Volume 86 No. 5 November 2019

Early Career Investigator

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Congratulations to Adam Numis, the Early Career Investigator for November. Originally a New Yorker, he became interested in pediatric epilepsy after a “life-altering” lecture by Elizabeth Thiele during his second year at Harvard Medical School. Migrating to the West Coast, Dr. Numis joined her research group and explored the field of epilepsy and autism in tuberous sclerosis complex. Recognizing the limitations of current therapeutics, he expanded his research interests to epileptogenesis and the identification of cohorts for whom therapeutic interventions may prevent future seizure disorders. This work was rewarded with a K23 award and an assistant professorship at the University of California at San Diego. His work on pro-inflammatory cytokines in hypoxic ischemic encephalopathy as a predictor of later development of epilepsy is the basis of additional commentaries and features in this issue. His advice: find the niche that gives you an infectious excitement, so that you can “enjoy and smile every day.” See pages 553, 548, 616 and 672

Optimizing symptom control in cancer

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Dupuis et al. review approaches used to improve symptom control for children receiving cancer treatments, such as systematic symptom screening and clinical practice guidelines (CPGs) for symptom management. Currently, few CPGs are applicable to symptom control. It is therefore essential to create new CPGs and identify ways to integrate symptom management into clinical workflows for treating pediatric cancer patients. (Photo: FatCamera/Getty.) See page 573

Recommendations for trials of medicinal products in newborns

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Marlow et al. reviewed outcomes of neonates treated with medicinal products in clinical trials to formulate an outline for long-term assessment. Most important are the effects of such products on neurodevelopment. The authors propose a framework for determining the need for long-term assessment—and its nature and duration—for regulatory trials involving neonates. See page 567

Lung mass growth in CDH

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Adaikalam et al. introduce a novel technique for measuring lung mass and provide the first investigation of lung mass growth in hypoplastic lungs in congenital diaphragmatic hernia (CDH). The authors used fetal and post-CDH repair magnetic resonance imaging to measure lung volume and density. In addition, they calculated lung mass and demonstrated catch-up growth of lung parenchyma in the more hypoplastic ipsilateral lung. See page 635

microRNA after hyperoxia

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Alam et al. used a mouse model of hyperoxia-induced lung injury to investigate the expression profile and functional role of microRNA199a-5p after hyperoxia. They found enhanced miR199a-5p expression in mouse lungs, with significant reduction in the expression of its target caveolin-1. These results indicate that miR199a-5p inhibitors might be a new therapeutic option for improving bronchopulmonary dysplasia. See page 579

Early prenatal biomarkers of fetal malformation

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Unsuspected congenital malformations cause 7% of neonatal deaths. In this review, Wagner et al. outline maternal plasma biomarkers indicating fetal malformations. In a related article, Denne and the Pediatric Policy Council promote the notion of including pregnant women in research. Finally, in an Insights article, one of the founders of the use of maternal blood from prenatal diagnosis, Diana Bianchi, offers her insights into the power of human touch. See pages 560, 554 and 670

Oral dosing of antenatal corticosteroids (ACS)

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Due to sporadic use of ACS and difficulties with routes of exposure, Schmidt et al. examined the pharmacokinetics of oral dosing with ACS in sheep. They found that oral ACS may be feasible and more available to low resource countries. In a related commentary, Watterberg and Ballard review the history of ACS, and highlight the surprises in this article. See pages 589 and 556