UMKC health professions students learn together in large simulation

UMKC students in the schools of Dentistry, Medicine, Nursing and Health Studies and Pharmacy participated in a large-scale poverty simulation.

In Kansas City, nearly one in five residents live below the poverty line — a harsh reality shared by many patients UMKC students see on Hospital Hill and beyond.

To better understand the challenges and frustrations of those living in poverty, students participated in a large-scale poverty simulation, part of the Interprofessional Education (IPE) program on the UMKC Health Sciences campus.

In November, more than 100 UMKC medical, nursing, pharmacy and dental students, along with faculty and volunteers, joined to experience the virtual realities of poverty and its effects on patients. The simulation was designed to incorporate IPE, an emerging teaching approach addressing the future of health care, in which a close-knit team of dentists, physicians, nurses and pharmacists provides personalized, integrated attention to patients.

In the simulation, one of five such sessions this fall, students role-played living for a month in poverty, with each “week” lasting 15 minutes. The goals were to keep their home, pay all bills, hold down jobs and feed their family and children each day – all while managing issues such as an illness in the family, a stolen car and expenses to repair their plumbing.

Students could rely on stations around the room, such as employers, a grocery store, a health care center, social services, a pawn shop and a quick cash outlet, to help them meet their goals. Following the simulation, the group members spent time sharing their experiences and discussing lessons learned.

”It was sad to realize that all my time was spent thinking about just getting the minimum needs taken care of, and that sometimes even the minimum isn’t enough,” one student said.

Interim Chancellor and Provost Barbara A. Bichelmeyer addressed the participants after observing the simulation. She noted that the first place people went was the employer, and that many sought help from the pawn shop rather than turning to other resources. And the one station that didn’t get much business? The medical center, a point not lost on the room full of future health-care providers.

“Today’s program shows poverty is not about people not being well-intentioned, but about people not being well-resourced,” Bichelmeyer said.

The simulation, created by the Missouri Association for Community Action, was created to help people — such as future health-care providers — understand the challenges of living in poverty day to day. It lets participants look at poverty from a variety of angles and then discuss the potential for change within their communities.

The UMKC Health Sciences IPE program is directed by Stefanie Ellison, associate dean for learning initiatives at the UMKC School of Medicine and emergency physician at Truman Medical Centers; and Valerie Ruehter, director of experiential learning and clinical assistant professor for the UMKC School of Pharmacy.

According to Ellison, who coordinated the simulation with Ruehter, the day purposely included data about poverty in Missouri.

“The activity is very personal and designed to have students walk in the shoes of someone in poverty,” Ellison said. “The takeaway is to empathize with our patients and learn very specifically about the problems our patients face.”

Ruehter agrees.

“We sometimes get frustrated when our patients aren’t doing what we asked them to do or don’t show up for clinic appointments,” Ruehter said. “This is an opportunity for students to come together and wear the other shoe, to see that it’s not always as easy as we think it might be. We can create individual practitioners, but in health care today, it takes an entire team to create positive patient outcomes. With IPE, we give students the chance to become familiar with what every discipline brings to the table, which hopefully will make a more seamless health care system.”

That’s a goal of IPE, Ellison said. “If we have our students learning in silos, but they are expected on day one in practice to begin working together as a team, then we haven’t really done our job. At UMKC, we are breaking down those silos.”

At the conclusion of the simulation, students heard a call to action: to do more, learn more, go where the patients are and ask how you can help change the system, even a little bit.

“If what we do at UMKC is to help our health-care professionals in the future think about the humanness of the people they are working with, both their peers and their patients, then I think we will have made a really significant contribution,” Bichelmeyer said.

Research office announces eight Sarah Morrison Award recipients

October 2017 Sarah Morrison student research award recipients:
Jonah Graves, Jonathan Jalali, Kelly Kapp, Landon Rohowetz, Subhjit Sekhon, Mehr Zahra Shah, Yevgeniy Khariton and Krishna Patel.

The School of Medicine Student Research Program has announced six medical students and two students from the biomedical and health informatics program as recipients of the Fall 2017 Sarah Morrison Student Research Award.

The awards support student research efforts and help fund presentations at conferences and scientific meetings.

