The Incubator

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In this episode of “At the Bench”, we are interviewing one of our show’s co-hosts, Dr. David McCulley. David is a neonatologist and developmental biologist at the University of California, San Diego and in this show he talks about what motivated him to build a research program investigating the genetic and developmental mechanisms responsible for congenital diaphragmatic hernia (CDH). David directs an NIH-supported study to determine the genetic mechanisms responsible for abnormal lung and pulmonary vascular development in patients with CDH. He describes the mentorship and collaborative research experiences that have shaped his career path. David also talks about the work that he is doing along with the Society for Pediatric Research and the co-hosts of this program, Dr. Misty Good and Dr. Betsy Crouch, to encourage and promote pediatric physician-scientist career development.

 

Some highlighted papers:

 Stokes, G., Li, Z., Talaba, N., Genthe, W., Brix, M.B., Pham, B., Wienhold, M.D., Sandok, G., Hernan, R., Wynn, J., Tang, H., Tabima, D.M., Rodgers, A., Hacker, T.A., Chesler, N.C., Zhang, P., Murad, R., Yuan, J.X., Shen, Y., Chung, W.K., McCulley, D.J. Rescuing lung development through embryonic inhibition of histone acetylation. Science Translational Medicine. 2024 Jan 31;16(732). Epub 2024 Jan 31. https://pubmed.ncbi.nlm.nih.gov/38295182/

Qiao, L., Wynn, J., Yu, L., Hernan, R., Zhou, X., Duron, V., Aspelund, G., Farkouh-Karoleski, C., Zygumunt, A., Krishnan, U.S., Nees, S., Khlevner, J., Lim, F.Y., Crombleholme, T., Cusick, R., Azarow, K., Danko, M.E., Chung, D., Warner, B.W., Mychaliska, G.B., Potoka, D., Wagner, A.J., Soffer, S., Schindel, D., McCulley, D.J., Shen, Y., Chung, W.K. Likely damaging de novo variants in congenital diaphragmatic hernia patients are associated with worse clinical outcomes. Genetics in Medicine. 2020 Dec;22(12):2020-2028. https://pubmed.ncbi.nlm.nih.gov/32719394/

McCulley, D.J., Wienhold, M.D., Hines, E.A., Hacker, T.A., Rogers, A., Pewowaruk, R.J., Zewdu, R. Chesler, N.C., Selleri, L., Sun, X. PBX transcription factors drive pulmonary vascular adaptation to birth. Journal of Clinical Investigation. 2018 Feb 1;128(2):655-667. https://pubmed.ncbi.nlm.nih.gov/29251627/

Kardon, G., Ackerman, K., McCulley, D.J., Shen, Y., Wynn, J., Shang, L., Bogenschutz, E.L., Sun, X., Chung, W.K. Congenital diaphragmatic hernias: from genes to mechanisms to therapies. Disease Models & Mechanisms. 2017 Aug 1;10(8):955-970. https://pubmed.ncbi.nlm.nih.gov/28768736/

McCulley, D., Wienhold, M.D., Sun, X. “The pulmonary mesenchyme directs lung development.” Current Opinion in Genetics & Development. 2015 Jun;32:98-105. https://pubmed.ncbi.nlm.nih.gov/25796078/

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This episode of the Incubator Podcast, hosted by Ben and Daphna, delves into the significant impact of Point of Care Ultrasound (POCUS) in neonatal care. Featuring experts from the National Neonatal POCUS Collaborative, including Dr. Yogen Singh, Dr. Maria Fraga, Dr. Shazia Bhombal, and Dr. Sai Mukthapuram, the discussion focuses on the advancements in neonatal diagnostics and care through POCUS, the collaborative's goals for standardization and education, and the future of POCUS in enhancing outcomes for neonates.

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Jennifer Harling, a pediatrician and medical missionary in Burundi, shares her experiences and challenges in providing healthcare in a low-resource setting. She discusses the decision to do medical mission work, the background of Burundi and the hospital where she works, the language and cultural challenges she faced, and the improvements she has made in neonatal care. Dr. Harling also talks about staying inspired and connected, her role in medical education, and the importance of finding a balance between work and personal life.

