Dates: October 9-10, 2020

The 2020 12th Annual CHOP Global Health Conference will explore how politics, governance, and leadership affect global child health. In low-, middle-, and high-income countries around the world, these key factors influence health systems in powerful ways, and affect healthcare delivery. This meeting will bring policy, political science and global child health experts together to share approaches for working with and within various political systems to positively impact child health. The meeting will also challenge and equip attendees to become advocates for child health within their own systems at the local, national, and international levels. Learn more and register here.

Date: October 14, 2020

Time: 4:30 - 6:00 pm

Join the Drexel University Dornsife School of Public Health for the virtual Jonathan Mann Health and Human Rights Memorial Lecture 2020 featuring Mary T. Bassett, MD, MPH, who has dedicated her career to advancing health equity. Learn more and register here.

Note: this event has been rescheduled from October 8th. Please join the University of Pennsylvania's Fels Institute of Government for a virtual conversation with Dr. Rachel Levine, Secretary of the PA Department of Health. Learn more and register here.

Date: October 16, 2020

Time: 1:00 - 3:00 pm

Join the Penn Center for Statistics in Big Data to delve Into EHR data and new linkages in public data sources. Learn more here.

Featured speakers include Bill Gates and Anthony S. Fauci, MD. Learn more and register here. 

Dates: October 19-21, 2020

Join researchers, educators, clinicians and patients to learn about the latest work to drive diagnostic quality and safety. Virtual education events will include keynotes, breakout sessions, oral abstracts, and poster sessions. Learn more and register here.

Date: October 21, 2020

Time: 1:00 - 2:30 pm

Join the National Academies of Science, Engineering, and Medicine for the release of its new report, which will review the available data and future research needs relevant to persons of diverse sexualities and genders, and persons with differences in sex development, across multiple dimensions over the course of their lives. Learn more and register here.

Dates: October 21-25, 2020

Given the evolving global pandemic, IDWeek organizers have made the unanimous decision to convert the meeting to a 100% virtual event. Receive the latest updates on COVID-19 and other infectious diseases through an exciting and content-rich virtual program. Learn more about the virtual program or register now. Anthony S. Fauci, MD, FIDSA will deliver the opening presentation during the Chasing the Sun event on Oct. 21 at 10 a.m. ET.

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: 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.

Elizabeth Lowenthal, MD, MSCE and her colleagues aimed to identify and evaluate interventions for youth with neurocognitive deficits in resource-limited settings. A systematic review of peer-reviewed literature was conducted within five databases, yielding 19 articles. Interventions included strategies involving caregiver training, computerized and non-computerized cognitive training, physical activity, and nutritional supplementation. Interventions were administered in medical facilities, educational facilities, or the home. The majority of the interventions targeted the domains of memory and attention. Overall, the efficacy of interventions was inconsistent. Results indicated that the relationship between cognitive improvement and intervention types was not consistent across cognitive domains. Some strategies demonstrated clinically- and statistically-significant improvement in cognitive function among specific groups of children.

Pollen from trees, grasses, and weeds can trigger asthma exacerbation in sensitized individuals. Chén Kenyon, MD, MSHP and colleagues described the local association between pollen and asthma exacerbation among children in the City of Philadelphia, and evaluated whether effects are modified by children's characteristics and clinical factors. They conducted a time-stratified case-crossover study of pediatric asthma exacerbation, with cases identified through electronic health records (EHR) of the CHOP health system. There was an inverse association (reduced asthma exacerbation) with ragweed pollen that was consistent across analyses. Pollen from other weeds was associated with increased odds of asthma exacerbation, without a clear exposure-response pattern. Increased odds from tree pollen and weeds (other than ragweed) were higher among children with allergic rhinitis.

Children with complicated appendicitis, osteomyelitis, and complicated pneumonia have historically been treated with postdischarge intravenous antibiotics (PD-IV) using peripherally inserted central catheters (PICCs). However, the extent to which use of PD-IV has since changed for these conditions is not known. Ron Keren, MD, MPH and his team used a national children's hospital database to evaluate trends in PD-IV during 2000-2018 for these three conditions. PD-IV decreased from 13% to 2% for complicated appendicitis, 61% to 22% for osteomyelitis, and 29% to 19% for complicated pneumonia. Despite these overall reductions, substantial variation in PD-IV use by hospital remains in 2018.

Kathleen Chiotos, MD, MSCE, Fran Balamuth, MD, PhD, and their colleagues ran a retrospective single-center study to compare presenting clinical and laboratory features among children meeting the surveillance definition for multisystem inflammatory syndrome in children (MIS-C) across a range of illness severities. They describe 3 groups with inflammatory syndromes during the SARS-CoV-2 pandemic. The initial profile of lymphopenia, thrombocytopenia, hyponatremia, and abnormal creatinine may help distinguish critically ill MIS-C patients from classic/atypical KD or more benign acute inflammation.

Participation in early intervention (EI) differs by child race, ethnicity, language, and sex. This study by Kate Wallis, MD, MPH, Whitney Guthrie, PhD, and colleagues evaluated disparities in rates of referral to EI and estimated the factors associated with referral before and immediately after a positive developmental screen. Children were included if they screened positive on the Survey of Well-being of Young Children (SWYC) Milestones during a 16- to 30-month well-child visit. Among children who screened positive, 17.5% were already in EI, and 39.9% were referred to EI during the visit with positive screen; 42.5% were not referred. The following factors were associated with being in EI before the positive screen: lower SWYC score and being male, older, and White. The following factors were associated with new referral to EI during a visit with positive SWYC: having lower SWYC score or lower income and being male, older, and Black race.

