in color Doppler echocardiography clips as expert clinicians. Even better, this novel model diagnoses this deadly heart condition from echocardiography images of varying quality — including from low-resource settings — a huge challenge that has delayed efforts to automate RHD diagnosis for children in these areas.

Why it matters

Current estimates are that 40.5 million people worldwide live with rheumatic heart disease, and that it kills 306,000 people every year. Most of those affected are children, adolescents and young adults under age 25.

Though widely eradicated in nations such as the United States, rheumatic fever remains prevalent in developing countries, including those in sub-Saharan Africa. Recent studies have shown that, if detected soon enough, a regular dose of penicillin may slow the development and damage caused by RHD. But it has to be detected.

The hold-up in the field

Diagnosing RHD requires an ultrasound image of the heart, known as an echocardiogram. However, ultrasound in general is very variable as an imaging modality. It is full of texture and noise, making it one of the most challenging to interpret visually. Specialists undergo significant training to read them correctly. However, in areas where RHD is rampant, people who can successfully read these images are few and far between. Making matters worse, the devices used in these low resource settings have their own levels of varying quality, especially when compared to what is available in a well-resourced hospital elsewhere.

The research team hypothesized that a novel, automated deep learning-based method might detect successfully diagnose RHD, which would allow for more diagnoses in areas where specialists are limited. However, to date, machine learning has struggled the same way the human eye does with noisy ultrasound images.

Children’s National leads the way

Using approaches that led to successful objective digital biometric analysis software for non-invasive screening of genetic disease, researchers at the Sheikh Zayed Institute for Pediatric Surgical Innovation, including medical imaging scientist Pooneh Roshanitabrizi, Ph.D., and Marius Linguraru, D.Phil., M.A., M.Sc., principal investigator, partnered with clinicians from Children’s National Hospital, including Craig Sable, M.D., associate chief of Cardiology and director of Echocardiography, and cardiology fellow Kelsey Brown, M.D., who are heavily involved in efforts to research, improve treatments and ultimately eliminate the deadly impacts of RHD in children. The collaborators also included cardiac surgeons from the Uganda Heart Institute and cardiologists from Cincinnati Children’s Hospital Medical Center.

Dr. Linguraru’s team of AI and imaging scientists spent hours working with cardiologists, including Dr. Sable, to truly understand how they approach and assess RHD from echocardiograms. Building the tool based on that knowledge is why this tool stands apart from other efforts to use machine-learning for this purpose. Orienting the approach to the clinical steps of diagnosis is what led to the very first deep learning algorithm that diagnoses mild RHD with similar success to the specialists themselves. After the platform was built, 2,136 echocardiograms from 591 children treated at the Uganda Heart Institute fed the learning algorithm.

What’s next

The team will continue to collect data points based on clinical imaging data to refine and validate the tool. Ultimately, researchers will look for a way that the algorithm can work directly with ultrasound/echocardiogram machines. For example, the program might be run through an app that sits on top of an ultrasound device and works on the same platform to communicate directly with it, right in the clinic. By putting the two technologies together, care providers on the ground will be able to diagnose mild cases and prescribe prophylactic treatments like penicillin in one visit.

The first outcomes from the program were showcased in a presentation by Dr. Roshanitabrizi at one of the biggest and most prestigious medical imaging and AI computing meetings — the 25th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI).

doctor measuring girl's height

Vosoritide shows promise for children with certain genetic growth disorders

doctor measuring girl's height

This is the first clinical trial in the world testing vosoritide in children with certain genetic causes of short stature, including hypochondroplasia, Noonan syndrome, NPR2 mutations and Aggrecan mutations.

Andrew Dauber, M.D., M.M.Sc., endocrinologist at Children’s National Hospital, presented preliminary results from a phase II clinical trial of a new drug, vosoritide, used to treat children with certain growth disorders, at the Pediatric Endocrine Society annual meeting held virtually on May 1.

Vosoritide is a C-type natriuretic peptide analog that binds its receptor on chondrocytes, leading to increased chondrocyte proliferation and differentiation via its inhibition of the ERK1/2-MAPK pathway.

This is the first clinical trial in the world testing vosoritide in children with certain genetic causes of short stature, including hypochondroplasia, Noonan syndrome, NPR2 mutations and Aggrecan mutations.

To date, 34 participants have enrolled in the trial with a median baseline height of -3.2 SD (interquartile range (IQR) -3.7, -2.6). 18 subjects have initiated on vosoritide and twelve have completed six months of therapy. The authors note that the mean increase in annualized growth velocity (AGV) was 1.8 cm/yr for subjects with hypochondroplasia and 6.1 cm/yr for subjects with Noonan syndrome or NPR2 mutations. The two subjects with NPR2 mutations had increased AGVs of 4.4 and 9.2 cm/yr, while the two subjects with Noonan syndrome had increased in AGVs of 7.5 and 3.3 cm/yr. One of the Noonan syndrome subjects was previously treated with growth hormone (GH) for 2 years and AGV was 6.7 cm/yr while on GH, 4.1 cm/yr during the trial 6-month observation period and 11.6 cm/year during the first six months of vosoritide treatment.

