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#198 - Review of the HIP Trial on inguinal hernia repair, Delphi 2024 and Incubator updates.




Hello Friends 👋

In this episode of The Incubator podcast, we reflect on our recent visit to Nationwide Children's Hospital in Columbus, Ohio. They discuss the welcoming atmosphere and the impressive cohesion among the hospital staff, from the division chief to the fellows and coordinators. We also review a recent JAMA paper on the timing of inguinal hernia repair in preterm infants, highlighting the study's findings and implications for practice.

The main focus of the episode is the upcoming Delphi Conference in Fort Lauderdale, Florida, on September 23-25, 2024. We discuss the conference's unique features, including the NSU Art Museum venue, workshops on point-of-care ultrasound, leveraging AI tools, unit design, and writing and reflection in the NICU. They also introduce the Neonatal Brainiacs trivia competition for fellowship programs and the pitch presentation session for sharing innovative ideas.

Additionally, We announce a special storytelling night during the conference's welcome event, featuring author and neonatologist Dr. Rachel Fleishman. They emphasize the conference's intimate and approachable atmosphere, encouraging attendees to reach out with any questions or concerns. The episode concludes with a reminder about the recently released episodes of the Neonatology Review Podcast and the successful launch of the Beyond the Beeps podcast.


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The articles covered on today’s episode of the podcast can be found here 👇


HIP Trial Investigators; Blakely ML, Krzyzaniak A, Dassinger MS, Pedroza C, Weitkamp JH, Gosain A, Cotten M, Hintz SR, Rice H, Courtney SE, Lally KP, Ambalavanan N, Bendel CM, Bui KCT, Calkins C, Chandler NM, Dasgupta R, Davis JM, Deans K, DeUgarte DA, Gander J, Jackson CA, Keszler M, Kling K, Fenton SJ, Fisher KA, Hartman T, Huang EY, Islam S, Koch F, Lainwala S, Lesher A, Lopez M, Misra M, Overbey J, Poindexter B, Russell R, Stylianos S, Tamura DY, Yoder BA, Lucas D, Shaul D, Ham PB 3rd, Fitzpatrick C, Calkins K, Garrison A, de la Cruz D, Abdessalam S, Kvasnovsky C, Segura BJ, Shilyansky J, Smith LM, Tyson JE.JAMA. 2024 Mar 26;331(12):1035-1044. doi: 10.1001/jama.2024.2302.PMID: 38530261 Clinical Trial.


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The transcript of today's episode can be found below 👇


Ben Courchia MD (00:00.93)

Hello everybody, welcome back to the incubator podcast. It is Sunday. We're back with another episode. Daphne, how are you this morning?

 

Daphna Barbeau (00:07.534)

I'm doing great. I'm just thinking about what a good time we had in Ohio. So that's what I'm reflecting on, what I've been reflecting on really since we got back.

 

Ben Courchia MD (00:14.419)

Oh yeah, you're jumping right into it.

 

Hmm. So for, um, as we mentioned previously on the podcast, we were visiting a nationwide children's hospital in Columbus, Ohio, which, uh, we were invited to give grand rounds. And this was, we had a very nice time. It was a very special experience, I guess, for us, because it's, um, the, the fellows are the ones who asked for.

 

Daphna Barbeau (00:37.078)

I totally agree.

 

Ben Courchia MD (00:42.494)

Like apparently they can pull their division to ask who would they like to bring on to give grand rounds and the fellows get to pick and they asked if we could come on. That was humbling and they were such a nice group. It's...

 

Daphna Barbeau (00:58.198)

Oh my gosh, yeah, they just have this bright, dynamic, cohesive group of fellows. They were funny and smart and they asked such insightful questions. And I mean, and obviously the faculty nationwide was phenomenal.

 

Ben Courchia MD (01:11.148)

Mm-hmm.

 

Yeah, but that's what to me was interesting was that we met with Dr. Nel and who's the division chief, but like from him, who's basically right the top of the food chain over there all the way to Sandra, who was coordinating our visit, like they were all so nice and so humble and so pleasant to work with. So it's kind of a surreal experience where you meet like.

 

Daphna Barbeau (01:21.49)

Mm-hmm.

 

Daphna Barbeau (01:27.482)

That's me.

 

Daphna Barbeau (01:31.246)

Yeah.

 

Ben Courchia MD (01:40.982)

the medical directors, the director of the BPD unit, the fellows, and then the, the division coordinator. And they're all just like the nicest people.

 

Daphna Barbeau (01:50.154)

Yeah, I mean, I think there's something to be said for being at one of the, you know, frontiers of neonatal care in the country and still being, you know, so humble. You can imagine how their patients must feel, right? In a group where there's like a lot of cohesion and they're just considerate. They took such great care of us and you can tell that.

 

Ben Courchia MD (02:10.612)

Uh-huh.

 

Daphna Barbeau (02:19.906)

It's not because we were there for grand rounds. It's just kind of their vibe. And so you just know that the patients and families must feel really well cared for, which is the greatest gift that we can give the families in our, in our units. So, um, and obviously the level of professionalism and expertise there is, is above and beyond. So it was, it was a great day, a whirlwind trip for us, but a great day. Yeah.

 

Ben Courchia MD (02:46.334)

That's true. But we're getting used to these very businessy type of trips where in and out, as we say.

