June 8, 2023

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UPDATES FROM RESEARCH ADMINISTRATION

Navigating Our Research Journeys

View the latest President's Message

The research journey can present challenges that make getting to the finish line difficult, including the challenge of deciphering the complex map of resources and collaborative networks within and in connection with Manne Research Institute. This month, President and Chief Research Officer Patrick Seed, MD, PhD, highlights our research navigation team—Lucia De Almeida, PhD, Samantha Engel, PhD, and Melissa Gesbeck, PhD,—and how they are fostering connections to put researchers in a better position to succeed.

“I’ve come to appreciate that a great research project is five percent having a good idea, and ninety-five percent figuring out how to actually get it done, and the navigators know the people and resources available through Manne Research Institute to help you complete your research.” - Alex Kula, MD

Introducing the 2023 Katz and Manne Research Institute Summer Scholars

Manne Research Institute and Lurie Children's are pleased to welcome the 2023 Katz and Manne Research Institute Summer Scholars Program participants.

The program begins June 12 and is designed to provide undergraduates summer experiences in research related to childhood health and disease through the ongoing generosity of the Robert Louis Katz Medical Research Foundation and the Manne Research Institute. Scholars spend eight weeks working daily with their faculty mentor and participate in a weekly course to learn about scientific presentations and careers in science.

The 2023 faculty mentors and their respective scholars are listed below. Full participant and mentor bios are outlined within the Summer Scholars Program Book.

• Monica E. Bianco, MD, and Nina Mondero
• Arun Gosain, MD, and Frances Lin
• Kyle MacQuarrie, MD, PhD, and Jonathan Hernandez
• Michelle Macy, MD, MS, and Mario Landa
• Erin Paquette, MD, JD, MBe, and Sydney Garner
• Neeraj Patel, MD, MPH, MBS, and Michelle Nuteschu
• Justin Ryder, PhD, and Lizeth Sepulveda
• Patrick C. Seed, MD, PhD, FIDSA, and Riogiani (Rio) Pena
• Tina Q. Tan, MD, and Ellen Shepard
• Debra Weese-Mayer, MD, and Daphne Yu

SCIENCE SHOWCASE

I2I Hackathon Inspires Innovative Solutions to Clinical Challenges 

Innovate2Impact (I2I) recently held its inaugural I2I Hackathon: Medical Devices event, a lively and interactive forum that brought together healthcare and innovation professionals to collaborate on ways to use technology to address real-world clinical problems faced daily at Lurie Children’s. 

“We designed the I2I Hackathon with two themes in mind—empower clinicians to generate solutions to the challenges they face daily and foster interdisciplinary collaboration—to show the participants that they hold the keys to innovation,” said Kosh Ghosh, Director of the Innovation Program. 

During the four-hour event held at Lurie Children’s, 24 participants, including nurses and doctors from the hospital and students from Northwestern University Segal Design Institute, were split into three inter-disciplinary teams to “hack” four clinical problems submitted by Lurie Children’s clinicians: enhancing bedside supply storage, automating peripheral intravenous extravasation detection, improving interfaces for non-invasive ventilation, and optimizing sterile field transfers. With guidance from professional facilitators, the teams discussed each clinical need and brainstormed and sketched concepts for medical device solutions. Then the teams came together as one group to share ideas, receive additional input, and vote on the top concepts. The event concluded with the opportunity for the participants to showcase these solutions to hospital leaders. 

“In total, 179 solutions to 4 clinical problems were generated during the hackathon. And while the top solutions as voted on by the participants were presented to leadership, all are being evaluated by the I2I team for development potential based on patentability, market relevance, regulatory requirements, and technical feasibility,” said Kelley Elahi, MSE, BSN, RN, CPN, Manager, Innovation Portfolio. 

Future hackathons and other I2I events are in the works. In the meantime, if you are interested in innovation, want to know more about the innovation process, or learn how your ideas can be scaled to have significant impact on health, contact Kosh Ghosh or explore more about I2I at luriechildrens.org/I2I. 

