ResearchMattersChildren’s Foundation Research Institute: Primary Contact PersonnelDennis Black, MD, Scientific Director: (901) 287-5355; CFRC 475R

Eunice Huang, MD, Chief Research Biomedical Informatics Officer: (901) 287-6300; FOB 267

Sheon Lynch, Executive Director: (901) 287-6208; CFRC 478R

Tamekia Jones, PhD, Director, Biostatistics Core: (901) 287-4473; CFRC 476R

Chris Smith, Director of Finance and Research Lab Operations: (901) 287-5090; CFRC 479R

Venessa Spearman, Director of Grant Adm and Contract Development: (901) 287-5036; CFRC 482R

Seun Ajayi, Biomedical Informatics Research Specialist: (901) 287-6879; CFRC 464R

Camden Harrell, Biostatistician: (901) 287-5646; CFRC 463R

Thomas Hobson, Business Manager: (901) 287-5221; CFRC 758R

Billie Masek, Research Lab Manager: (901) 287-5083; CFRC 312R

Kerry Moore, Manager of Regulatory and Compliance: (901) 287-6871; CFRC 479R

Amanda Preston, PhD, Scientific Editor: (901) 287-5368; CFRC 481R

Ruchi Ruchi, Biomedical Informatics Research Specialist: (901) 287-5044: CFRC 461A

Terrie Swearingen, Executive Assistant: (901) 287-5355; CFRC Reception area

Lauren Camp, Surgery Research Data Specialist: (901) 287-5425; FOB 2nd fl

Jordan Cunningham, Cardiology Clinical Research Coordinator: (901) 287-7457; FOB 358

Ellen Ellison, Clinical Research Coordinator (UT): (901) 287-7485; CFRC 369R

Kenishia Guy, Research Data Specialist, Neuroscience & Cardiology: (901) 287-6871; FOB 3rd fl

Cathy Horobetz, Pulmonology Clinical Research Coordinator (UT): (901) 287-6483; FOB 211

Latonya Ivy, Clinical Research Coordinator: (901) 287-6474; FOB 125

Krislyn Jeffries, Research Data Specialist : (901) 287-5179; CFRC 4th fl Reception area

Raquel Mack, Obesity Program Clinical Research Coordinator (UT): (901) 287-6869; CFRC 367R

Tracee Ridley-Pryor, Neuroscience Research Director: (901) 287-5338; FOB 376

Jonathan Rowland, Ortho Clinical Research Coordinator: (901) 287-5413; FOB 111

Brandy Vaughn, Neurosurgery Clinical Research Coordinator: (901) 287-5892; Main Hosp 7107

Misha Webb, Neurology Clinical Research Coordinator: (901) 287-5330; FOB 377

Le Bonheur neuroscientist to present research at AES

Le Bonheur neuroscientist Abbas Babajani-Feremi, PhD, will present his research using a novel presurgical language mapping method to predict postoperative language deficits in December at the 2018 Annual Meeting of the American Epilepsy Society (AES). His research explores various neuroimaging techniques including functional magnetic resonance imaging (fMRI), diffusion-weighted imaging (DWI) and magnetoencephalography (MEG) and compares how each technique predicts postoperative language deficits. “The aim of this study was to compare the predictive power of DWI, fMRI and MEG to determine postoperative language outcome,” said Babajani-Feremi. “Results of this study could be utilized by physicians to calculate the language outcomes of different resection plans prior to surgery, and select the optimal surgical plan by accurately weighing the risk and benefits of each plan.”

Babajani-Feremi will present the results from 11 pediatric patients who underwent epilepsy surgery. All patients underwent presurgical language mapping using DWI, fMRI and MEG. Patients also received pre- and six-month post-operative neuropsychological evaluation of language using the Boston Naming Test (BNT).

Nine patients had some degree of postoperative language deficit. As predicted, patients with greater language deficit had more resected language areas, as identified through presurgical language mapping using fMRI and MEG. They also had a larger ratio of resected fiber tracts of the language network.

The study also compared the prediction error of the three methods and found that the error of DWI mapping was less than MEG but larger than fMRI, although there was no significant difference between each. However, a multimodal model using all three methods (i.e. DWI, fMRI and MEG) had a significantly smaller margin of prediction error than the unimodal models.

Fall 2018

(continued on page 2)

(continued from page 1)Le Bonheur neuroscientist to present research at AES

Babajani-Feremi concluded that the use of multiple presurgical language mapping modalities should be used prior to epilepsy surgery as it leads to a safer surgery for the patient. “The results of the study showed that it is highly desirable to have additional presurgical language mapping methods,” said Babajani-Feremi. “A multimodal language mapping approach based on DWI, fMRI and MEG can provide an accurate and reliable prediction for postoperative language outcome.”

