NUCATS CTSA TL1 Fellows
Matthieu K. Chardon, MS, PhDMentor: Santhanam Suresh, MD
Charles J Heckman, PhD
Computer Controlled Pediatric Regional Anesthesia to Improve Patient Safety
Matthieu Chardon, PhD, will be developing a tool to measure the effectiveness of local anesthetic dosage in children with the goal of reducing dosage and increasing safety. “Regional anesthesia in pediatrics has dramatically increased over the past 30 years because it provides localized pain relief, diminishes opioid use and facilitates earlier mobilization, internal feeding and hospital discharge,” said Dr. Chardon. “It is also used frequently due to concerns about the effect of general anesthesia on brain development.” Nonetheless, Dr. Chardon explains that there are several concerns surrounding local anesthesia, and that there are no tools to determine its effectiveness or toxicity in real time. As a result, he is seeking to develop a solution in partnership with his mentors Santhanam Suresh, MD, Professor of Anesthesiology and Pediatrics, and Charles Heckman, MD, Professor of Physiology/Physical Medicine and Rehabilitation and Physical Therapy and Human Movement Sciences.
Bimal P. Chaudhari, MD, MPHMentor: Justin B Starren, MD/PhD
Aaron Hamvas, MD
Electronic Medical Record Integration of Genomic Testing Results
Bimal Chaudhari, MD, MPH, is developing a knowledge base that will deliver genomic testing results to non-geneticist clinicians via an electronic medical record. Many patients may benefit from genomic testing, but not all physicians feel prepared to take action based on the results of genetic testing. However, this new knowledge base will address this problem by offering clinical decision support that is patient specific and compatible with a physician’s workflow. “Right now, methods for DNA sequencing are fairly robust and well-developed but methods of sequence interpretation are evolving,” said Dr. Chaudhari. “The result is that, unlike an X-ray or blood culture, the interpretation of a sequencing test result can change over time. Results may also be more or less relevant at different points in time.” “The TL-1 program provides me the support I need to develop my knowledge base in this area and gain practical experience,” said Dr. Chaudhari. “I'm developing collaborations in fields I didn't even know existed a year ago. My hope is that this relatively novel collaboration is the foundation for sustained extra-mural research funding.”
Lajja Desai, MDMentor: Gregory Webster, MD, MPH
Michael Markl, PhD
Novel Non-Invasive cMRI Technique to Estimate Continuous Oxygen Saturations in Pediatric Heart Disease
Despite gains in survival, decreased quality of life and morbidity continue to be challenges in congenital heart disease (CHD). Until recently, blood oxygen content in the heart and central vessels (i.e., ‘oximetry’) has only been measured by an invasive technology: catheterization. However, this technique does not take into account complex streaming effects in complex CHD. The course and extent of deoxygenated blood streaming likely contributes to poor tissue growth and abnormal neurodevelopment. Non-invasive data obtained with cardiac magnetic resonance imaging (cMRI) has improved surveillance capabilities in these children and adults. Lurie Children’s and Northwestern University are leaders in advanced cMRI. Our long-term goal is to establish an accurate, non-invasive and non-Gadolinium-contrast cMRI technique (T2 mapping) to estimate continuous oxygen saturations in the heart and vasculature.
Michael Dominick DiVito, PhDMentor: Jason Albert Wertheim, MD/PhD
Differentiating Hepatocytes from iPSCs to Treat Pediatric Metabolic Liver Disease
Dr. DiVito will be studying ways to treat pediatric metabolic liver deficiencies using induced pluripotent (iPS) stem cells derived from liver cells. He plans to improve iPS cell differentiation protocols and to develop an infusion method for these cells with the overall goal of making both in vitro and living models of metabolic liver diseases that can be used to develop stem cell therapies and other treatments for these diseases. “I am excited at the potential of using stem cells with our lab’s bioreactor systems to develop disease models and cell therapies for pediatric metabolic diseases,” said Dr. DiVito. “With this award and the resources it offers, I feel I am in a great position to fulfill these goals. I am excited to see the output of this project after two years under the TL1 training program” Because the TL1 program promotes interdisciplinary mentorship, Dr. DiVito will be able to not only have the opportunity to enhance his engineering knowledge but also acquire new knowledge of hepatology, stem cell biology and other topics important to his research.
Alicia Lenzen, MDMentor: Derek A Wainwright, PhD
Alexander H Stegh, PhD
Rishi R Lulla, MD
A Novel siRNA Approach for Targeting Immunosuppresive IDO1 in Pediatric Brain Tumors
Alicia Lenzen, MD, will be studying a novel form of treatment for pediatric brain tumors that will use immunotherapy combined with nanotechnology. She will be researching the inflammation-induced expression of indoleamine 2,3 deoxygenase 1 (IDO1), its role in suppressing tumor immunity, and therefore its promising therapeutic reactivation of the immune response against brain tumors. Dr. Lenzen will also integrate nanotechnology as a direct delivery mode into central nervous system tumors in order to create precise targeting. “This TL1 training will facilitate the building blocks of that research foundation now, obtaining findings related to the development of novel treatment regimens using mouse brain tumor models, with the possibility of direct translation into patients,” said Dr. Lenzen. “It will also allow me a look into multi-disciplinary work in order to create the best projects.”
Yen-Sheng Lin, MS, PhDMentor: Yasin Y Dhaher, PhD
The Effects of tDCS on Abnormal Synergistic Coupling in Children with CP
Gait deviations in children with hemiplegic cerebral palsy are multifactorial including sagittal plane impairments at the ankle and knee combined with hip hiking and circumduction. These kinematic patterns are metabolically inefficient and may lead to significant musculoskeletal comorbidities including joint diseases. While it has been proposed that weakness, spasticity, and leg length discrepancy may contribute, the underlying factors remain unknown. We argue that these impairments may be a manifestation of aberrant motor coordination. The goal of this project is to construct a training paradigm to help shape the underlying motor sequence during gait in children with cerebral palsy with hemiparesis. The technique will leverage our understanding of the motor control of hemiparetic gait and neuromodulation for locomotor training.