Research Scholar Day Highlights Recent Research Advances for Lurie Children's Audience

The 2023 Research Scholar Day showcased cutting-edge pediatric medical research being conducted at Ann & Robert H. Lurie Children’s Hospital of Chicago and Stanley Manne Children’s Research Institute. The event, held last month, brought together research staff, senior residents, postdoctoral fellows, fellows, and graduate students who presented their scholarly work to medical staff and colleagues in a professional conference setting. In addition to the poster session reviews, Research Scholar Day featured Alexander Chervonsky, MD, PhD, a professor in the Department of Pathology at The University of Chicago, as keynote speaker. Dr. Chervonsky spoke about the latest research being conducted in the areas of immunology and autoimmunity. Research Scholar Day is hosted by Lurie Children’s Department of Pediatrics and Manne Research Institute.

Click the link below for a list of 2023 Research Scholar Day Awards.

NEWS FROM THE RESEARCH PILLARS

Lurie Children’s Hospital Expert Calls for Prioritizing Research Focusing on Reducing Mortality (REFORM)

Need for a coordinated approach aimed at reversing declining life expectancy in US

Matthew M. Davis, MD, MAPP, a population health expert at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, proposes a more holistic approach to reducing mortality across the lifespan. In his commentary published in JAMA Health Forum, Dr. Davis calls for national prioritization of research that looks for connections across the leading causes of mortality, rather than research on diseases in isolation. He suggests that this effort be dubbed Research Focusing on Reducing Mortality (REFORM).

Highlighting the importance of REFORM, Dr. Davis points to increased death rates for nearly every age group in 2021, compared with 2020, which were related in part to COVID-19 and several other causes as well. In the US, life expectancy (76.1 years) is shorter than in similarly wealthy and sociodemographically diverse countries – for example, Canada (83 years).

“In the past, the United States has prioritized national research focusing on specific diseases or disease categories, such as the Cancer Moonshot and COVID-19. But to improve survival across many diseases and age groups, we need a broader approach that will connect mortality-focused research across federal institutes, institutions and investigators to help them move further and faster,” said Dr. Davis, Chair of the Department of Pediatrics at Lurie Children’s and Northwestern University Feinberg School of Medicine. “Causes of mortality are often similar with respect to groups at risk and the social factors that exacerbate disease. We need to improve health equity and life expectancy, especially in historically marginalized groups that currently bear too much of the mortality burden.”

New Expert Guidance Document Updates Strategies to Prevent Clostridioides difficile Infections 

A multi-center team led by Larry Kociolek, MD, Attending Physician of Infectious Diseases and Vice President of System Preparedness, Prevention, and Response at Ann & Robert H. Lurie Children’s Hospital of Chicago, has published an expert guidance document that presents recommendations to help acute care hospitals implement and prioritize strategies for preventing Clostridioides difficile infections (CDI) in their facilities. The document, which is published in Infection Control & Hospital Epidemiology, expands upon previously published guidelines from 2014 that detailed recommendations for detecting and preventing healthcare-associated infections. After a thorough evaluation of the medical literature, the authors identify “essential practices” as those that all hospitals should implement to prevent CDI and “additional approaches” that should be implemented in certain situations, such as in high-risk hospital locations or patient populations and/or if additional CDI prevention efforts are needed after implementing essential practices. The authors also discuss several strategies that are unresolved because effectiveness for CDI prevention is not yet supported by the available evidence.  

In the updated guidelines, a newly recommended essential practice is one that proposes appropriate use of antimicrobials by implementing an antimicrobial stewardship program. This is a change from the 2014 document, which considered appropriate use of antimicrobials an essential practice, but formally adopting an antimicrobial stewardship program was considered an additional approach at that time. Another newly recommended essential practice is taking steps to ensure appropriate testing strategies to avoid CDI misdiagnosis.  

Dr. Kociolek is a leading researcher in the area of healthcare-associated infections and infections caused by emerging high-consequence pathogens. His translational research program is focused on COVID-19, Clostridium innocuum, and C. difficile, which is one of the most common healthcare-associated infections in the United States. Pediatric research at Lurie Children's is conducted through Stanley Manne Children's Research Institute.