Fran Balamuth, MD, PhD and her team ran an observational cohort study to describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and the identified patients and to evaluate the definition using a published framework for evaluating sepsis definitions. The Improving Pediatric Sepsis Outcomes Sepsis definitions demonstrated strengths in content validity, convergent construct validity, and criterion validity; weakness in reliability. Improving Pediatric Sepsis Outcomes Sepsis definitions had significant initial measurement burden; timeliness improved once data capture was established.

Strain analysis with speckle-tracking echocardiography shows promise as a screening tool for silent myocardial dysfunction in pediatric-onset systemic lupus erythematosus (pSLE). Joyce Chang, MD, MSCE, Pamela Weiss, MD, MSCE and their colleagues compared left ventricular (LV) systolic deformation (measured by strain) in children and adolescents with pSLE to controls, and assessed the relationship between strain, disease activity, and other noninvasive measures of cardiovascular health. Their results showed that longitudinal myocardial deformation is impaired in pSLE patients despite clinical remission and may represent early myocardial damage.

Researchers including Stephanie Doupnik, MD, MSHP ran a retrospective cohort analysis of US rural children to identify where rural children with mental health conditions are hospitalized and to determine differences in outcomes based upon location of hospitalization. Adolescent males living in poverty with externalizing behavior disorder had the highest percentage (69.4%) of hospitalization at rural hospitals. Although hospitalizations at children's and metropolitan non-children's hospitals were longer, patient outcomes were more favorable.

Sagori Mukhopadhyay, MD, MMSc and her colleagues wrote a review on the neonatal intestinal tract, the initial colonization of which is influenced by delivery mode, feeding, the maternal microbiota, and a host of environmental factors. After birth, the composition of the infant's microbiota undergoes a series of significant changes particularly in the first weeks and months of life ultimately developing into a more stable and diverse adult-like population in childhood. Intestinal dysbiosis is an alteration in the intestinal microbiota associated with disease and appears to be common in neonates. Strong circumstantial evidence and limited confirmations of causality suggest that dysbiosis early in life can influence the health of the infant acutely, as well as contribute to disease susceptibility later in life.

Urinalysis, liver enzymes (LE) and lipase are used to screen for abdominal injuries in children with suspected physical abuse (SPA). However, data on the utility of urinalysis is limited. Joanne Wood, MD, MSHP and her team ran a retrospective analysis to describe the prevalence of hematuria in evaluations for SPA. Their results showed that Hematuria alone did not lead to detection of kidney injury. Test characteristics of hematuria were largely similar or inferior to LE and lipase.

Vancomycin is eliminated via glomerular filtration, but current approaches to estimate kidney function in children are unreliable. Kevin Downes, MD and his colleagues ran a prospective observational study to compare the suitability of cystatin C (CysC)-based glomerular filtration rate equations with the most commonly used creatinine-based equation, bedside Schwartz, to estimate vancomycin clearance (CL). Their analysis showed that CysC-based equations help better estimate vancomycin CL than bedside Schwartz in critically ill children.

Appendicitis is the most common surgical condition in pediatric emergency department (ED) patients. Prompt diagnosis can reduce morbidity, including appendiceal perforation. Robert Grundmeier, MD, Scott Lorch, MD, MSCE, and their colleagues ran this retrospective cohort study to measure racial/ethnic differences in rates of: 1) appendiceal perforation; 2) delayed diagnosis of appendicitis; 3) diagnostic imaging during prior visit(s). Results showed racial disparities in appendiceal perforation. There were also racial disparities in rates of delayed diagnosis of appendicitis and diagnostic imaging during prior ED visits. These disparities in diagnostic imaging may lead to delays in appendicitis diagnosis, and thus, may contribute to higher perforation rates demonstrated among minority children.

The Fontan operation or the total cavopulmonary connection is a palliative surgery for single ventricle congenital heart disease where the systemic venous return circumvents a pumping chamber and flows directly into the pulmonary circuit. With surgical and medical advances, there has been improvement in life expectancy of these patients but also unique complications from the physiology that requires diligent surveillance. A critical component relies on optimal imaging for diagnosis and treatment of these complications. This article by Hansel Otero, MD and colleagues describes the normal anatomy of the Fontan circulation, current imaging modalities and techniques, and frequently encountered complications seen when imaging the patients who have undergone Fontan palliation.

Dual-energy computer tomography (DECT) technology has experienced rapid growth in recent years, now allowing for the collection of 2 CT data sets and opening the potential for functional data acquisition. In children, DECT is of particular interest because it has been shown to be dose neutral in most applications, dose-reducing in multiphase studies, and to increase the contrast to noise ratio in suboptimal studies. Hansel Otero, MD and his colleagues review the basics of acquisition, postprocessing, and thoracic applications of DECT with a focus on pulmonary blood volumes as a surrogate for perfusion imaging. The discussed applications include pulmonary embolism, hypoplastic lung, pulmonary hypertension in bronchopulmonary dysplasia, and pediatric lung masses.

A relatively small proportion of children with asthma account for an outsized proportion of health care use. Researchers including Chén Kenyon, MD, MSHP, Douglas Strane, MPH, Chandler Floyd, and David Rubin, MD, MSCE sought to use quality improvement methodology to reduce repeat emergency department (ED) and inpatient care for patients with frequent asthma-related hospitalization. This multidisciplinary quality improvement intervention reduced health care use in a high-risk asthma population, which was confirmed by using quasi-experimental methodology. The authors provide a framework to analyze broader interventions targeted to frequently hospitalized populations.