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Developmental Research Program Making a Difference for Multiple Specialties

Dr. Namasivayam Ambalavanan looks through a microscope in a lab at UAB. Ambalavanan leads the TReNDD research program at Children’s.

Much research in pediatrics focuses on disorders related to specific organ systems such as the brain, liver or kidneys, without an emphasis on the developmental time period that influences how those disorders may unfold in babies and young children. But a 15-year-old program at Children’s of Alabama bridges that gap, connecting investigators from a bevy of disciplines and supporting basic and translational research efforts that have paid off in better outcomes for patients.

Established in 2008, the Translational Research in Normal and Disordered Development (TReNDD) program is run by the Division of Neonatal Research. Namasivayam Ambalavanan, M.D., has been at the helm since its inception, directing TReNDD and neonatal research as well as co-directing the Division of Neonatology at Children’s.

“Our focus is on normal and abnormal development from late fetal life through early childhood—not so much on one disease or organ system, but the entire time period,” Ambalavanan said. “Ours is a highly collaborative network, bringing together people interested in disorders that occur during this time period. It’s relevant to all pediatrics, rather than one subspecialty.”

Faculty members from pediatric specialties such as neonatology, nephrology, pulmonology and critical care participate in TReNDD and typically approach the program with a certain research priority in mind, Ambalavanan explained. Ongoing basic science and clinical research projects, for example, are examining a wide variety of problems affecting neonates and other infants, from ventilator-induced lung injury to acute kidney injury to vitamin D supplementation in preterm babies.

Investigators can also rely on TReNDD facilities to help advance these projects, including core facilities able to run a wide variety of assays and a repository of pediatric biospecimens and model systems.

“Investigators come in with an area of interest, and we help them develop an animal model or assay to meet that interest,” Ambalavanan said. “We also put them in touch with additional people who can help, whether here or off campus.”

Over its history, the TReNDD program has produced research breakthroughs that have benefited children far and wide. Evaluating multiple signaling pathways during lung development, for example, led to key insights about lung impairments in preterm infants and tests determining who’s most vulnerable to certain breathing problems from their first day of life. Other lung research on the microbiome of tracheal aspirates of preterm babies led to the development of probiotics that can benefit lung health.

“I think TReNDD has a vital role because there are many people who want to do pediatric research but don’t know how to get started,” said Ambalavanan. “We’re a way of enabling people to both get their research done and find mentorship in research in the Department of Pediatrics.”

Upcoming Events

Children’s and UAB to Host International Neonatal Nephrology Symposium

The inaugural International Neonatal Nephrology Symposium (INNS) takes place in Birmingham in September 2024.

The Pediatric and Infant Center for Acute Nephrology (PICAN) at Children’s of Alabama and the University of Alabama at Birmingham (UAB) will host the inaugural International Neonatal Nephrology Symposium (INNS) September 11-15, 2024, at the Hilton Birmingham Downtown at UAB.

This symposium will bring together experts, researchers and clinicians from across the globe to share knowledge, exchange ideas and collaborate on the latest advancements in neonatal kidney disease. The event will provide a unique platform for networking and foster scientific dialogue that will contribute to improving outcomes in the youngest patients.


  • Practical aspects of neonatal kidney care—the science and the art
  • From crib to bench and back to the crib
  • Kidney health metrics in neonates and young children
  • Fetal kidney disease—a new era
  • Neonatal organ cross talk
  • Neonatal nephrology potpourri

Featured Workshops

  • Clinical roundtables—caring for neonates with kidney disease and their families
  • Hands-on practical skills sessions—tools to optimize care of neonates with kidney disease

For more information, visit

Hematology and Oncology

Proton Center Offers Safer Cancer Treatment Option

The UAB Proton Center, a technologically advanced, 32,500-square-foot facility, opened in 2020. (Andrea Mabry/UAB)

Until 2020, pediatric cancer patients in Alabama who could benefit from proton radiation needed to travel far and wide to receive the state-of-the-art treatment. Now, Children’s of Alabama, in a joint program with the University of Alabama at Birmingham (UAB), offers the first and only proton center in Alabama, enabling young patients to stay closer to home and attracting others from surrounding states.

The center, which opened at the advent of the COVID-19 pandemic, has more than doubled the number of pediatric cancer patients it treats in just the last three years—from 11 in 2020 to 23 by the midpoint of 2023.