To the researchers, the safety profile is quite reassuring. So far, the preliminary results showed increased growth in all the genetic subgroups with the patients with hypochondroplasia demonstrating a response similar to that seen previously in patients with achondroplasia. While the results are very promising for patients with Noonan syndrome and NPR2 mutations, the clinical trial must be completed before drawing further conclusions. The experts also plan to submit the study to a peer-reviewed journal in the future to validate the findings.

The big picture

This is the first medication that directly targets the pathway in chondrocytes (cells in the growth plate that make the bones grow longer) affected by these specific mutations. This means that the novel approach may give patients additional therapeutic options outside of growth hormone.

Why we’re excited

“These are the first patients in the world to ever receive this medication for their conditions,” said Dr. Dauber. “The results are very promising and may change the way we practice medicine. Patients have come from all over the world to participate in the study.”

Children’s National leads the way

This clinical trial funded by BioMarin is the first of its kind to treat children with genetic short stature who do not have achondroplasia. Children’s National is the only site in the world offering this therapy for patients with these conditions.

Find out more about the trial here.

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Children’s National Hospital at the 2022 Pediatric Academic Societies Meeting

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

 

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

 

life sciences industry imagery

Grand Rounds analyzes the state of life sciences industry in Maryland

life sciences industry imagery

A recent Children’s National Grand Rounds panel analyzed the state of the life sciences industry in the region and the potential steps that can be taken to accelerate the manufacturing landscape.

The BioHealth Capital Region, consisting of Maryland, Virginia and Washington, D.C., has surged in recent years to become one of the nation’s strongest biopharma clusters. While the region does not lack opportunity to cultivate and grow innovation, manufacturing business related to scientific research and development in Maryland is lagging compared to other leading states.

That was the message from Martin Rosendale, CEO of the Maryland Tech Council, who was recently the featured speaker of the Children’s National Grand Rounds panel, which analyzed the state of the life sciences industry in the region and the potential steps that can be taken to accelerate the manufacturing landscape. The Maryland Tech Council is a not-for-profit collaborative community actively engaged in building strong life sciences and technology industries.

Moderated by Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer at Children’s National Hospital, the panel cited data recently compiled by the Milken Institute Center for Regional Economics that demonstrated the degree to which Maryland’s life sciences manufacturing industry needs to catch-up.

“On the manufacturing business front, we’ve actually been lagging compared to the rest of the country. Other metros have grown faster than we have over the last five years, but that presents an opportunity,” says Rosendale. “We have the opportunity to work more with academia and medical institutions like Children’s National to produce more companies, more intellectual property and more startups.”

According to the Milken data, when compared to other leading states including Massachusetts (2nd), California (3rd), New York (8th), Florida (9th) and Texas (12th), Maryland ranked as the 20th state for life sciences manufacturing growth over a five-year period. Of the growth that occurred over that time, the greatest came in the Washington-Arlington-Alexandria and Baltimore-Columbia-Towson metros, where industry wages tend to be higher.

Kolaleh-Eskandanian

Kolaleh Eskandanian, vice president and chief innovation officer at Children’s National Hospital, recently moderated the Children’s National Grand Rounds panel, which analyzed the state of the life sciences industry in the BioHealth Capital Region.

Highlighting the region’s status as a rich biopharma cluster, and the fact that the innovation sector is growing up in and around Washington, D.C., Rosendale identified the key to help bolster life sciences manufacturing in the region – sustaining life sciences business spending in Maryland. Evidence has demonstrated that incentives are a core component of supporting business research and development, and sustained spending has helped support high-tech business formation and high-wage job creation. It has also generated job creation in occupations that require fewer credentials, such as non-tech-intensive industries.

Growth in these areas can be bolstered by Maryland’s existing life sciences landscape, which ranks as one of the strongest and most robust in the nation. It contributes more than 54,000 high paying jobs in the state with over 2,700 life science firms and more than 500 biotech firms, according to a recent Milken Institute report.

“The District of Columbia has a robust pipeline of up-and-coming talent to further develop the life sciences industry in the region. The potential this expertise offers is a key focus of the new Children’s National Research & Innovation Campus, to drives discoveries that save and improve the lives of children,” says Eskandanian. “Children’s National has combined our strengths with those of public and private partners, including industry, universities, federal agencies, start-up companies and academic medical centers, to provide a rich environment to help bolster pediatric innovation and commercialization to further advance the life sciences industry.”