Children With Drug-Resistant Epilepsy Live Longer After Cranial Surgery

Risk of early death reduced by over 80 percent

Survival rate beyond 10 years in children with drug-resistant epilepsy (DRE) was highest after cranial epilepsy surgery and lowest when treated only with antiseizure medications, according to a study published in The Lancet Child and Adolescent Health. This large, retrospective study was the first to compare long-term survival in children with DRE among cohorts treated with medications only, vagus nerve stimulation plus medications, and cranial epilepsy surgery plus medications. Results show that risk of early death was reduced by over 80 percent after surgery and by 40 percent after vagus nerve stimulation, compared to medication-only treatment.

People with epilepsy have increased mortality rates compared to the age-matched population. Epilepsy is one of the most common neurological conditions, affecting at least 3.4 million people in the United States. Among children with epilepsy, an estimated 20 percent have DRE.

“We provide critical evidence for healthcare decision making for pediatric patients with drug-resistant epilepsy,” said senior author Sandi Lam, MD, Division Head of Neurosurgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and Professor of Neurological Surgery at Northwestern University Feinberg School of Medicine. “Our findings also highlight the importance of the multidisciplinary team approach to the treatment of epilepsy, such as that offered at a comprehensive epilepsy center, which includes tailored evaluation and deployment of medical and surgical treatment options for patients with this challenging disease.”

More Than Three in Five Children Do Not Receive Timely Mental Health Services After Firearm Injury

More mental health screening and follow-up needed in youth after firearm injury

More than three in five children (63 percent) enrolled in Medicaid do not receive mental health services within six months after a firearm injury, according to a new study published in the journal Pediatrics.

In the United States, 11,258 youth experienced nonfatal firearm injuries in 2020. Children who survive firearm injuries are at increased risk for adverse mental health outcomes, such as newly diagnosed trauma-related disorders, substance use and disruptive disorders. In addition to these disorders, the study found that after injury, the percentage of children diagnosed with bipolar disorder, schizophrenia spectrum disorders, and suicidal ideation/self-injury nearly doubled.

“In our study, we found that while too many children did not receive mental healthcare follow-up, children with a new mental health diagnosis identified during the firearm injury encounter had over twice the odds of timely connection to outpatient mental healthcare,” said lead author Jennifer Hoffmann, MD, MS, Emergency Medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “This shows that after a firearm injury, mental health screening and referral for youth at high risk are essential, as well as required by the 2022 American College of Surgeons standards for pediatric trauma centers. This best practice still needs wider implementation.”

The study also detected inequities in mental healthcare access after a firearm injury, with Black youth less likely to have any mental health follow-up than White youth.

“Mechanisms underlying these inequities may include stigma and costs related to accessing care, limited diversity in the mental health workforce, and shortages of mental health professionals in areas where Black children live,” said Dr. Hoffmann. “Attention is needed to address barriers at the individual, health system, and societal levels that may prevent Black youth from accessing mental health services.”

Hispanic Women Still at Higher Risk for Births with Neural Tube Defects After Voluntary Folic Acid Fortification of Corn Masa Flour

Mandatory fortification of corn masa flour products may achieve more substantial prevention of neural tube defects

The US Food and Drug Administration (FDA) mandated folic acid fortification of all enriched cereal grains in 1996, and this regulation resulted in a reduction of neural tube defect (NTD)–affected pregnancies for the population in the United States. While this mandatory food fortification strategy is an example of a public health success, Hispanic women in the US continued to be twice as likely to give birth to a child affected by NTD compared to non-Hispanic women. It was not until the year 2016 that the FDA approved voluntary, but not mandatory, folic acid fortification for corn masa flour products in the US to focus on the Hispanic diet staples, such as tortillas. Since that time, the rates of Hispanic births with NTD were not significantly reduced, according to a new study published in the journal Child’s Nervous System.

“Well over half of neural tube defects can be prevented with sufficient folic acid consumption before conception and in early pregnancy,” said senior author Sandi Lam, MD, MBA, Division Head of Pediatric Neurosurgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and Professor of Neurological Surgery at Northwestern University Feinberg School of Medicine. “Our study results show that voluntary, but not mandatory, folic acid fortification of corn masa flour products did not work to lower the rate of congenital neural tube defects in babies born to Hispanic women in the United States. Mandatory fortification of cereal grains has been much more effective in preventing congenital defects and reducing the rates of babies born with NTDs to non-Hispanic women in this country. Why do Hispanic communities continue to be more severely affected? Additional research, policy initiatives, and advocacy are needed urgently. Here, let's raise awareness in all communities, especially Hispanic communities, about the impact of folic acid intake on healthy birth outcomes.”

