A Waiākea High School graduate is now a physician after completing his medical training in May at the University of �鶹��ý at ����ԴDz� (JABSOM), a journey shaped by his �鶹��ý Island roots, early classroom curiosity, and a commitment to returning home to serve.

Duke Escobar has been described by teachers and peers as approachable, trustworthy and easy to connect with.

“You wish you had a full class of Dukes,” one educator said, noting his friendliness and ability to relate to both younger and older people.

Despite his accomplishments, Escobar often returns to a phrase that reflects his perspective growing up: “just a kid from Waiākea.” The sentiment speaks to his humility as a first-generation college student raised in a close-knit �鶹��ý Island community.

Early inspiration

His interest in medicine began at Waiākea High School, where a health academy course introduced him to medical problem-solving through activities such as diagnosing cases from the television show House. A teacher recalled his curiosity and enthusiasm in class.

Escobar went on to study cell and molecular biology at before completing research gap years at Stanford University and the University of Washington. He was later accepted to JABSOM after years of preparation and persistence.

At medical school, he joined the School Health Education Program, helping bring medical learning into local classrooms. He said working with students came naturally.

“Maybe it’s like the same level of maturity, but we get along quite well,” he said.

Serving his community

Escobar also discovered his interest in pediatrics, drawn to working with children and building connections through humor and trust. He matched into a pediatrics residency and will continue training in �鶹��ý.

“I always kind of felt like I needed more of a human connection, and I felt like being a physician is where I could find that,” he said.

Escobar plans to return to Hilo to serve the community that raised him and hopes to inspire �鶹��ý Island students to pursue careers in medicine.

.

A common emergency room issue—objects stuck in children’s ears—is driving innovation through the University of �鶹��ý at ����ԴDz�’s (MIND) �鶹��ý competition.

(JABSOM) pediatric emergency physician Travis Hong said the problem is more frequent than many expect.

“You’d be surprised how often kids come in with things stuck in their ears—beads, food, small toy parts,” Hong said. “I see these cases at least every couple of weeks, if not more.”

Removing those objects safely can be challenging and sometimes requires improvisation.

“A lot of ER care involves figuring out what works in the moment,” Hong said. “In some cases, we use a small amount of medical-grade adhesive on a cotton swab to try to extract the object—but it requires precision, and the child has to stay very still.”

Student-driven solution

That challenge inspired this year’s winning team in the MIND �鶹��ý competition.

“We wanted to create something safer, more controlled and designed specifically for this problem,” said Aileen Ferrer, a JABSOM student and leader of the StickieEars team.

The team developed a hybrid suction-adhesive device to improve safety and control during removal.

“It’s a common issue, but there isn’t a standardized tool,” Ferrer said. “We saw an opportunity to improve that.”

Developing the prototype required collaboration across disciplines—central to MIND’s mission. The annual competition brings together students from across campus, including JABSOM, the , the and the , to tackle real-world healthcare challenges.

Working with students and mentors from different backgrounds changed how we approached the problem.
—Aileen Ferrer

“Working with students and mentors from different backgrounds changed how we approached the problem,” Ferrer said. “That collaboration was one of the most valuable parts of the experience.”

“Students are addressing real clinical needs, and the level of innovation in these projects is exciting to see,” said faculty advisor Peter Di Rocco, clinical assistant professor at JABSOM.

Ferrer hopes StickieEars will eventually reach clinical use.

“I think this could have a real impact in everyday practice and make a difference for patients,” she said.

.

University of �鶹��ý at ����ԴDz� student Elizabeth Rooks is earning national recognition for her research on retinoblastoma, a pediatric eye cancer, during a dedicated research year.

Rooks was awarded the Research to Prevent Blindness Medical Student Eye Research Fellowship, a competitive program supporting students advancing the understanding and treatment of eye disease.

“It’s an incredible honor,” she said. “This fellowship feels like an investment in my future, but more importantly in work that directly impacts patients.”