 

Daphna Barbeau (02:52.498)

That's right. So thank you everybody who hosted us and hung with us and we'll be hearing more things that some of these amazing clinicians, educators, and researchers are doing in the coming months with some recordings.

 

Ben Courchia MD (03:11.082)

Yeah, we have a few of their staff members who are working on exciting things come on the show. And just to tease, I mean, we're going to talk to them about BPD, and we are going to talk to them about like, how do we write notes? So that's going to be fun. That's going to be fun. In the meantime, we will make our way to Philadelphia, I think, in the beginning of May, right before PAS.

 

Daphna Barbeau (03:27.334)

Mm-hmm.

 

Daphna Barbeau (03:36.05)

Mm-hmm.

 

Ben Courchia MD (03:36.834)

So we're looking forward to that visit as well. And then we will see all of you at PAS in Toronto. I think this Toronto PAS is really unfortunate because everyone is talking about this PAS edition as the one before Hawaii. So Gabriel, it's a great place, but I was talking to Gabriel about this and, and they're like, yeah, it's in Toronto, but next year, but next year.

 

Daphna Barbeau (03:57.403)

That's it. And Toronto is such a great place, right?

 

Daphna Barbeau (04:05.074)

I'm gonna go.

 

Ben Courchia MD (04:05.462)

So everybody is already looking at next year, almost as if we could register, we would right now. But yeah.

 

Daphna Barbeau (04:11.286)

Well, I didn't get that far. I'm very much looking for Toronto, forward to Toronto, and I feel like we're just going up month to month at this point.

 

Ben Courchia MD (04:19.646)

That's right. That's right. We wanted to do just a different kind of episode today. Just talk about some, some of the upcoming Delphi conference, but we would be remissed if we didn't talk about this paper because it came out in, in JAMA and really created a buzz. The effect of early versus late in Guignol-Hernier repair. And interestingly enough, Martin Blakely is the, is the corresponding author.

 

Daphna Barbeau (04:22.69)

Um...

 

Daphna Barbeau (04:32.39)

Mm-hmm.

 

Ben Courchia MD (04:49.602)

who we got a chance to meet at the, I believe it was the.

 

Daphna Barbeau (04:59.826)

Thank you.

 

Ben Courchia MD (05:00.27)

I wonder if it was next symposium or CHNC. I'll have to look back, but we did get a chance to speak to him. And he's a fascinating pediatric surgeon. Yeah. Delightful, very bright. So his, his interview is on the podcast and on YouTube. I'm sure you're looking for it right now, but it's a big deal because I feel like it's one of these papers that almost like Bill Rubin, it's like something we all have to deal with.

 

Daphna Barbeau (05:03.134)

I can't remember. Yeah. Delightful.

 

Daphna Barbeau (05:17.855)

Mm-hmm. That's right.

 

Daphna Barbeau (05:27.867)

We are.

 

Ben Courchia MD (05:29.15)

and we don't really have a good answer for. So let's talk about this quickly, because I highlighted some stuff, and I think this is going to pique your interest. So...

 

Daphna Barbeau (05:39.746)

Yeah, I think people are talking about it, so everybody should know what they're talking about.

 

Ben Courchia MD (05:44.082)

Yeah. So, so this is the HIP trial, right? It's published in JAMA and the bottom line is that a congenital inguinal hernia, an inguinal hernia is one of the most common congenital abnormalities requiring surgery in preterm infants. And the incidence, which I had forgotten is reaching like 40% in males born at 24 weeks gestation. So when I was saying earlier that we all have to deal with it, it really is true. Like if you care, yeah, if you care for, for 10, 10 neonates at 24 weeks, four of them might.

 

Daphna Barbeau (06:06.634)

It's super common.

 

Ben Courchia MD (06:13.11)

be dealing with that. So yeah, the question they were asking was what's the safety of doing the repair early versus late? Right? And there's not much evidence for that. So they conducted this randomized control trial through the NICHD, 39 medical centers in the US. And they included babies who had a diagnosis of inguinal hernia and who had an estimated gestational age younger than 37 weeks. They excluded.

 

infants who had any factors affecting the timing of their repair, whether they were undergoing other operative procedures. So they really wanted to just look at like the kid who just needs the hernia repair, right? Any major congenital chromosomal anomalies, or if there were issues for the family to actually come back for follow up. So early repair was just very defined super simply was, can you get this done before they go home from the

 

Ben Courchia MD (07:10.918)

after discharge from the NICU, but the baby had to be older than 55 weeks postmenstrual age. And that was kind of a peculiar number, which I was not so familiar with. And they said that this was a threshold that was selected based on current pediatric anesthesia guideline that allows preterm infants to have elective outpatient operations when they are older than 55 weeks postmenstrual age, given the decreased risk of anesthesia related apnea or bradycardia. So that was interesting. Then they followed

 

these kids for one month after discharge from the NICU when they sort of made the plan for the surgery around 55 weeks, they randomized the patient population one to one, basically two weeks, when they thought the kid was about two weeks prior to discharge, they said, okay, let's randomize them then. And the primary outcome that they looked at was any serious adverse event in the 10 months that followed. And the serious adverse events were categorized in five, yeah, five categories.

 

There were pulmonary events, so like apnea requiring intubation, unplanned reintubation, stridor, pneumonia. They had cardiac events, they had surgical events, any events related to the hernia, like incarceration, recurrence, re-operation, and death. And then for the secondary outcomes, it was the number of days in the hospital during the 10-month subsubstantiation period and the individual serious adverse event. They are also doing two-year follow-up, which is currently ongoing. So...

