October 2022
IN THIS NEWSLETTER
Have an update to share? Research news, milestones, funding announcements, and events can be submitted via the Research Communications request form. In addition to the monthly newsletter, Manne Research Institute distributes a bi-weekly "Events and Opportunities" email featuring upcoming events, including virtual and in-person educational opportunities, and relevant research deadlines. All previous updates can be found in the Research Communications archive.
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UPDATES FROM RESEARCH ADMINISTRATION
Office of President and Chief Research Officer
Empowering Research Professionals Through a Community of Practice

In the most recent President's Message, Dr. Patrick Seed highlights our Research Professionals Education and Mentoring Committee, an exemplar community of practice that empowers peers to share knowledge, innovate, and facilitate their professional growth.
Research Institute Additions and Promotions
Alison Bender, MA
Executive Assistant, Office of Clinical and Community Trials 

The Office of Clinical and Community Trials recently welcomed Alison Bender as Executive Assistant. She will support Dr. William Muller, Scientific Director of the Clinical and Community Trials Pillar, and Ashley Hoambrecker, Director of the Office of Clinical and Community Trials, as well as Kosh Ghosh, Director of the Innovation Program. Bender, a creative systems-level thinker with a keen ability to identify, analyze, and resolve complicated issues, is highly regarded for her outstanding interpersonal and communication skills. Prior to joining Lurie Children’s, she served as the Academic Project Manager at National Louis University’s National College of Education. As a senior member of the dean’s immediate office, she led and coordinated priority projects on strategic initiatives, operations, communications, and stakeholder engagement. She also worked at the University of Georgia, Western Kentucky University, and Centre College. She earned a master’s degree in Folklore with a concentration in Historic Preservation from Western Kentucky University and a bachelor’s degree in Anthropology from Centre College.
SCIENCE SHOWCASE
NIDCD Grant Awarded to Dr. Nancy M. Young Will Support Research to Improve Language Outcomes for Children with Cochlear Implants
The National Institute on Deafness and Other Communication Disorders (NIDCD) recently awarded an R01 grant to Nancy M. Young, MD, FACS, FAAP, Medical Director of Audiology and Cochlear Implant Programs at Ann & Robert H. Lurie Children’s Hospital of Chicago and the Lillian S. Wells Professor of Pediatric Otolaryngology at Northwestern University Feinberg School of Medicine. The multimillion-dollar grant will fund the project, “Neural Prediction to Enhance Language Outcomes in Children with Cochlear Implant.”

The study will use pre-surgical brain magnetic resonance imaging scans and AI-enabled analytical methods to predict individual-level language outcomes in English- and Spanish-learning children up to four years after cochlear implantation. The long-term goal of the research is to customize therapy to maximize children’s hearing and language ability after receiving a cochlear implant. This is important because the language level achieved after implantation is more variable than for children born with typical hearing. The researchers will build predictive machine learning-enabled models to identify which children will not develop age-appropriate spoken language so that they can receive more intensive language habilitation therapy. The study will be among the first to demonstrate that a predict-to-prescribe approach to holistically treat hearing loss is feasible, cost-effective, and can lead to optimization of language outcomes of children with cochlear implants, according to Dr. Young.

The grant is the result of a more than 15-year collaboration between Dr. Young and Patrick Wong, PhD, Professor of Linguistics at Chinese University of Hong Kong. Dr. Wong, a neuroscientist, speech language pathologist and former faculty member of the Department of Communication Sciences and Disorders at Northwestern University, is a Multiple Principal Investigator of the study. Lurie Children’s and four other U.S. sites will enroll study participants. The language treatment arm of the study will be conducted by Megan Roberts, PhD, Jane Steiner Hoffman and Michael Hoffman Assistant Professor at Northwestern University’s Department of Communication Sciences and Disorders.
Gustave Falciglia Receives STTR Grant to Develop Technology Designed to Optimize Nutrition for Neonatal Growth in the NICU
Gustave Falciglia, MD, Attending Physician, Neonatology, at Ann & Robert H. Lurie Children’s Hospital of Chicago, and Medical Predictive Science Corporation have been awarded a Small Business Technology Transfer (STTR) grant to develop a clinical decision support system (CDSS) to optimize nutrition for neonatal growth in the neonatal intensive care unit. This NIH grant, awarded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, will support the research to develop a CDSS to positively impact the lives of critically ill infants throughout the world.

“My goal is to improve clinical decision making with the support of CDSSs and ultimately improve healthcare delivery to critically ill infants,” said Dr. Falciglia, who is also an Assistant Professor of Neonatology at Northwestern University Feinberg School of Medicine. “This research strives to develop tools that enhance clinician’s awareness regarding the nutrition that an infant has received and should receive to optimize growth.”
Dolutegravir-Based Antiretroviral Therapies for HIV-1 Shown to be Effective in Pregnancy
First study to directly compare dolutegravir to other commonly used antiretroviral regimens in pregnancy found that dolutegravir-based regimens had a high probability of viral suppression at delivery
Dolutegravir-based antiretroviral therapy (ART) for HIV-1 infection is more effective in pregnancy than some other ART regimens commonly used in the U.S. and Europe, according to a study published in the New England Journal of Medicine.

“Our study showed that dolutegravir-based regimens had a high probability of maternal viral suppression at delivery, and there were no observable differences in the risks of adverse birth outcomes, such as preterm birth, low birth weight, small for gestational age, or neonatal death, between dolutegravir and the other contemporary regimens,” said co-author Ellen Chadwick, MD, Director of Section of Pediatric, Adolescent and Maternal HIV Infection at Ann & Robert H. Lurie Children’s Hospital of Chicago and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “This is great news, since dolutegravir also has other important benefits compared to older antiretroviral drugs.”

