Dates: October 27-30, 2020

The National Institutes of Health invites you to take part in a unique opportunity to learn more about

working with the NIH grants process, programs, policies, and staff. Learn more and register here.

Date: October 28, 2020

Time: 12:00 - 1:00 pm

Penn Sociology Colloquium Series with Adia Harvey Wingfield, PhD, co-presented by Penn LDI, Penn Medical Ethics & Health Policy, Penn Center for Africana Studies, and Penn Department of Africana Studies. Learn more and register here.

Dates: October 28, November 12, November 18, December 2, 2020

Time: 1:00 - 2:15 pm

Join clinical experts, thought leaders, and advocates for a collaborative discussion on the issues of health disparities, structural racism, and medicine as we examine specific dermatologic diseases in a series of four free and open educational webinars. The series kicks off October 28th with "Racism and Racial Bias in Medicine." Learn more and register for one or all four events here.

Date: October 29, 2020

Time: 1:00 - 5:00 pm

This meeting is being organized by the Health Resources and Services Administration’s Maternal and Child Health Bureau, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Agency for Healthcare Research and Quality to hear ideas for advancing our scientific understanding of the effects of COVID-19 on health services for children and families. View the agenda or watch the videocast.

Date: November 2, 2020

Time: 9:45 am - 3:00 pm

Join us virtually for the 10th annual event featuring a poster session, workshops on quality and safety, a keynote address, presentations of the best abstracts received and awards. Learn more here.

Date: November 6, 2020

Time: 11:30 am - 7:30 pm EST

This annual research symposium will bring together faculty, trainees, students, and postdocs from Stanford and beyond to explore the latest developments and innovations in maternal and child health research. The keynote speaker is David A. Williams, MD, the Senior Vice President and Chief Scientific Officer at Boston Children’s Hospital’s, and internationally-recognized pediatric hematologist and oncologist. Learn more and register here.

Date: November 6, 2020

Time: 12:00 - 1:00 pm

2020 has been an unprecedented year in health care, politics, and public health. Join a panel of Penn LDI Senior Fellows as they reflect on the outcomes of the presidential and congressional races and discuss the possible ramifications for health care reform in 2021. Learn more and register here.

Date: November 11, 2020

Time: 12:00 - 4:00 pm

This Symposium is an opportunity to learn about the experience of children and adolescents with kidney stones, the work PKIDS is doing to improve patient outcomes, and the importance of partner-based research projects in generating knowledge that improve outcomes that matter the most to patients. Learn more or register for this free event.

A team including Diana Montoya-Williams, MD, Molly Passarella, and Scott Lorch, MD, MSCE sought to evaluate racial/ethnic differences in maternal resilience and its associations with low birthweight (LBW). They found that the risk-adjusted rate of LBW among highly resilient Black women (15.6%) was significantly higher than the risk-adjusted rate of LBW among highly resilient white women (9.1%) and highly resilient Hispanic women (8.6%). Thus they concluded that resilience scores differ significantly among women of different race and ethnicity but do not appear to entirely account for racial/ethnic disparities in LBW.

Evan Fieldston, MD, MBA, MSHP and colleagues sought to determine the impact of including observation status (OBS) in calculating length of stay (LOS) across children's hospitals. They conducted a Retrospective cohort study of hospitalized children in 2017 from the Pediatric Health Information System. Risk-adjusted geometric mean length of stay (RA-LOS) for inpatient (IP) -only and IP plus OBS was calculated and each hospital was ranked by quintile. Across hospitals, OBS represented 0.0% to 60.3% of total discharges. The RA-LOS in hours for IP and IP plus OBS was 75.2 and 54.3, respectively. For hospitals reporting OBS, the addition of OBS to IP RA-LOS calculations resulted in a decrease in RA-LOS compared with IP encounters alone. Three-fourths of hospitals changed ≥1 quintile in LOS ranking with the inclusion of OBS.

Pedimacs, an originally NIH-sponsored U.S. database, provides a platform to understand the population of children supported with ventricular assist devices (VADs) during this time of increasing numbers, new devices, expanding indications, and improved outcomes. Between 9/19/12-12/31/19, 44 hospitals implanted 1031 devices in 856 patients under 19 years-of-age. Positive outcome (alive on device or bridge to transplantation/recovery) occurred in 82% at 6-months overall. By device type, positive outcomes at 6 months based on device type were: implantable continuous flow (IC) - 92%, paracorporeal continuous flow (PC) - 68%, and paracorporeal pulsatile (PP) - 81%. The incidence of cerebrovascular accidents (CVA) in the IC, PC, and PP cohorts is 7%, 14% and 15%, respectively. IC VADs, the most common VAD-type placed in children, are associated with improved outcomes compared to PP/PC devices, though PP/PC devices are limited to supporting our most challenging patients. Noteworthy, the incidence of CVA for pediatric VADs has significantly decreased and is now 11% overall.