 

the trial ended up looking at 338 infants that were randomized between 2013 and 2021. And you can tell that this was both a frustrating trial and a satisfactory one because, number one, they mentioned how this happened in the midst of the covid pandemic, so this really threw them for a loop in terms of getting the babies enrolled and so on, but the trial was also stopped early because they met the criteria for efficacy. So that was kind of nice when

 

when your original hypothesis is demonstrated. But the most common reason, so basically they had 613 infants who the parents decided not to participate. And 280 of them preferred early repair, 196 preferred late repair, 71 parents,

 

Ben Courchia MD (09:34.134)

For 71 infants, the parents wanted the clinician to make the decision and 66 had other reasons. And after randomization, nine infants were withdrawn, each withdrawn by the parents or the guardian because of treatment preferences for other reasons. Which by the way, considering the talk we just gave at Nationwide, it is so interesting to see that beyond what the data will show us, ask the parents what they want. Ha ha ha.

 

Daphna Barbeau (09:56.87)

That's right. I think even if they don't know what they want and they want the physician to decide, they want to be asked what they want.

 

Ben Courchia MD (10:06.514)

Absolutely. So I believe that whatever the results we'll discuss in a second, it will never be that, oh, since these results have come out, then we will do X. I think what will end up happening is that you will present the data we're just going to talk about, and then you'll let the parents decide. So among the 163 infants in the early inguinal repair group, 93% underwent repair in about 41 weeks, and they had a weight of about 3.1 kilos, which by the way,

 

is kind of nice and high. I've seen kids go for hernia repair with much lower weights and God knows about the effects of anesthesia in that case. So that's something that we'll have to be looking in the future whether the kids on the lower end, but they didn't have a lot of numbers, which is what's gonna cause the issue for future analysis of the data here. The reason for 11 infants not undergoing early inguinal hernia repair was that in seven, the hernia resolved.

 

Daphna Barbeau (10:39.754)

Mm-hmm. Mm-hmm, absolutely.

 

Ben Courchia MD (11:05.686)

two were medically unstable, there was diagnostic uncertainty in one, and one of them got transferred. But just remember that seven of these early kids got resolution of the hernia. Now among the 157 infants who went through late inguinal hernia repair, 82% who were in that late inguinal hernia repair group, 82% underwent the repair at about 57 weeks post menstrual age and a weight of about six kilos, which again, much higher.

 

Ability to tolerate anesthesia will have to be considered. But 28 infants did not undergo the repair because you remember how seven had the resolution before? In this case, 17 had resolution of the hernia by the time it was time for repair. So let's look at some of the outcomes. The primary outcome showed that among the 308 infants with complete data, 28% in the early repair groups.

 

Daphna Barbeau (11:46.809)

Mm.

 

Ben Courchia MD (12:01.958)

experienced at least one serious adverse event during the 10-month observation period compared to 18% in the late repair group. So a 10% difference between early versus late. The late repair group had 18% incidence of serious adverse events versus 28% in the early repair group. So early did not do better. In terms of the secondary outcome, the median number of days in the hospital

 

Ben Courchia MD (12:32.274)

19 days in the early group versus 16 in the late repair group and the median time from inguinal hernia repair to discharge was about six days. In the early repair group the most common serious adverse event was apnea requiring increased respiratory intervention, prolonged intubation and bradycardia requiring pharmacological intervention. In the late repair group the most common serious adverse event were apnea again, inguinal hernia incarceration which is what we're all afraid of.

 

bradycardia and cardiopulmonary resuscitation. So I think that was quite interesting. I want to talk about the, I would like to talk about the inguinal incarceration because that was actually displayed in table three, but in the early inguinal hernia repair group, that was two infants, which yeah, out of 159. And in the late, it was six. So three times as high, but again, small numbers.

 

So I mean, I remember when I was a young attending, I sent a baby home that didn't have the hernia repaired before discharge. You got some flack for it by the art team when the baby came back like a month or two later for her for repair. And that's the biggest concern that was discussed at the time was that we send these kids home and what if they have an incarceration? I feel like, I feel I didn't have, I had no idea about this data at the time, but I feel very vindicated now that I'm like, oh, you see. But...

 

Daphna Barbeau (13:49.138)

Mm-hmm.

 

Daphna Barbeau (13:53.454)

You didn't have... Validated, yeah.

 

Ben Courchia MD (14:01.258)

But yeah, so those are the interesting numbers. The conclusion are that among preterm infants with inguinal hernia, the late repair strategy resulted in fewer infants having at least one serious adverse event. And that according to the authors, these findings support delaying the inguinal hernia repair until after initial discharge from the neonatal intensive care unit. I will remind you, as I've already said, was that the trial, so you may say, oh, the numbers are low. Another, I'm sorry, before I finish.

 

Figure three in the paper is so good, basically a subgroup analysis. And they found that they looked at babies whether they were more premature or not. But for the babies that are born at less than 28 weeks, the late inguinal hernia repair was favored. And in the babies with bronchopulmonary dysplasia, late repair was favored. All babies that I would have thought we should just get done as soon as they can before they go home. And it turns out, you can look at it. I'm not gonna go too much into the details right now, but a very interesting.

 

Daphna Barbeau (14:53.377)

Yeah.