Medical students who received the awards are Jonah Graves, fifth-year; Jonathan Jalali, third-year; Kelly Kapp, sixth-year; Landon Rohowetz, fourth-year; Subhjit Sekhon, fifth-year; and Mehr Zahra Shah, fourth year. Two recipients, Yevgeniy Khartion and Krishna Patel, are graduate students in the school’s Department of Biomedical and Health Informatics.

Sarah Morrison awards of up to $2,500 are presented each year in October and April. More than 100 students have received an estimated $104,669 in financial support from the program to conduct research projects at the School of Medicine.

Students interested in the Sarah Morrison awards are encouraged to apply prior to the April 1 and Oct. 1 deadlines each year. Applicants are reviewed by a committee of faculty judges and processed through the Office of Research Administration.

For complete application information, visit the student research website.

Fall 2017 Sarah Morrison Research Awards
(Recipients, Project titles, Mentors)
  • Jonah Graves, MS 5, Mechanism for FGF23 induced mechanical alternans in mouse hearts, Mike Wacker
  • Jonathan Jalali, MS 3, Retinal blood vessel morphometry as a biomarker for progression of diabetic retinopathy to diabetic macular edema and neovascular complications, Peter Koulen
  • Kelly Kapp, MS 6, Glycocalyx Production by Viridans Streptococci Causing Endocarditis: Assessment of the Tryptophan Assay as a Marker to Predict Disease, Lawrence Dall
  • Landon Rohowetz, MS 4, The role of innate immune system signaling pathways in age-related macular degeneration pathogenesis, Peter Koulen
  • Subhjit Sekhon, MS 5, Identification of Gene Expression, Ferdaus Hassan
  • Mehr Zahra Shah, MS 4, The role of estrogen hormone signaling pathways in glaucoma pathogenesis, Peter Koulen
  • Yevgeniy Khartion, DBHI, Patterns of Intravenous Fluid and Diuretic Co-Administration in Acute De-Compensated Heart Failure: Insights from the Health Facts Registry, John Spertus
  • Krishna Patel, DBHI, Imaging findings associated with potential survival benefit with early revascularization in patients undergoing stress myocardial perfusion imaging using Positron emission Tomography for suspected coronary ischemia, Timothy Bateman

SOM announces interim chair of psychiatry

Dr. Stephen Jarvis

The UMKC School of Medicine has announced that Stephen Jarvis, M.D., will serve as interim academic chair of the UMKC Department of Psychiatry.

Jarvis received his medical degree from University of Missouri-Columbia, and completed residency and fellowship training from the Western Psychiatric Institute and Clinic in Pittsburgh, Pennsylvania.

As a UMKC faculty member, Jarvis has held multiple administrative positions at Truman Medical Centers and at the former Western Missouri Mental Health Center. He serves as the associate chief medical officer and Clinical Department Chair for Psychiatry at Truman Medical Centers.

Jarvis assumed his new role on November 20, 2017.

He replaces Nash Boutros, M.D., who served as chair of the UMKC Department of Psychiatry and  medical director for the Center for Behavioral Medicine from 2014 to 2017. Boutros, a professor of psychiatry, holds tenure in the department of Biomedical and Health Informatics. Boutros will remain at UMKC to continue his research program.

Gummi, Nizamuddin take Kansas City Free Eye Clinic to national stage

Ravali Gummi spoke about the Kansas City Free Eye Clinic during the opening session of the 2017 Clinton Global Initiative University.

Volunteers with the student-operated Kansas City Free Eye Clinic (KCFEC) are working to extend free eye care to the city’s refugee community. The plan took a national stage in October when Ravali Gummi, a sixth-year medical student at UMKC, pitched the idea to more than 1,200 college students from across the globe and national leaders at the Clinton Global Initiative University.

Ravali Gummi, middle, and Imran Nizamuddin, right, met with Dr. Vivek Murthy, the 19th Surgeon General of the United States, at the Clinton Global Initiative University.

The annual meeting is an event of the Clinton Foundation that brings together young visionaries from across the globe to discuss and explore global challenges.

Gummi serves as student clinic director of the KCFEC. Imran Nizamuddin, a fifth-year medical student, is the organization’s communications director. Both were invited to attend this year’s Clinton Global Initiative University in Boston based on a Commitment to Action plan submitted on behalf of the KCFEC.

In addition to being selected to attend the national meeting, their action plan, “A Vision for Our Refugees: The Efforts of a Free Eye Clinic,” was one of just five chosen for presentation on the main stage during the meeting’s opening session.