Dolutegravir, a more recently approved antiretroviral drug, is taken once-a-day, is more tolerable, and is less likely to result in resistance mutations compared with other antiretroviral drugs.

“This is one of the largest studies to examine the effectiveness and safety of dolutegravir in pregnancy compared to regimens that have been commonly used during pregnancy in the U.S. and Europe,” said co-author Jennifer Jao, MD, MPH, an infectious diseases physician at Lurie Children’s and Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Our results show viral suppression at delivery in considerably more participants.”

In the current observational study, the researchers compared dolutegravir-based ART in pregnancy to atazanavir/ritonavir-, darunavir/ritonavir-, and raltegravir-based regimens that are currently classified by the Department of Health and Human Services Guidelines Panel as “Preferred” for use in pregnancy in the U.S. About half of the participants started ART before conception. At delivery, 96.7 percent of the pregnancies in participants who received dolutegravir had viral suppression, whereas atazanavir/ritonavir and raltegravir had viral suppression rates of 84 percent and 89.2 percent, respectively.

This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, National Institute of Dental and Craniofacial Research, National Institute of Allergy and Infectious Diseases, National Institute of Neurological Disorders and Stroke, National Institute on Deafness and Other Communication Disorders, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Alcohol Abuse and Alcoholism, National Heart, Lung, and Blood Institute (grants HD052102 and HD052104), and Harvard Chan School for PHACS 2020 (P01HD103133), and the Swiss National Science Foundation (grant 201369).

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine.
Gamechanger: New Way to Improve Outcomes in Kids with Eosinophilic Esophagitis
New measure of early scarring in esophagus allows immediate intervention to prevent further damage and food impaction

A groundbreaking study from Ann & Robert H. Lurie Children’s Hospital of Chicago determined the threshold for a new measure of early scarring in the esophagus of children with eosinophilic esophagitis (EoE), which allows immediate intervention during endoscopy to halt further damage and prevent food from getting stuck in the esophagus (feeding tube) of kids with this condition. Findings were published in the journal Clinical Gastroenterology and Hepatology, and were supported by the Campaign Urging Research for Eosinophilic Diseases (CURED) Foundation.

EoE is a chronic immune-mediated disorder of the esophagus that affects adults and children with a prevalence of 0.5 to 1 per 1000. Left untreated, chronic inflammation promotes scarring of the esophagus, and the development of esophageal rings and stricture, which interferes with passage of solid food and can cause impaction (when food is stuck in the esophagus and cannot dislodge).

Endoscopic Functional Luminal Impedance Probe (EndoFLIP) was used in the study to measure the “distensibility index,” which is a functional measure of how much force is required to stretch open the esophagus. Previously, the extent of scar tissue in the esophagus could only be evaluated visually during endoscopy, making it challenging to detect the early changes and intervene before the damage becomes more extensive.

“This is a gamechanger in how we care for kids with EoE,” said senior author Joshua Wechsler, MD, MSCI, Medical Director of Eosinophilic Gastrointestinal Diseases Program at Lurie Children’s, CURED Research Scholar at Lurie Children’s, and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Now, if distensibility is low, we can dilate the esophagus during the same procedure, and because we can pinpoint exactly where the scarring is, our intervention is more targeted and takes much less time. We are seeing improvements in symptoms, which is incredibly exciting.”

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine.
Research Brief: The Role of Hip Surveillance in the Care of Children with Cerebral Palsy 
Patients with cerebral palsy are at risk for developing hip displacement and dislocation, which are painful conditions that lead to functional decline and loss in quality of life. A new summary review published in Pediatrics Annals suggests that starting a hip surveillance program at age 2 can help with the early detection of hip displacement in children with cerebral palsy and allow for less invasive interventions.

Key Takeaways  
  • Effective hip surveillance programs include both clinical and radiographic monitoring of patients with cerebral palsy, which helps providers determine if hip subluxation is present, and if so, to recommend treatment options to prevent dislocation. 
  • The researchers noted that early identification of the signs of hip displacement in children with cerebral palsy is important and that these children should be referred to an orthopedic surgeon or other qualified provider for hip surveillance as young as age 2. 
  • While there are no formal hip surveillance programs in the United States, there are some that have been successfully implemented in other countries, and the researchers pointed out that these have contributed to reducing the rates of hip dislocation in patients with cerebral palsy. They added that while the schedules of each surveillance program varied, each program takes into consideration age and Gross Motor Function Classification System level (a classification system of motor function in children with cerebral palsy) when determining how often radiographic and clinical follow-up is needed.  

Vineeta T. Swaroop, MD, Attending Physician, Division of Orthopaedic Surgery and Sports Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago, and Professor of Orthopaedic Surgery and Physical Medicine and Rehabilitation at Northwestern University Feinberg School of Medicine, co-authored the study.

Article Citation 
San Juan AM, Swaroop VT. Cerebral Palsy: Hip Surveillance. Pediatric Annals. 2022; 51(9): 353–356. Epub Sept. 1. doi: 10.3928/19382359-20220706-06
FCHIP's 2022 Grandparent's Day Report: Active GrandparentingHealth and Involvement
For many grandparents, having grandchildren is one of life’s greatest treasures. Remaining active is one way for grandparents to be able to remain engaged with their grandchildren. The Family and Child Health Innovation Program's 2022 Grandparent's Day Report (.pdf) examines ways to improve health and wellbeing among older adults, for the benefit of themselves and their grandchildren. Topics include:
  • Age and Grandparenting by the Numbers
  • Orphaned Children and the Rise of Grandparent Care
  • Changing Landscape of Grandparenthood
  • Promoting Grandparent Health
  • Exercise: How much physical activity do older adults need?
  • Skin Care
  • Vaccines
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