Editor: Sara Davies
DECEMBER 2, 2016

Dr. BiasiniSince 2005, the McNulty Civitan Scientist Award has been awarded to outstanding scientists with a long-term career commitment to research on developmental disabilities. The award is given each year in honor of the McNulty family who 
were long-time members of the Chesapeake District of Civitan International. Tom and Mary McNulty with their son Tommy were the driving force behind the creation of the Civitan International Research Center and the research focus of Civitan International Foundation. To date, the award has provided support for a number of successful research projects and helped to develop successful clinical programs benefitting individuals with developmental disorders.  

Fred Biasini, Ph.D., director of the UAB Civitan-Sparks Clinics, is the 2016-2017 recipient of the coveted McNulty Civitan Scientist Award. He is an Associate Professor in the Department of Psychology at the University of Alabama at Birmingham and he is the director of the Lifespan Developmental Psychology Program. His research and teaching interests include autism spectrum disorder, developmental disability, social development and children of substance abusers. 

On Tuesday, Nov. 29, a diverse team of Children's physicians, trainees, and faculty visited Calhoun, Ala., in the heart of Wilcox County. This Black Belt region is likely the most impoverished in the U.S. Our team saw health care delivery first hand visiting the Spartan J. Paul Jones Hospital and outpatient clinics. The county has only three practicing physicians, one dentist, and no psychiatrists. Its single youth enrichment program, Bama Kids, is in dire need of literacy materials and resources. A ferry ride brought us to the history rich but resource destitute Gee’s Bend area. Our visit instilled new insights into health disparities the challenges of rural poverty, and the resilience of those who practice there. We left inspired and grateful to our Area Health Education Centers (AHEC) hosts for the venture. Dr. Tina Simpson’s essay summarized the experience:
Don’t Forget About Me
I’m that:
Person living in that trailer you passed asking yourself, “Does someone live there?”

Woman in labor at the local hospital ready to push but can’t because OB is 40 miles away.

Person in that area of town with no grocery store but now getting Top Golf, that place you were so excited about.

Watch Pediatric Grand Rounds Live every Thursday from your computer by going to https://www.childrensal.org/cme and clicking on Live CME Opportunity. Live Broadcasts begin at 11:55 a.m. every Thursday.

To ensure an optimal viewing experience, we strongly encourage viewers to download our viewer guide and set up or test your system prior to the webcast. The viewer guide can be found here or on the Live CME Opportunity page.
*** Please Note: Due to call volume real-time assistance may not be available

During testing if you are experiencing trouble viewing the streaming video and are currently viewing from the Children’s of Alabama campus please contact the Children’s of Alabama Customer Support Desk (CSD):
Email: gethelp@childrensal.org
Phone: (205) 638-6568
Create a Support Ticket: http://csd.chsys.org/support_ticket.html
If you are experiencing 
streaming issues and you are not viewing from the Children’s of Alabama campus, please contact your local internet provider or IT Department. 

Click here to view December Grand Rounds schedule. 

Congratulations to Ambika Ashraf, M.D., Pediatric Endocrinology, Santiago Borasino, M.D., Pediatric Cardiac Critical Care, Jeffrey Lebensburger, D.O., Pediatric Hematology & Oncology, and Julie Wolfson, M.D., Pediatric Hematology & Oncology, on their recent election to the Society of Pediatric Research. The goal of the Society for Pediatric Research is to create a network of multidisciplinary researchers to improve child health. Each of these new members will contribute greatly to this mission. 

The winner of this quarter’s Extra Mile Award in Primary Care Clinic is Dr. Thomas Tyner. His nomination came from his attending physician and clinic staff after a particularly difficult encounter with a hypothermic newborn. He coordinated care with the RNICU and spent an extraordinary amount of time with the family devising a plan for this patient as there were many unique challenges and social concerns. He displayed patient advocacy at its best by actually running the “extra mile” to ensure this infant was safe and seeking care. 

UAB's genetics clinics have moved from the previous locations in the Hugh Kaul Human Genetics Building. Pediatric clinics are now on the sixth floor of the Dearth Tower at Children's of Alabama. Adult clinics are located on the first floor of the Kirklin Clinic.  

Appointments can be made by calling 934-4983. Click here for more information. 

Boni E. Elewski, M.D., an international leader in fungal and psoriasis research and dermatological clinical trials, has been named the new chair of the UAB Department of Dermatology. 