After making her presentation (that begins at 37:35 of the video), Gummi had the honor of shaking hands with former President Bill Clinton.

“The opportunity to speak on stage prompted many conversations through the rest of the weekend, as students approached us to ask more about our free eye clinic or to share their own efforts,” Gummi said.

In her presentation, Gummi explained how the KCFEC has treated more than 3,100 patients and distributed more than 1,000 pairs of free eye glasses since its inception eight years ago. Five years ago, the clinic moved to a location densely populated with homeless shelters to target local underserved populations.

“This year, we are seeking to reach the increasing number of refugees entering the Kansas City area and enhance their access to eye health care,” Gummi said.

During the Clinton Global Initiative University program, Gummi and Nizamuddin networked with other students, met with national leaders and learned about the diverse array of global challenges facing the world.

In 2009, KCFEC began in part as a commitment from Clinton Global Initiative University with a grant from the foundation. About 30 volunteers, including UMKC medical and physician assistant students, and Kansas City University of Medicine and Biosciences students, actively participate in the KCFEC.

In addition to the initiative to expand eye care to the refugee community, Gummi said the clinic is working toward starting a new mobile eye clinic to better serve patients for whom transportation is a barrier.

Celebrating lives saved by TMC lung cancer screening

Dr. Justin Stowell, a radiology resident at Truman Medical Center, talked about the success of an early lung cancer screening program he leads.

The UMKC Health Sciences District marked Lung Cancer Awareness Month on Thursday with “Smokin’ Out Lung Cancer,” a midday event that outlined the district’s early lung cancer screening, treatment and prevention efforts, led by Truman Medical Centers.

TMC’s screening program emphasizes early detection and treatment for longtime smokers and ex-smokers. The event Thursday celebrated its patients’ and doctors’ success in committing to healthy living and saving lives. The screening program uses low-dose CT scans and is the only one in the nation to be driven by resident physicians, who are supervised by faculty from the UMKC School of Medicine.

Among the speakers at the event was Dr. Justin Stowell, the radiology resident who started the screening program and who has compiled statistics on its early success. When lung cancer is detected in its early stage, he said, cure rates of 70 to 80 percent are possible.

And besides catching lung cancer early, Stowell said TMC’s  program has had success in getting more than one-fifth of the people tested to quit smoking.

Lung cancer is responsible for 155,000 U.S. deaths a year, more than breast, prostate and colon cancer combined, which emphasizes the need for awareness events such as “Smokin’ Out Lung Cancer.” Stowell also noted that Medicare covers the early screening for many longtime smokers, and insurance companies have been adding coverage as the success of the screenings has been demonstrated.

The event, which included a barbecue lunch, was attended by some lung cancer survivors who had benefited from the screenings and subsequent treatment or surgery to remove their cancer. A video was shown that told the survival story of Thaddus Owens, who was at the luncheon.

The event also drew some smokers whose doctors had encouraged them to attend. One of them was 64-year-old Carl Kendall, who said he had tapered off in recent years but still smoked at least half a pack a day.

“I started smoking in 1968,” he said. “I have a doctor’s appointment next week, and I’m going to ask about this screening.”

Charlie Shields, TMC president and CEO, kicked off the presentations. Besides highlighting the screening program’s success, he noted that “Smokin’ Out Lung Cancer” was the first event sponsored by the UMKC Health Sciences District—a newly formed, premier academic health district made up of collaborating health care institutions on Hospital Hill.

Representatives of the School of Pharmacy presented information on smoking and lung cancer.

 “Truman Medical Centers is proud to be part of this exciting partnership,” Shields said. “The UMKC Health Sciences District is proving to do what it was intended, and that is to improve the health of the community in a variety of ways.”

The UMKC Health Sciences District is a cooperative partnership formed by 12 neighboring health care institutions on Hospital Hill: University of Missouri- Kansas City and its School of Medicine, School of Nursing and Health Studies, School of Pharmacy and School of Dentistry; Truman Medical Centers; Children’s Mercy; Kansas City, Missouri, Health Department; Missouri Department of Mental Health Center for Behavioral Medicine; Jackson County Medical Examiner; Diastole Scholars’ Center; and Ronald McDonald House Charities of Kansas City. 