 

Ben Courchia MD (14:59.666)

subgroup analysis. And for the people who say that, ah, you know, these, this is such, this is a small trial. There were some limitations. Remember that they had to stop it early due to the meeting, the pre-specified Bayesian stopping rule for effectiveness, which limits the trial size, but is ethically justified as they say. So that, so that it's not like they were sloppy and they didn't enroll more. It's just that they were supposed to continue enrolling and they said, no, the point is made here. Done.

 

Daphna Barbeau (15:14.498)

Right.

 

Daphna Barbeau (15:24.862)

Mm-hmm. And I mean, it's an interesting way to do research, right? Because it, you know, why, that's the point, right? Why enroll more babies if we think that, you know, that the secondary group may have worse outcomes, right? So I think that's super interesting.

 

Ben Courchia MD (15:42.646)

Absolutely, absolutely.

 

Daphna Barbeau (15:44.638)

And you know, I think this is great. I think this is super informative. We've been talking about it since I was a resident for sure about when is the right time. I what I would love to see from this group of investigators is some of the babies, you know, we've had a handful of them have these like giant hernias. I would love to see a subgroup analysis like that based on based on these kids with

 

Ben Courchia MD (16:10.055)

Good luck to you.

 

Daphna Barbeau (16:13.942)

enormous hernias and I don't know how you quantify that but maybe one day. I think that's a special group, a special group of babies.

 

Ben Courchia MD (16:17.554)

Yeah. Yeah, we've had these babies. We've had these babies with distinct bow sounds in their scrotum from such large hernias. That's true, but it's interesting because...

 

Daphna Barbeau (16:26.242)

Yeah, for sure, for sure. When the radiologist is exclaiming on the abdominal films about the hernias, then it starts.

 

Ben Courchia MD (16:35.646)

Yeah. And does not need you to clinically correlate.

 

Daphna Barbeau (16:39.47)

They don't know clinical correlation needed.

 

Ben Courchia MD (16:42.23)

But many parents will ask you when you tell them that they need their hernia repair before discharge, what are the risks? And I think this is the data now, you got the data. So that's very cool. Now, I mean, we, mini journal club. All right, what else are we talking about today?

 

Daphna Barbeau (16:47.396)

Yeah.

 

Daphna Barbeau (16:52.134)

Well thank you for reviewing that.

 

Daphna Barbeau (16:57.234)

Mm-hmm.

 

Daphna Barbeau (17:01.674)

We're talking about the Delphi Conference. Okay?

 

Ben Courchia MD (17:03.586)

That's right. That's right. So the Delphi Conference is coming to Fort Lauderdale, Florida, September 23, 24 and 25. We are very excited about this year's edition for people who are wondering why we were doing it in March in 2023. But in September, obviously, we want trainees and fellows to be able to attend because it's an opportunity to meet some of the giants in our field.

 

Daphna Barbeau (17:21.128)

Mm-hmm.

 

Ben Courchia MD (17:31.166)

We do we do make a point to try to invite people who are pretty big names and for the people who have been To the first edition it doesn't it's not the scale of it is much smaller So you actually it's not like PAS where you may run into someone We make a conscious effort to get people to mingle So you will get to mingle with some of the Giants in our field and for trainees It's super important because who knows what kind of opportunities this can lead to collaboration

 

Daphna Barbeau (17:54.545)

Yeah.

 

Ben Courchia MD (18:00.094)

And that's really the theme of the Delphi conference, which is that people come in with such a number of ideas. And then the in-between sessions are these times where you could film people just say, hey, I want to work with you on that. So we wanted to make sure that the boards were not becoming a hindrance for the trainees to come and attend. Last year was kind of fun to see when...

 

Daphna Barbeau (18:17.581)

Mm-hmm.

 

Ben Courchia MD (18:22.41)

Atlee Moen and then Tom Hayes presented like one after another. Tom went to Atlee and was like, let's, let's work on this together. Like, I know some people who can do these sorts of statistical analysis. Same thing with, yeah, same thing with Kristen Beam, who, and, and Andrew Beam, who presented, and then we're sort of almost harassed by a bunch of people say, Hey, like, I want to work with you on this, but then we have the pitch sessions as well. Yeah. But you know, it's, um,

 

Daphna Barbeau (18:29.042)

Mm-hmm. It's really exciting. Yeah.

 

Daphna Barbeau (18:41.094)

Ha ha!

 

Be careful what you ask for at the Delphi Conference.

 

Ben Courchia MD (18:50.39)

Like sometimes we say, oh, we have such a hard time finding people who want to take this on, but like this is the place. So we have we have some very impressive names coming this year. Again, thank you for them for agreeing to participate. Dr. Susan Hintz from California, among others. So that's all very exciting. Now.

 

Daphna Barbeau (18:55.95)

Yeah.

 

Daphna Barbeau (19:01.616)

Mm-hmm.

 

Daphna Barbeau (19:10.222)

And people can check out the full agenda, the full list of speakers and line up is on our website, right, at the-incubator.org.

 

Ben Courchia MD (19:16.247)

Yeah.

 

Ben Courchia MD (19:22.109)

What are some of the other cool things we're doing this year for Delphi, Daphna?

 

Daphna Barbeau (19:25.774)

Well, you know, we're gonna make sure that we try to push ourselves a little bit each year. So I think one of the interesting things about our conference this year is our venue choice. We looked at a lot of different venues. Last year, our venue was at the Levant Center of Innovation at Nova Southeastern University. And actually people loved the venue. So we aren't leaving because it wasn't a great spot with awesome.

