"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
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Winter 2018 | Volume 26, No. 1 Bringing CNS Members Together to Make Children’s Lives Better “The Gold Standard” Humility, Compassion, and Grace Looking Back on KC, Looking Ahead to ‘The Big C’—Chicago 2018
CHILD NEUROLOGY SOCIETY From the President Seizing Opportunities, Setting Priorities I wish everyone a Happy New Year. May you all diversity. For any member who is interested in serving have happiness and success in 2018. It is an on a committee, please contact me (Jonathan_Mink@ exciting time for the field of child neurology. urmc.rochester.edu) or Roger Larson (rblarson@ Disease-modifying therapeutics for rare and fatal childneurologysociety.org) to express your interest neurodegenerative disease are now becoming reality and which committee(s) would be most aligned with with FDA approval in the past year of Brineura your interests. In addition, we will be launching a new (cerliponase alfa) for CLN2 disease (late-infantile effort to include junior member participation on the Batten Disease) and Spinraza (nusinersen) for committees. An announcement regarding nominations spinal muscular atrophy; more are on the horizon. will be forthcoming in the next couple of months. Despite a tight funding environment, research in Jonathan Mink, MD, PhD child neurology and developmental neuroscience Another priority is to increase our alliances with President, CNS continues to provide important advances. other organizations active in our field. These include The number of clinical child neurologists also the American Academy of Neurology, the American continues to grow, providing improved access to Academy of Pediatrics, the International Child Neurology high quality neurological care for children. Association, The Child Neurology Foundation, and others. I do believe that there is “safety in numbers”. Plans are already underway for what promises to We must not relinquish our identity as child neurologists be an exciting 47th Annual Meeting in Chicago and must not allow the needs of child neurology to My Top Priorities: this year. By now, you have probably received a become secondary priorities to the needs of the larger few notices that the meeting days will be different fields of pediatrics and neurology. However, to have the ...Increase diversity from our traditional Wednesday through Saturday. greatest impact advocating for our profession we must in CNS leadership This year’s meeting will start Monday October 15 work with these other organizations. Two years ago, a and run through Thursday October 18. Proposals for Child Neurology working group was formed that includes ...Strengthen alliances symposia and breakfast seminars have been received representatives from CNS, AAN, AAP, PCN, and CNF and will be reviewed by the Scientific Selection and with a goal of coordinating our efforts to assure that the with other Program Planning Committee over the next month. professional needs of child neurologists are supported. organizations in The abstract submission site will remain open until midnight, April 2. A third priority is to expand programming at the our field Annual Meeting and between meetings for our junior As I assume the role of President, I want to state members. They are the future of our profession. In my ...Expand programming some of my priorities for the next two years. view, the Child Neurology Society has a responsibility for Junior Members to provide career-development support and mentoring The first is to increase the diversity of membership in a broader context than is available at individual on the CNS committees and ultimately in the institutions. We will work to implement a “junior leadership of the Society. The membership of the member track” with activities on each day of the CNS is currently about 50 percent men and 50 Annual Meeting targeted at junior members. percent women, but 70 percent of current residents in child neurology are women. The number of I am excited about the Child Neurology Society and historically under-represented minorities is also opportunities to continue and enhance our role as a increasing among our members and trainees. professional society in advancing education, research, As the path to leadership in professional societies clinical care, and career satisfaction. I am proud to have usually starts with participation on a committee, been part of the CNS for over 25 years and look forward this will be one focus of our efforts to increase to working with all of you over the next two years. 2 Child Neurology Society | Winter 2018
CONTENTS WINTER 2018 Photos by Suzanne Shaff Connecting with Colleagues 4 In Memoriam: Arnold P. Gold, MD DEPARTMENT 6 Q&A with Erika Augustine, MD, PhD 2 FROM THE 21 2018 Abstract Submission Guidelines PRESIDENT 22 CNS and Foundation Awards and Grants Guidelines 36 PERSONNEL 26 Focus On Young Researchers REGISTRY 28 Strategic Goals of the CNS: 2018 Committees and Charges Connecting with the Past 8 Looking Back on the 45th CNS Annual Meeting in Kansas City 10 Thank You CNS Annual Meeting Presenters 11 Thank You to Our Sponsors 14 Legacy Reception 15 Child Neurology Society Awards 16 Scientific Sessions 17 Exhibits & Poster Review 18 Networking Connecting to the Future Child Neurology Society 12 Child Neurology Career Development Program (CNCDP-K12) 1000 West Cty Rd. E, Suite 290 St. Paul, MN 55126 13 2nd Annual CNS John M. “Jack” Pellock Tel: 651/486-9447 Resident Seminar on Epilsepsy Fax: 651/486-9436 Email: nationaloffice@ Connecting with Colleagues Globally childneurologysociety.org www.childneurologysociety.org 23 2018 Bernard D’Souza International Fellowship Award Guidelines Editor: Daniel Bonthius, MD, PhD 24 ICNC 2018 in Mumbai Managing Editor: Roger Larson, CAE Connecting with Partners Published Quarterly 33 Professors of Child Neurology Cover photo: René Perez 34 Association of Child Neurology Nurses All CNS Annual Meeting photos in this issue by Suzanne Shaff. Child Neurology Society | Winter 2018 3