Data from Genetic Engineering & Biotechnology News (GEN) continues to show that Maryland and the greater BioHealth Capital Region remains one of the country’s premier hubs for innovation companies. The rankings are based on five criteria including NIH funding, VC funding, patents, lab space and jobs. In 2021, the BioHealth Capital Region held its top-four ranking and is expected to rise to a top-three cluster by 2023. The current top-three clusters ranked in the United States are Boston/Cambridge, MA (1st), the San Francisco Bay Area (2nd) and New York/New Jersey (3rd).

human heart

Heart anatomy determines outcomes of valve repair for single ventricle hearts after Fontan procedure

human heart

The data shows that the valve repair surgery itself doesn’t increase the likelihood of heart transplant or death. Instead, it is only those with right ventricle dominant heart function who are significantly more likely to have such a negative outcome.

A new study in the Journal of the American College of Cardiology finds the anatomy of the heart is a key predictor of how efforts to repair atrioventricular valve regurgitation — or a leaky heart valve — will impact children with single ventricle heart defects who have undergone a Fontan surgical procedure.

The study uses retrospective data from the largest database of patients who have had the Fontan procedure, the Australia and New Zealand Fontan Registry. The data shows that the valve repair surgery itself doesn’t increase the likelihood of heart transplant or death. Instead, it is only those with right ventricle dominant heart function who are significantly more likely to have such a negative outcome.

It was conducted by cardiac surgeons at Royal Children’s Hospital, including Yves d’Udekem, M.D., Ph.D., who is now chief of cardiac surgery at Children’s National Hospital. Dr. d’Udekem presented the findings at the recent American College of Cardiology Scientific Sessions in Washington, D.C.

What this means

Until now, it was unclear why patients who had undergone a Fontan heart procedure were more likely to need a heart transplant or die after they also underwent surgery to repair atrioventricular valve regurgitation. This type of leaking valve is common in patients who have undergone a Fontan procedure, and it can also be dangerous if left untreated. But because existing data showed poor outcomes following atrioventricular valve repair, it was considered high risk to perform this repair on children with Fontan circulation.

However, this study drilled down into the outcomes of atrioventricular valve repair for these patients and found that it isn’t the surgery that leads to a poor outcome. Instead, it’s a specific anatomic feature — having a dominant right ventricle — that is predictive of the outcome.

Up to now, it was unclear whether surgery should be offered to all patients with a Fontan circulation who had leaky atrioventricular valves. This study shows that things are different for patients with dominant left or dominant right ventricle. For patients with dominant right ventricle, leaving this regurgitation not repaired is much more likely to lead to death and transplantation, and these patients should be operated at the earlier stages of the deficiency of their valves.

The hold-up in the field

One of the biggest challenges to identifying evidence-based best practices for children born with single ventricle heart defects, which are critical congenital heart defects, is the small number of patients at any one institution each year. The Australia and New Zealand Fontan Registry, founded by Dr. d’Udekem and the team at Royal Children’s Hospital, forms one of the world’s longest standing databases of patient information, including outcomes, for this population.

The patient benefit

This data can help doctors and families make the best care decisions possible for children with single ventricle defects by understanding how each child’s unique anatomy may impact how their heart will respond to treatment.

What’s next

Dr. d’Udekem hopes results from this study will improve how doctors strategize and recommend (or not) surgical repair of atrioventricular valve regurgitation. Additionally, the study shows the value of centralized patient registries and data for informing the standard of care. Similar registries across the world may promise to provide even greater insight into the long-term outcomes for patients born with these congenital heart conditions.

Handrawn illustration of human Kidneys

Children’s National Nephrology team presents virtually at IPTA’s 11th Congress

Handrawn illustration of human KidneysThe International Pediatric Transplant Association (IPTA) is hosting their 11th Congress meeting March 26-29, 2022, and many Children’s National Hospital providers will be presenting throughout the conference. We hope you will join us!

Diversity, inequity and inclusivity in the practice of pediatric transplantation in the U.S.

Presenter: Marva Moxey-Mims, M.D., division chief, Nephrology

Dr. Moxey-Mims will review the trends in pediatric kidney transplantation over the past decade, focusing on differences by race and ethnicity, whether the gaps have narrowed over that time and steps that can be taken to increase equity.

Prevalence of mycophenolate mofetil discontinuation and subsequent outcomes in pediatric kidney transplant recipients: A PNRC study

Presenter: Asha Moudgil, M.D., medical director, Kidney Transplant

Mycophenolate mofetil (MMF) is a common maintenance immunosuppressant in children receiving kidney transplants but is often discontinued for various reasons. In this multi-center Pediatric Nephrology Research Consortium study, researchers sought to determine the prevalence and reasons for MMF discontinuation and its association with patient and allograft outcomes. They will be discussing their methodology and results from this study.