Before the proton center opened, Children’s and UAB would send many patients to be treated at other hospitals. “Now, we draw patients from all of Alabama as well as from Mississippi, Georgia and the Florida panhandle,” said Michael Soike, M.D., a radiation oncologist at Children’s and an assistant professor of radiation oncology at UAB. “It has also grown the trust and collaboration between UAB and Children’s in meaningful ways.”

Unlike traditional X-ray or “photon” radiation, proton therapy delivers positively charged particles to tumors at extremely high energy. This energy enables protons to stop at the desired depth in the body instead of traveling all the way through. The result? Cancer cells are destroyed with pinpoint precision without damaging healthy surrounding cells.

This equates to fewer side effects and less long-term damage that could seriously impact a child’s quality of life and future, including problems with growth and cognition as well as secondary cancers, Soike said.

About 85% of Children’s oncology patients undergoing radiation now receive proton therapy instead of traditional radiation. Proton therapy is particularly well-suited for certain brain and spinal cord tumors, lymphomas and sarcomas since it avoids sensitive tissues around the brain, heart and lungs.

“In young patients, we want to spare brain tissue from radiation as much as we can,” Soike explained. “It can mean the difference between a child being able to excel in life, attend college and live a normal life after treatment for a brain tumor instead of a child that struggles to finish high school and is significantly impaired.

“Proton therapy isn’t more effective for treating cancers—the cure rates are similar—but the late side effects are reduced,” Soike added.

Clinical trials in proton therapy at Children’s are building on prior research to test personalized treatment protocols appropriate to each patient’s case. For example, the Head Start 4 trial now in progress allows the use of a chemotherapy-first approach and then radiation tailored to the response of the tumor in children up to age 10, Soike said. “As with every clinical trial, it is experimental, but it significantly reduces the dose and field of radiation we would typically deliver. The protocol takes a chance at giving the child a head start on life after cancer—pun intended.”

The proton center includes 20,000 square feet of clinical space, offices, exam rooms and prep/recovery areas. Multidisciplinary tumor boards meet weekly to discuss individual cases, tailoring treatment to each patient.

“What stands out at Children’s is that we have this really well-oiled machine where we know each other’s expertise and what each of us can do,” Soike said. “Our culture here is collaborative, and we all learn from each other in important ways.”

Hematology and Oncology

Increasing HPV Vaccination Rates in Young Cancer Survivors

A Children’s of Alabama researcher is working to improve HPV vaccination rates among childhood cancer survivors.

Childhood cancer survivors are significantly less likely to receive the HPV vaccine than their peers without cancer, despite having a three times higher risk of developing HPV-related cancers later in life[1]. A new initiative at Children’s of Alabama aims to improve vaccination rates, so patients can be protected long into their survivorship.

According to an HPV vaccine study led by Wendy Landier, Ph.D., CRNP, uptake among childhood cancer survivors was only about 24% compared to more than 50% in the general population. Although it’s not clear why young cancer survivors are more at risk for HPV-related cancers, it is likely due to effects from radiation and chemotherapy.

“One major reason for low vaccine uptake is that cancer survivors often don’t get a recommendation from their healthcare provider to receive the vaccine,” said Landier, the deputy director of the Institute for Cancer Outcomes and Survivorship at Children’s and the University of Alabama at Birmingham (UAB). Without that recommendation, there is a tenfold higher risk the young cancer survivor will not get the vaccine. This could be due to gaps in follow-up care after cancer treatment, Landier said, when preventive health measures such as vaccination may be overlooked. “When a child has cancer, they are often followed in their cancer center or in their pediatric hematology oncology center for many years beyond their treatment,” she said. “Sometimes the focus of that follow-up care is on the disease and not prevention.”

The vaccine, which helps prevent cervical, anal, penile and throat cancers, is recommended for everyone ages 9 to 26, and should be considered for people up to age 45. But, Landier said, primary care providers may also be uncertain about whether it’s OK to vaccinate these children. Landier and her team showed the vaccine is safe and provides a similar level of protection against HPV in pediatric cancer survivors when compared with people of similar age in the general population.[2]

Their study also showed, however, that the main reasons cancer survivors and their parents refused to participate in the trial testing the safety and efficacy of the vaccine were health beliefs and family decisions—for example, some had already decided that the child would not receive the HPV vaccine. Vaccine-related information deficits can influence vaccine refusals. For example, some parents or patients may not understand that males can benefit from the vaccine or that it should be given before a person becomes sexually active.[3]

To improve vaccination rates in pediatric cancer survivors, Landier is currently leading a study to test an intervention called HPV PROTECT.[4] The goal is to educate pediatric oncology providers on the importance of recommending the vaccine. The intervention focuses on communication training and tools to facilitate vaccine access. Investigators then monitor the vaccination rates in the clinic and let the providers know how they’re doing.