CONNECTING WITH COLLEAGUES In Memoriam: Arnold P. Gold, MD (1925-2018) By Nigel S. Bamford, MD and Darryl C. De Vivo, MD Education and Training: • University of Texas, (1943-1947) B.A. • University of Florida, (1947-1949) M.S. • University of Lausanne, (1950-1954) M.D. • Charity Hospital of Louisiana, New Orleans, (1954-1955) Rotating Internship • Children’s Hospital, Cincinnati, Ohio, (1955-1958) Debra Classen Residency in Pediatrics • Columbia-Presbyterian Medical Center, (1958-1961) Fellow in Pediatric Neurology D r. Arnold P. Gold, one of the true giants in child growing divisional ranks with Abe Chutorian, Niels Low, neurology and American medicine, passed away Jim Hammill and Richard Koenigsberger. These colleagues on Tuesday, January 23, 2018 at the age of 92. also would make their own marks and become giants in the Gold was a founder of modern child neurology and a nascent field of child neurology. Gold rose from assistant to longtime colleague, collaborator and mentor of many full professor over fifteen years. During this rise in academia, who worked and trained at the Columbia University he would distinguish himself as an outstanding teacher and Medical Center and the Neurological Institute of New able clinician. He enjoyed seeing patients with a broad array York. Much has changed in medicine since Dr. Gold began of neurological diseases and published widely in many diverse his career, but his ideals and teachings have not, and now areas of pediatric neurology. He developed a special interest live on in many, if not all, practicing child neurologists. in the areas of vascular neurology and neurocutaneous diseases which led to chairmanships of the NIH Child Study While a resident in pediatrics at Cincinnati, Gold developed Group for Stroke and the Medical Advisory Board of the an interest in endocrinopathies, published a few papers National Tuberous Sclerosis Association. He served as a on the subject and planned a fellowship in endocrinology member on the American Heart Association Stroke Council at Johns Hopkins. These plans changed after spending a and the Committee on Drugs of the American Academy one month rotation with Sidney Carter at the Neurological of Pediatrics. His diverse interests in child neurology also Institute of New York. Carter, a founding father of modern contributed to our basic understanding of epilepsy, migraine, American child neurology, had established one of the cerebral palsies, collagen vascular diseases, attention/ country’s first training programs and Gold considered Sid hyperactivity disorders, movement disorders, infectious “a very special person: a friend, mentor and role model; and inflammatory disorders, developmental neurology, the ultimate of what a physician should be.” During his neuromuscular disease, and learning disabilities. His presence fellowship, Gold viewed Carter as an astute diagnostician was always felt on the wards at Babies Hospital in New York, and a compassionate clinician who cared about every where compassion for the sick children and their families was child and their suffering family members and conveyed constant—a continuing measure of the Carter/Gold legacy. these admirable qualities to all of his trainees. Dr. Gold was indefatigable as he sought out new ways to help the children and their families under his care, and he At the end of Gold’s training, Carter offered him a faculty later explored philanthropy to improve clinical care and the position at the Neurological Institute and he joined the hospital infrastructure. 4 Child Neurology Society | Winter 2018
Gold received numerous awards and visiting coat is a symbol that emphasizes the ethical, moral and professorships for his contributions to medicine and humane imperatives that medical students accept upon child neurology. He was the recipient of the National matriculation. Brennerman Award in Pediatrics, Lifetime Community Service Award from the Autism Society of America, In creating the Arnold P. Gold Foundation, the Gold’s an Honorary Doctorate from the University of institutionalized their vision of compassionate healthcare Medicine and Dentistry of New Jersey, an Honorary through sponsored programs which promote humanism Doctorate of Humane Letters from Sacred Heart in medicine, along with student and resident recognitions University, and awards for Humanitarian Excellence for individuals who exemplify Gold’s values, including from various institutions, including the New Jersey integrity, compassion, empathy, cultural sensitivity, Council for the Humanities. effective communication, trust and confidence, respect, service and deep appreciation for Gold was a beloved teacher and mentor the emotional concerns of patients and for the many pediatricians who trained family members. at Babies Hospital and the pediatric Humility, neurologists who trained at the compassion and Gold encouraged programs to evaluate Neurological Institute. Undoubtedly an grace characterize problems in medicine that resulted from the de-emphasis of humanity inborn tendency, Gold elevated the thoughtful manner of his mentors “the Gold Standard” in medicine. He believed that a and colleagues to promote care in the practice of constant awareness of suffering for the families of his patients; and the capacity to alleviate it by one often heard the words “care child neurology, maintaining competency would for the family, not just the patient.” and are the prevent physician “burnout”. The first Arnold P. Gold Foundation Gold would often extend his clinical visits with the child to spend quality essential traits that Humanism in Medicine Award was time with the child’s parents and Dr. Arnold P. Gold presented to Dr. Ruth Nass at the other family members. The net result personified Child Neurology Society Annual often was a comprehensive plan that Meeting in 2010. Nass was one would ultimately embrace the family throughout his of Gold’s former trainees who had and improve each child’s long term long and promoted humanism in pediatric quality of life—the true signature of a neurology throughout the New York caring, compassionate child neurologist. distinguished tri-state area. Since that time, the career. Foundation has supported seven additional A charter member of the Child Neurology CNS awardees that exemplify the Gold Society and recipient in 2005 of the Society’ example, and a biennial Humanism in Medicine Lifetime Achievement Award, Gold is perhaps best Forum at the CNS meeting. By honoring those known for founding, in 1988 along with his wife, clinicians who actively promote humanism in medicine, and Dr. Sandra Gold, the Arnold P. Gold Foundation, by continuing dialogue about the factors that contribute dedicated to fostering humanism in medicine. With a to physician burnout, Dr. Gold felt that the nobility of grant from the Robert Wood Johnson Foundation, medicine would be preserved and elevated. Those trainees he gathered fifty medical school deans together to who have followed and who did not have the privilege of discuss ways to offset the diminishing emphasis on the interacting directly with Dr. Gold will benefit indirectly from humane aspects of medicine. He proposed mechanisms the ongoing work of the Foundation and will be viewed that would inculcate these humanistic behaviors in as his “grandchildren”. These fundamental principles of medical students at the beginning of their careers; humanism will allow the profession to serve our children behaviors that he regarded as fundamental to the humanely and to thrive well into the future. Humility, practice of medicine. One outcome was the White Coat compassion and grace characterize “the Gold Standard” Ceremony that medical and dental students participate in the practice of child neurology, and are the essential in at the beginning of their training. The first ceremony traits that Dr. Arnold P. Gold personified throughout his was in 1993 at the Columbia University College of long and distinguished career. Physicians and Surgeons; it has since spread to nearly every medical and dental school in the United States Dr. Gold is survived by his wife, Sandra; his children and more than a dozen countries overseas. The white and 13 grandchildren. Child Neurology Society | Winter 2018 5