 

views of the city and kind of a high tech place where you're greeted by robots. But we wanted to do something a little bit different. And the goal, our overarching goal of the Delphi conference is to open people's minds, see if we can get some cross pollination. You know, you study the lung, I study the brain, sepsis, you know, and really get people thinking about things in a different way. So we...

 

We're really interested in hosting it at, say, somewhere totally unexpected. And this year, we're at the NSU Art Museum. They have a beautiful auditorium, which we're really excited about because what we hope when people go to the conferences, you're just totally engrossed in the talks. We're asking people to do different kinds of talks, very short talks. So we want this to be an experience.

 

Ben Courchia MD (20:43.662)

That's right.

 

Daphna Barbeau (20:51.014)

going for a night at the theater, really.

 

Ben Courchia MD (20:53.668)

It's, it's a, it's a, I mean, I think for, for us, for our new generation, there's really two opportunities to attend conferences in person versus virtual. And we feel that if you're coming in person to attend a conference, it has to be like an all sensory experience where you're surrounded by something that is going to be so stimulating that you're going to return to your home base energized and full of ideas.

 

Daphna Barbeau (21:04.882)

Mm-hmm.

 

Daphna Barbeau (21:10.575)

Yeah, exactly.

 

Ben Courchia MD (21:20.398)

And this begins with the environment in which the discussions are going to happen. So it's very exciting. I mean, you found the venue, so you deserve all the credit. And then we'll see how it goes. But

 

Daphna Barbeau (21:24.643)

Yeah.

 

Daphna Barbeau (21:31.019)

Well, we'll see how it goes. But yeah, so then aside from the auditorium, some of our breakfasts will be like right in the, you know, entryway to the museum. We'll have museum tours, some of our workshops, which we'll talk about in a little bit. We'll be in some of the galleries. So lots of opportunity just to do something new, be in a new space, and we hope that this will enhance everybody's learning.

 

Ben Courchia MD (21:59.23)

Absolutely.

 

Daphna Barbeau (22:01.07)

So you'll tell us about the workshops, huh?

 

Ben Courchia MD (22:03.102)

Yeah, so we are going to have some workshops again, trying to reward the people who are here with special experiences. And we want to make sure that the experiences you can have at Delphi are things that you would not usually be able to go through at other venues or things that would not be available fairly routinely. So we're going to have.

 

a workshop conducted by Lauren Ruas and Gabriel Altit on point of care ultrasound. They're going to have some special point of care ultrasound workshops looking at just trying to, I think one of their workshop is about the crashing baby and trying to do ultrasound in those instances. And we will have ultrasound devices that you can try under their

 

Ben Courchia MD (23:02.73)

So this is going to be very exciting, and all of this will happen in the comfort of an art gallery. So this is very, very exciting. We are very thankful for GE, who sponsors this workshop and is allowing us to get all this equipment for the purpose of the workshop. So we will...

 

make registration for the workshop open, I would say, next week or something along those lines. So if you are interested, register for the conference so that you can then get access to the registration for the workshop, because obviously we don't want this to be a very crowded and unpleasant experience. So there'll be multiple opportunities to go through the workshop, but you need to register so that we can make sure that the ratio of instructor to attendee is reasonable.

 

We're going to have another super interesting workshop by Ryan McAdams and Jim Berry from the NeoMind AI group on the leveraging artificial intelligence tools in the day-to-day practice of a neonatologist. So they'll walk us through some of the stuff that's already available that you can take right back to your home base and use for administrative patient care and so on. So that's another very exciting workshop that will be taking place.

 

have a workshop on unit design and how do we set up the spaces around us to be conducive for effective delivery of care. And then.

 

Daphna Barbeau (24:32.462)

Yeah, she did a great lecture at Delphi last time and we were like, but how do we do it? So that's why we went ahead with this workshop.

 

Ben Courchia MD (24:38.239)

Yeah.

 

And the reason for that is because if you haven't seen her lecture, you should go on YouTube and on the incubator podcast channel, you'll see the lecture. And she did something on a scale that was quite impressive. So they basically recreated in a hanger, the new pediatric children's hospital, right? And then, and then basically created almost like these TV sets where they would just run through codes and see what like, Oh, did I bump into a sink? Let's remove this. And that's something that we may not be.

 

all privileged to be able to do, but she has a lot of insight into what could we do within our constraints as well to try to reinvent a little bit how we set ourselves up for patient transfer from incubator to chair and so on and so forth. So that's going to be very exciting. And then we're going to have more workshops on, you want to tell us more about that, about writing and reflection in the NICU. Yeah, you're very excited about this one.

 

Daphna Barbeau (25:36.034)

Yeah, well, we have some really exciting things about that, but Dr. Rachel Fleishman is going to join us for a number of things, one of which is a special evening of storytelling, which we'll talk about in a second. But the other is really about introducing this concept of narrative medicine and if you wanted to take that back.

 

to your unit for your trainees or your colleagues or your patients even. There's some cool opportunities to do that. So she's going to help us with that workshop. I'm really excited about that.