Le Bonheur Children’s Hospital has the unique ability to utilize state-of-the-art equipment, like its brand new MEG, for presurgical functional mapping in children undergoing epilepsy or tumor surgery. “While there are several MEG systems in the U.S., not all have been actively used for presurgical functional mapping,” said Babajani-Feremi. “Our team of physicians and researchers utilize these groundbreaking imaging techniques in treatment of children with epilepsy.”

Kerry Moore, RN, BS, CCRC, has been promoted to manager of Research Regulatory and Compliance. In her new role, she will oversee all regulatory and compliance issues for clinical trials conducted at Le Bonheur to ensure compliance with federal and institutional regulations and guidance. Kerry will audit and monitor investigator-initiated studies, provide supervision for CFRI research nurse coordinators and training for division

research coordinators.

Kerry joined CFRI in 2018, as the IRB Regulatory Coordinator and has worked closely with UTHSC, IRB, Le Bonheur and university staff. She has been a certified clinical research coordinator through the Association of Clinical Research Professionals (ACRP) for 16 years. She has been a nurse for 25 years, and 18 of those years have been in the clinical research setting.

CFRI researchers are publishing articles in greater number, and in higher impact journals. The projected number of articles published by our researchers for the end of 2018 is 226. Approximately 42.5% of all CFRI journal articles are published in the top quartile of journals, based in Impact Factor rank in primary subject category (Impact Factor rankings from Journal Citation Reports, Clarivate Analytics; http://jcr.incites.thomsonreuters.com).

Moore named Research Regulatory and Complicance manager

CFRI projected to publish 226 articles in 2018

Laboratory SafetySafety is the No. 1 priority in the lab. Eyewash station maintenance and appropriate chemical storage are important areas of the lab that are often overlooked. Please take the time to check these areas in your lab.

• Eyewash Stations: Check your eyewash stations weekly. Ensure that eyewashes are not blocked and are in good working order by flushing the eyewash once a week for a period long enough to verify operation and ensure that flushing fluid (water) is available and running clear.

• Chemical Storage: Make sure all your chemicals are stored appropriately – in particular, ensure that all secondary containers are labeled appropriately. If you are unsure of the correct storage for a chemical, consult the Safety Data Sheet and contact the CFRI Research Laboratory Manager, Billie Masek (Billie.Masek@lebonheur.org; 287-5083), for assistance.

Le Bonheur researchers explore social determinants of health in Nature Digital Medicine

Environmental and socioeconomic sociomarkers can predict the likelihood of a pediatric asthma patient’s return visit to the hospital, according to new research from the Center for Biomedical Informatics at the University of Tennessee Health Science Center.

“Health is a social as much as a biological matter,” said Arash Shaban-Nejad, PhD, MPH. “Our research directly shows the importance of living environment and social and economic conditions for individual health outcomes.” He and fellow researchers Oguz Akbilgic, PhD, Ruhi Mahajan, PhD, and Eun Kyong Shin, PhD, published research in Nature Digital Medicine.

Their research introduced the idea of sociomarkers – a measurable indicator of social conditions in which a patient is embedded. The sociomarkers used in this study included the proportion of individuals living below the federal poverty level, blight prevalence, neighborhood quality, trash dumping presence and broken window pervasiveness. The research focused on pediatric asthma, one of the major chronic conditions in the United States (U.S.) and worldwide with high sensitivity to the environment and sociomarkers.

The study compiled information from three data sources – pediatric asthma encounter records from 2016 at Le Bonheur Children’s Hospital in Memphis, the 2010 U.S. Census and the neighborhood and quality survey data by Memphis Property Hub. By integrating these datasets and performing analytics, researchers were able to examine the effect of social features in identifying the patients who visited the hospital more than once during the observation period.

Using demographic information and sociomarkers alone, researchers could predict which patients would return to the hospital with 61percent accuracy. Using demographics and biomarkers alone predicted return visits with 65 percent accuracy and using all three data sets – demographics, biomarkers and sociomarkers – could predict with 66 percent accuracy.

Because of the importance of sociomarkers in health, the study proposes further exploration into the effect of environment in other areas of medicine so that healthcare providers can predict which patients may be prone to certain health outcomes.

Shin EK, Mahajan R, Akbilgic O, Shaban-Nejad A. Sociomarkers and biomarkers: predictive modeling in identifying pediatric asthma patients at risk of hospital revisits. npj Digital Medicine 2018; 1:50.

John Bissler, MD has dedicated more than 30 years of his career to reduce the suffering for tuberous sclerosis complex patients and their families. Here at UTHSC and Le Bonheur Children’s Hospital, this is evident in the world-class Tuberous Sclerosis Complex Center of Excellence, which he directs with his co-Directors, Jim Wheless, MD, and Tanjala Gipson, MD. His basic science and clinical research efforts are trained on trying to find ways to help these patients and families.