Q&A CONNECTING WITH COLLEAGUES Toward Treatments and Cures for Rare Diseases: Perspective of Dr. Erika Augustine By Daniel J. Bonthius, MD, PhD | CNS Connections Editor QUESTION | Let’s start by talking about QUESTION | Do clinical trials need to be the development of therapeutics for rare organized differently or have different goals diseases. How did you become interested when they are addressing a rare disease, in this topic? in comparison to more common diseases? One of the great aspects of clinical child The same principles underlying high quality neurology is the opportunity to care scientific research and rigorous evidence for patients with a broad spectrum of apply in rare diseases, even with the disorders, from common to rare. The unique challenge of small samples. This is critical expertise of a child neurologist regarding for generating robust knowledge regarding the interactions of each organ system with the safety and efficacy of new treatments. the brain and the diagnostic challenges of The infrastructure for trials targeted to rare complex metabolic and genetic conditions disorders may necessarily be multi-center drew me to the field. Even as a medical or even multi-national, in order to garner student, it was clear to me that the field sufficient patient numbers. In addition, Erika Augustine, MD, PhD of Child Neurology would change during patient partnership in the development and the course of my career as new scientific execution of trials is especially important. knowledge led to novel therapeutics. The need for effective therapies is especially QUESTION | Do the funding agencies in the high in these rare, complex diseases US give enough priority to rare diseases? that initially sparked my interest in child There are a number of efforts to support neurology and subsequently became rare disease research from federal agencies, my focus. including the Food and Drug Administration (FDA) Office of Orphan Products. The 21st QUESTION | What are the special Century Cures Act, passed in late 2016, challenges that researchers face when includes several provisions related to rare they are dealing with rare diseases? diseases, including reauthorization of the The key is in that word ‘rare’. By definition, FDA Rare Disease Priority Review voucher these are disorders that affect small numbers program and updates to the FDA Orphan of people, which, in turn, impacts every Drug grant program. There are, however, aspect of care and research—garnering more than 7,000 rare diseases, the majority interest in the area, access to expertise, of which lack disease-modifying treatments. small numbers of researchers, limited There is certainly a continued need for dedicated research funding, and challenges greater priority and support. with developing clinical studies of sufficient size to enable rigorous research. 6 Child Neurology Society | Winter 2018
QUESTION | Are there challenges in motivating QUESTION | What was your personal experience with ELF? pharmaceutical companies to pursue development ELF was a fantastic experience and I recommend it of treatments for rare diseases? highly. We spend close to a decade in medical school The Orphan Drug Act of 1983 was developed to address and residency (or more with fellowship) preparing for this specific issue. It provides financial incentives to the practice of child neurology, building our medical motivate development of new treatments for rare knowledge and our ability to work with patients to diseases. Based on the annual number of treatments provide high quality, compassionate care. Yet, much of approved by the FDA for rare conditions, the Act has what we do involves leadership—leading a clinical team, been quite successful. building a research program, directing a course, clerkship, or residency/fellowship are just a few examples. Dedicated QUESTION | Are there certain rare diseases of pediatric opportunities to develop those critical leadership skills and neurology about which you have particular optimism structured ways to build professional networks early in for a new treatment in the near future? one’s career can be invaluable. During my participation in ELF, Dr. Ann Tilton (President of the Child Neurology We are seeing new therapeutics emerge with great Foundation) was a phenomenal mentor and resource. impact. A particularly exciting aspect of recently approved I am delighted that my relationship with the Emerging technologies is the potential for use in many diseases. Leaders Program continues today, now as a mentor to As gene transfer, RNA-based approaches, and CNS- another Child Neurology Society member, Dr. Mathula directed enzyme replacement therapies expand in Thangarajh of the Children’s National Health System. application, there is the potential for huge impact on rare diseases, many of which are genetically based, and consequently for the entire field of child neurology. QUESTION | Let’s change the subject a bit and talk about your experiences with the Emerging Leadership Program. How about if you start by explaining what the ELF program is? The Emerging Leaders Program (formerly Emerging Leaders Forum, ELF) is a leadership initiative of the American Academy of Neurology and is part of its growing portfolio of leadership programs. The Emerging Leaders Program is a 6-month leadership training program targeted to individuals in the early career phase, within 10 years of completion of residency. Changing of the Guard: 2018-19 Scientific Program Chair, Erika Augustine, exchanges intel with 2016-17 Program Chair, Marc Patterson in Kansas City. Editor’s Note: Dr. Erika Augustine is an Associate Dr. Augustine’s research interests include methodology Professor of Neurology and Pediatrics at the University of of clinical research and experimental therapeutics in rare Rochester Medical Center where she serves as Assistant pediatric neurological disorders. She also currently serves as Program Director for the NINDS-funded Experimental the Diversity Officer for the NIH-funded Child Neurology Therapeutics training program. She is a member of the Career Development Project (CNCDP-K12; see page 12) NIH Taskforce on Childhood Motor Disorders and is a and chairs the Scientific Program Committee for the 2018 consultant to the FDA Neurological Devices Panel. and 2019 CNS Annual Meeting. Child Neurology Society | Winter 2018 7