Early results are promising, Landier said, with pediatric oncology providers showing enthusiasm for the intervention. The intervention shouldn’t be limited to pediatric oncologists, however. “It can benefit all pediatric providers,” she said.

“Vaccines are such an incredibly important tool in helping our survivors to stay healthy across the lifespan,” Landier said. “And we certainly hope in the future there’ll be other vaccines to even prevent the original cancers.”

[1] Klosky JL, Hudson MM, Chen Y, Connelly JA, Wasilewski-Masker K, Sun CL, Francisco L, Gustafson L, Russell KM, Sabbatini G, Flynn JS, York JM, Giuliano AR, Robison LL, Wong FL, Bhatia S, Landier W. Human Papillomavirus Vaccination Rates in Young Cancer Survivors. J Clin Oncol. 2017 Nov 1;35(31):3582-90. Epub 20170824. doi: 10.1200/jco.2017.74.1843. PubMed PMID: 28837404; PMCID: PMC5662846.

[2] Landier W, Bhatia S, Wong FL, et al. Immunogenicity and safety of the human papillomavirus vaccine in young survivors of cancer in the USA: a single-arm, open-label, phase 2, non-inferiority trial. Lancet Child Adolesc Health. 2022;6(1):38-48. doi:10.1016/S2352-4642(21)00278-9

[3] Cherven B, Klosky JL, Keith KE, Hudson MM, Bhatia S, Landier W. Reasons for refusal of the human papillomavirus vaccine among young cancer survivors. Cancer. 2023;129(4):614-623. doi:10.1002/cncr.34521

[4] Landier W, Bhatia S, Richman JS, et al. Implementation of a provider-focused intervention for maximizing human papillomavirus (HPV) vaccine uptake in young cancer survivors receiving follow-up care in pediatric oncology practices: protocol for a cluster-randomized trial of the HPV PROTECT intervention. BMC Pediatr. 2022;22(1):541. doi:10.1186/s12887-022-03562-1

Hematology and Oncology

At the Intersection of Sickle Cell Disease and Asthma

A child uses an inhaler. (Stock photo)

While many people know of sickle cell disease (SCD), it may be surprising to learn that there is a high prevalence of co-occurring asthma among children with SCD. Brandi Pernell, DNP, has been researching social determinants of health that impact young patients with a double diagnosis.

“While I was pursuing different strategies for improvements among the asthma population, I discovered a connection between environmental stress and asthma,” said Pernell, an assistant professor in hematology and oncology at Children’s of Alabama and the University of Alabama at Birmingham (UAB). “When you look at the general population in comparison to the sickle cell population, you’re going to see that more children with sickle cell have a diagnosis of asthma because these two conditions have some overlapping inflammatory physiological pathways. That in itself is going to increase the risk of having asthma along with sickle cell.”

Asthma affects oxygen levels, especially among those who are undiagnosed or who are diagnosed but whose disease isn’t fully managed, Pernell said. And low oxygen is a risk factor for red-cell sickling. Patients with both asthma and SCD experience higher rates of pain and acute stress as a result.

Pernell estimates that she provides clinical care for 80 to 90% of young patients in the area who have both SCD and asthma, as well as any patient hospitalized with acute chest syndrome, an acute lung complication. “I have an acute care follow-up clinic where I see anybody who has been hospitalized with acute chest syndrome within four weeks of discharge to make sure that they have focused sickle cell management and any asthma management that needs to take place to reduce the risk of it happening again,” she said.

Another major component of care, Pernell believes, is patient education. She works with community-based organizations and the Sickle Cell Disease Foundation to provide health education. She also gives patients and their families handouts with up-to-date information for disease management. “I try to employ a multimodal approach to education, but I think that the best method is still face-to-face interaction,” she said. “After all the clinical care is done, I take time to see if there are any questions from patients. I explain why I’m recommending this therapy or why this therapy is so important and how it works exactly in your body—because I think that improves adherence if you understand why you need it—or what can happen if you don’t take a medicine or how it could further impact your health in a negative way.”