 

‘Slow Medicine’ aims to foster more thoughtful care

Pieter Cohen, M.D., gave the 31st lecture in the William Goodson Jr., M.D., Memorial Lectureship series.

In an age of rapidly advancing technology and conflicting economic forces, it is important to guard against overuse of medical treatments and interventions, according to Pieter Cohen, M.D. He was this year’s William Goodson Jr. lecturer.

Cohen, an associate professor of medicine at Harvard Medical School, spoke Nov. 3 about “Slow Medicine,” the approach he and others promote at slowmedupdates.com. Cohen described Slow Medicine as thoughtful practice that involves patients, relies on the best evidence available and is “applied to help decrease excessive and potentially harmful interventions.”

Relatively high use of medical resources and procedures does not produce better results in many areas, Cohen said. For example, research indicates that 30 percent of U.S. knee replacement surgeries are not appropriate. That’s 200,000 major surgeries a year that should have been avoided, he said, resulting in 14,000 people needlessly suffering serious complications and side effects.

Similarly, aggressively ordering lots of CT scans and other tests can result in other overtreatments, not to mention increased anxiety and other side effects, he said, especially when tests produce false positive results.

Cohen cited research in 1973 by John Wennberg, M.D., author of “Tracking Medicine,” who identified the two main drivers of medical overuse. One is supply, so that adding physicians, specialists and hospital beds to an area will increase its use of medicine. The other is the style of medical practice prevalent in an area.

When Wennberg did his research, it was rejected by the Journal of the American Medical Association. But Dartmouth University then financed Wennberg’s work and started the Atlas Project, which examined patterns of medical use and resource intensity in the U.S.

According to Cohen, Wennberg’s conclusions have been proven correct, and Slow Medicine “digs deeper into the style issue to figure out what we can do better.” By involving patients, fully looking at options and not quickly reaching for a specific diagnosis and treatment, he said, Slow Medicine can improve care.

Economic pressures from pharmaceutical companies and medical device makers can promote overuse of some treatments, while cost pressures can curb others than might be beneficial. Slow Medicine tries to put the focus back on what’s best for the patient, which can end up saving money, but for the right reasons. It also keeps physicians from doing things mainly to make themselves feel better, and can prevent extending a treatment that works for some types of patients to others for whom it really wouldn’t be beneficial.

Cohen said Slow Medicine also can take more effort, to fully explain possible risks and rewards of different treatment choices, so that patients have more information and can know that there’s a good case to be made for more than one treatment option. In the end, more thoughtful, appropriate and caring practice can result.

Slow Medicine also is “about letting go of a specific, certain diagnosis” in favor of a more general assessment and then watchful waiting for signs of a particular ailment or for a clearer indication that treatment is needed. The slower approach often provides time for healing without intervention, he said, or provides the data needed to take the best treatment approach possible.

Cohen was the 31st speaker in the William B. Goodson Jr., M.D., Memorial Lectureship, which was established in 1987 by a group of families, patients, colleagues and friends to honor Goodson’s many contributions to medicine.

Pieter Cohen, M.D., associate professor of medicine at Harvard Medical School, was flanked by David Wooldridge, M.D., associate professor of medicine at the UMKCSchool of Medicine, and John Goodson, M.D., also an associate professor of medicine at Harvard, who presented last year’s lecture in the series named for his father, William Goodson, M.D.

Hundreds of Hospital Hill students participate in IPE poverty simulation

Students take on various family roles in IPE poverty simulation sessions.

More than 400 students from the UMKC School of Medicine, School of Pharmacy, School of Dentistry and School of Nursing and Health Studies have taken part this fall in five interprofessional education sessions of the Missouri Community Action Poverty Simulation.

In each simulation, about 80 students act as people living for a month in poverty. Students are assigned to families and receive a description of their role and goals of the simulation. They work to keep their home, pay all bills, keep their jobs, and feed their family each day. Some students serve as teenagers or young children and are asked to behave as their character descriptions.
 
Participants receive challenges such as an illness in the family, expenses to repair their plumbing, and getting robbed or fired. Students spend four “weeks” living in poverty. Each “week” lasts 15 minutes. There are stations around the room for students to visit to help meet their goals, such as the employer, a “Foodarama” for groceries, a health care center, child care, community action agency, inter-faith services, social services, and a pawn shop and quick cash business.
 