Dr. Elewski has been a professor of Dermatology at UAB for the past 17 years. She holds the James E. Elder M.D. Endowed Professorship for Graduate 
Education, and is currently vice chair for Clinical Affairs and director of the Dermatology Residency Program.  She will assume her new role as chair on January 1. Click here to read more. 

The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is shocked and deeply disappointed by the decision of the U.S. Court of Appeals for the Tenth Circuit to overturn the federal government’s strict safety standard for small, high-powered magnets. This legal ruling does not change the hazard these products pose to children. Click here to continue reading the statement and find recommendations moving forward. 

Positions on executive committees of select AAP Councils and Sections are currently available. Executive committees are the leadership bodies of Councils and Sections. Involvement in AAP Councils and Sections are great opportunities for AAP members to participate at the national level. Click here for more information on AAP Councils and Sections.

The Society for Pediatric Research is now accepting applications for the Young Investigator's Coaching Program for junior investigators who have embarked on a career in pediatric research.​ The purpose of the program is to connect junior faculty members conducting child and adolescent health research to successful investigators in the appropriate research field, thereby increasing opportunities for mentoring, networking, collaboration, and funding. Deadline for applications is Dec. 14, 2016. Click here for more information. 

Marilyn Crain, M.D.,
Pediatric Infectious Disease, is participating in the Muscular Dystrophy Association (MDA) Lock-Up. In order to "break out," she must raise her goal amount or "bail." This money will help kids and adults break free from the harmful effects of muscle debilitating diseases. Muscular dystrophy, ALS and related diseases take away everyday freedoms like walking, running, hugging and even breathing. 

The Muscular Dystrophy Clinic at Children's provides care to more than 250 children and young adults from across Alabama, Tennessee and Florida. The clinic provides multidisciplinary services by physicians (pulmonary, neurology, genetics, and rehabilitation medicine specialties), social workers, counselors, and respiratory therapists. 150 of these 250 patients are 18 years of age or younger, and eligible for the wonderful summer camp sponsored by MDA. 

Please consider making a donation to MDA! With your support, we'll move toward a future in which kids and adults with muscular dystrophy, ALS and related life-threatening diseases live longer and grow stronger. Click here to find out more

Development of an Outcome Measure for Young Adults with JIA
Melissa Mannion, M.D.
Assistant Professor
Division of Pediatric Rheumatology
Implementing an Early Mobility Program in a Pediatric Intensive Care Unit
Kristina Betters, M.D.
Pediatric Critical Care Medicine Fellowship
Emory University School of Medicine
Atlanta, GA

Click here to view the CHIF schedule for December 2016. 

Diana R Quintero, M.D.
Pediatric Pulmonologist
Associate Professor of Pediatrics
Medical College of Wisconsin
Cystic Fibrosis Center Director
Children’s Hospital of Wisconsin

Dr. Quintero will present, "The Evolution of Cystic Fibrosis Care: The Impact of Systematic Quality Improvement" on Friday, Dec. 9 at 2 p.m. in the Lowder Building 6th floor, conference room B. Click here to download the flyer.

Please make plans to attend the 2017 McMillan Lecture, featuring Association of Maternal & Child Health Programs (AMCHP) Brent Ewig and focusing on the impact of the election results on Maternal and Child Health (MCH) policy. Click here to view the flyer. Feel free to download and post this information, and forward it to interested students and colleagues. The lecture will take place Feb. 9, 2017 at 11 a.m. in the Hill Student Center Alumni Theater.