From DC to BC to KC to “The Big C”—Chicago The last three CNS Annual Meetings (2015 in Washington DC, 2016 in Vancouver BC, and last year in Kansas City) all surpassed previous attendance records, setting a new “threshold” of 1000+ attendees and 275-300 exhibitors gathered for what is, hands down, THE meeting of choice for professionals active in the field of child neurology. This year’s meeting in Chicago will shatter those records, lured by the easy access to a full menu of flight options and the meeting hotel’s unbeatable proximity to the river, the Magnificent Mile, Millenium Park and world-class museums. Kansas City 2017—Largest-ever Gathering in the United States Last year’s meeting in KC didn’t quite eclipse Vancouver the multicenter study group was launched at the for attendance, but it did stake a serious claim to being 2002 CNS Annual Meeting in Washington, DC. the largest-ever gathering of child neurologists in the • More than 80 PCN members and an additional United States to date (again, Chicago is a lock to set a 25 members of the Program Coordinators of Child new record). And people didn’t come just in time for the Neurology met on Wednesday afternoon, incorporating traditonal Wednesday evening Welcome Reception or leave for the first time, an audience response system providing immediately after the Saturday morning Hower Award immediate feedback to questions from the podium. Lecture and final scientific symposium. They gathered on “the shoulders” as well, for special interest meetings before That all took place before the first wine bottle was uncorked and after the main CNS meeting: and the first appetizer served on the Exhibit Floor at the • The NIH-funded Child Neurology Career Development Wednesday evening Welcome Reception, sponsored by Program (CNCDP) staged its second annual retreat on Children’s Mercy Hospital. And it didn’t end on Saturday the front end of the CNS Annual Meeting, with nearly at noon. More than 125 attendees stayed on to attend 30 young physician-scientists presenting their research the 3rd Annual Child Neurology Foundation Symposium; and/or interviewing for available slots in future years. this year’s meeting brought neurologists, nurses, parent and advocacy groups together to focus on SUDEP. • CNS and CNF Boards both logged long hours before Nearby, the 2nd Annual Biomedical Writing Workshop any general sessions were held. attracted early career academic-researchers eager to be • Nine faculty members and 58 PGY5 residents gathered “schooled” by seasoned editors Jon Mink, Marc Patterson, on Tuesday evening and all-day Wednesday for the Scott Pomeroy and Steve Roach. 2nd Annual CNS John M. “Jack” Pellock Residents And the traditional annual meeting time block in between? Seminar on Epilepsy. Lots of networking, a little bit of rain (OK—a lot), an • Bernie Maria’s all-day Wednesday Neurobiology of impressive line-up of continuing medical education, Diseases in Children Symposium on Leukodystrophies including six breakfast seminars, four symposia, four drew over 300 attendees. SIG-organized CME sessions, two platform sessions, four satellite programs, three award lectures, scientific posters • The Association of Child Neurology Nurses met for and a record-shattering 100 exhibit booths. Toss in a their traditional all-day Wednesday educational half-dozen SIG meetings, Wednesday’s first ever Legacy program, then added special interest group meetings Reception honoring Drs. Abe Chutorian, Don Shields, David to their usual follow-up fare of mid-day Thursday and Coulter and Kenneth Swaiman, the Friday evening Gala Friday lunch seminars. Receptions, numerous smaller receptions, and you have • The International Pediatric Stroke Study Investigators a great meeting, setting the table for what will be a truly (30+) gathered for their 15th pre-CNS meeting since memorable meeting this year in Chicago, if...if...if...if...if... 8 Child Neurology Society | Winter 2018
IF... you remember to mark your calendars, make your reservations, and book your flights to arrive on Sunday night or Monday, NOT your traditional Tuesday/Wednesday grand entrance. This year’s meeting (and this year’s meeting only) will run from Monday thru Thursday. In addition to marking your calendars for a Sunday/Monday arrival, please note the following: • The line-up of seminars and symposia selected from member-submitted proposals will be announced in early March. • Abstracts will be accepted for review from February 1 to April 2, with acceptance letters slated to go out in May. • A call for SIG-designed educational fare will be announced in April. • Meeting registration and hotel reservations will be available on-line beginning mid-June. th Fo rty -S ev en CNS A N N U A L M EE TI N G , 2018 October 15-18 INOIS CHICAGO, ILL Wed Thu Fri Sat Sun Mon Tue 5 6 2 3 4 1 9 10 11 12 13 7 8 14 15 16 17 18 19 20 23 24 25 26 27 21 22 29 30 31 28 Child Neurology Society | Winter 2018 9
Thank You CNS Annual Meeting Presenters E xpertise is great and the JOHN M. “JACK” PELLOCK SYMPOSIUM II: PRESIDENTIAL CNS is no different than RESIDENCY SEMINAR ON EPILEPSY SYMPOSIUM: PRACTICE ISSUES any other major medical Organizers: Phillip Pearl, MD IN CHILD NEUROLOGY association in showcasing and Renée Shellhaas, MD Kenneth Mack, MD, PhD, Organizer offering it to members at its Elaine Wirrell, MD Jeffrey Buchhalter, MD, PhD annual meeting. What sets Faculty: Carol Camfield, MD Bruce Cohen, MD the CNS apart from many Peter Camfield, MD Sidney Gospe, Jr., MD, PhD organizations is the generosity Kevin Chapman, MD its members consistently Bill Gaillard, MD SYMPOSIUM III: GLOBAL HEALTH demonstrate by offering their Nancy McNamara, MD Jorge Vidaurre, MD, Organizer expertise pro bono. Fifty CNS Katherine Nickels, MD Harry Chugani, MD members served as faculty on Heather Olson, MD Dave Clarke, MBBS Carl Stafstrom, MD, PhD Solomon L. Moshé, MD one or more of the seminars Syndi Seinfeld, DO and symposia offered at the 2017 CNS Annual Meeting. SYMPOSIUM IV: CONVERSION BIOMEDICAL WRITING DISORDERS AND PSYCHOGENIC Their willingness to present WORKSHOP NON-EPILEPTIC SEIZURES pro bono continued a long and E. Steve Roach, MD, Organizer Steven Leber, MD, PhD, Organizer honorable tradition of CNS Marc Patterson, MD Leon Dure, MD members making common Jonathan Mink, MD, PhD Jonathan Mink, MD, PhD cause with their colleagues to Scott Pomeroy, MD, PhD ensure high level CME without SYMPOSIUM V: PEDIATRIC commensurately high level SYMPOSIUM I: NEUROBIOLOGY NEURO-ONCOLOGY registration and course fees by OF DISEASE IN CHILDREN Sonia Partap, MD, MS foregoing honoraria, per diems, (LEUKODYSTROPHIES) Yasmin Khakoo, MD waived registration fees, and Bernard Maria, MD, MBA Nicole Ullrich, MD, PhD other perks. So, before taking Joshua Bonkowsky, MD, PhD a backward glance at last fall’s Florian Eichler, MD SYMPOSIUM VI: CHILD meeting in the eight pages to Ali Fatemi, MD NEUROLOGY FOUNDATION follow, let’s pause to offer a Sakkubai Naidu MD SYMPOSIUM: SUDEP special thanks to CNS members Adeline Vanderver, MD William Trescher, MD, Organizer for their generous gift of time Keith VanHaren, MD Jeffrey Buchhalter, MD, PhD and talent in Kansas City. Elizabeth Donner, MD All CNS Annual Meeting photos in this issue by Suzanne Shaff. 10 Child Neurology Society | Winter 2018
