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The Southern Society for Pediatric Research (SSPR) first-place award in the Clinical Young Investigator Competition was recently awarded to an attending staff neonatologist at Walter Reed National Military Medical Center (WRNMMC) and the Uniformed Services University of the Health Sciences (USUHS).

Army Maj. Devon Kuehn was recognized for earning the award Feb. 9 to 11 during the SSPR annual meeting in New Orleans, where she presented her work regarding "Congenital Diaphragmatic Hernia."

"Congenital diaphragmatic hernia is a potentially devastating birth defect, and as a neonatologist who has taken care of babies diagnosed with this abnormality, I was interested in understanding its causes," Kuehn said.

She explained, "The diaphragm is a thin muscle layer under the lungs that separates the chest and abdominal cavities. If it is not properly developed, the abdominal organs (such as intestines, stomach, liver, etc.) will push up into the chest, and the lungs develop poorly. This developmental defect occurs in about one in every 3,000 births, and can be deadly in the most severe cases.

Treatment includes surgery and support for the poorly developed lungs. Causes are not well known, but most likely include genetic abnormalities and environmental influences," according to Kuehn. "One area of current interest is the vitamin A pathway and it has been suggested that alterations in levels and signaling may play a role in abnormal diaphragm development."

Kuehn said during her fellowship training from 2008 to 2011 in the National Capital Consortium, which included the former Walter Reed Army Medical Center, the former National Naval Medical Center and USUHS, she began research work in collaboration with the National Institutes of Health (NIH), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

As an attending staff neonatologist at WRNMMC and USUHS, Kuehn said she has "the privilege to work with an amazing team to provide care for premature and extremely ill infants born to Soldiers, Sailors, Airmen and Marines.

"The field of neonatology continues to evolve through significant research efforts, thereby improving the care we provide every day," she added. "Neonatologists at WRNMMC are heavily involved in this research, and support from WRNMMC makes this possible."

Kuehn said she joined the military in 2001 to attend USUHS, and was commissioned into the Navy.

"I grew up in the military health care system and always wanted to practice medicine in the military," she continued. "From an early age, I had an interest in pediatrics and neonatology. This interest continued to evolve during my medical school training."

While at USUHS, Kuehn met her husband and transferred service to the Army.

"While he completed his general surgery residency, I was fortunate to complete both my pediatric residency and neonatology fellowship, with both of us training in the National Capital Consortium (NCC)," Kuehn said.

It was during this time she did her research.

"Through collaboration with New York State and NICHD, I was able to obtain DNA from infants born with congenital diaphragmatic hernia," Kuehn continued. "I studied the DNA for variations within the genes of the vitamin A pathway and found several potential causes for the birth defect. My results suggest that abnormal DNA sequence may lead to alterations in the vitamin A signaling pathway resulting in congenital diaphragmatic hernia. These findings are preliminary and do not change current recommendation for vitamin A supplementation in pregnant women."

Kuehn said she was "extremely honored" that her work was recognized by SSPR, one of four regional societies of the American Pediatric Society (APS) and Society for Pediatric Research (SPR). The APS/SPR's shared vision includes promoting "advances in pediatric health with sustained and lifelong improvements in human well-being through excellence and innovation in pediatric research and scholarship, according to their website. WRNMMC and USUHS faculty are eligible for membership in the SSPR.

Col. Thomas R. Burklow, Chief of Pediatrics at WRNMMC, said Kuehn's talents as a bedside clinician and research investigator were first recognized during her residency in pediatrics.

"Since that time, she has continued to demonstrate excellence in clinical medicine and in academic research. As a fellow, her fellowship research at NIH resulted in four manuscripts for peer-reviewed publications, and she presented [her work] at six regional or national conferences," said Burklow.

Burklow said one of Kuehn's mentors described her as "proficient in every aspect of neonatal intensive care. She calmly and expertly manages the most complex cases with the utmost compassion."

He added that Kuehn is passionate about all aspects of neonatology.

"She enthusiastically mentors residents and fellows, and is recognized for her teaching skills," the chief of pediatrics said. "The fact she was recognized as the Southern Society for Pediatric Research Young Investigator does not come as a total surprise, and we see her developing into one of the most productive researchers in military pediatrics."

Kuehn said she hopes to continue to pursue research "to improve the lives of our smallest, most vulnerable dependents. I feel extremely fortunate to work at WRNMMC and conduct research within the unique collaboration between WRNMMC, USUHS, NIH and NCC. The academic support of these organizations is truly world-class."