The Pediatric Residency Program is busy with Recruiting Season!  We are working to recruit 24 Pediatric Residents, 4 Med-Peds Residents, 1 Peds-Neurology Resident and 1 Peds-Genetics Resident. We will be conducting interviews through January and then getting ready for Match Day on March 17, 2017!  
Alabama Drug Discovery Alliance (ADDA) Accepting Pre-Proposals
These ADDA proposals can include any aspect of drug discovery and development, including - but not limited to - target validation, assay development for high-throughput screening, molecular modeling and medicinal chemistry efforts, or proof of concept studies in animals. The deadline is Dec. 12 at 12 p.m. and more information is available here
Pilot Funding Opportunity in Outcomes, Population Health and Disparities Research
This opportunity is targeted at full-time UAB faculty who will be competitive for an R01, R18, PCORI, program project proposals, or equivalent independent funding. $200,000 is available to fund two pilot grants of $50,000/year for up to 2 years of support. The deadline for applications is Dec. 31 by 5 p.m. 
Pilot Grants Available for Community Health Scholars
Up to three investigators will receive up to $30,000 each for community-based participatory research that addresses important health and public health issues directly relevant to the Birmingham community. LOIs are due Dec. 13, and completed applications are due Jan. 31, 2017, to the Center for the Study of Community Health. 
Community Access to Child Health (CATCH) Planning, Implementation, and Resident Grants
The 2017 Cycle 2 call for proposals is now open, with applications due Jan. 31, 2017 by 2 p.m. Two webinars will be held on Dec. 13 (at 10:30 a.m. and 4:30 p.m.) to answer questions and discuss the application process. More information, including links to register for the webinars, can be found here.
Alabama Launchpad Startup Competition
The first competition cycle for 2017 is offering up to $25,000 in startup funding. Alabama Launchpad is for new, innovative ventures in the seed or early-growth stages, or for existing businesses moving into a new high-growth market. The deadline for applications is Monday, Dec. 19 by 9 a.m. 
UAB's 6th Short Course on Next-Generation Sequencing
Presented by the UAB Department of Biostatistics and funded by the National Human Genome Research Institute (NHGRI), this course will provide a venue for statisticians, genetic epidemiologists, bioinformaticians, and genome biologists to discuss novel data analysis strategies.  The course will be held Dec. 12-15 from 8 a.m. - 4 p.m. in Room 210 of the Learning Resource Center. For more information or to register, click here
UAB Graduate Course: The Science of Metabolomics
GBSC 724 will introduce and equip investigators, new and experienced, with the metabolome and the tools needed to view, statistically analyze, and interpret metabolomic data. It will also cover newer topics, including the role of metabolites in chronic diseases. The course is MWFs Jan. 9 through March 31 from 1:30 - 3 p.m. in Shelby 515.  More information is available here.


Final RPPR To Be Used Effective Jan. 1, 2017

NIH Implementation of Final Research Performance Progress Reports (Final RPPR)
(NOT-OD-17-022) National Institutes of Health

December 8 

“How 140 Characters are Changing Health Care: Digital Health & Innovation”

Wendy Sue Swanson, MD, MBE
David Askenazi (Ped - Nephrology) OTSUKA PHARMACEUTICAL DEVELOPMENT & COMMERCIALIZATION, INC. $44,300. 11/08/2016 - 05/31/2017.

Matthew Kutny (Ped - Hematology/Oncology) AALL 1521; A Phase 2 Study of the JAK1/JAK2 Inhibitor Ruxolitinib with Chemotherapy in Children with De Novo High-Risk CRLF2- Rearranged and/or JAK Pathway-Mutant Acute Lymphoblastic
Lukemia CHILDREN'S HOSPITAL (PHILADELPHIA). $18,500. 11/04/2016 - 11/03/2024.

David Askenazi (Ped - Nephrology) Recombinant Erythropoietin for Protection of Infant Renal Disease (REPAIReD) SEATTLE CHILDREN'S RESEARCH INSTITUTE. $375,144. 09/01/2016 - 08/31/2017.

Marilyn Crain (Ped - Infectious Disease) Pediatric HIV/AIDS Cohort Study (PHACS) Data and Operations Center (DOC) Harvard School of Public Health. $321,598. 08/01/2016 - 07/31/2017. 

Hector Gutierrez (Ped - Pulmonary) Transformative Integrated Model for Continuous CF Care Cystic Fibrosis Foundation. $81,000.  03/01/2016 - 02/28/2017. 