Additional Children’s National staff involved in the study include:

Changes in diastolic function and cardiac geometry after pediatric kidney transplantation: A longitudinal study

Presenter: Kristen Sgambat, Ph.D., clinical assistant professor

Children with end stage kidney disease are at high risk for cardiovascular morbidities. Indicators of systolic function, such as ejection fraction and fractional shortening, are often preserved and may not reveal cardiac dysfunction until it is severe. Longitudinal changes in diastolic function and cardiac geometry have not been well studied.

Additional Children’s National staff involved in the study include:

COVID19 in pediatric kidney transplant recipients: Incidence, outcomes, and response to vaccine

Presenter: Asha Moudgil, M.D., medical director, Kidney Transplant

At the start of the pandemic, no information was available on the outcomes of pediatric kidney transplant recipients with COVID-19. When the COVID-19 vaccine became available, response of immunosuppressed children to the vaccine was not known. While more information has become available in adult transplant recipients, information on pediatric transplant recipients remains limited.

The team will discuss their methodology of collecting information and their results and conclusions.

Additional Children’s National staff involved in the study include:

Poster presentation: Psychological functioning and adaptive behavior in pediatric patients awaiting renal transplantation.

Presenter: Kaushal Amatya, Ph.D., psychologist

Psychosocial functioning of children with chronic kidney disease (CKD) at pretransplant evaluation is associated with transplant readiness and post-transplant outcomes. Higher prevalence of emotional/behavioral issues is noted in children with CKD compared to healthy counterparts. Although issues with functional impairment is often reported, research on adaptive functioning using a validated measure is lacking. The study aimed to explore psychological and adaptive functioning in pediatric pre-transplant patients to identify areas in need of intervention.

Additional Children’s National staff involved in the study include:

  • Asha Moudgil, M.D., medical director, Kidney Transplant
  • Paige Johnson, Psychology resident

 

Charles Berul

Charles Berul, M.D., receives Meritorious Achievement Award

Charles Berul

Charles Berul, M.D., chief of Cardiology at Children’s National Hospital has earned a lifetime achievement award, the 2021 Council on Lifelong Congenital Heart Disease and Heart Health in the Young (Young Hearts) Meritorious Achievement Award.

The Meritorious Achievement Award recognizes a person whose achievements have made a significant impact in the field of congenital heart disease and heart health in the young and have helped to further the mission of the Young Hearts council. The council’s mission is to improve the health of children and adults with congenital heart disease and acquired heart disease during childhood through research, education, prevention and advocacy.

Dr. Berul received this award in recognition of his lifelong achievements in the field of pediatric electrophysiology. He is known for his development of innovative electrophysiologic studies for phenotypic evaluations of genetically manipulated pre-clinical models. Over the past two decades, his research focus and passion have been to develop novel minimally invasive approaches to the heart and improving methods for pediatric pacing and defibrillation.

He has also mentored dozens of trainees who have gone on to successful careers and particularly advocates for young investigators and clinician-scientists. He is known for his collaborative style and for supporting advancement of faculty physicians in academic medicine.

Dr. Berul has served on multiple society committees, task forces and writing groups, and is currently an associate editor for the Heart Rhythm Society’s journal. He is also actively involved in other key organizations such as Mended Little Hearts and the Pediatric and Congenital Electrophysiology Society (PACES). He has more than 300 publications and is an invited speaker nationally and internationally in the areas of pediatric cardiac electrophysiology and miniaturized device development.

Dr. Berul received the award on November 12 during a virtual presentation at the American Heart Association’s Scientific Sessions. He is the fourth Children’s National cardiologist to be recognized with this prestigious honor from the council in the last decade.

Kolaleh Eskandanian

Health IT Panel Focuses on Leveling the Playing Field for Women in Healthcare Leadership

Kolaleh-Eskandanian

Kolaleh Eskandanian, PhD, MBA, PMP, vice president and chief innovation officer at Children’s National Hospital, spoke on gender gaps in healthcare leadership during the 6th annual Health IT + Revenue Cycle Conference hosted by Becker’s Healthcare.

Although women account for nearly half of entry-level jobs in the healthcare industry, female clinician-scientist executives continue to be sparse among healthcare leadership ranks. Less than a third of C-suite roles – approximately 26 percent – are filled by women and tend to focus on human resources or marketing, according to a recent analysis by Becker’s Hospital Review.

Addressing and bridging this gender gap in healthcare leadership was the focus of the recent panel, “Leveling the Playing Field for Women in Healthcare at Macro and Micro Levels,” as part of the 6th annual Health IT + Revenue Cycle Conference hosted by Becker’s Healthcare. Moderated by Alya Ellison of Becker’s Hospital Review, the panel examined the different ways that leading healthcare institutions are working to improve mentorship and leadership opportunities for women to create a more equitable path to the C-suite.