The simulation is required for students pursuing M.D., D.D.S. B.S.N., Pharm.D. and P.A. degrees. Doctor of Nursing Practice graduate  students help run the simulations along with past participants and volunteer faculty and staff.
 
The final session this semester took place on Nov. 11.

The right dose of research could help children, professor says

J. Steven Leeder

The challenge of finding the right dosage of medicines for young patients is complex and requires fresh thinking, J. Steven Leeder, Pharm.D., Ph.D., told the audience for the latest installment of the Health Sciences Deans’ Seminar Series.

Leeder, a professor of pediatrics and pharmacology at the UMKC School of Medicine, spoke Oct. 25 in the Health Sciences Building on Hospital Hill on “Exploring Inter-Individual Variability in Drug Response: Moving Beyond the Dose-Exposure Relationship.”

Leeder, who leads the pediatric clinical pharmacology group at Children’s Mercy Hospital, noted that many drugs are initially developed for adults and tested on them, making dosage calculations for children more difficult. On top of that, he said, the typical differences in how people respond to a drug can be magnified in children, given great differences in patient weight and in how rapidly different biological mechanisms in children can change during growth and development.

 The maturation of the brain, Leeder said, implies that receptors and transporters affecting drugs’ effectiveness may be changing in children and adolescents, but there’s relatively little research knowledge of these changes.

Given those challenges, he said, it makes sense to invert the usual sequence of “dose-exposure-response”:  administering a standard dosage of a drug and then seeing how much of that dosage is present in a patient’s body and how much the patient’s condition responded to the drug. Instead, he favors looking at “response-exposure-dose”: identifying the desired response or therapeutic outcome, and determining the amount of drug that needs to be in the body – the “exposure” — to achieve the desired response. Given that knowledge, he said, then a dosage can be tailored to the patient.

Leader, who practices at Children’s Mercy Hospital, noted that many drugs are initially developed for adults and tested on them, making dosage calculations for children more difficult. On top of that, he said, the typical differences in how people respond to a drug can be magnified in children, given great differences in patient weight and in how rapidly different biological mechanisms in children can change.

The maturation of the brain, Leeder said, means receptors and transporters that affect drugs’ effectiveness must be changing in children and adolescents, but there’s relatively little research knowledge of these changes.

Given those challenges, he said, it makes sense to invert the usual sequence of administering a standard dosage of a drug and then seeing how much of that dosage was used by a patient, and how much the patient’s condition responded to the drug. Instead, he favors looking at the response or outcome that’s desired, and then trying to gauge how well an individual patient’s system will use a drug. Given that knowledge, he said, then a dosage can be tailored to the patient.

Such an approach, he said, might best use the “more information on everyone” being provided by the increase in genomics, bioinformatics and population-wide data from electronic health records.

Leeder holds the Marion Merrell Dow Endowed Chair in Pediatric Clinical Pharmacology and is division director for clinical pharmacology and therapeutic innovations. He earned his pharmacy degree at the University of Minnesota and his doctorate at the University of Toronto. He completed a fellowship in clinical pharmacology at the Hospital for Sick Children in Toronto.

School of Medicine announces new chair of Biomedical and Health Informatics

Shui Qing Ye, M.D., Ph.D.

School of Medicine Dean Steven Kanter, M.D., has announced the appointment of Shui Qing Ye, M.D., Ph.D. as chair of the Department of Biomedical and Health Informatics. The appointment will take effect January 1, 2018.

A professor of pediatrics at the School of Medicine, Ye will continue to occupy the William R. Brown / Missouri Endowed Chair in Medical Genetics and Molecular Medicine.

As department chair, he will work closely with faculty, staff, and students to help position the Department of Biomedical and Health Informatics as a catalyst of innovation and creativity. Ye is an expert in genomics and translational bioinformatics, which will help foster important collaborations with other units throughout the university and with School of Medicine clinical partners. He has a strong track record of using new-age tools to gather and explore Big Data, and of partnering with researchers locally and worldwide in an effort to pinpoint new diagnostic biomarkers and therapeutic targets for human diseases.

Ye is the author of two highly acclaimed books on bioinformatics and Big Data in addition to extensive research experience. He served previously as director of the Gene Expression Profiling Core at the Center of Translational Respiratory Medicine at Johns Hopkins University School of Medicine. Additionally, he served at the University of Chicago Pritzker School of Medicine as director of the Molecular Resource Core.