Support for her patients is also multi-modal. Pernell relies on assistance from a social worker who can lock in community services as needed. She also works with the Children’s of Alabama school liaison to ensure patients have comprehensive support. “By school age, about 30% of children with sickle cell will have suffered a silent stroke, which can impact the child neurocognitively and lead to a decline in academic performance,” Pernell said. She and the liaison also make sure that each patient has a 504 plan in place for important classroom accommodations, such as being able to maintain hydration and avoid temperature extremes to avoid a sickle cell crisis.

The research Pernell has undertaken looks closely at social determinants of health and those factors within a patient’s control that can improve symptoms. “We are focusing on lifestyle interventions,” she said. “Are there dietary changes (that can reduce symptoms?) Are there different stress reduction tactics that can be taken or things prenatally that moms can do?”

These and other research questions are also guided by input from the patients themselves. Pernell believes that patients, as the ultimate end users of any research discoveries, must be invested in the research planning process and study design. “We need to make sure that the outcomes that we’re pursuing are the outcomes that the patients themselves care about.”


New Device Makes Esophageal Endoscopy Faster and Safer for Patients with EoE

Dr. Nicholas CaJacob performs a transnasal endoscopy on a patient using a new endoscope manufactured by EvoEndo.

Children’s of Alabama is among the first 10 pediatric medical centers in the nation to use a new endoscope that can make transnasal endoscopy (TNE) faster and easier for some patients with eosinophilic esophagitis (EoE). The device, manufactured by EvoEndo, was approved by the U.S. Food and Drug Administration last year. Children’s began using it in June 2023.

EoE is a chronic immune-mediated inflammatory disease of the esophagus resulting in symptoms and signs of esophageal dysfunction. Physicians use endoscopy every two to three months to biopsy tissue to evaluate treatment success. The new endoscope, which is inserted through the nose into the esophagus, requires no general anesthesia, just an anesthetic spray to numb the nasal passages. Patients remain awake during the procedure and need to fast only for two hours prior. Virtual reality goggles keep patient’s focus off the procedure, while a family member can be in the room observing and getting updates in real time. Children’s pediatric gastroenterologist Diana Montoya Melo, M.D., says it’s a potential game changer for patients and their families.

Montoya Melo and Nicholas CaJacob, M.D., also a pediatric gastroenterologist at Children’s, each perform about 10 EoE endoscopic procedures a week.Previously, the standard endoscopic procedure involved inserting the endoscope through the mouth into the esophagus. That method requires general anesthesia and intubation, fasting for at least six hours, a very early arrival at the hospital, IV insertion and about an hour in the recovery room after the 10-minute procedure—all of which puts a tremendous burden on the family and increases costs and the risk of potentially serious side effects.

With the new device, transnasal endoscopies takes about 15 minutes, and Montoya Melo expects the endoscopy team to be able to complete them even faster as they gain more experience. Patients also are able to leave right after the procedure. “We don’t have to monitor anything,” she said. “We’re getting the same results but in a safer, more convenient way for families and patients.”

An added bonus, Montoya Melo says, is that the endoscope is disposable. “Families like to know that it hasn’t been used on anybody before.” This also expedites the procedure because doctors don’t have to process or reprocess the equipment. “We just take it out of the box and use it,” she said. The device is approved for children 5 and older, although most centers limit its use to those 10 and older, she says.

TNE isn’t for everyone. “There are some children who are more anxious, or they will not tolerate the endoscope going through the nose,” Montoya Melo said. “This is mostly for patients and families who are interested in a different approach.” One way to know if a child is a good candidate? “We ask how they tolerated their COVID test,” she said. “And we tell them it won’t feel any worse than that.”


Gupta Aims to Make Children’s a “Destination of Choice” for Gastroenterology

Dr. Sandeep Gupta joined Children’s of Alabama as chief of Pediatric Gastroenterology, Hepatology and Nutrition in April 2023.

Ask Sandeep Gupta, M.D., Children’s of Alabama’s new chief of the Division of Pediatric Gastroenterology, Hepatology and Nutrition, about his goals, and he answers immediately: “To drive positive change and empower people to rise. At the end of the day, their success is our collective success.”