Among those participating in the discussion was Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer at Children’s National Hospital, who noted that some organizations may require one or two cycles of leadership change for more female clinician-scientist executives to reach the C-Suite. Even so, Eskandanian emphasized that the desire and strategy to bridge this gap should be imprinted in the DNA of every major healthcare organization.

“Hopefully, many organizations started thinking about diversity and inclusion years ago. At Children’s National Hospital, this is deeply engrained within our culture and is something that we consciously focus on,” Eskandanian says. “In addition to focusing on inclusion at the leadership level, we also work diligently with medical school graduates in our residency program to ensure that both the micro and macro levels of balance are in place.”

Eskandanian adds that Children’s National Hospital also has developed and implemented a program for physicians and scientists known as W@TCH (Women @ Children’s Hospital) to help address the specific needs of women in academic medicine. Led by Naomi Luban, M.D., vice chair of Faculty Affairs and medical director for the Office for the Protection of Human Subjects, the program began as a series of informal lectures designed to address the challenges faced by women in medicine and academia and, with the help of junior faculty, has expanded to include a yearly “brown bag” seminar series with a formal W@TCH-related Grand Rounds that includes a half-day Career Development Workshop and a growing organizing committee of junior faculty.

Senior W@TCH members, many of whom are division chiefs at Children’s National Hospital, also oversee the selection of faculty members to attend different Association of American Medical Colleges (AAMC) programs including Women in Medicine and Science (GWIMS) Professional Development Seminars for early and mid-level faculty and minorities.

“This incredible program started organically at the hospital and has proven highly successful, so we hope that many organizations can follow the same organic process, which truly demonstrates the kind of leadership we need in order to be problem-solving organizations that lead to positive outcomes,” Eskandanian says.

Eskandanian and fellow panelists Tracy Donegan of MLK Community Health and Amy Schroeder of Lexington Regional Health agreed that, as there are still inequities in healthcare leadership roles, it is up to organizations to acknowledge disparities in order to start a dialogue that creates a more inclusive culture focused on manageable strategic goals that make awareness actionable.

screenshot of conversation between Dr. Beers and Simone Biles

Dr. Lee Beers speaks with Olympic gold medalist Simone Biles about mental health

Lee Savio Beers, M.D., F.A.A.P., medical director of Community Health and Advocacy at the Child Health Advocacy Institute (CHAI) at Children’s National Hospital and president of the American Academy of Pediatrics (AAP), delivered the President’s Address to AAP members around the world and held a keynote conversation with Olympic gold medalist Simone Biles about mental health during AAP’s National Conference and Exhibition.

After being introduced by her children, Charlotte and Jonah, Dr. Beers thanked AAP members around the world for their ability to adapt and provide quality care to patients throughout the COVID-19 pandemic. “The COVID-19 pandemic has changed our collective calculus of uncertainty, yet you continue to adapt and adjust to provide quality care in your clinics, emergency departments, ICU’s and exam rooms,” said Dr. Beers.

Dr. Beers continued by reflecting on accomplishments that AAP members and volunteers were able to achieve over the last year including the establishment of community immunization efforts, interim guidance provided on numerous pandemic-related issues and bi-weekly COVID-19 townhalls and educational sessions.

Shortly after her address, Dr. Beers sat down with Simone Biles to discuss the importance of advocating for mental health as an athlete.

During their conversation, Biles discussed the importance of making her mental health a priority by withdrawing from several events during the 2020 Tokyo Olympics. She reflected on the outpouring support she received and how it made her feel.

Biles also offered advice for youth dealing with mental health issues and stressed the importance of reaching out to parents or peers so they can get the help and support they need.

AAP’s National Conference and Exhibition, held from October 8 through October 11, serves as an opportunity to keep pediatric providers abreast of the latest best practices in pediatrics and strives to meet participants’ identified educational needs and support their life-long learning with a goal of improving care for children and families.

Speaker and presentation information can be found here.

screenshot of conversation between Dr. Beers and Simone Biles

Simone Biles discussed the importance of making mental health a priority with Dr. Lee Savio Beers.

Drs. Wernovsky and Martin

Cardiac care leaders recognized for mentorship and innovation at AAP

Two Children’s National Hospital cardiac care leaders received prestigious recognition awards from the American Academy of Pediatrics (AAP) during that organization’s virtual National Conference and Exhibition in October 2021.

  • Gil Wernovsky, M.D., cardiac critical care specialist at Children’s National Hospital, received the 2021 Maria Serratto Master Educator Award from AAP Section on Pediatric Cardiology and Cardiac Surgery, celebrating his 30-plus-years as a clinician, educator, mentor and leader in the field.
  • Gerard Martin, M.D., FAAP, FACC, FAHA, C. Richard Beyda Professor of Cardiology, Children’s National Hospital, received the AAP Section on Advances in Therapeutics and Technology (SOATT) Achievement Award, in recognition of his work to establish the use of pulse oximetry to screen newborn infants for critical congenital heart disease in the first 24 hours of life.