Advancing retinoblastoma research

Collaborating with researchers at the University of Washington, Rooks examines the genetic mutations behind the retinoblastoma and how they are inherited.

“Some patients also go on to develop osteosarcomas or other cancers in their 40s and 50s, while others never do,” she said.

Her work uses long-read genetic sequencing, which can identify not only mutations but also which parent passed them on.

“Unlike traditional sequencing methods, long-read sequencing lets us see the parental origin of a mutation without needing to test the parents. This is important because earlier research shows that mutations inherited from the father can make retinoblastoma more aggressive,” she said.

Rooks also helps collect and sequence DNA from patients and return findings to clinicians, potentially informing care in a fast-progressing cancer. Understanding the origin may help identify high-risk children earlier and guide more precise treatment.

After her research year, Rooks will return to �鶹��ý to complete her medical training.

“I am so grateful for this fellowship and for my team,” she said. “Working with them has taught me so much and has shown me the kind of physician I want to become.”

.

Cheers, hugs and tears flowed at the University of �鶹��ý at ����ԴDz� (JABSOM) as the Class of 2026 opened envelopes revealing the next step in their medical journeys.

On March 20, 78 students participated in Match Day, learning where they will continue their training in residency programs across the country.

This year’s class is strongly committed to primary care, with 56% matching into internal medicine, family medicine, pediatrics and OB-GYN—fields that remain in high demand across �鶹��ý. Additionally, 33% of graduates will remain in �鶹��ý for residency.

Staying home to serve �鶹��ý

For many students, staying home made Match Day especially meaningful.

“As cheesy as it might sound, I think it means the world to me,” said Kerrick Chinen. “I grew up in this place, these people have raised me, and it’s an absolute honor to be back serving the people and practicing even more at home.”

He added, “The heart said I really wanted to stay at home, but I knew the reality of it. It was a little dicey. So it was an absolute relief opening that envelope up and seeing the University of �鶹��ý.”

Jonathan Carino shared a similar goal. “That’s always been my intention,” Carino said. “To do residency somewhere not in �鶹��ý didn’t sit right with me, and I’m really glad I’m staying home here at UH.”

JABSOM Dean Sam Shomaker said that commitment reflects the school’s mission to serve the state’s most pressing health care needs.

“Primary care is the backbone of a healthy community, and �鶹��ý continues to face a critical need in these areas,” Shomaker said. “We are proud to see so many of our students choosing this path and staying true to our mission of training physicians who will serve our communities here at home.”

It was also a notable year for surgery, with 19% of the class matching into surgical specialties.

Nationally, more than 38,000 medical students matched into residency programs this year, marking the largest Match in the history of the National Resident Matching Program.

.

Walton K.T. Shim, �鶹��ý’s first pediatric surgeon and a longtime professor of surgery and pediatrics at the University of �鶹��ý at ����ԴDz� (JABSOM), died in November 2025 at his family home in Montana. He was 94.

Over the span of his long career, he trained residents, mentored future surgeons and helped raise the standard of pediatric care statewide.

Born and raised in �鶹��ý, Shim attended Dartmouth College and Columbia University School of Medicine before completing surgical training in Chicago. Shim returned to �鶹��ý in 1967 determined to build pediatric surgery as a specialty so children could receive complex care without leaving the islands. For many years, he was the only pediatric surgeon statewide.

In addition to his faculty role at JABSOM, Shim held multiple leadership positions at Kapiʻolani Medical Center for Women & Children, including division chief of pediatric surgery and chief of staff. He was also a founding member of the Pacific Association of Pediatric Surgeons.

A doctor who never delayed

“There’s all sorts of ways you can delay seeing patients,” said his wife, Vicki Shim. “He never did that. In other words, if somebody came into the ER or someone like Dr. Boychuk called him, he was there, right away.”