 

Links mentioned in the episode

https://mccropders.blogspot.com

Dr. Harling’s contact: [email protected]

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. David Kaufman discusses his interest in pediatrics and infectious disease, particularly in the prevention and treatment of neonatal infections. He highlights the challenges of antibiotic use in the NICU and the interplay between probiotics, prebiotics, antibiotics, and infections. Dr. Kaufman emphasizes the need for better quality control and standardization of probiotics, as well as the importance of consent and shared decision-making in their use. He also discusses the potential benefits of lactoferrin in reducing necrotizing enterocolitis (NEC) and the future directions in infection management. The episode concludes with a discussion of the Neonatal Antibiotic Stewardship web app.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Jonathan Swanson discusses the evolution of neonatal nutrition and the major tenants of neonatal nutrition that have been learned over the years. He emphasizes the importance of breast milk and the role it plays in neurodevelopment and short-term outcomes. Dr. Swanson also explores the impact of necrotizing enterocolitis (NEC) on neonatal nutrition and the efforts to prevent NEC through good nutrition and optimizing homeostasis. The conversation then delves into the role of the maternal-fetal dyad in preparing the infant microbiome and the potential for probiotics to re-regulate the microbiome. The discussion concludes with a focus on the challenges and opportunities surrounding the use of probiotics in the NICU, including the role of families in decision-making and the impact of FDA regulations.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Jonathan Blau discusses the FDA warning on probiotics and its implications for the future of probiotic use in the NICU. He expresses mixed feelings about the FDA's involvement and highlights the need for regulation while also expressing concerns about the way the warning was issued. The debate between single-strain and multi-strain probiotics is also discussed, with Dr. Blau emphasizing the importance of using the triple strain recommended by ESPAGAN and AAP. He shares his experiences with rolling out probiotics in his NICU, including the decision-making process and the involvement of different disciplines. The administration and preparation of probiotics, as well as the consent and assent process, are also explored. Dr. Blau concludes by discussing the outcomes of probiotic use in his NICU and the ethical considerations surrounding the use of probiotics.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Jonathan Blau discusses the evidence for probiotics in the prevention of necrotizing enterocolitis (NEC) in the neonatal intensive care unit (NICU). He explains that the history of probiotics in neonatology spans almost 20 years, with meta-analyses showing a significant reduction in NEC rates. The pathophysiology of NEC is related to dysbiosis in premature infants, and probiotics aim to restore a healthy microbiome. The use of probiotics varies internationally, with Europe and Canada having higher rates of use compared to the United States. Dr. Blau also discusses the optimal study design for probiotics and the potential benefits beyond NEC prevention.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of the Incubator Podcast, Ben and Daphna discuss maternal mental health with Maureen Fiora, CEO of Mammha, a femtech startup aimed at revolutionizing maternal mental health care. Mammha focuses on addressing postpartum and perinatal depression by improving identification, diagnosis, referral, and treatment processes. Maureen shared her personal journey, highlighting the significant gaps in current healthcare systems regarding maternal mental health, emphasizing that less than 20% of physicians screen for these conditions. She detailed how Mammha streamlines screening with technology and ensures that women who screen positive receive comprehensive follow-up care, overcoming the usual fragmentation in care pathways.

The conversation also touched on the importance of screening in NICUs due to the heightened vulnerability of parents there, with Mammha capturing significant data on both mothers and fathers experiencing mental health issues. Maureen explained how Mammha operates, starting with provider-initiated screening using QR codes and validated tools, to engaging care coordinators for immediate follow-up. The company's success stories include partnerships and awards for their innovative approach to closing care gaps, especially among underserved populations.

Mammha's model has significantly increased engagement and follow-up care for screened parents, showcasing a promising pathway to better maternal mental health outcomes. Maureen's background in policy and advocacy, combined with personal experience, positions her uniquely to lead this initiative, aiming to make a tangible difference in the lives of parents navigating the challenges of mental health during the perinatal period.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this week’s episode of The Incubator Podcast, hosts Ben Courchia, MD, and Daphna Yasova Barbeau, MD, dive into the complex world of neonatal care for infants with congenital heart disease. 