Dr. Wernovsky: 2021 Maria Serratto Master Educator Award, AAP Section on Pediatric Cardiology and Cardiac Surgery

Gil Wernovsky

Gil Wernovsky, M.D., received the 2021 Maria Serratto Master Educator Award from AAP Section on Pediatric Cardiology and Cardiac Surgery.

The Master Educator Award is presented each year to a pediatric cardiologist or cardiothoracic surgeon who exemplifies excellence as an educator, mentor and/or leader in the field.

A practicing cardiac critical care specialist with more than 30 years’ experience in pediatric cardiology, Dr. Wernovsky trained and mentored more than 300 fellows in pediatric cardiology, cardiac surgery, neonatology, critical care medicine and cardiac anesthesia, in addition to countless residents and fellows. He also organizes national and international symposia to share expertise around the world. During the COVID-19 public health emergency, for example, he co-founded the Congenital Heart Academy (CHA). The CHA provides content from an international faculty of cardiac care to more than 26,000 practitioners in 112 countries and includes a thriving YouTube channel.

Dr. Wernovsky is also a founding member of several international societies focused on bringing together clinicians, researchers and students across sub-specialties of pediatric cardiology and cardiac surgery for knowledge exchange and best practice sharing. These include: the Pediatric Cardiac Intensive Care Society, World Society for Pediatric and Congenital Heart Surgery, the International Society of Pediatric Mechanical Circulatory Support and the Cardiac Neurodevelopmental Outcome Collaborative.

Dr. Wernovsky received the award on October 10 at the virtual Scientific Sessions of the 2021 American Academy of Pediatrics National Conference and Exhibition.

Dr. Martin: AAP Section on Advances in Therapeutics and Technology (SOATT) Achievement Award

Gerard Martin

Gerard Martin, M.D., FAAP, FACC, FAHA, C. Richard Beyda Professor of Cardiology, Children’s National Hospital, received the AAP Section on Advances in Therapeutics and Technology (SOATT) Achievement Award.

The Section on Advances in Therapeutics and Technology (SOATT) educates physicians, stimulates research and development and consults on therapeutics and technology-related matters for the AAP. The Achievement Award recognizes someone who has shown leadership in applying innovative approaches to solve pressing problems.

Dr. Martin is the C. Richard Beyda Professor of Cardiology and has cared for children at Children’s National for more than 30 years. As an advocate for congenital heart disease efforts nationally and internationally, he played an integral role in the development of an innovative use of existing hospital technology—the pulse oximeter—to detect critical congenital heart disease in newborn babies.

Today, Dr. Martin and colleagues across the United States and around the world have worked to make this screening method a standard of care for newborns everywhere. It is a part of the Health Resources and Services Administration (HRSA) Recommended Uniform Screening Panel and has become law in every state. They continue to conduct research to refine the recommendations and hone-in on the most effective ways to harness these tools.

Dr. Martin was selected for this award in 2020. He accepted it and offered remarks during the 2021 virtual AAP National Conference and Exhibition on Monday, October 11, 2021.

Charles Berul receives award

Charles Berul, M.D., named Pioneer in Cardiac Pacing and Electrophysiology by Heart Rhythm Society

Charles Berul receives award

Dr. Berul receives the Pioneer in Cardiac Pacing and Electrophysiology from the Heart Rhythm Society at their 2021 meeting.

The Heart Rhythm Society has awarded its 2021 Pioneer in Cardiac Pacing and Electrophysiology Award to Charles Berul, M.D., chief of Cardiology and co-director of the Children’s National Heart Institute at Children’s National Hospital.

The award recognizes an individual who has been active in cardiac pacing and/or cardiac electrophysiology for many years and has made significant contributions to the field. It is typically given to electrophysiologists who treat adults. Dr. Berul is the second pediatric specialist to receive it. Dr. Berul accepted his award at Heart Rhythm 2021, the society’s annual meeting.

“It is wonderful news that Dr. Berul is receiving this award in recognition of his major contributions to this field and to improve the lives of children with heart rhythm challenges,” says David Wessel, M.D., executive vice president, chief medical officer and physician-in-chief at Children’s National Hospital. “We are proud of all he has achieved so far, and are so thankful that he shares his expertise, leadership, mentorship and friendship with us at Children’s National every day. Congratulations to him on this tremendous honor.”

The Heart Rhythm Society notes that Dr. Berul has mentored dozens of trainees who have gone on to successful careers and particularly advocates for young investigators and clinician-scientists. He is known for his collaborative style and promotion of faculty physicians in academic medicine. His scientific work began with cellular electrophysiology and clinical genetics of inherited arrhythmia disorders.