 

Ben Courchia MD (26:13.802)

Yeah. And so these are the workshops that will be happening around the lecture schedule. We have a very interesting set of lectures. It will follow the same format as last year. Talks will be 15 to 18 minutes long. So we will cycle through many speakers, many interesting topics for each session, which makes it super, super interesting. As I said,

 

Dr. Susan Hintz will be here. Dr. Pia Wintermark from Canada will be here. Dr. Terry Ender is gonna join us. Dr. Guillermes Santana, Dr. Natalia Henner. We have Dr. Henry Lee from California joining us. And many, many more. Dr. Satyan Lakshminarishma.

 

Daphna Barbeau (26:58.675)

I know it's hard to stop reading the agenda. You don't want to leave anybody off the list, but there's some really... Yeah.

 

Ben Courchia MD (27:00.902)

But they're all, I mean, I'm just trying to give you, just try and give you some of the people that have fairly, here's our mission at the incubator as well, is that you may recognize these names, but our job is to then squeeze in the people that you may not recognize the name, but are just as equally talented, and surprise you with that. We will also have, like last year, a dedicated TED event. So this is a TEDx event that we are,

 

Daphna Barbeau (27:16.242)

Mm-hmm.

 

Daphna Barbeau (27:19.516)

three.

 

Ben Courchia MD (27:29.642)

officially licensed to hold that basically welcomes speakers from medicine, but also from the outside to talk about innovation. We have some very interesting speaker coming this year, and we will surprise you with the various themes that will be approached and you do not want to miss that. Obviously for the people who may be wondering, once you register for Delphi, you have access to the TEDx event. These are not separate.

 

they are not separate registration, even though the public is allowed to come and register for the TEDx events separately. So, yeah. What else do I have to say? I think should we talk about we have two more things that we want to talk about when it comes to the to the conference. One of them is the pitch session and one of them is our neonatal brainiacs trivia competition. Which one should we start with?

 

Daphna Barbeau (28:18.802)

I mean, let's start with the Brainiac competition because I'm just so excited about it.

 

Ben Courchia MD (28:24.19)

Yeah. So, um, definitely I had this idea to hold a trivia competition for some time where fellows trainees would be on, on stage and just answer questions for some form of a prize because we think it's just fun and thankfully, um, thanks to the new unitology review podcast and thanks to the generosity of Dr. Brodsky and Martin.

 

we're now able to have sort of a mini grant that we can use to support educational activities around the world for neonatology trainees. So we are always looking to help out whoever we can. Most recently, we're super proud that this fund was able to help setting up some educational activities for a brand new fellowship program in Rwanda, in Africa. That's really an honor for us to do that.

 

But one of the ways we will continue to support educational activities for trainees is going to be through the Delphi conference by holding this trivia competition. And so if you are a fellowship program, we invite you to submit an application on our website where you can send three trainees to take part in this trivia competition. I think we will have three to four fellowship programs to compete. And then the winners will win like.

 

Daphna Barbeau (29:27.989)

Mm-hmm.

 

Daphna Barbeau (29:43.203)

Mm-hmm.

 

Ben Courchia MD (29:48.558)

the Brodsky and Martin Cup, I guess, with an educational grant award for the fellowship program. We're very thankful for the team at TCAN, who is partnering with this project as well. And right now, as we're just launching this project, we haven't been overwhelmed by too many responses. But if we have a lot of responses, we will...

 

Daphna Barbeau (29:50.618)

That's right.

 

Daphna Barbeau (30:00.345)

Mm-hmm.

 

Ben Courchia MD (30:17.342)

discuss with TCAN a way for us to select three to four fellowship programs to participate, whether it will be through a preliminary round or through some other means. So you want to register sooner rather than later because we will have to confirm these fellowship programs to attend. That being said,

 

Daphna Barbeau (30:36.258)

And it's not supposed to be like super intimidating. Like this is supposed to be fun. It's gonna be super fun. Yeah, do we get to highlight your programs? Absolutely. But it's supposed to be super laid back. So don't be scared.

 

Ben Courchia MD (30:39.534)

This is gonna be fun. Yeah.

 

Ben Courchia MD (30:49.406)

Yeah. And no, absolutely. And you can be creative, like if you want to show up with your, with a team t-shirt, uniform, whatever that is.

 

Daphna Barbeau (30:58.082)

Oh, if you think there's not an award for most spirited team, then you haven't been paying attention.

 

Ben Courchia MD (31:08.315)

Regarding trainees as well, I think that for us, as you've always known, we are not a for-profit endeavor. So if you are a trainee or if you're a fellowship program and there are any issues with the registration cost, it's the same thing as it's always been for us. You send us an email and we will waive whatever cost we can to get you to attend.

 

Daphna Barbeau (31:30.83)

And we do already have a reduced cost for trainees. We're really excited to offer that for sure, but absolutely just let us know.

 

Ben Courchia MD (31:33.62)

Of course.

 

Ben Courchia MD (31:37.142)

But even last year, we had some fellows that said, hey, I burned through my CME money, but I want to come. It's like, all right, I don't know. I mean, we'll waive the ticket fee. I mean, I don't care. I mean, sometimes we're worried that we might end up in the red, but we just take these chances. The other thing, though, is that I will say that I know. But I will say, though, that if we do extend this kind of options for fellows, then.

 

Daphna Barbeau (31:41.147)

Yeah.

 

Yeah.

 

Daphna Barbeau (31:51.558)

Just trying to break even here.

 

Ben Courchia MD (32:01.61)

We will ask that you obviously attend because we do have limited space. So we would hate for a ticket to be assigned to someone that then says, I'm sorry, I'm just not going to come in yet. So if you're definitely coming, but the price may be saying it's still too expensive for me, just let us know, send us an email. You know how it is. The people who have asked already will tell you that we're good for it.