Hector Gutierrez  (Ped - Pulmonary) CF Center in Chile, Pilot and Feasibility Program Cystic Fibrosis Foundation.  $47,376. 01/01/2016 - 12/31/2016.
Thorax. 2016 Nov 15. pii: thoraxjnl-2016-208949. doi: 10.1136/thoraxjnl-2016-208949. Microbiological efficacy of early MRSA treatment in cystic fibrosis in a randomised controlled trial. Muhlebach MS, Beckett V, Popowitch E, Miller MB, Baines A, Mayer-Hamblett N, Zemanick ET, Hoover WC, VanDalfsen JM, Campbell P, Goss CH; STAR-too study team. Collaborators (32) Ng D, McNamara J, Johnson M, Moonnumakal S, Schaap N, Anthony M, Clancy JP, Gibson R, McNamara S, Michelson P, Hicks T, Sharma P, Hebert A, Brand K, Schuler P, Baker D, Filbrun A, Linn M, Sammut P, Telfer R, Moormann K, Schultz K, Urbanek H, Guill M, LiPuma JJ, Sontag M, Murray S, Hunt M, Howe DL, Hocevar-Trnka J, Mitchell R, Browne L.
The prevalence of MRSA in patients with cystic fibrosis (CF) has increase dramatically in recent years with some centers reporting upwards of 35% incidence. MRSA has also been linked to worsening respiratory health and increased mortality.  Limited evidence exists as to whether MRSA can be effectively eradicated from CF airways. This study demonstrates a significant short term treatment effect with a fairly rigorous eradication protocol. Further studies are needed to evaluate successful sustained eradication and effect on clinical outcomes.

Am J Respir Cell Mol Biol. 2016 Nov 21. Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice. Saadoon A, Ambalavanan N, Zinn K, Ashraf AP, MacEwen M, Nicola T, Fanucchi MV, Harris WT.
This study investigates the consequence of prenatal vitamin D deficiency on airway and alveolar development in a novel mouse model and analyzes the optimal timing for supplementation. Vitamin D deficient mice manifest abnormal lung function and structure. Postnatal supplementation improves lung function and alveolar development but does not correct defective tracheal architecture. Our findings provide an in vivo model to investigate respiratory sequelae of Vitamin D deficiency that can be used to test preventive and therapeutic strategies.

J Microbiol Methods. 2016 Nov 16. pii: S0167-7012(16)30328-1. doi: 10.1016/j.mimet.2016.11.011. Shaken or stirred?: Comparison of methods for dispersion of Mycoplasma pneumoniae aggregates for persistence in vivo. Totten AH, Xiao L, Crabb DM, Ratliff AE, Dybvig K, Waites KB, Atkinson TP.
My graduate student demonstrates in this methods paper that, perhaps contrary to expectations, sonication of suspensions of Mycoplasma pneumoniae actually increases by about 10-fold the number of individually culturable organisms by breaking up aggregates while vortexing the suspensions appears to decrease viability. This observation will be of use to researchers working with this organism, particularly in animal models.

J Pediatr. 2016 Nov 15. pii: S0022-3476(16)31095-2. doi: 10.1016/j.jpeds.2016.10.027. Outcomes from a 12-Week, Open-Label, Multicenter Clinical Trial of Teduglutide in Pediatric Short Bowel Syndrome. Carter BA, Cohran VC, Cole CR, Corkins MR, Dimmitt RA, Duggan C, Hill S, Horslen S, Lim JD, Mercer DF, Merritt RJ, Nichol PF, Sigurdsson L, Teitelbaum DH, Thompson J, Vanderpool C, Vaughan JF, Li B, Youssef NN, Venick RS, Kocoshis SA.

J Pediatric Infect Dis Soc. 2016 Dec;5(4):349-355. Epub 2016 Oct 7. Update From the Advisory Committee on Immunization Practices.
Schuster JE, O'Leary S, Kimberlin DW.

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) meets three times per year to determine national policy for immunization schedules. The American Academy of Pediatrics has two liaisons at each ACIP meeting to ensure that the AAP and ACIP recommendations are harmonized. This manuscript summarizes the June 2016 ACIP meeting.

Proc Natl Acad Sci U S A. 2016 Nov 16. pii: 201611711. Role of nucleotide-binding oligomerization domain 1 (NOD1) and its variants in human cytomegalovirus control in vitro and in vivo. Fan YH, Roy S, Mukhopadhyay R, Kapoor A, Duggal P, Wojcik GL, Pass RF, Arav-Boger R.
Human cytomegalovirus (HCMV) is a leading cause of fetal infection that results in lifelong sensory and cognitive disability and it is a leading cause of morbidity in immunocompromised patients. There is great variability in the outcome of HCMV infection that cannot be accounted for by current knowledge. This report examines the role of innate immunity in control of HCMV by study of nucleotide binding oligomerization domain 1 (NOD1), a cytoplasmic pattern recognition receptor. Studies in vitro and in mice (murine CMV) showed that activation of NOD1 suppressed CMV infection and inhibition of NOD1 led to enhanced CMV replication. Mutations of NOD1 varied in their effect on HCMV replication with some enhancing and others suppressing. NOD1 suppression of HCMV involved interferon-β. NOD1 polymorphisms were significantly associated with risk of HCMV infection among women who were infected during the course of a CMV vaccine clinical trial. These results suggest that genetic susceptibility to HCMV could be determined by NOD1 polymorphisms and that variability in innate immune responses could be an important factor in outcome of HCMV infections.  