For families who cannot afford to come to Memphis, the TSC Center of Excellence is employing telehealth, supported in part by the Be Cureful Charity, to provide world-class care at the

family’s kitchen table. In addition, Bissler has been supported in his efforts to deliver care to patients who have no help. Organizations in other countries raise money for his travel, and he visits, teaches and sees patients in many

different countries. The support from the University and Le Bonheur Children’s Hospital has been greatly appreciated.

During one recent trip to Yichang, China, Bissler encountered a pale child with tuberous sclerosis complex who had significant flank pain and a history classic for a tumor hemorrhage. They quickly got a CT angiogram that confirmed Bissler’s diagnosis. Instead of using the local practice of removing the child’s kidneys, Bissler taught them a procedure that he had pioneered over his career - to remove the tumor blood supply but avoid the vigorous immune reaction called post-embolization syndrome.

The child was almost pain-free in less a day and was able to return home taking a medicine that Bissler had studied that also worked to treat these lesions. The ability to quickly restore the child to such health and to be able teach and change the approach to such devastating disease left a family, a community and a country of patients with a rare disease with significant hope, all because of the compassion and understanding initiated in Le Bonheur Children’s Hospital.

John Bissler is chief, Division of Pediatric Nephrology, Le Bonheur Children’s Hospital, Federal Express Chair of Excellence, Professor of Pediatrics, UTHSC Department of Pediatrics, and medical director of Nephrology, St. Jude Children’s Research Hospital.

TSC Center of Excellence Outreach

Top Panel: Arrow points to hemorrhage in patient’s right kidney. Both kidneys had significant tumor burden. Bottom Panel: Local interventional radiologists perform procedure with Dr. Bissler’s guidance.

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53. Tokita MJ, Chen CA, Chitayat D, Macnamara E, Rosenfeld JA, Hanchard N, Lewis AM, Brown CW, Marom R, Shao Y, Novacic D, Wolfe L, Wahl C, Tifft CJ, Toro C, Bernstein JA, Hale CL, Silver J, Hudgins L, Ananth A, Hanson-Kahn A, Shuster S; Undiagnosed Diseases Network, Magoulas PL, Patel VN, Zhu W, Chen SM, Jiang Y, Liu P, Eng CM, Batkovskyte D, di Ronza A, Sardiello M, Lee BH, Schaaf CP, Yang Y, Wang X. De Novo Missense Variants in TRAF7 Cause Developmental Delay, Congenital Anomalies, and Dysmorphic Features. Am J Hum Genet. 2018 Jul 5;103(1):154-162. Epub 2018 Jun 28. PubMed PMID: 29961569; PubMed Central PMCID: PMC6035372.

54. Veerapandian R, Snyder JD, Samarasinghe AE. Influenza in Asthmatics: For Better or for Worse? Front Im-munol. 2018 Aug 10;9:1843. eCollection 2018. Review. PubMed PMID: 30147697; PubMed Central PMCID: PMC6095982.

55. Veras LV, Smith JR, Gosain A. Lack of disparities in screening for associated anomalies in children with anorectal malformations. J Surg Res. 2018 Nov;231:10-14. Epub 2018 May 30. PubMed PMID: 30278916; PubMed Central PMCID: PMC6173204.

56. Waldman M, Han JC, Reyes-Capo DP, Bryant J, Carson KA, Turkbey B, Choyke P, Naggert JK, Gahl WA, Mar-shall JD, Gunay-Aygun M. Alström syndrome: Renal findings in correlation with obesity, insulin resistance, dyslipidemia and cardiomyopathy in 38 patients prospectively evaluated at the NIH clinical center. Mol Genet Metab. 2018 Sep;125(1-2):181-191. Epub 2018 Jul 24. PubMed PMID: 30064963.

57. Weems MF, Upadhyay K, Sandhu HS. Survey of ECMO practices for infants with hypoxic ischemic encepha-lopathy. J Perinatol. 2018 Sep;38(9):1197-1204. Epub 2018 Jul 25. PubMed PMID: 30046182.

58. Wheless JW, Gienapp AJ, Ryvlin P. Vagus nerve stimulation (VNS) therapy update. Epilepsy Behav. 2018 Jul 12. pii: S1525-5050(18)30487-6. [Epub ahead of print] Review. PubMed PMID: 30017839.

59. Willis KA, Weems MF. Hemodynamically significant patent ductus arteriosus and the development of bron-chopulmonary dysplasia. Congenit Heart Dis. 2018 Oct 20. [Epub ahead of print] PubMed PMID: 30343505.

60. Yuhan BT, Svider PF, Mutchnick S, Sheyn A. Benign and Malignant Oral Lesions in Children and Adolescents: An Organized Approach to Diagnosis and Management. Pediatr Clin North Am. 2018 Oct;65(5):1033-1050. Review. PubMed PMID: 30213347.

CFRI Publications July – October 2018