 

Daphna Barbeau (32:04.91)

Mm-hmm.

 

Yeah.

 

Daphna Barbeau (32:21.73)

Okay, the pitch presentation.

 

Ben Courchia MD (32:23.018)

All right, the pitch presentation is one of my favorite things. It is taking place this year on, let me see, it will be on Tuesday at 1130 in the morning. And this is one of my favorite things where people come with ideas, projects, and just present their ideas, whether it is a new tool, whether it is an interesting preliminary results or an interesting idea.

 

So last year we had the people, I mean, we can tell the story, right? Um, uh, we had the people, a speech therapist came, uh, Michael Dettmer and, and presented this idea for like a bottle for babies where as soon as they start sucking, it becomes, it starts playing a music, the lot of feed. And I was like, this is, this is amazing. And, and then, I mean, we, we each, like, uh, our team basically reached out to him and said, like, how can we support you? And we basically ended up supporting his, his work.

 

Daphna Barbeau (32:56.091)

Mm-hmm.

 

Daphna Barbeau (33:04.795)

Mm-hmm.

 

Daphna Barbeau (33:11.814)

Super cool.

 

Ben Courchia MD (33:20.162)

just based on his presentation at the pitch session. We've had hospitals who have reached out to some of the people who had some EMR integration stuff. So there's always some interesting ideas. We had an engineering student who had created this OG tube with opportunities to detect basically vital signs so that you wouldn't have all just if you have an OG and then you don't need any of the other stickers and stuff. I mean, all that stuff is just fascinating. And we have an amazing group of people presenting their ideas.

 

Daphna Barbeau (33:40.21)

Mm-hmm.

 

Ben Courchia MD (33:49.546)

Some of them more junior, some of them very senior with some very, very cool ideas. And the presentations are uber short. It's a bit like Shark Tank where they come for five minutes to tell you what they're up to. And then you take notes, you talk to them after the session or you reach out to them afterwards. But regardless, this is very cool.

 

Daphna Barbeau (34:08.59)

Yeah, what we like about the pitch presentation is it's an opportunity to share your work, find some collaborators. You know, I think people have been worried about sharing their early research, but you stake it out here first and nobody can deny that you're the first person to talk about it. And so you don't have to have, you know, all the whole study done. It's not an ad poster presentation. It's different than that. It's really talking about something new and interesting and innovative that...

 

You may not have all the data for or you may not know how to find all the data. So hoping to make some connections that way. So very excited about that. Okay. Should I, did you want to add something more about, I know you love the pitch presentation. Okay. And the only other thing that I wanted to talk about is our storytelling night, right? Okay.

 

Ben Courchia MD (34:53.483)

I'm done. I mean, I think...

 

Ben Courchia MD (35:01.11)

Yeah, yeah, you alluded to it. You alluded to it earlier. I was wondering if you were going to go into more details.

 

Daphna Barbeau (35:05.674)

Yeah. So we always like to host a welcome event. Obviously, like a lot of conferences do. But we are so excited to, you know, the Delphi Conference isn't, we don't, it's not coming to, hosted quote unquote in Fort Lauderdale. This is where we live. So when we invite you to our home, you know, we'd really like to welcome you. I think last year, our welcome event was super fun. It was really well attended. People didn't want to leave, which I've never seen before.

 

There's so much to do around here and people just wanted to stay and hang and chat and eat some Cuban inspired food. But this year we wanted to do something a little bit different, still going to have a great space, great food, but we wanted to give the community an opportunity to do some storytelling. So please listen to our episode next week.

 

with Dr. Rachel Fleischman, who is a neonatologist, but she's also an author, and learn more about what she's doing. But this is an opportunity for people in our community who are writers, poets, storytellers, to work with her over the next few months so that we can put on this, for lack of a better word, kind of show about storytelling about stories from the

 

So I think it's twofold. I think people can be participating. But again, we wanna make this kind of an experience for people who are just showing up to the Welcome event to just think about some of the things that we deal with in the NICU and medicine and work-life balance. So we're really, really excited about that event.

 

Ben Courchia MD (36:55.53)

Yeah, I'm going to moderate what you said, because I think even if you're not a writer or a poet, like this is an opportunity to get out of your comfort zone. And the fact that Dr. Fleischman was so generous with her time to say that she will, she will work with people ahead of the conference. It's kind of reassuring because I think if you write something in the comfort of your home, like to actually take that to a public forum can be frightening, but she's written for the time. She's written for so many outlets that having her.

 

Daphna Barbeau (37:02.854)

Totally agree.

 

Daphna Barbeau (37:06.626)

Yeah, mentor, yeah.

 

Ben Courchia MD (37:25.09)

give you the support you need is so nice. It's an opportunity that I think rarely comes around. And you may decide that to participate and not ask her for her opinion. If you don't wanna work with her, that's perfectly fine. But I know that to me, this would be very intimidating and knowing that she would help along the way is very, very reassuring. So I think we welcome anyone and it's an opportunity to share something that we're not often allowed to share on the public platform.

 

Daphna Barbeau (37:31.459)

Yeah.

 

Daphna Barbeau (37:36.978)

Hehehe

 

Daphna Barbeau (37:53.611)

Yeah.

 

Ben Courchia MD (37:54.794)

So it's very, very exciting. And like you said, she's going to talk to us a little bit about the power of writing in neonatology on next week's episode. So check it out and stay tuned for that.