Ye earned his medical degree from Wuhan University School of Medicine at Wuhan City, Hubei Province, China. He completed a postdoctoral fellowship in lipid metabolism at the Oklahoma Medical Research Foundation in Oklahoma City, and received his Ph.D. in molecular mechanisms of disease from the University of Chicago Pritzker School of Medicine.

New research fellowship explores pediatric headache treatment

Dane Stephens, Subhjit Sekhon

Two students at the UMKC School of Medicine have received a new award from the Children’s Mercy Hospital Philanthropy Fund to support research interests in neurology.

Dane Stephens, a fourth-year student, and Subhjit Sekhon, a fifth-year student, are the first recipients of the Neurology Research and Scholar Award. The award is given to students who will work on research projects with the Headache Research Group in the Division of Neurology at Children’s Mercy Kansas City.

Award recipients will work closely with the research group to design, implement and present research findings in the area of pediatric headache assessment and management. Research fellows also attend the American Academy of Neurology annual conference. There they will network with other professionals in the field, and attend presentations and poster displays, as well as other pertinent educational opportunities.

Research projects, while focused on headache treatment, vary based on current studies being conducted at any given time within the group.

The research fellowship award is available to qualified fourth, fifth or sixth-year B.A./M.D. students or second, third or fourth-year M.D. students at the UMKC School of Medicine. Students must commit to at least 80 total research hours throughout a 12-month period. A medical school research elective with the Children’s Mercy Hospital Department of Neurology is highly encouraged.

Jennifer Bickel, M.D., associate professor of pediatrics and chief of the headache section at Children’s Mercy, will serve as faculty mentor for the research projects.

The Headache Research Group is comprised of physicians, nurse practitioners and additional allied health professionals. Bickel leads the interdisciplinary team in its commitment to improving education, advocacy and research regarding headache care in children.

Stephens and Sekhon are part of a fast growing number of students actively taking part in research activities. Below is a list of some School of Medicine students who have recently been selected for summer and yearlong research fellowships and been invited to present their research at regional and national meetings.

Year-long Fellowships:
Grant Randall, NIH Medical Research Scholars Program
Sultan Khan, TL1 Predoctoral Clinical Research Training Program, Washington University
Carlee Oakley, TL1 Clinical Research Training Program, University of Kansas Medical Center
Dane Stephens, Subhjit Sekhon, Neurology Research and Scholar Award, Headache Research Group in the Division of Neurology at Children’s Mercy Kansas City

Summer Fellowships:
Akash Jani, George Washington University Summer Research Internship, Dept. of Emergency Medicine
Vishnu Harikumar, Pediatric Oncology Education Program, St. Jude Children’s Research Hospital
Priyesha Bijlani, Washington University Pediatric Student Research Program
Elizabeth George, Unite for Sight Summer Program in India
Ashwath Kumar, Health Policy Fellowship Initiative (American Academy of Ophthalmology, Washington, D.C.
Ben Bernard*, NIDDK Medical Student Research Training Program in Diabetes, Obesity, and Metabolic Disorders (*had to decline due to another research opportunity in Israel)
Chizitam Ibezim*, NIH Summer Internship Program (*had to decline due to other obligations)

Selected to present research at regional or national meetings:
Sarah Alshami, International Facial Nerve Symposium, Los Angeles, CA, August 2017
Noor Alshami, American Academy of Pediatrics, Chicago, IL, September 2017
Morgan Warren, Central Association of OB/GYN, Scottsdale, AZ, October 2017
Sumita Sharma, American Academy of Physical Medicine and Rehabilitation, Denver, CO, October 2017
Suzan Lisenby, American Academy of Physical Medicine and Rehabilitation, Denver, CO, October 2017
Siri Ancha, World Congress of Gastroenterology, Orlando, FL, October 2017
Ravali Gummi and Imran Nizamuddin, Clinton Global Initiative, Boston, MA, October 2017
Chizitam Ibezim, AHA Scientific Sessions, Anaheim, CA, November 2017
Amber (Leila) Sarvastani, AHA Scientific Sessions, Anaheim, CA, November 2017
Hunter Faris, AMA, Honolulu, HI, November 2017
Vaishnavi Vaidyanathan, Child Neurology Society Annual Meeting, Kansas City, MO, October 2017