He is known for his development of innovative electrophysiologic studies for phenotypic evaluations of genetically manipulated pre-clinical models. Over the past two decades, his research focus and passion have been to develop novel minimally invasive approaches to the heart and improving methods for pediatric pacing and defibrillation.

Dr. Berul is an active member of the Heart Rhythm Society. He has served on multiple society committees, task forces, and writing groups, and is currently an associate editor for the society’s journal, Heart Rhythm. He is also actively involved in other key organizations such as Mended Little Hearts and the Pediatric and Congenital Electrophysiology Society (PACES).

He has more than 300 publications and is an invited speaker nationally and internationally in the areas of pediatric cardiac electrophysiology and miniaturized device development.

pediatric cardiac and vascular MRI coil

Overcoming real and perceived barriers to pediatric device innovation

pediatric cardiac and vascular MRI coil

A working group of innovators, engineers and clinicians from Children’s National Hospital and other institutions came together to address the real and perceived barriers to the creation of pediatric devices, such as this pediatric cardiac and vascular MRI coil developed by Inkspace Imaging.

A working group of innovators, engineers and clinicians from Children’s National Hospital, Children’s Hospital of Orange County and other institutions came together to address the real and perceived barriers to pediatric device innovation through opportunities that may change the return-on-investment in this market and improve health outcomes.

The new report, published in the Journal of Translational Engineering in Health and Medicine, mentions barriers that impede the advancement of pediatric devices, including excessive limitations for testing and validation, lack of incentives, inadequate research models and inconsistent pediatric-related knowledge among companies, regulatory experts, ethic review panels and government reviewers.

To remove the real and perceived barriers fostering excessive limitations, the researchers suggest reducing the perceived risk by establishing guidelines that standardize the review process and ethical research models, incentivizing small companies to participate in pediatric device innovation.

To increase incentives, the researchers call for the development of pediatric versions of adult devices with or without enforcement of regulations, develop incentives for small, medium and large-size companies, extend patent protection and more.

Since science corroborates the device’s effectiveness and safety, tailored pediatric research models are needed to help advance pediatric device innovation. While randomized trials in well-defined cohorts are commonly used in the scientific quest, they do not reflect the clinical practice in the pediatric devices field.

“Overcoming this barrier will require greater opportunity for creativity in the design of clinical trials, including delayed entry, intent-to-treat analysis, personalized outcome measures, and post-hoc subgroup analysis,” said Terence et al. “Effective research for pediatric device innovation will require greater ability to rely on ‘real-world’ data from post-market use of the proposed device or similar devices.”

On the education side, stakeholders, such as device sponsors and researchers, must receive an improved education on pediatric devices, according to the authors. Pediatricians should also be added to the regulatory review panels and advisory boards, so decision-makers can receive the pediatric perspective and fold it into their considerations.

“The consensus outcome of this meeting is that there are multiple opportunities, and a flexible combination of new programs and regulatory changes can be created to benefit the multiple stakeholders in pediatric device development,” said Terence et al. “An essential component will be building a cadre of experts with the development, regulatory, and clinical expertise to support all innovators.”

Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer at Children’s National Hospital adds that supporting and expanding pediatric innovation is a key focus of the new Children’s National Research & Innovation Campus, the first-of-its-kind focused on pediatric health care innovation, with the first phase currently open on the former Walter Reed Army Medical Center campus in Washington, D.C. With its proximity to federal research institutions and agencies, universities, academic research centers, the campus provides a rich ecosystem of public and private partners which will help bolster pediatric innovation and commercialization.

Authors from Children’s Hospital Orange County include Terence Sanger, M.D., Nadine Afari, M.S., Anthony Chang, M.D., William Feaster, M.D., Sharief Taraman, M.D., Debra Beauregard, Brent Dethlefs, Tiffani Ghere, R.D., C.S.P., Mustafa Kabeer, M.D., and George Tolomiczenko.

Screenshot of Drs. Northam, Newman and Batshaw

4th Annual Children’s National Hospital-NIAID Virtual Symposium

Screenshot of Drs. Northam, Newman and Batshaw

Keynote speaker Virginia Governor and pediatric neurologist, Ralph Northam, joined Dr. Kurt Newman, president and CEO of Children’s National Hospital, and Dr. Mark Batshaw, executive vice president, physician-in-chief and chief academic officer at Children’s National Hospital, during the 4th Annual Children’s National Hospital-NIAID Virtual Symposium.

Children’s National Hospital and the National Institute of Allergy and Infectious Diseases (NIAID) hosted their 4th annual symposium, attracting nationwide researchers, trainees and health care professionals to share updates on the COVID-19-related condition known as Multisystem Inflammatory Syndrome (MIS-C) in Children, allergy and immunology in the pediatric population.