Our guest, Dr. Nim Goldshtrom, shares insights from his extensive experience in neonatology and pediatric cardiac intensive care, focusing on the multidisciplinary approach to caring for the sickest infants at Columbia University Irving Medical Center and Morgan Stanley Children’s Hospital. Dr. Goldshtrom discusses the evolution of his career, the importance of specialized training for dealing with congenital heart disease in neonates, and how modern technology like near-infrared spectroscopy (NIRS) is being used to improve patient outcomes. The conversation also touches on the challenges and opportunities presented by genetic screening and the future directions of neonatal and congenital heart disease care. Join us for an enlightening discussion that sheds light on the nuanced care required for these vulnerable patients and the ongoing advancements in the field.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Hello Friends,

We have a new episode of journal club for you this week. On this episode Ben & Daphna review the latest research in neonatology, and welcome the EBNEO team for a new commentary. The articles reviewed this week include:

Esophageal versus Rectal Temperature Monitoring during Whole-body Therapeutic Hypothermia for Hypoxic-ischemic Encephalopathy: Association with Short and Long-term Outcomes. Wu TW, Schmicker R, Wood TR, Mietzsch U, Comstock B, Heagerty PJ, Rao R, Gonzalez F, Juul S, Wu YW.J Pediatr. 2024 Feb 1:113933. doi: 10.1016/j.jpeds.2024.113933. Online ahead of print.PMID: 38309524 Free article.

Neonatal Outcomes After COVID-19 Vaccination in Pregnancy. Norman M, Magnus MC, Söderling J, Juliusson PB, Navér L, Örtqvist AK, Håberg S, Stephansson O.JAMA. 2024 Feb 6;331(5):396-407. doi: 10.1001/jama.2023.26945.PMID: 38319332

Maternal syphilis rates tripled in the US between 2016 and 2022, data show. Tanne JH.BMJ. 2024 Feb 15;384:q416. doi: 10.1136/bmj.q416.PMID: 38359912 No abstract available.

 Therapeutic hypothermia for preterm infants 34-35 weeks gestational age with neonatal encephalopathy. Kim SH, El-Shibiny H, Inder T, El-Dib M.J Perinatol. 2024 Jan 16. doi: 10.1038/s41372-024-01874-x. Online ahead of print.PMID: 38228763

Randomised study of a new inline respiratory function monitor (Juno) to improve mask seal and delivered ventilation with neonatal manikins. Tracy MB, Hinder M, Morakeas S, Lowe K, Priyadarshi A, Crott M, Boustred M, Culcer M.Arch Dis Child Fetal Neonatal Ed. 2024 Feb 9:fetalneonatal-2023-326256. doi: 10.1136/archdischild-2023-326256. Online ahead of print.PMID: 38336472

Dextrose gel prophylaxis for neonatal hypoglycaemia and neurocognitive function at early school age: a randomised dosage trial. Wei X, Franke N, Alsweiler JM, Brown GTL, Gamble GD, McNeill A, Rogers J, Thompson B, Turuwhenua J, Wouldes TA, Harding JE, McKinlay CJD; pre-hPOD Early School-age Outcomes Study Group.Arch Dis Child Fetal Neonatal Ed. 2024 Feb 12:fetalneonatal-2023-326452. doi: 10.1136/archdischild-2023-326452. Online ahead of print.PMID: 38307710

Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk: a randomised controlled trial. Jensen, G. B., Domellöf, M., Ahlsson, F., Elfvin, A., Navér, L., & Abrahamsson, T. eClinicalMedicine (2023).

Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula: A Randomized Clinical Trial. Colaizy TT, Poindexter BB, McDonald SA, et al. JAMA. 2024;331(7):582–591. doi:10.1001/jama.2023.27693

EBNEO Commentary: De-MIST-ifying the 2-year outcomes of non-invasive surfactant therapy. Loft L, Ferguson KN, Tingay DG. Acta Paediatr. 2024 Jan 25. doi: 10.1111/apa.17116. Online ahead of print.

 

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!