Chicago Parent Survey Highlights Swimming Safety in Lake Michigan

Differences in family swimming habits and beach safety features were found in a recent Voices of Child Health in Chicago Parent Panel Survey from Ann & Robert H. Lurie Children’s Hospital of Chicago. Over 1,000 parents from all 77 community areas in the city reported where they swim in Lake Michigan and what safety equipment they noticed at beaches.

The report found that 61% of parents say they swim at Lake Michigan beaches with their children, while 27% said they do not swim at Lake Michigan and 8% said they do not swim at all. Smaller proportions of parents swim in lake areas other than beaches, such as off a boat (4%), or unsafe areas including the rocks (5%) and piers (3%).

Swimming in areas other than beaches was more common among families with high household income (19%), compared to families with low household income (8%). Last summer, 85% of parents reported spending time at Lake Michigan; 16% of families did so at least once per week, 29% one to three times per month, 40% less than once per month and 15% never at all.

The presence of safety features also varied by parent demographic characteristics. Asian/other-race parents and white parents were more likely to report seeing flags about water conditions at the lakefront beaches than parents of other races/ethnicities (66%-65% vs. 53%-44%) and parents with higher household income were more likely to report seeing a life ring or throw bag on the beach (47%) than parents with lower household income (35%).

“Lake Michigan is the most dangerous of the Great Lakes. Winds and structures, like piers and jetties, make the beaches in southern Lake Michigan prone to deadly rip currents. Conditions can change quickly, that’s why it is so important to pay attention to beach flags and swim in designated areas during times that lifeguards are on duty,” said Michelle L. Macy, MD, MS, Scientific Director, Community, Population Health and Outcomes, Stanley Manne Children’s Research Institute.

Skin Patch Shows Promise for Toddlers with Peanut Allergy

Lurie Children’s clinical trials program for food allergies contributed to global study

A global phase 3 clinical trial that included Ann & Robert H. Lurie Children’s Hospital of Chicago found that a year-long immunotherapy through a skin patch safely desensitized toddlers with peanut allergy, lowering the risk of a severe allergic reaction from accidental exposure. Results of this randomized, double-blind, placebo-controlled trial for children 1-3 years of age, funded by DBV Technologies, were published in the New England Journal of Medicine.

“We were excited to contribute to this landmark study that carries so much promise for our young patients with peanut allergy,” said co-author Melanie Makhija, MD, who was the Principal Investigator of the study at Lurie Children’s and is an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Children who originally reacted to a small fraction of a peanut were able to tolerate the equivalent of one to four peanuts after completing the treatment course. This means that these children will be well protected from accidental exposure to peanuts. Importantly, we found that the peanut patch was safe, with very low chances of a severe allergic reaction. This is terrific news for families of kids with peanut allergies.”

MANNE RESEARCH INSTITUTE IN THE MEDIA

• Skin Patch Shows Promise for Toddlers With Peanut Allergy - Science Daily
• Strong Fathers/Padres Fuertes, with Dr. Craig Garfield - Strong Beginnings Podcast
• More Than Three in Five Children Do Not Receive Timely Mental Health Services After Firearm Injury - EurekAlert
• Hispanic Births With Neural Tube Defects Not Significantly Reduced After Voluntary Folic Acid Fortification of Corn Masa Flour - News Medical
• Tina Tan, MD, Discusses Cost Burden Associated With the COVID-19 Public Health Emergency Expiration - Contemporary Pediatrics
• New Clues Emerge About Possible Factors Behind Sudden Infant Death Syndrome - NBC News
• 'Landmark’ Peanut Allergy Skin Patch Desensitizes Kids Using Immunotherapy to Stop Allergic Reaction - Good News Network
• Louisville Tech Company Helps Create App to Detect Early Signs of Child Abuse - WDRB
• Two Shootings Involving 2-Year-Olds in Chicago Hours Apart - CBS News
• Pfizer’s Infant RSV Vaccine Receives FDA Advisory Committee’s Support - Contemporary Pediatrics