To that end, he said, he wants to bring “positive energy and collaborative change so as to make everyone a winner.” Without that, he said, the department can’t do its most important job: serving patients.

Gupta came to Children’s of Alabama in April after nearly 30 years at Indiana University School of Medicine and Riley Hospital for Children in Indianapolis. He brings leadership experience to Children’s, including roles as the editor-in-chief of the Journal of Pediatric Gastroenterology and Nutrition and the vice-chair of the Pediatric Growth and Development Biology Section of the American Gastroenterological Association Institute. He’s also the co-director of the training core and chair of the publications committee of the Consortium of Eosinophilic Gastrointestinal Diseases Researchers (CEGIR). Since his arrival, he’s been impressed by the team at Children’s.

“The beauty of GI at Children’s of Alabama/the University of Alabama at Birmingham (UAB) is the fantastic people in the division,” he said. “People are our most valuable resource. Our people are here for the right reason, they have their heart in the right place, and they want to do the right thing.”

He wants to make their jobs easier and more efficient with stronger infrastructure and support systems, so, as he said, “We are working at the top of our license and being effective, rather than just busy.” That means ensuring goals and synergies are aligned. He also wants to drive the academic mission in addition to patient care. “We want to take care of all patients—from simple to complex—and serve the missions of Children’s and of UAB,” he said.

Gupta wants to make Children’s a destination of choice, not just of need, by patients. He envisions Children’s as a preeminent center of excellence, not only in Alabama, but also in surrounding areas regionally and nationally. His vision encompasses four As: access for patients, ambitions and aspirations for GI personnel and academic work.

Gupta’s special areas of focus are in eosinophilic GI diseases, nutrition, pediatric obesity and pediatric endoscopy. “What I love about this field is there is so much innovation happening, plus a strong national and international community,” he said. “Yes, we do procedures, but we also use our analytical skills because we are seeing patients in clinic and in the hospital and delivering exemplary care. GI provides an enviable mix of critical thinking and procedural skills.”


New Clinic Offers Care for Children with Pancreatitis

Children with chronic pancreatitis are at increased risk for multiple issues.

While pancreatitis is not as prevalent in children as in adults, it can be an aggressive disease resulting in significant morbidity and even death. Now, children with this condition have access to a multidisciplinary clinic at Children’s of Alabama designed to manage their medical, physical and emotional health needs.

Chinenye Dike, M.D. M.S, a pediatric gastroenterologist at Children’s, started the Pancreatic Disorders Center of Excellence clinic in January 2023. It serves children with any type of pancreatitis, whether it be a single episode or recurrent attacks and chronic pancreatitis. It also serves children with pancreatic ductal anomalies and exocrine pancreatic insufficiency from other causes such as Shwachman-Diamond syndrome. The clinic is the only National Pancreas Foundation Pediatric Center of Excellence in Alabama.

“A major advantage of the multidisciplinary format is the ability to address the diverse medical and psychosocial effects of chronic pancreatic diseases all in one place,” Dike said. “Children with chronic pancreatitis are at increased risk for multiple issues including constant pain, missed school, diabetes, poor nutrition and reduced quality of life.” By bringing together physicians, nutritionists, pain specialists, psychologists and other providers to evaluate and create integrated treatment plans for these patients, Dike says the clinic aims to improve long-term outcomes and reduce repeat hospitalizations.

The multidisciplinary team also includes a genetic counselor—because many children with chronic pancreatitis have genetic mutations—and a pediatric endocrinologist to address endocrine complications from chronic pancreatitis, such as Type 3c diabetes, which develops when the pancreas experiences damage, such as from chronic pancreatitis or cystic fibrosis.

The clinic sees patients once a month. “We have the potential to grow,” Dike said, “given the increasing need for specialized pediatric pancreatic care in Alabama and surrounding states.” Data shows that some children can develop chronic pancreatitis even without a first episode of acute pancreatitis, she says, while some children with a severe first episode of acute pancreatitis can progress to chronic pancreatitis within four years. Additionally, a child’s quality of life can be impaired, and complications can develop after just a single episode of acute pancreatitis.

Dike and her team also track outcomes, including patient-reported outcomes such as quality of life.


Children’s, UAB to study diabetes in minority youth

Cases of Type 2 diabetes are on the rise among minorities in the U.S.