“Children’s National relationship with the NIAID is a strategic and novel alliance that benefits children everywhere,” said Kurt Newman, M.D., President and CEO of Children’s National Hospital. “I’m so proud of our unique partnership and how it has enriched the high-quality research being conducted at Children’s National and enabled us to interact on pressing health issues. With the opening of our new Children’s National Research & Innovation Campus on the grounds of the former Walter Reed Army Medical Center, the sky is the limit to how we can work together with the NIAID to innovate for kids so that we help them grow up stronger.”

The discussions at the symposium centered around various topics, including clinical manifestations of SARS-CoV-2 in children, comparative disease biology manifestation in children and adults, therapies and vaccines in the pediatric setting, intersectionality of allergy, immunology and COVID-19, modulating biologic factors in immune regulation and treatments that invoke tolerance in allergy.

Keynote speaker Virginia Governor and pediatric neurologist, Ralph Northam, spoke about the COVID-19 pandemic and strategies to reintroduce children into schools and sports.

“Schools provide stability and structure. We know that children need to be in school for educational achievements and their mental health, but it has taken time to make school staff and families more comfortable with a greater time of in-person learning,” said Dr. Northam. “Our goal is to have all in-person learning this fall. That is where our children need to be because it is the safest place for children.”

During the keynote session, Dr. Northam also addressed the mental health issues related to the pandemic where pediatricians have seen an increase in depression and suicide rates.

“As we move forward to a back more normal life, we need to keep an eye on these children and make sure that they continue to get the support and treatment that they need,” said Dr. Northam.

Below are the speakers and the focus of their presentations.

  • Post-COVID cardiac manifestations in children: Anita Krishnan, M.D., Children’s National
  • Immunomodulation and Cytokine Profiling in MIS-C: Hemalatha Srinivasalu, M.D., Children’s National
  • The MUSIC study: Long-TerM OUtcomes After the Multisystem Inflammatory Syndrome in Children: Jane Newburger, M.D., Boston Children’s Hospital
  • MIS-C in Typical Cases and Down Syndrome: Dusan Bogunovic, M.D., Mount Sinai
  • Age-Related Virus-Specific T-Cell Responses to SARS-CoV-2: Susan Conway, M.D., Children’s National
  • Systems Immunology of COVID-19: Integrating Patient and Single Cell Variations: John Tsang, Ph.D., NIAID
  • Therapeutics for Children with COVID-19: Trying to be Data Driven in the Absence of Pediatric Trials: Andy Pavia, M.D., University of Utah
  • SARS-CoV-2 Vaccine Clinical Research: Alicia Widge, M.D., NIAID
  • Implementation and Public Health Aspects: Cara Biddle, M.D., M.P.H., Children’s National
  • COVID-19 and Pediatric Asthma: William Sheehan, M.D., Children’s National
  • The COVID-19 Pandemic and Immunodeficiency: The Burden and Emerging Evidence: Jessica Durkee-Shock, M.D., NIAID
  • SARS-CoV-2 Infection in Children with Cancer: The MSK Experience: Andy Kung, M.D., Memorial Sloan Kettering
  • Adaptive and Maladaptive Immunity to the Microbiota: Implication for Inflammatory Disorders: Yasmine Belkaid, M.D., NIAID
  • Deep Immune Profiling of Peanut Reactive CD4+ T-Cells Reveals Distinct Immunotypes Link to Clinical Outcome: Erik Wambre, M.D., Benaroya Research Institute
  • B Cells and Food Allergy: Not Just for Making IgE: Adora Lin, M.D., Ph.D., Children’s National
  • Emerging Biologic Therapies for Food Allergy: Hemant Sharma, M.D., Children’s National
  • The Promise and Limits of Allergen Immunotherapy: Carla Davis, M.D., Texas Children’s
  • Maternal Fetal Interactions in Food Tolerance: Michiko Oyoshi, M.D., Harvard Medical School

The Clinical and Translational Science Institute at Children’s National (CTSI-CN) and the NIAID organized the 4th annual symposium and wished to showcase some of the critical research being done on this worldwide infectious disease, particularly amongst the pediatric population and those affected with allergic and immunologic disease. By sharing this work, they hope it will help continue to drive the advancement of pediatric research in relation to this disease.

The research partnership between Children’s National and the National Institute of Allergy and Infectious Diseases (NIAID) is devoted to protecting and advancing the health of children with allergic, immunologic, autoinflammatory and infectious diseases through collaborative research and education. The partnership co-hosts an annual symposium to disseminate new information about science related to the partnership.

To view all the presentations from the symposium, click here.

For questions about the symposium or projects there, contact: CN-NIAIDPartnership@childrensnational.org.

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