SEMINAR 1: UPDATE ON SEMINAR 3: HOW TO GET SEMINAR 5: THE PAROXYSMAL MOVEMENT STARTED IN CHILD NEUROLOGY COMPREHENSIVE EVALUATION DISORDERS RESEARCH AT ANY POINT OF MITOCHONDRIAL Harvey Singer, MD, Organizer IN YOUR CAREER MYOPATHIES Donald Gilbert, MD Adam Hartmann, MD, Organizer Zarazuela Zolkipli, MBChB, MRCP, Toni Pearson, MD Mustafa Sahin, MD, PhD Organizer Courtney Wusthoff, MD, PhD Shana McCormack, MD SEMINAR 2: SEX: WHY THIS BIOLOGICAL VARIABLE IS SEMINAR 4: NEWBORN SEMINAR 6: DIAGNOSING RELEVANT TO THE CHILD SCREENING CONSIDERATION FOR DRAVET SYNDROME— NEUROLOGIST SPINAL MUSCULAR ATROPHY WHAT’S THE RUSH? Mary Zupanc, MD, Organizer Han Phan, MD, Organizer Kelly Knupp, MD, Organizer Tallie Z. Baram, MD, PhD Sookyong Koh, MD, PhD Bradley Schlaggar, MD, PhD Elaine Wirrell, MD Thank You to Our Sponsors LEADER LEVEL PARTNER LEVEL SUPPORTER LEVEL ($100,000+) ($50,000+) ($20,000+) Agilis Biotherapeutics Children’s Mercy Biogen Eisai, Inc. • Unrestricted Grant Kansas City • Child Neuro News Forum • Child Neuro News Wrap • Wednesday Welcome (Thursday poster review) • Hotel key cards Reception, Host • Satellite Symposium • Meeting app Institution AveXis • Connections Courtyard Greenwich Biosciences • Satellite Symposium PTC Therapeutics Mallinckrodt • Unrestricted Educational bluebird bio • Unrestricted Grant • Charging Stations Grant • Unstricted Grant • Wall-to-Wall Wifi Sarepta Therapeutics • Meeting tote bags Jazz Pharmaceuticals Child Neurology • Satellite Symposium Foundation • Unrestricted Educational Grant Sunovion Pharmaceuticals • Connections Corridor Thanks to the following for their continued support of awards presented at the CNS Annual Meeting Akron Children’s Hospital Arnold P. Gold Foundation Blue Bird Circle • Hower Award Lecture • Humanism in Medicine Award & Luncheon • CNS/PCN Training Director Award Child Neurology Society | Winter 2018 11
Connecting to the Future Child Neurologist Career Development Program (CNCDP-K12) Funded by NIH-NINDS T he NIH Child Neurologist Career Development PhD, UPenn; and Autumn Ivy, MD, PhD, Stanford. Dr. Chao Program held its second annual retreat also presented a paper at one of the Friday morning platform just prior to the CNS Annual Meeting in sessions, for which she received one of four CNS Outstanding Kansas City. The retreat brought together key Junior Member Awards (photo on page 15). Dr. Boes is the program directors from the NINDS, division chiefs subject of this issue’s Research Focus (see page 26). representing more than a dozen child neurology training programs, and more than three dozen child neurology residents and fellows. CNCDP PI and Director, Dr. Michael Johnston outlined the program in a piece published last year in CNS Connections, noting that it was “the brainchild” of Dr. Stephen Korn, Director of Training at NINDS, who envisioned “an open selection process whereby child neurology residents completing their clinical training at any institution in the country would receive three years of critically important funding and focused mentorship that would lead, over time, to increased number of child neurologists actively pursuing NIH-funded research careers.” The first cohort, selected at the retreat in Vancouver in 2016 and presenting their work for critique at the 2017 retreat included Hsaio-Tuan Chao, MD, PhD, Baylor University; Aaron Boes, MD, PhD, University of Iowa; Christa Habela, MD, PhD, Johns Hopkins; Mai Dang, MD, 12 Child Neurology Society | Winter 2018
2nd Annual CNS John M. “Jack” Pellock Resident Seminar on Epilepsy M eanwhile, in another section of the Sheraton Crown Center, a select cohort of 58 PGY5 residents participated in the 2nd Annual CNS John M. “Jack” Pellock Resident Seminar on Epilepsy, organized by Drs. Phillip Pearl, Renée Shellhaas and Elaine Wirrell. One of the primary objectives of the seminar, in addition to providing a significant opportunity for the next generation of child neurologists to meet peers from around the country and launch the kind of lifelong, career-enhancing friendships and collaborations driving the Child Neurology Society’s mission and success, is to cultivate an ethos of “dual citizenship” typified by Jack Pellock. To that end, the CNS, AES, and CNF launched a three-year pilot program in 2017, funded by Upsher-Smith, that will select and recognize two residents from each Pellock Seminar cohort as “Pellock Fellows”. The fellows will receive both CNS and AES membership dues and annual meeting fee waivers, and follow up their participation in the Pellock Seminar with active participation in a leadership development program at the following year’s AES Annual Meeting. The first two CNS Pellock Fellows selected in 2017 were Dr. Thomas Foutz, from Seattle Children’s Hospital, and Dr. Lila Worden, from Massachusetts General Hospital. Faculty pictured left. Front Row (l-r):Drs. Syndi Seinfeld (who was trained by and practiced with Jack Pellock), Carl Stafstrom, Karen Nickels, Carol Camfield, Elaine Wirrell, Heather Olsen. Back Row (l-r): Drs. William Gaillard, Phillip Pearl, Kevin Chapman. Not Pictured: Drs. Nancy McNamara, Renée Shellhaas. Child Neurology Society | Winter 2018 13
Legacy Reception I n a conference devoted to sharing insights and mentor, Don Shields, and Leonardo Garcia introduce his old information about the developing brain, one doesn’t friend, Abe Chutorian, each recipients of the 2017 Roger and hear much talk about the heart. Even less about the soul. Mary Brumback Lifetime Achievement Awards; to link the But if one were to search for the vital center of the Child memories Dr. Mary Cerreto shared introducing her husband, Neurology Society, that place where the heart and mind and David Coulter, to the Arnold P. Gold Foundation Award soul are most radiantly and resonantly present and alive, for Humanism in Medicine Award he was about to receive; one need look no further than the Legacy Reception in and then to hear each of these honored men speak with Kansas City on the opening night of the 2017 CNS Annual wisdom and humor and humility—and even a little poetry— Meeting. To listen to friends and colleagues of Ken Swaiman was to learn or re-learn more, perhaps, about how and why recall the animating vision and relentless drive he and a you came to be here in Kansas City with 1000 other child supporting cast, now largely gone, summoned in service neurologists on this night, at this Legacy Reception, than to the founding of the CNS, PCN, CNF and the journal you might have ever thought possible. It was a night to Pediatric Neurology; to hear Chris Giza tell tales about his remember. 14 Child Neurology Society | Winter 2018
Child Neurology Society Awards CNS President, Kenneth Mack Melissa A. Walker, MD, PhD, and Philip R. Dodge Young from Massachusetts General Investigator Awardee, Audrey Hospital, received the Shields Brumback, MD, PhD. Research Grant. Pictured (L-R): CNS/PCN Blue Bird Circle Training Director Dr. Roy Elterman, President, Award recipient, Sidney M. Gospe, Jr, MD, Pediataric Epilepsy Research PhD stands alongside the traditional award Foundation (PERF); Dr. Walker; profile board. W. Donald Shields, MD. Lauren Singer, recipient of the CNS Bhuwan Garg High Hower Award Lecturer, Nina Schor (center) was School Neuroscience Award. introduced by her twin sons, Jonathan (L) and Stanford (R), flanked here by CNS Executive Director, Roger Larson (L) and her husband, Robert Schor (R). CNS Outstanding Junior Member Award recipients: (L-R) Carla Watson, MD, Children’s Hospital of Michigan; Rachel Goldstein Hirschberger, MD, MPH, Boston Children’s Hospital; Hsaio-Tuan Chao, MD, PhD, Baylor 2017 Sachs Award Lecturer, Solomon Moshé, College of Medicine, Ka Ye Clara Chan, MD, MD (center) with his wife, colleagues, and Loma Linda University Medical Center. past trainees. Child Neurology Society | Winter 2018 15
