December: Perspectives from the Society for Pediatric Research. Neonatal encephalopathy clinical trials: developing the future.
Therapeutic Hypothermia has long been the standard of care for infants with moderate to severe neonatal encephalopathy. However, the future of treatment for neonatal encephalopathy (NE) will focus on hypothermia adjuvant therapies. There needs to be a rethink in how future NE clinical trials are designed and analyzed, according to a multi-disciplinary expert panel who met at the 'Hypoxic-Ischemic Encephalopathy Symposium: Developing the Future'. In this episode we meet Dr. Kristen Benninger, a neonatologist at Nationwide Children's Hospital in Columbus Ohio who wrote up the panel's summary. Have a listen! Related Article.
November: Pediatric pulmonary hypertension: insulin-like growth factor-binding protein 2 is a novel marker associated with disease severity and survival.
Pediatric Pulmonary Hypertension (PAH) is a heterogeneous disease, characterised by sustained elevation of pulmonary arterial pressures and death from right ventricular failure. Given the extremely high burden of morbidity and mortality associated with this disease, and the risk of the invasive procedures required for diagnostics, novel biomarkers for this disease would be beneficial. In this episode, we meet Early Career Investigator, Dr. Megan Griffiths from Johns Hopkins University, School of Medicine, who examined two candidate IGF axis proteins as potential predictors of PAH severity. Have a listen! Related Article.
October: Rapid exome sequencing in PICU patients with new-onset metabolic or neurological disorders.
Effective decision making in the Pediatric Intensive Care Unit relies on quickly ascertaining diagnostic information in order to deliver a tailored clinical response. The utility of rapid genetic testing of critically ill patients has been demonstrated several times, owing to their relatively high diagnostic yield. However the cost and slow turnaround of results have been major barriers in the past to the widespread uptake of this technology in the clinical setting. In this episode, we meet Professor Steve Kernie from Columbia University Irving Medical Center and Morgan Stanley Children's hospital, who conducted a pilot study to assess what impact the use of rapid exome sequencing would have on the length of stay of a subset of children admitted to the Pediatric Intensive Care Unit. Have a listen! Related Article.
September: Child tobacco smoke exposure and healthcare resource utilization patterns.
Smoking in adults and adolescents is at an all-time low today, yet around 1 in 2 children who visit the Emergency Department have been exposed to tobacco smoke. We know that there numerous health consequences associated with tobacco smoke exposure (TSE), and that this also comes at a substantial monetary cost- in 2010, child tobacco smoke exposure resulted in more than 101,570 annual ED visits, costing nearly $63 million. In this episode, we meet Early Career Investigator, Ashley Merianos from the University of Cincinnati and Cincinnati Children's Hospital Medical Center, who performed a cross-sectional analysis of children visiting the ED in order to assess the contribution of child TSE on healthcare resource utilization patterns. Have a listen! Related Article.
August: A pilot study exploring interventions for physician distress in pediatric subspecialists.
Institutions and healthcare systems had started to introduce wellness initiatives following the growing realization of the widespread problem of physician distress and burnout. Whilst these programs might be effective, there is currently a lack of evidence about who uses them and whether they are best suited to their target audience. In this episode, we meet Dr. Andrea Weintraub from the Icahn School of Medicine at Mount Sinai, who conducted a cross-sectional national survey amongst different pediatric subspecialties to find out which initiatives were available, whether people knew about them or used them, and to better understand what initiatives pediatricians would like to see made available. Have a listen! Related Article.
July: Continuous glucose monitoring profile during therapeutic hypothermia in encephalopathic infants with unfavorable outcome.