That dedication was felt at home as well. “I remember them calling him late at night on the phone,” said daughter Jennifer Shim. “He actually had his own telephone line installed just for emergencies…I realize it now as an adult.”

Shim is survived by his wife, four children, six grandchildren and generations of patients whose lives he helped save.

“Dr. Shim was a pioneer in pediatric surgery whose contributions to the field left a lasting impact,” said Russell Woo, professor of surgery at JABSOM and associate dean for clinical programs at �鶹��ý Pacific Health. “His legacy of caring, skill and dedication to the children of �鶹��ý is a high bar for all of us who follow in his footsteps.”

.

To help children feel less afraid of surgery, a graduate of the (JABSOM) at the University of �鶹��ý at ����ԴDz� created a story to guide young patients through the experience. Mariah Gosling, a 2022 alumna, wrote Toby’s Magic Bubbles: An Anesthesia Story to comfort pediatric patients in the moments leading up to their operations.

I discovered my passion for helping children feel safe and empowered in the medical setting,
—Mariah Gosling

The story follows Toby, a young sea turtle who feels nervous before surgery. He soon discovers “magic bubbles”—a child-friendly symbol of anesthesia—that carry him into a dreamlike world of friends and adventures, where he finds his courage.

Now in her final year of the University of Miami’s Anesthesiology Residency Program, Gosling hopes that Toby’s bravery resonates with her young readers.

“As a soon-to-be pediatric anesthesiology fellow, spending time with patients in the preoperative setting, I discovered my passion for helping children feel safe and empowered in the medical setting,” she said.

Gosling credits her time at JABSOM and mentors Jason Isa (a 2002 JABSOM alumnus) and Cindy Ku for shaping her growth as a compassionate physician.

“[Drs. Isa and Ku] taught me the foundations of anesthesia and welcomed me like family,” she said. “I admired their knowledge, procedural skills, and the genuine rapport they built with patients—and it was in those moments that I knew anesthesiology was the path I wanted to follow.”

Toby’s Magic Bubbles is now available on . Gosling hopes to donate copies to children’s hospitals to inspire young patients facing surgery.

.

Anna-Kaelle Ramos, a fourth-year medical student at the University of �鶹��ý at ����ԴDz� (JABSOM), fulfilled a childhood dream by matching into the UH pediatrics residency program. Joining her were 76 other students, all matched into various residency programs, continuing JABSOM‘s streak of 100% match rate for two consecutive years.

“Even though I didn’t know at that time that I was necessarily going to go into pediatrics or OBGYN or anything like that, being born and raised here, I knew I wanted to serve the exact communities I grew up in,” said Ramos, a Kaiser High School graduate.

Austin Corpuz, who grew up on the Leeward side, was inspired by the care he received from his community. Now, he’s matched with the UH internal medicine program, eager to give back.

Corpuz said, “I like to think about how I’ll impact this community in the future. That purpose is what really drives me forward.”

Primary care specialties fill need

A �鶹��ý continues to grapple with a physician shortage, more than half of JABSOM students are pursuing primary care specialties of internal medicine, family medicine and pediatrics.

For many of them, staying in �鶹��ý to learn and serve is a priority. Although not all specialties are available locally, 31% of the JABSOM class of 2024 will continue their training in �鶹��ý.

This year JABSOM matched 16 students in pediatrics, the highest number in seven years, promising increased care for �鶹��ý‘s children.

For more than three decades, Lynn Iwamoto has served �鶹��ý as a neonatologist at Kapiʻolani Medical Center for Women & Children while training the next generation of as an associate professor at the (JABSOM) at the University of H�鶹��ý at ����ԴDz�.

Iwamoto was honored by �鶹��ý Pacific Health (HPH) and �鶹��ý Health Partners as the Member of the Year for making the healthcare landscape safer for patients. She created the Maintenance Certification Program, which gives physicians credit for their quality and patient safety work.