Scientific Sessions 16 Child Neurology Society | Winter 2018
Exhibits Poster Review Child Neurology Society | Winter 2018 17
Networking 18 Child Neurology Society | Winter 2018
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Forty-Seventh CNS ANNUAL MEETING October 15-18, 2018 CHICAGO, ILLINOIS This year’s meeting (and this year’s meeting only) will run from Monday thru Thursday. at M o n Tu e Wed Thu Fri S Sun 5 6 2 3 4 1 9 1 0 11 12 13 7 8 1 7 1 8 19 20 14 15 1 6 2 3 2 4 25 26 27 21 22 28 29 30 31 Remember to mark your calendars, make your reservations, and book your flights to arrive on Sunday night or Monday, NOT your traditional Tuesday/Wednesday grand entrance. 20 Child Neurology Society | Winter 2018
CONNECTING WITH THE FUTURE Deadline April 2, 2018 2018 Abstract Submission Guidelines Submissions 6. Abstracts accepted for presentation will Future Leaders Program be published in an Annals of Neurology (Grant pending; awarded only if (Deadline: April 2, 2018; 11:59 pm PDT) supplement. Submitting authors outside funding is secured.) 1. CNS Membership not required for assume all responsibility for accuracy of Registration fee waiver for CNS Junior abstract submission or presentation. information submitted and printed. Members presenting as first/ primary 2. First Author listed will be required to 7. Authors of abstracts accepted for author. To qualify, author must be: verify work submitted is their own. presentation are required to register • Primary/first author enrolled in child 3. Multiple submissions allowed. Multiple for the 47th Annual CNS Meeting. neurology or neurodevelopmental authors allowed. (Max. 3 submissions) A registered proxy listed as contributing disabilities training program as of 4. Word Count: 250 (does not include title, author may present for author unable April 2, 2018 authors, or text embedded in graphs or to attend. • CNS Junior Member (or have graphics) (Maximum of 2 graphics) 8. Authors are responsible for all expenses application for Junior Membership 5. Work presented at other meeting(s) and related to attending and presenting completed and pending approval or recently published will be reviewed; at the meeting. No honoraria will be as of May 15, 2018). author must identify previous presentation venues and verify work was presented awarded for poster or platform/plenary before a substantially different audience presentations. Questions? Contact... in space provided. nationaloffice@childneurologysociety.org 6. Abstracts should be broken into four- Junior Member Awards & header format: Objective, Methods, Registration Fee Waivers Please Note: Results, Conclusions. Notification of acceptance for presentation 7. SAVE & FINALIZE when submission is • The Abstract Submission site is will be emailed to contact author listed on completed. Once your submission is independent of the CNS. or before May 7; notice of non-acceptance completed. Submitter is required to click • You will be required to create a will be emailed on or before May 25. “Publish” and the submitter will receive username and password before Junior Members of the CNS may qualify a confirmation email to verify completed beginning a submission. for the following awards: submission has been received. • You may use the same username/ password as you have for the CNS, Outstanding Junior Member Awards (4) however, you will be required to Review & Presentation Presented to four qualifying first/primary create this independently on the 1. Abstracts will be reviewed by minimum author of abstracts submitted by CNS Abstract website. five members of the CNS Scientific Selection Junior Members. Includes hotel/air/ • All auto generated emails will appear as and Program Planning Committee as registration fee waiver, plaque. they are coming from Emily McConnell assigned by the committee chair. (ermcconnell@childneurologysociety. 2. Anonymous review; author ID is not M. Richard Koenigsberger Scholarship org). available to reviewers prior to final Presented to best abstract submitted by Some auto generated emails show selection of abstracts. CNS Junior Member in following subject up in your spam folder. Please be 3. Notification of acceptance and guidelines areas: neonatal neurology, genetics diseases, sure to check your spam mail if for presentation will emailed to first HIV, metabolic disorders. Includes $300 you do not receive an email after author on or before May 7, 2018. scholarship and registration fee waiver. completing a submission. 4. Notification of non-acceptance will be • Please begin a submission only after emailed to first author on or after AAP Section on Neurology 1. Completely reading guidelines and May 25, 2018. Trainee Travel Award 2. When final abstract is ready to 5. Authors presenting papers in platform/ Criteria for selection will include the upload/submit plenary session(s) will be required to adhere significance of the question addressed, to ACCME financial disclosure/conflict of methodological rigor, and broad relevance Abstract Submission Link: interest guidelines as defined by the meeting to child health. All eligible submitted https://catalyst.omnipress. Joint CME Sponsor, MN Medical Association. abstracts will automatically be considered. com/#collection/302/submission Child Neurology Society | Winter 2018 21
CONNECTING WITH COLLEAGUES Focus on Young Investigators Child Neurology Society and Foundation Awards and Grants Dr. Kenneth Swaiman was honored at the 2017 CNS Annual Meeting Legacy Reception for his seminal role in founding the Child Neurology Society in 1972 and the Child Neurology Foundation Deadline in 2001. While the Society is the professional organization for the nation’s pediatric neurologists, April 1, 2018 the Foundation is committed to serving as a connective center of education and support for children and their families living with neurologic conditions. Together, the CNS and CNF have developed a joint committee, chaired by Dr. Nigel Bamford, to review applications and work submitted by young members of the CNS for the following Awards and Grants: The Philip R. Dodge Young The Child Neurology Shields Pediatric Epilepsy Research Investigator Award is an award Research Grant supports Foundation (PERF) Scientific for basic science or clinical research by translational or clinical research by a Research Grant supports clinical promising young investigators who are child neurologist or developmental or basic science research by a members of the Child Neurology Society. pediatrician early in his/her academic child