Editor’s Focus

    Volume 88 No. 5 November 2020

    Early Career Investigator

    Congratulations to Ariel Salas, the Early Career Investigator for November 2020. Dr. Salas is an assistant professor in the Department of Pediatrics at the University of Alabama at Birmingham. He obtained his medical degree from the Universidad Mayor de San Andrés. Inspired by several mentors, including Jorge Salazar, William W. Fox, Amed Soliz, Namasivayam Ambalavanan, and Wally Carlo, Dr. Salas chose neonatology as his specialty and completed his pediatric residency at Dr. Ovidio Aliaga Children’s Hospital and Children’s Hospital of Philadelphia and a neonatology fellowship at the University of Alabama at Birmingham. He is a well-trained physician–scientist who addresses knowledge gaps in neonatal nutrition and growth outcomes by applying rigorous research methods. In this issue, Dr. Salas and colleagues report on infant body composition as a primary outcome of growth. His advice to others early in their career: practice mindfulness, develop a growth mindset, find a conducive environment that promotes career growth, master concepts of effective communication, and promote collaboration. See https://doi.org/10.1038/s41390-020-01129-3 and https://doi.org/10.1038/s41390-020-1052-x

    Racial and social determinants of child health

    Racial and social injustice continues to be a hot topic across all domains, including healthcare. In this issue, a series of commentaries from the American Pediatric Society explain how the organization will address racism and social injustice in academic medicine and child health (Abman et al.); how academic institutions can address racism, lack of diversity, and social injustice (Abman); racism as a public health issue and the negative health consequences of racial injustice (Wright et al.); the inherent challenges and the strategies to overcome these challenges in our academic health systems (Walker-Harding et al.); and how to address structural bias and inequity at the organizational level (Pursley et al.). See https://doi.org/10.1038/s41390-020-01126-6, https://doi.org/10.1038/s41390-020-01131-9, https://doi.org/10.1038/s41390-020-01141-7, https://doi.org/10.1038/s41390-020-01132-8, and https://doi.org/10.1038/s41390-020-01142-6

    Pediatric-onset psychogenic nonepileptic seizures are on the rise

    Pediatric-onset psychogenic nonepileptic seizures (PNES) is a poorly characterized, underdiagnosed, and often neglected childhood disorder. In a Danish population-based study, Hansen et al. show that PNES is increasing in incidence and is associated with several morbidities and diagnostic and therapeutic challenges, indicating the need for collaborative pediatric and mental healthcare to improve the outcome of children affected with PNES. In their Correspondence, Hansen et al. note the importance of carefully choosing the words to describe disorders such as PNES to avoid stigmatization as well as improve patients’ understanding of their diagnosis, thus optimizing the benefits of treatment. See https://doi.org/10.1038/s41390-020-0945-z and https://doi.org/10.1038/s41390-020-1095-z

    Imaging biomarkers of poor executive function in very preterm infants

    Accurate predictors of long-term neurodevelopmental outcomes in very preterm (VPT) infants remain elusive. In a cohort study from Switzerland, Schnider et al. found that markers of abnormal brain metabolism can be useful biomarkers of poor neurodevelopmental outcomes in infants. Using proton magnetic resonance spectroscopy (MRS), the investigators demonstrate that an increased frontal white matter myo-Inositol (mI)/creatine (Cr) ratio in VPT infants and a decreased frontal matter glutamate–glutamine (Glx)/Cr ratio in VPT and term infants are predictors of poor executive function. In a related Comment, Ostojic notes that these results need to be interpreted with caution because of the gestational age-specific effects on Cr metabolism and differences in the brain region–specific Cr concentrations. See https://doi.org/10.1038/s41390-020-1024-1 and https://doi.org/10.1038/s41390-020-1088-y

    Less is not always better

    Bronchopulmonary dysplasia (BPD) is a common lung morbidity of preterm infants that occurs secondary to mechanical ventilation and lacks curative therapies. Recent evidence indicates intratracheal budesonide + surfactant therapy is one of the promising therapies to decrease lung injury and prevent BPD. Using preterm lambs, Hillman et al. demonstrate that budesonide elicits a dose-dependent effect on mechanical ventilation-induced lung and systemic inflammation when administered along with surfactant. These results emphasize the fundamental concept of performing dose-response studies to determine the risk-to-benefit ratio of drug therapies. See https://doi.org/10.1038/s41390-020-0809-6

    Knowledge is power

    Insights acquired by patients and their families go a long way toward improving their comprehensive healthcare management and allaying their anxiety. In this issue, Tim and Jenna Hanson describe the turbulent journey of their daughter with infantile hemangioma. They explain how their own education about hemangioma and guidance from their healthcare team helped them navigate the journey and mitigate their concerns. In related articles, Cheng et al. demonstrate that topical timolol maleate is a safe and effective therapy for small superficial infantile hemangiomas, and Park et al. explore what may cause and resolve infantile hemangioma and which biomarkers in patients with infantile hemangioma predict their response to propranolol therapy. See https://doi.org/10.1038/s41390-020-1089-x, https://doi.org/10.1038/s41390-020-0917-3, and https://doi.org/10.1038/s41390-020-0862-1

    Global Pediatric Research Investigators

    Congratulations to Felicity Gumbo and Mohammod Jobayer Chisti, the Global Pediatric Research Investigators for November 2020. Dr. Gumbo grew up in Harare, Zimbabwe. She obtained her medical degree and master’s degree in pediatrics from the University of Zimbabwe. She received a PhD from the University of Oslo, Norway, for her work on HIV transmission before returning to Zimbabwe to be an associate professor of pediatrics at the University of Zimbabwe College of Health Sciences. Dr. Gumbo studies the effects of maternal infections on infant outcomes. She believes that working collaboratively is the best way to tackle the global problems of child health. Dr. Chisti grew up in a village northeast of Bangladesh and obtained his medical degree from the Dhaka Medical College and Hospital. Inspired by M. A. Salam and Tahmeed Ahmed and his personal experience with children with respiratory problems, Dr. Chisti obtained a master’s degree in pediatric medicine and a PhD in pediatric respiratory medicine from the University of Melbourne in Australia and returned to Bangladesh to be a senior scientist and the clinical lead of the Intensive Care Unit at the International Centre for Diarrhoeal Disease Research, Bangladesh. Dr. Chisti studies the impact of low-cost innovative respiratory support devices on childhood mortality in developing countries, including Bangladesh and Ethiopia. His advice is to be compassionate and collaborative and to use failures as stepping stones toward success. In this issue, Chisti, Gumbo, and colleagues propose much-needed guidelines, based on available evidence and best practices, to improve the outcomes of children affected by COVID-19, in both high- and limited-resource settings. See https://doi.org/10.1038/s41390-020-1094-0, https://doi.org/10.1038/s41390-020-1087-z, and https://doi.org/10.1038/s41390-020-1053-9

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    Editor’s Focus. Pediatr Res 88, 683 (2020). https://doi.org/10.1038/s41390-020-01198-4

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