Alina Yu-Hsin Rwei, PhDMentor: John Rogers, PhD
Aaron Hamvas, MD
Debra Weese-Mayer, MD
Innovative physiologic recording devices Skin Patch Sensors as a Substitute for Continuous Heart Rate and Blood Pressure Monitoring in the Neonatal Intensive Care Unit (NICU)
Millions of premature infants worldwide suffer from infant respiratory distress syndrome, which could be fatal. It is important to be able to detect the vital signals, such as blood oxygenation, blood pressure, and heart rate, in a safe and continuous manner. Current methods in the detection of neonatal blood flow are invasive, cumbersome and difficult to operate. In this project, I am developing a wearable, non-invasive skin patch for continuous monitoring of blood flow that could be mounted on the skin of neonates.
Michael G. Sherenian, MDMentor: Rajesh Kumar, MD
Ramana V Davuluri, PhD
Development of a Virtual Flow Cytometry for use on Longitudinal Large Cohort Studies
Michael Sherenian, MD, will be studying the association between whole methylome sequencing and T-cell subsets to identify and establish differences between these cells. In doing so, Dr. Sherenian wants to develop alternative ways to examine T-cell development and pathology in allergic diseases. “The skills that I develop through the program will promote my learning of asthma, allergic disease, and the immunologic basis of these conditions,” said Dr. Sherenian. “The experience will increase my knowledge of important research gaps, relevant epidemiological approaches, and understanding of data science.”
Susan M. Slattery, MDMentor: Karna Murthy, MD/MSCI
Process Vulnerabilities in Hospital Discharge after Neonatal Intensive Care Unit Stays
Dr. Slattery will be focusing her research on the timing of a safe transition home from the Neonatal Intensive Care Unit. Along with her mentors, she hopes to develop a valid, reliable predictive tool using data captured in the Electronic Health Record.
Khalid K. Alam, PhDMentor: Julius B. Lucks, PhD
TxDx: A Platform for Diagnostics Powered by Transcription
Ribonucleic acid (RNA) is a unique biomolecule with a diversity of functions. RNA can store and propagate genetic information, sense compounds in the environment (aptamers), regulate gene expression (riboswitches), and perform chemical reactions (ribozymes). RNA is also highly engineerable and can be evolved for a variety of new functions. Transcription, the conversion of a static DNA template to a dynamic RNA molecule, is therefore the key reaction that unlocks an assortment of biological function. Through the regulation of transcription and careful design of the functional end product, elaborate biological circuits can be constructed to sense and respond to a variety of compounds, including those for which current diagnostic paradigms fall short. The TxDx (Transcription Diagnostic) platform seeks to develop, validate and apply such RNA-based sensors for resource-limited settings and detection of medically relevant compounds. As a TL1 participant and father of two, Khalid is looking forward to collaborating with pediatric fellows to identify diagnostic challenges in child and adolescent health and apply the TxDx platform towards them.
Emily Cibelli, PhDMentor: Matt Goldrick, PhD
Vijay Mittal, PhD
Detecting speech motor disruptions in adolescents at high risk for psychotic disorders
Disruptions to cortico-cerebellar pathways in schizophrenia are argued to be a common source for certain cognitive, behavioral, and motor abnormalities in the disorder. Tracking cerebellar motor dysfunctions has been a promising diagnostic tool for assessing adolescents at high risk for psychosis, but who have not yet received a diagnosis. However, current motor assessments rely on specialized equipment and are not easily employed in non-research settings, restricting their clinical utility. Our project investigates whether subtle disruptions to speech motor control - a highly-regulated motor behavior that relies on the cerebellum - can also signal early risk in this population. We are developing signal processing tools for to enable fast, automatic processing of recorded speech, and will apply them to the assessment of speech acoustics as a potential biomarker for psychosis risk.
Tyler Ray, PhDMentor: John Rogers, PhD
Epifluidic Platform for Clinical Diagnostics via the Stimulation, Collection, and Analysis of Sweat
Sweat chloride testing is the gold standard technique for diagnosis of cystic fibrosis, a fatal, genetic disease affecting over 30,000 people in the United States. Current FDA approved screening technologies are cumbersome, have high rates of failure in collecting sufficient sample volumes, prone to chloride contamination, and are time consuming in both collection and lab analysis. The main objective of my work is to develop a superior diagnostic approach that integrates stimulation, collection, and analysis into a single epidermal platform providing both an improvement in diagnostic capabilities by decreasing analysis time, eliminating sources of contamination, improving repeatability and reliability.
Natalie Roebuck, MDMentor: Mark S Wainwright, MD, PhD
Daniel Abrams, PhD
Dynamic energy balance in the ICU
Natalie Roebuck is studying and developing novel energy equations used to estimate calorie and fluid goals at the bedside in the ICU. Current equations can under or over estimate calorie goals in the pediatric ICU population by up 400%. This level of inaccuracy in energy balance leaves patients vulnerable to malnutrition, infection, and prolonged mechanical ventilation. Along with collaborators in Applied Mathematics at Northwestern University, she will be developing and validating a novel equation to predict energy requirements in the pediatric ICU. She will validate this method in the Lurie Pediatric ICU and Pediatric Cardiac ICU while integrating dynamic physiologic data to improve our ability to account for dynamic energy change in critical illness. Natalie seeks to integrate clinical medicine with data science in order to gain usable knowledge at the bedside to improve care during pediatric critical illness.