Years ago, once doctors became certified, they stayed certified throughout their careers.
However, in medicine, advances and breakthroughs are constant, and the American Board of Medical Specialties currently requires physicians to stay up-to-date.

“They’re showing that they’re really trying to keep up with the information that is rapidly increasing and that they’re trying to do things to help their patients by improving care,” Iwamoto said.

Creating a blueprint for physician certification

Through the Maintenance Certification Program, Iwamoto created a blueprint for physicians at HPH to get credit to keep them current within the American Board of Medical Specialties standards.

“The whole board perspective is that physicians are already doing the work, so what we just want to do is give them credit for what they are already doing.”

Iwamoto started crafting the guidelines for HPH and shared an example in neonatology that HPH physicians were already working on that they can now receive credits for.

Their efforts to boost breast milk rates for preemie babies included educational interventions for staff and parents. The initiative led to a notable increase in preemies going home with breast milk feedings, contributing to better outcomes and recognizing physician participation in the project.

“[This not] only contributes to better outcomes for babies, but we were able to give our physicians credit for actively participating in the project,” Iwamoto said. “The sense of giving back is special. Being part of the community is being able to contribute. That’s the best part of practicing medicine here.”

.

Obese adolescents have their most rapid weight gain before the age of five and are usually already obese by that age. Due to limited pediatric obesity research and lack of appropriate body composition technologies, researcher John Shepherd was awarded $3.1 million from the National Institute of Child Health and Human Development to discover body composition technologies that can detect health outcomes of obesity among young children.

• Related UH News story: $3.1M to advance pediatric obesity research, January 20, 2022

Shepherd’s team hopes to recruit 360 children ages 0 to 5 years old for a study, to create advanced body shape models using 3D scans.

These scans will provide detailed descriptions of how body shape and composition are related to obesity-related risk factors, including high blood pressure, increased cholesterol levels, and risk for developing cancer among children in �鶹��ý and the Pacific.

“The inclusion of our diverse population in �鶹��ý for this specific study will help us to more fully understand the extent of health inequities and the mechanisms in which to address them,” said Shepherd.

Recent research suggests that interventions to prevent obesity and metabolic diseases later in life need to be implemented in early childhood. Studies such as Shape Up! Keiki are needed to explore innovative technologies to assess and understand the risk factors of metabolic diseases.

Parents who are interested in enrolling their children in the study can visit the for more details. To contact the study team, call (808) 440-5234 or email bodycompstudies@cc.hawaii.edu.

September 1, 2022 update: This paper has been selected for “American Physiological Society (APS) Select,” a collection from APS that showcases some of the best recently published articles in physiological research. This paper will be free to access for two months.

Original story:

Menthol in e-cigarettes may be harmful to respiratory health, according to new research by a team of University of �鶹��ý at ����ԴDz� experts. The findings come as e-cigarette use is on the rise among �鶹��ý’s youth.

Yi Zuo, UH ����ԴDz� professor of and adjunct professor of , has invented a groundbreaking method that allows the study of the health impact of e-cigarette aerosols. This breakthrough research was published in June 2022 in the American Journal of Physiology—Lung Cellular and Molecular Physiology, “.”

Zuo’s research found that flavorings used in e-cigarettes, especially menthol, impaired a lipid-protein film at the air-water surface of the lung. This film is called the lung surfactant. It plays a central role in maintaining the normal respiratory mechanics of the lung. Therefore, Zuo’s research indicated that menthol in e-cigarette aerosols may cause an adverse impact on the respiratory health of the user.

“E-cigarettes were initially advertised as a healthier and safer alternative to conventional tobacco smoking when they first appeared in the mid-2000s,” Zuo said. “However, increasing research evidence, especially long-term (more than 10 years) toxicological data that emerged only in recent years, has suggested that e-cigarettes are not as safe as originally promised.”