Imaging is often used at the time of diagnosis to exclude conditions other than arthritis, to confirm the physical examination if equivocal, and to assess the degree of inflammation and baseline damage. Plain radiography is helpful in the evaluation of damage from chronic inflammation, while ultrasound and magnetic resonance imaging (MRI) are helpful in the assessment of early disease and active inflammation. Multiple studies have shown that tenderness on physical examination of the sacroiliac joint is often discordant with imaging results, so MRI is increasingly relied upon to assess for objective evidence of inflammation. There are no widely accepted, validated tools for the pediatric population using ultrasound or MRI assessment of the peripheral joints. Validated tools exist for objective assessment of pediatric hip disease on radiographs and axial disease on MRI, but not on other imaging modalities. The utility of these scoring systems in clinical care and clinical trials remains untested.

A team including Jeffrey Gerber, MD, PhD, MSCE sought to describe antibiotic prescribing patterns in ambulatory children with community acquired pneumonia, and to assess the relationship between antibiotic selection and clinical outcomes, via a retrospective cohort study of ambulatory Medicaid-enrolled children 0-18 years of age diagnosed with CAP from 2010-2016. Among 252,177 outpatient pneumonia visits, macrolide monotherapy was used in 43.2%, narrow-spectrum antibiotics in 26.1%, and broad-spectrum antibiotics in 24.7%. A total of 1488 children (0.59%) were subsequently hospitalized and 117 (0.05%) developed severe pneumonia. Compared with children receiving narrow-spectrum antibiotics, the odds of subsequent hospitalization were higher in children receiving broad-spectrum antibiotics and lower in children receiving macrolide monotherapy and macrolides with narrow-spectrum antibiotics. Children receiving macrolide monotherapy had lower odds of developing severe pneumonia than children receiving narrow-spectrum antibiotics. However, the absolute risk difference was <0.5% for all analyses.

A pilot study conducted by Alexandra Psihogios, PhD, Lisa Schwartz, PhD and colleagues explored the feasibility and acceptability of implementing text-based assessments of oral chemotherapy adherence in adolescents and young adults (AYA) with leukemia. AYA received daily text message surveys and utilized an electronic pill bottle for 28 days. Text surveys assessed adherence and contextual associates (eg, mood). Feasibility was defined by recruitment/retention rates, survey completion rates, cost, and technical issues. After the 28-day period, AYA completed an acceptability survey. Secondary analyses compared text survey and electronic pill bottle adherence rates, and explored the daily associations between contextual factors and nonadherence.

Nadia Dowshen, MD, MSHP and colleagues aimed to understand parent and caregiver perspectives about potential legislation to ban gender-affirming medical information for minors and perceived effects on their transgender and gender-diverse youth (TGDY)’s mental health. The team developed and launched a social-media based, anonymous online survey with two open-ended questions about these laws. The most salient theme, which appeared in the majority of responses, described parent and caregiver fears that these laws would lead to worsening mental health and suicide for their TGDY. Additional themes included a fear that their TGDY would face increased discrimination, lose access to gender-affirming medical interventions, and lose autonomy over medical decision-making due to government overreach.

Information regarding whether daily bathing with chlorhexidine gluconate (CHG) reduces central line-associated bloodstream infection (CLABSI) in pediatric oncology patients and those undergoing hematopoietic stem cell transplantation (HCT) is limited. In this trial conducted by Brian Fisher, DO, MSCE and colleagues, patients aged ≥2 months and <22 years with cancer or those undergoing allogeneic HCT were randomized 1:1 to once-daily bathing with 2% CHG-impregnated cloths or control cloths for 90 days. The study was stopped early because of poor accrual. Among 174 enrolled patients who were considered as evaluable, the rate of CLABSI per 1000 central line days in the CHG group was 5.44 versus 3.10 in the control group. Post hoc conditional power analysis demonstrated a 0.2% chance that the results would have favored CHG had the study fully enrolled.

Pediatric patients with relapsed and refractory acute lymphoblastic leukemia (ALL) who are treated with chimeric antigen receptor (CAR) T-cells are at increased risk of both cytokine release syndrome (CRS) and sepsis. A team including Richard Aplenc, MD, PhD, MSCE sought to investigate the biologic differences between CRS and sepsis and to develop predictive models which could accurately differentiate CRS from sepsis at the time of critical illness. The team identified 23 different cytokines that were significantly different between patients with sepsis and CRS. Using elastic net prediction modeling and tree classification, they identified cytokines that were able to classify subjects as having CRS or sepsis accurately. As CAR-T therapies become more common, these data provide important novel information to better manage potential associated toxicities.