Humanitarian Award, Psychosis with 22q11.2 Deletion, Antibiotic Stewardship, Continuous Glucose Monitoring, New Algorithm for DNA Methylation

By Emily Shafer

This week’s roundup of research headlines includes a Humanitarian Award for Tami Benton, MD, a link between language assessment in childhood and psychosis in 22q11.2 deletion syndrome, and a clinician intervention that reduces antibiotic prescribing for acute respiratory infections. Other highlights include youth involvement in continuous glucose monitoring decisions, and a new algorithm that identifies sites of DNA methylation.

Tami Benton Receives 2020 Humanitarian Award

Tami Benton, MD, psychiatrist-in-chief and chair of the Department of Child and Adolescent Psychiatry and Behavioral Sciences at CHOP, received the 2020 Humanitarian Award by The Society of Biological Psychiatry. This award recognizes individuals who have demonstrated service and advocacy for mental illness.

“My journey toward a career in academic psychiatry has not been a typical one,” Dr. Benton said in her acceptance speech online. “As a first-generation college graduate and an African American woman, medical school was not predicted for me and psychiatry was unknown to me until I reached medical school. I did not know at the time that treating the psychiatric disorders of children and families would become my life’s work, and that advocacy for vulnerable and suicidal youth would become my career.”

Dr. Benton is also an associate professor of Psychiatry at Perelman School of Medicine at the University of Pennsylvania. Her research focuses on pediatric mood and anxiety disorders, sickle cell disease and psychiatric conditions, HIV and psychiatric conditions, neuroimmunology and mood disorders, health services research, eating disorders, and ethnically diverse children.

Language Assessment Performance Linked to Psychosis in 22q11.2 Deletion Syndrome

Poorer performance on language assessment in childhood was linked to later psychosis symptoms among individuals with 22q11.2 deletion syndrome, researchers from CHOP found.

Cynthia Solot, MA, CCC-SLP, senior speech-language pathologist and co-director of the Velopharyngeal Dysfunction Program at CHOP, is first author of the study that appeared in the American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics. Donna M. McDonald-McGinn, MS, CGC, chief of the Section of Genetic Counseling and director of the 22q and You Center at CHOP, and Raquel E. Gur, MD, PhD, psychiatrist at CHOP and professor of Psychiatry Neurology and Radiology at the University of Pennsylvania Perelman School of Medicine, are co-senior authors of the study.

The researchers evaluated associations between early language measures and psychosis spectrum symptoms an average of 10.1 years later, in 166 youths with 22q11.2 deletion syndrome, which is associated with an increased risk for schizophrenia spectrum disorders.

“Such data are needed for elucidating a lifespan trajectory for affected individuals and may help understand pathways to psychosis applicable to the general population,” the researchers wrote.

Clinician Intervention Reduced Antibiotic Prescribing for Pediatric Respiratory Infections

An intervention in which clinicians received online tutorials and webinars about antibiotic prescribing, as well as individual antibiotic prescribing feedback reports, reduced antibiotic prescribing during outpatient visits for pediatric acute respiratory tract infections (ARTIs), according to a study that appeared in Pediatrics.

CHOP researchers involved in the study included Jeffrey S. Gerber, MD, PhD, associate chief clinical research officer, CHOP Research Institute and Distinguished Chair in the Department of Pediatrics; Robert Grundmeier, MD, director of Clinical Informatics in the Department of Biomedical and Health Informatics at CHOP; and Alexander Fiks, MD, MSCE, Distinguished Chair in the Department of Pediatrics. Drs. Gerber, Fiks, and Grundmeier are also faculty with the Clinical Futures.

The study was a stepped-wedge clinical trial in which 19 pediatric practices were assigned to four wedges. The intervention included three program modules that contained online tutorials and webinars on evidence-based communication strategies and antibiotic prescribing, booster video vignettes, and individualized antibiotic prescribing. The researchers found a 7 percent decrease in the probability of antibiotic prescribing for ARTIs after the intervention.

“Providing online communication training and evidence-based antibiotic prescribing education in combination with individualized antibiotic prescribing feedback reports may help achieve national goals of reducing unnecessary outpatient antibiotic prescribing for children,” the researchers wrote.

Youth Involved in Continuous Glucose Monitoring Decisions More Likely to Use It

Youth with diabetes who are involved from the start in deciding to use continuous glucose monitoring (CGM) are more likely to continue using the tool, CHOP researchers found.

“To maximize the clinical benefits of CGM, our results suggest that providers should involve youth in the decision-making process from the beginning, eliciting their opinions, concerns, and questions about the device and providing information about the device directly to them,” said Victoria A. Miller, PhD, a psychologist in the Craig-Dalsimer Division of Adolescent Medicine at CHOP. “Parents also have a role to play, and providers can encourage parents to engage their children in conversations about the decision to start CGM without dominating the discussion, which may increase the likelihood that they are in agreement about waiting or proceeding.”

In the study, which appeared in Diabetes Care, Dr. Miller and colleagues found that when the children spoke up more in discussions about CGM, they used it more regularly up to 12 weeks after starting CGM. However, if parents spoke up more, children used the technology less frequently two months later.

Read more about the findings in this CHOP press release.

New Algorithm Helps Identify Sites of DNA Methylation

Researchers at CHOP, in collaboration with researchers from New Jersey Institute of Technology, used machine learning to develop an algorithm that helps predict sites of DNA methylation, and could identify disease-causing mechanisms that may be missed with conventional screening methods.

DNA methylation is a process that can change the activity of DNA, and it is involved in many cellular processes. Errors in methylation can cause a variety of human diseases. Current tools, such as genomic sequencing, are unable to capture the effects of methylation.

“Previously, methods that had been developed to identify these methylation sites in the genome were very conservative and could only look at certain nucleotide lengths at a given time, so a large number of methylation sites were missed,” said Hakon Hakonarson, MD, PhD, director of the Center for Applied Genomics at CHOP, and one of the senior co-authors of the study, which appeared in Nature Machine Intelligence.

“We needed to develop a better way of identifying and predicting methylation sites with a tool that could identify these motifs through the genome that may have a robust functional impact and are potentially disease causing.”

Learn more about the algorithm and the study in the CHOP press release.

ICYMI

Catch up on our headlines from our July 31 In the News:

• COVID-19 Projections: Resurgence Continues Spread to Northeast
• CHOP and Penn Study Team Identify Disparity in Virus Exposure in Pregnant Women
• Researchers Refine Gene-delivery Technique to Reach Whole Brain
• Pulse Oximetry Monitoring Paper Among Top 10 in Field of Pediatric Hospital Medicine
• Improving Injury Prevention Counseling During Doctor Visits

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