E-cigarette use is on the rise among �鶹��ý’s youth, according to a by the UH ����ԴDz� . Survey respondents who reported they used an e-cigarette or vaping product at least one day during the previous 30 days before taking the survey increased from 25.1% to 30.6% from 2015 to 2019. Respondents who used vapor products for more than 20 days in the past 30 days before taking the survey increased from 3.6% in 2015 to 10.4% in 2019.

Flavor is a main attraction to e-cigarette users, especially youth. As of 2018, there were more than 15,000 different e-cigarette flavor blends available on the market. Although most flavorings used in e-cigarettes are food-grade additives and scents, their safety and health impact on the respiratory system, at levels inhaled by e-cigarette users, have been largely unknown, until now.

Menthol is a substance found in peppermint, spearmint and other mint plants. It gives a cooling and soothing sensation, and is used to relieve minor pain and irritation. Menthol is added to products as a flavoring including cough drops, beverages, gum and candy. However, none of these products are smoked or inhaled when used. E-cigarette companies, contrastingly, add menthol to their products to make them more appealing and seemingly less harmful when used.

Zuo hopes this research finding may contribute to a better understanding of the health impact of e-cigarettes, especially on youth, and a better regulation of e-cigarette products. This research was a collaborative effort between Zuo’s lab and Professors Ellinor Haglund and Rui Sun in the UH ����ԴDz� . This research was supported by a National Science Foundation award and the George F. Straub Trust and Robert C. Perry Fund of the �鶹��ý Community Foundation.

Other stories from UH News involving e-cigarettes:

• Cancer Center awarded $1.4M for e-cigarette research, November 23, 2018
• Teens who use e-cigarettes are more likely to start smoking cigarettes, January 25, 2016
• E-cigarette use by �鶹��ý teens is nearly triple national average, December 16, 2014

—By Marc Arakaki

An assistant clinical professor at the University of �鶹��ý at ����ԴDz�’s (JABSOM) has gone viral across social media with her educational, fun and down-to-earth videos.

Board-certified Pediatric Ophthalmologist Rupa Wong has been on social media for only three years, but her social media posts as @drrupawong have captured the attention of many across the world.

Wong has accumulated more than 225,000 followers/subscribers across , and . She also has a weekly podcast, “,” where she delves into the challenges of balance, time management, entrepreneurship and being a boss on your own terms.

How it started

I really do believe that if you see it—you can be it.
—Rupa Wong

It all started with Instagram in 2019, when Wong discovered a group of other doctors that were interested in promoting health information. Together, they formed the non-profit organization, the , a resource for social media usage by healthcare professionals that advocates for using social media as a public health tool to combat misinformation.

“Through that group, that’s when I started branching out into different types of social media platforms just in an effort to get others to understand eye health and information and also what it’s like to become a doctor and a woman in medicine,” said Wong. She soon found a strong following, particularly in young women, who were inspired by the transparency depicted in her videos not only about her life as a physician, but also as a mother of three.

“I started getting messages from younger women in high school, college and medical school that said, ‘My family said I can’t be a surgeon and a mother. What do you think of this?’ There were so many (similar messages) that I felt that it was really important to address that,” said Wong. “I really do believe that if you see it—you can be it. I have my daughter and my two boys and I thought it was really important to pull back the curtain so that others can see how I make my life work.”

Originally from Raleigh, North Carolina, Wong attended Duke University and earned her MD from Cornell University Medical College. After residency, she completed her fellowship in pediatric ophthalmology and adult strabismus in Boston, which is where she met her “local boy” husband and comprehensive ophthalmologist Jeffrey Wong (JABSOM MD 2003). They moved back to �鶹��ý in 2008 and practice together at Honolulu Eye Clinic.

.

Metabolic diseases such as obesity are the leading causes of deaths among adults, and are increasingly becoming an epidemic in the U.S. A researcher has been awarded $3.1 million from the to further his research efforts to provide new body composition technologies to detect the risks of metabolic consequences of obesity among young children. These include hypertension, type 2 diabetes and premature heart disease.