 

Daphna Barbeau (38:06.642)

Okay. Yeah. We're very excited. We've got some great sponsors who are helping us do the work. But what and what we really was so moving about, I think our first iteration of the Delphi conference is how much

 

Ben Courchia MD (38:07.522)

We're very excited by this conference overall. I mean.

 

Daphna Barbeau (38:25.394)

People who participated really connected with the conference. You know, they kept showing up. If they had to leave early, they were pretty bummed about it. They were talking and sharing and meeting in the middle. It was really exciting.

 

Ben Courchia MD (38:34.139)

Amen.

 

That's been the striking thing to me, which is that a lot of the registrations that have happened thus far are the people who were here already last year. So they were looking forward to the next edition. So to us, it was a nice reinforcement that we were doing something interesting and compelling. Um, yeah, absolutely. So that's, that's super exciting. And please.

 

Daphna Barbeau (38:43.568)

Yeah.

 

Daphna Barbeau (38:57.27)

Oh, I did want to mention one thing if people are looking into registering. Um, we, the venue is at the art museum right across the street from the art museum is the Hyatt centric where we'll be having some of our meals, some of, um, our, um, other types of events. Um, but that's a great place where we do have a reduced room rate, um, for people to stay, so you don't have to go looking all over because it's literally just across the street. So that would be.

 

Ben Courchia MD (39:20.864)

Yeah.

 

Ben Courchia MD (39:25.182)

Yeah, last year was a bit challenging because you had to arrange for busing because the innovation center was in the center of the university campus. So we had to organize a bus that would take attendees from their hotel to the... But here, like you said, it's right across the street. So you might want to book the rooms while they're still available so that it's just like you just cross the street and you're at the venue.

 

Daphna Barbeau (39:27.026)

See ya.

 

Daphna Barbeau (39:31.467)

campus, yeah.

 

Ben Courchia MD (39:49.674)

Yeah, this will be a lot of fun. And thank you for everybody who's registered. And if you have any questions, you email us. If you want to participate in any way, you let us know.

 

Daphna Barbeau (40:00.002)

And sorry, on the website where people hit click the agenda, see the agenda is all the information about all of this. So it's the most up to date place and it tells you about all the individual sessions, how to get the room rate. So it's all there on the website.

 

Ben Courchia MD (40:15.614)

And I want to reinforce that while the conference appears super professional, like if you watch the YouTube videos, it's like, we're, we're a very, uh, kitschy type of organization. So, so you can email us with any, yeah, or you can email us and say, Hey, like, can I just book reserve this reserve that like, well, like you can just email the show and then we'll, we'll work with you. Like it's not, uh, I don't want you guys.

 

Daphna Barbeau (40:26.254)

We're chill.

 

Daphna Barbeau (40:34.36)

Yeah.

 

Daphna Barbeau (40:37.75)

I mean, because... Go ahead.

 

Ben Courchia MD (40:39.97)

No, no, I was just going to say, if you don't find a piece of information you're looking for, just email us and we'll work with you. We'll make it happen.

 

Daphna Barbeau (40:46.626)

Yeah, I think because it's a small conference and the intimacy is, I think, really valuable. We want to make this as personal experience as possible. You know, if you just, if you want to email us just to tell us you're coming, then we'd love to get that email as well. So, lines of communication are always open.

 

Ben Courchia MD (41:01.919)

Yeah.

 

Ben Courchia MD (41:06.378)

Yeah, absolutely. Absolutely. All right. I think that does it for us today. What do you think?

 

Daphna Barbeau (41:13.178)

I think so, buddy. We're looking forward to seeing people in September. And like we said, we've got a great interview next week. Oh.

 

Ben Courchia MD (41:20.454)

I have one more thing actually. For the people who are also subscribed to the Neonatology Review Podcast, we wanna give you a special shout out because you recorded three episodes for pre-board sort of prep that were released a few days ago. So go check them out. Obviously there's, now it's the final push to the test. Exactly, but very interesting episodes about how to approach the day of the test from a, with...

 

Daphna Barbeau (41:25.624)

Mmm

 

Daphna Barbeau (41:30.93)

Mm.

 

Daphna Barbeau (41:40.198)

The final push.

 

Ben Courchia MD (41:49.55)

with a psychologist. So that was great. So go check these out.

 

Daphna Barbeau (41:53.219)

Absolutely.

 

Ben Courchia MD (41:54.826)

All right, Daphna, I will see you next week. Oh, and if you haven't listened, the first episode of the Beyond the Beeps was released earlier this week. It did phenomenal. I mean...

 

Daphna Barbeau (41:56.214)

Okay, sounds good.

 

Daphna Barbeau (42:02.93)

That's right. It was great. There's gotten a lot of buzz from the community. It was very well received. And that's just the first episode. They've got a lot of things coming down the line. So it's very exciting.

 

Ben Courchia MD (42:12.702)

Mm-hmm. Another group of our team members who are very approachable, so feel free to email them if you have suggestions, ideas, and stuff. Now we're done. Okay, fine. Okay.

 

Daphna Barbeau (42:21.942)

Okay, now we have to stop. We're gonna keep saying, I thought of one more thing.

 

Ben Courchia MD (42:27.37)

All right. Well, thank you. Bye.

 

Daphna Barbeau (42:28.678)

Bye everybody.

 

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