neurologist or developmental Applications will be judged on the basis career. The selected investigator will pediatrician early in his/her academic of originality, scientific merit, succinctness receive a $100,000 grant of $50,000 career. The selected investigator will and relevance. The recipient of the Dodge per year for two years. The Shields receive a $100,000 grant of $50,000 award will receive a $30,000 grant-in-aid Grant is supported by the Winokur per year for two years. The PERF Grant and will be invited to present their work at Family Foundation and the Pediatric is supported fully by PERF. the Annual Meeting of the Child Neurology Epilepsy Research Foundation (PERF). Society immediately prior to the CNS Eligibility Criteria Bernard Sachs Award Lecture, signaling a Eligibility Criteria 1. The applicant completed line of succession between established 1. The applicant must be a junior training in child neurology or and emerging researchers in the field of faculty member who has developed neurodevelopment disabilities in child neurology. clinical research skills and has a an ACGME-approved program plan for further development of no more than seven years prior Eligibility Criteria that research or has basic science to application. 1. The applicant completed a pediatric research skills related to child 2. The applicant is a legal resident neurology residency on or after June 30, neurology and who has a plan of the United States or Canada. 2013 or a neurodevelopmental disability to translate the new knowledge 3. The applicant is a Junior or residency on or after June 30, 2014, into clinical care for children with Active member of the Child and graduated medical school on or neurologic diseases. Neurology Society. after May 2008, or after May 2007 if 2. The Shields Grant must have 4. Applicants with current or approved the applicant completed a 3-year a clinical research/patient pending NIH funding will be pediatric residency. care component. excluded. No NIH grant is allowed, 2. The scientific work is mainly the result 3. The applicant is a legal resident other than an institutional (i.e. K12, of the applicant’s efforts. of the United States or Canada. T32) or training grant (i.e. NRSA). 3. The applicant is a Junior or Active 4. The applicant is a Junior or member of the Child Neurology Society. Active member of the Child APPLICATIONS FOR THESE AWARDS 4. Candidates are NOT disqualified if Neurology Society. ARE DUE APRIL 1. APPLICANTS WILL they have received NIH funding. 5. Candidates are NOT disqualified if BE INFORMED OF THE COMMITTEE’S 5. Candidates should consider applying they have received NIH funding. DECISION BY MAY 10. before their final year of eligibility. 6. A pre-application is no longer To access full criteria and application, required. go to CNS website. 22 Child Neurology Society | Winter 2018
CONNECTING WITH COLLEAGUES GLOBALLY 2018 Bernard D’Souza International Fellowship Award The Child Neurology Society is now accepting applications Expenses Covered for the 2018 Bernard D’Souza International Fellowship • CNS Annual Meeting registration fee waiver Award, which will sponsor two child neurologists from • Round-trip coach fare originating and ending in developing countries to attend the 47th Annual Meeting of home country with in-between flights to/from the Child Neurology Society to be held in Chicago, Illinois Chicago, IL and a single host training program (October 15-18, 2018). Following the meeting, D’Souza (strong preference for child neurology programs fellows will spend one week visiting a selected training within 250 mile radius of Chicago, IL). Travel must program in North America before returning home. be arranged through CNS designated travel agent. The purpose of the award is to promote child neurology • Hotel room nights at CNS Annual Meeting and in developing countries. up to one-week at host training program in a CNS-designated hotel. A link will be published on the CNS 2018 Annual Meeting • Standard per diem payment for up to five days in page March 1 for applications to be submitted on-line Chicago and seven days in host training program thru May 1, 2018. Applicants will be required to upload city (including transportation to and from airport). a CV and up to three letters of recommendation. • Award recipient will be responsible for all other expenses. Requirements • Applicant trained in a developing country. • Applicant is practicing child neurology in an academic environment in a developing country. • Applicant should be prepared to present a scientific paper in English. • Preference will be shown to applicants less than age 45 years. Deadline CNS International Affairs Committee Chair, May 1, 2018 Dr. Jorge Vidaurre is pictured here with the two 2018 Bernard D’Souza International Fellowship Awardees: (Above): Dr. Charles Hammond, from Kumasi, Ghana. (Below): Dr. Aye Mya Min Aye, from Yangon, Myanmar. Child Neurology Society | Winter 2018 23
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CONNECTING WITH COLLEAGUES Focus on Young Researchers Thinking Outside the Lesion: Lesion Network Mapping By Daniel J. Bonthius, MD, PhD | CNS Connections Editor Currently, neurologists’ ability to accurately predict the clinical outcome of stroke and other focal lesions is poor. Dr. Boes hypothesizes that information regarding lesion location and the networks associated with the lesion can improve the accuracy of outcome predictions. Aaron Boes, MD, PhD I mportant advances in neurology often begin small stroke in the non-visual region of the thalamus with an intellectually curious physician observing induce visual hallucinations? Aaron hypothesized that an interesting patient. Such was the case that this condition—peduncular hallucinosis—is due to led Dr. Aaron Boes to the discovery of lesion brain dysfunction not restricted to the lesion site itself, network mapping. but to neuronal networks connected to the lesion. Aaron was a resident in child neurology at With the help of his colleagues, Aaron investigated Massachusetts General Hospital when he encountered the lesions of 23 patients with peduncular hallucinosis. an unusual teenager. The patient was a previously- He utilized the 3D volume of each lesion in a large healthy 17-year-old girl, who had the sudden onset of normative database of functional connectivity MRI visual hallucinations. She was previously a straight-A to examine the networks associated with each lesion student and captain of her soccer team, but she location. In this way, he was able to infer the remote was suddenly impaired by the presence of vivid sites impacted by the lesions. visual symptoms, including the perception of objects coming in and out of focus “like a zoom lens” and Dr. Boes found that there was much more overlap in of the scenery around her being drawn in by crayon. the networks associated with the lesions than in the A toxicology screen and head CT scan were negative, lesion locations themselves. He further found that but an MRI scan of the brain revealed a small stroke 22 of the 23 studied lesions in peduncular hallucinosis in the thalamus. fell along a single network with connectivity to the ventral extrastriate visual cortex, a brain region Aaron realized that the MRI results could explain the long-hypothesized to be involved in the generation etiology of the patient’s symptoms, but could not of hallucinations. adequately explain their mechanism. Why would a 26 Child Neurology Society | Winter 2018