By Emma Shepard (UAB)

The prevalence of Type 2 diabetes in youth is increasing in the U.S., primarily among minorities, with Black and Hispanic youth showing the greatest increase. Neither the reason for the increase nor the mechanism underlying the disproportionate risk in minority youth is known.

Researchers at Children’s of Alabama and the University of Alabama at Birmingham (UAB) have received more than $3.7 million from the National Institutes of Health to study the increasing prevalence of diabetes in youth as part of a nationwide consortium. Ambika Ashraf, M.D., director of the Division of Pediatric Endocrinology and Diabetes at Children’s of Alabama and UAB, and Barbara Gower, Ph.D., interim chair and professor in the UAB Department of Nutrition Sciences, will lead the UAB site.

The study is part of a project designed to identify the predictors of Type 2 diabetes in youth. UAB and Children’s, located in the U.S. diabetes belt and home to the UAB Comprehensive Diabetes Center and Diabetes Research Center, were collectively one of 15 institutions selected to participate.

“Our research aims to further understand health disparities in diabetes prevalence, as well as study the impact of particular risk factors on the conversion of prediabetes to Type 2 diabetes,” Ashraf said. “This knowledge would allow us to better treat children, especially minority children, who have prediabetes.”

Prediabetes is a serious health condition in which blood sugar levels are higher than normal, but not high enough yet to be diagnosed as Type 2 diabetes. 

Over the course of the project, which will end in November 2027, researchers hope to enroll 1,500-3,000 youth who are at risk for diabetes. The main objective of the study is to identify factors that predict conversion to Type 2.

All participants will be non-diabetic, but at risk, at the time of recruitment and baseline testing. The team of researchers will record body composition, beta-cell function, insulin sensitivity, diet, physical activity, psycho-social factors, the intra-uterine environment, genetic polymorphisms related to diabetes risk and other factors that may affect risk for Type 2 diabetes.


Personalized Care for Pediatric Thyroid Cancer Patients

Dr. Sajal Patel leads the Thyroid Nodule Clinic at Children’s of Alabama.

Pediatric endocrinologists at Children’s of Alabama are caring for children and adolescents with thyroid cancer in a leading-edge, multidisciplinary thyroid nodule clinic. Sajal Patel, M.D., and Nicole Barnes, M.D., take a multidisciplinary approach to assessing thyroid nodules and, if they are cancerous, managing them in conjunction with pediatric surgeons, nuclear medicine specialists and pathologists, along with their adult counterparts.

Thyroid cancer is rare in children, with a prevalence ranging from 4 to 5 per 100,000 compared with approximately 14.3 per 100,000 in adults. However, thyroid nodules in children are far more likely to be cancerous than in adults. The nodule clinic team meets regularly to review cases and optimize treatment plans. “This ensures that each patient receives the most suitable and personalized care,” Patel said.

The first step in treating thyroid cancer patients is surgery to remove all or part of the thyroid and any affected lymph nodes. This is followed, if needed, by radioactive iodine to destroy any remaining thyroid that may harbor small foci of cancer. After that comes continued surveillance through the clinic and management with thyroid hormone replacement.

“Thyroid cancer tends to be very slow spreading and localized, either within the thyroid or lymph nodes in the surrounding area,” Patel said. “It doesn’t typically metastasize.” For this reason, oncology is not a cornerstone of multidisciplinary thyroid cancer management. “When you need systemic treatments like immunotherapies or chemotherapy, then oncology gets pulled in.”

The disease typically manifests in the teenage years. When diagnosed in younger children, the team considers genetic cancer syndromes and does genetic testing to assess familial cancer risk. These syndromes include PTEN hamartoma tumor syndrome, DICER1 syndrome and multiple endocrine neoplasia syndrome. The team follows these cases closely, relying on pathology and genetics to analyze tissue samples and family histories.

The clinic is currently managing 10 to 15 children with thyroid cancer. The relatively large number of patients the clinic has followed over the years has contributed to a wealth of retrospective data, Patel said, which is vital given the rarity of the condition.

The clinic is involved in a collaborative project with Children’s Hospital of Philadelphia to establish a comprehensive thyroid cancer and nodule registry. The registry aims to provide long-term follow-up data, analyze treatment outcomes and gather information that can improve the care of pediatric thyroid cancer patients. “Currently, much of the knowledge in this field is derived from adult data,” Patel said, “making the need for dedicated pediatric research even more critical.”