40% of infants with hypoxic ischemic encephalopathy (HIE) go on to develop long-term disability, despite receiving therapeutic hypothermia. Mounting evidence suggests that children with HIE are at a higher risk of both hypoglycemia and hyperglycemia, which may explain the variable outcomes to therapeutic hypothermia. In this episode, we meet this month's featured Early Career Investigator Dr. Paolo Montaldo, from Imperial College London, UK and the University of Campania Luigi Vanvitelli, Italy who used continuous glucose monitoring to assess the association between neonatal glucose control and neurological outcomes at 18-24 months. Have a listen! Related Article.
June: Prevalence and stability of insufficient sleep measured by actigraphy: a prospective community study.
There is a growing body of evidence to suggest that insufficient sleep can have detrimental effects on school-age children's cognitive, emotional and behavioral regulation. But there remains a lack of objectively measured data on the stability and prevalence of insufficient sleep. In this episode, we meet Bror Ranum who is currently doing his PhD at the Norwegian University of Science and Technology. He was involved in a large prospective study of almost 800 children between the ages of 6-12 years to objectively measure the prevalence and stability of insufficient sleep using actigraphy. The results suggest the importance of measuring the number of nights of insufficient sleep as opposed to only taking an average measure over a week. Have a listen! Related Article.
May: A novel, composite measure of screen-based media use in young children (ScreenQ) and associations with parenting practices and cognitive abilities.
Young children face unprecedented access to screens in the modern environment. It was recently estimated that children between the ages of 3-8 get almost 3 hours of screen use a day. The American Academy of Pediatrics (AAP) have recommendations for screen-based media use which focus on four variables: access to screens, frequency of use, content and grownup-child interaction, or “co-viewing". In this episode, we meet Early Career Investigator, Dr John Hutton, from Cincinnati Children's Hospital Medical Centre, who has created a composite measure of these variables, reflecting current modes of screen-based media use. Have a listen! Related Article.
April: Demographic and psychosocial factors associated with hair cortisol concentrations in preschool children.
There is a growing body of evidence to suggest that early life stress can have detrimental effects on a child's physical and mental health. Hair cortisol concentrations are increasingly accepted as a cumulative measure of stressful experiences but they are understudied in preschool children. In this episode, we meet Professor Sunny Anand from Stanford University School of Medicine who developed a sensitive assay for hair cortisol concentrations. He and his team took hair samples from children aged 1-4 years in order to uncover psychosocial and demographic factors associated with this measure of physiological stress. Have a listen! Related Article.
March: Sex-specific relationships between early nutrition and neurodevelopment in preterm infants.
In this episode, we meet Early Career Investigator, Dr Anna Tottman who during her time at the University of Aukland, Liggins Institute performed a retrospective cohort study looking at the relationship between neonatal nutrition and neurodevelopmental outcomes. Her research suggests that nutrition for preterm infants may need to be sex-specific. Have a listen! Related Article.
February: Fetal exposure to mercury and lead from intrauterine blood transfusions.
Preterm infants regularly need Packed red blood cell transfusions. This life-saving therapy can help prevent anaemia of prematurity and in turn, safeguard normal organ function. However, there is a risk that donor blood contains the heavy metals mercury (Hg), lead (Pb) and Cadmium (Cd) which are known developmental neurotoxicants and may be present in neurotoxic doses. In this episode we meet Alison Falck, Assistant Professor of Pediatrics at the University of Maryland School of Medicine who has studied the relationship between the donor concentration, number of transfusions and exposure in preterm infants. Her results may have implications for prescreening of donor blood. Related Article.
January: Eye-tracking during simulation-based neonatal airway management.
Medical Simulation is a powerful model for pediatric education. This type of experiential training is used to teach various skills including stressful medical tasks like resuscitation, without putting patients at risk. In order to better understand the behaviour of healthcare providers during these situations, researchers have started to use eye-tracking technology. In this episode, we meet Early Career Investigator, Michael Wagner from the Medical University of Vienna, who during a fellowship at the Yale University, carried out a simulation-based study using eye-tracking glasses to explore the gaze behaviour and subjective experience of care-givers during a neonatal resuscitation to assess the usability of this technology for training. Related Article.