Neurosurg Clin N Am. 2017 Jan;28(1):91-102. doi: 10.1016/j.nec.2016.07.004.Classification and Management of Pediatric Subaxial Cervical Spine Injuries. Madura CJ, Johnston JM Jr.
 2016 Nov 22;16(1):364. Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time? Bang A, Patel A, Bellad R, Gisore P, Goudar SS, Esamai F, Liechty EA, Meleth S, Goco N, Niermeyer S, Keenan W, Kamath-Rayne BD, Little GA, Clarke SB, Flanagan VA, Bucher S, Jain M, Mujawar N, Jain V, Rukunga J, Mahantshetti N, Dhaded S, Bhandankar M, McClure EM, Carlo WA, Wright LL, Hibberd PL.
Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings based on a resuscitation program developed at UAB and shown to reduce neonatal mortality in low income settings. It is not known if refresher training is needed. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities. During pre-refresher training evaluation of 835 birth attendants at a mean of 6.7 (SD 2.49) months after the initial training, 99% passed the knowledge test, but the successful completion rate fell to 81% for resuscitation skills test. Characteristics associated with deterioration of resuscitation skills were BAs from tertiary care facilities, no prior resuscitation training, and the timing of training (initial vs. catch-up training).

Pediatr Res. 2016 Nov 28. doi: 10.1038/pr.2016.260. A Functional ATG16L1 (T300A) Variant is Associated with Necrotizing Enterocolitis in Premature Infants. Sampath V, Bhandari V, Berger J, Merchant D, Zhang L, Ladd M, Menden H, Garland J, Ambalavanan N, Mulrooney N, Quasney M, Dagle J, Lavoie PM, Simpson P, Dahmer M.
In a large multicenter cohort of preterm infants, a novel association was discovered between a hypomorphic variant in an autophagy gene (ATG16L1) and necrotizing enterocolitis (NEC). Our data suggest that decreased autophagy arising from genetic variation may confer protection against NEC

Pediatr Res. 2016 Nov 28. doi: 10.1038/pr.2016.259. Biomarkers associated with bronchopulmonary dysplasia/mortality in premature infants. Balena-Borneman J, Ambalavanan N, Tiwari HK, Griffin RL, Halloran B, Askenazi D.
Our ability to predict which infants will develop bronchopulmonary dysplasia in first days of life is limited, but could be enhance using novel biomarkers. Using an available clinical and urine biomarker database obtained from a prospective 113 infant cohort (birth weight ≤1200 g and/or gestational age ≤31 weeks), we found that urine clusterin and urine albumin were independently associated with BPD/mortality after controlling for gestational age (GA), small for gestational age (SGA), and intubation status (Independent OR for maximum clusterin was 9.2 (95% CI 3.3 - 32.8, P<0.0001). The area under the curve incorporating clinical factors and biomarkers was 0.941. Future studies are underway to validate these findings.

Ann Am Thorac Soc. 2016 Nov 29. Lumacaftor/Ivacaftor Treatment of Patients with Cystic Fibrosis Heterozygous for F508del-CFTR.
Rowe SM, McColley SA, Rietschel E, Li X, Bell SC, Konstan MW, Marigowda G, Waltz D, Boyle MP; VX09‐809‐102 Study Group.
This study showed that lumacaftor/ivacaftor, a combination of a corrector and potentiator of F508del CFTR function, was not sufficiently efficacious in patients heterozygous for F508del CFTR to be of clinical value, in contrast with patients homozygous for F508del. The improvement in biomarkers of CFTR activity and clinical status, along with the apparent gene dose effect, opens the door for testing more efficacious combinations in the future. UAB will be conducting such an effort in the next quarter.
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Copyright © 2016 The UAB Department of Pediatrics, All rights reserved.

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