To conduct these studies, Dr. Boes developed a novel method In a second project, Dr. Boes is attempting to improve the to assess the effects of cerebral lesions on remote brain regions accuracy of prognosis following the onset of focal brain lesions. and networks. The technique involves mapping a brain lesion Currently, neurologists’ ability to accurately predict the clinical from a clinical scan onto a reference brain, then using the outcome of stroke and other focal lesions is poor. Dr. Boes lesion volume as a seed region of interest for a resting state hypothesizes that information regarding lesion location and functional connectivity MRI analysis that uses normative data the networks associated with the lesion can improve the from a large representative cohort (see figure). Aaron named accuracy of outcome predictions. this technique lesion network mapping and published his findings in Brain (138: 3061-3075). In a third set of projects, Dr. Boes is studying TMS. He is working with neurosurgical colleagues, who implant Now an Assistant Professor of Pediatrics at the University of intracranial electrodes, to examine the remote effects of Iowa, Dr. Boes utilizes lesion network mapping in several TMS on network dynamics and to identify the basic exciting projects. In one project, he is examining the neural mechanisms through which TMS improves outcome in some basis for posterior fossa syndrome (PFS). Following surgery patients with depression. He hopes that understanding the of the cerebellum, many pediatric patients develop dramatic basic mechanisms of TMS will expand its clinical indications. neuropsychiatric symptoms, including mutism and other behavioral problems. With the use of lesion network mapping, Dr. Boes’ research idea—utilizing network localization to Dr. Boes is examining the neuroanatomical and neural explain symptoms—originated from a single patient with network basis for this syndrome. Elucidation of the involved visual hallucinations. The technique is proving versatile structures could guide neurosurgical approaches to avoid PFS. and durable, as it is now being used in a wide range of In addition, knowledge of the lesion-associated networks could applications, and may, someday, become a standard tool augment rehabilitation for those who develop PFS. in neurology. Figure Legends: Lesion network mapping involves two steps. First, a brain lesion from Lesion Network Mapping Method a clinical scan is mapped onto a reference brain (columns 1 & 2). Second, the lesion volume is used as a seed region of interest for a resting state functional connectivity MRI analysis that uses normative data (column 3). The lesion-associated networks derived from the latter step can be used for research or clinical applications, providing more information than is available from the lesion location alone. Dr. Boes directs the Noninvasive Brain Stimulation Clinical Program at the University of Iowa and the Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory. Child Neurology Society | Winter 2018 27
CONNECTING WITH COLLEAGUES Committee Rosters Strategic Goals of the Child Neurology Society 1. Provide current, relevant, and 4. Achieve awareness among the engaging mechanisms for life-long public and national policy makers learning among child neurologists of general health needs and Archives, Awards, Electronic challenges for individuals with communication, Ethics, International chronic neurological conditions affairs, Practice, Research Scientific of childhood origin Program Electronic communication, 2. Establish for the CNS stable and Legislative affairs consistent funding sources for 5. Engage and encourage the child specific, longitudinal, targeted neurology workforce of the future initiatives Archives, Awards, Electronic Finance communication, International affairs, 3. Achieve awareness among the public Membership and national policy makers of the 6. Provide a robust infrastructure and importance and cost-effectiveness consistent direction for the CNS of child neurologist workforce Bylaws, Finance, Long-range 2018 CNS Executive Committee: Front (L-R): Archives. Awards, Electronic planning, Membership, Nominating, Peter Kang, Mary Zupanc, Gary Clark. Back communication, Legislative affairs Administrative liaison (L-R): Bruce Cohen, Kenneth Mack, Jonathan Mink, Donald Gilbert, Michael Shevell. Archives Proximate Goal and Deliverable: Awards The 50th anniversary of the CNS will Co-Chairs: E. Steve Roach and occur in 2021-2022, beginning with Chair: Nigel Bamford Robert Rust the 50th Annual Meeting of the CNS. Emeritus: Dean Timmons Liaison: Michael Shevell The Archives Committee is charged with Liaison: Don Gilbert Staff Liaison: Roger Larson organizing and presenting historical Staff Liaison: Roger Larson documents/displays for presentation 1. Collect and categorize materials of on-site at the 50th Anniversary Meeting 1. Solicit nominations and select historic significance to the CNS. in Boston in October 2021, and on-line recipients: Hower and Sachs These materials might include before, during and after. Lectureships, Roger and Mary videos or other information about Brumback Memorial Lifetime prominent members, information Archives Committee Members Achievement Awards, and the about the founding of the Society, Dara Albert (2019) Arnold P. Gold Foundation or materials about the development Stephen Ashwal (2020) Humanism in Medicine Award. of significant concepts in the field of James Bale (2021) 2. Solicit submission of proposals and child neurology. Audrey Brumback (2019) select recipient: Philip R. Dodge 2. Create displays for the annual Pat Crumrine (2019) Young Investigator Award. meeting that illustrate the career of Francis DiMario (2019) 3. Work with Finance Committee to the Society’s award winners or the Claudio de Gusmao (2019) secure sustainable funding for awards. history of the Society. John Mytinger (2019) 4. Work with Archives Committee to 3. Pursue and create innovative uses, Farooq Osman (2019) ensure publicity of award winners showcasing, and publicizing of Phillip Pearl (2021) in lay and professional press and materials created that serve to educate Thomas Reynolds (2018) to awardees’ respective U.S. the public and national policy makers Robert Safier (2019) governmental representatives. about the contributions of child Nina Schor (2021) 5. Work with Child Neurology Foundation neurology and child neurologists to review and select CNF Scientific to healthy communities and cost- Grant/Awards submissions. effective, high-quality health care. 28 Child Neurology Society | Winter 2018
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