John Shepherd, in collaboration with partner Steven Heymsfield, of the , are working on a study called Shape Up! Keiki (children). This observational study of 360 children, between the ages of birth to five years, will create advanced models of body shape from 3D optical whole-body scans. This study will provide clear descriptions of how body shape and composition are related to metabolic risk factors—high blood pressure, increased cholesterol levels and risk of developing cancer among children of �鶹��ý and the Pacific.

Through this study, Shepherd hopes to provide newly found health traits in children, including emotional stability and management of stress levels, by studying their body shape and providing tools to visualize and quantify body shape in research and clinical practices.

“Obese adolescents have their most rapid weight gain before the age of five, and are usually already obese by that age. Despite clear connections between obesity and disease risk, pediatric obesity research is limited due to the lack of appropriate body composition technologies,” said Shepherd.

The outcome of the Shape Up! Keiki study will provide descriptions of how the body shape of �鶹��ý residents varies across their lifespan with technological tools that will be useful to probe the intricate relationships of aging, activity level, diet and genetic associations related to diabetes and fatty liver disease.

In the future, Shepherd hopes this technology will be accessible worldwide through consumer-level gaming and smartphone technologies, which will help parents and pediatricians monitor their children’s health from home.

This research is an example of UH ����ԴDz�’s goal of (PDF), one of four goals identified in the (PDF), updated in December 2020.

• Related UH News stories:
  • Researcher elected to elite medical fellows program, March 24, 2021
  • 3D scan study by UH Cancer Center student hailed for obesity findings, November 12, 2019
  • 3D scanners give new insight to body shape and health, April 16, 2018

The University of �鶹��ý and The Queen’s Health Systems (Queen’s) announced a three-party affiliation agreement between UH ����ԴDz�’s (JABSOM), Queen’s and University Health Partners of �鶹��ý (UHP). This affiliation agreement, expected to be operational by September, will expand medical education and research, engage the next generation of healthcare professionals and improve the health and well-being of the people of �鶹��ý.

UH is currently working with another one of its valued healthcare partners, Hawaii Pacific Health, to develop a separate affiliation addressing the departments of Pediatrics, OB/GYN and Family Medicine.

The new affiliation agreement with Queenʻs will benefit patients and the community by:

• Strengthening and enhancing the education of the next generation of medical students, residents, fellows and other health professionals in �鶹��ý.
• Attracting and retaining talented faculty, physicians and researchers in �鶹��ý.
• Expanding clinical and research programs and providing opportunities to create innovative models of care.
• Enhancing teaching, research and community service missions.
• Encouraging and creating pathways for the next generation of healthcare professionals to provide care in our state.
• Improving each organization’s ability to meet the needs of vulnerable communities and address health inequities.
• Accelerating the achievement of improving the overall health of communities served.

A key component of this affiliation agreement is the creation of a combined physician group to be named The Queen’s University Medical Group (QUMG). This group of more than 450 providers, representing 17 specialties, will further strengthen high quality, compassionate care, innovation, research and education in �鶹��ý.

As part of the QUMG, UH faculty will be employed and supported by �鶹��ý’s largest clinical site for training medical students and more than 100 residents and fellows from JABSOM. Queen’s will ensure the medical group has the support needed to meet educational needs. JABSOM will oversee the academic activities of the faculty, and UHP will help sustain support of JABSOM’s teaching and research mission.

“This opportunity to align the clinical care and academic roles of those working at Queen’s to enhance training of our learners will transform medical education and research at JABSOM. We look forward to working with Queen’s through this new affiliation to help support �鶹��ý’s healthcare training and service needs for the future,” said Jerris Hedges, dean of JABSOM.

“By unifying our practices, we will strengthen the education and development of the next generation of caregivers in a culturally grounded way, infuse research and innovation into our delivery systems, and expand and improve key clinical programs,” said Jill Hoggard Green, CEO of The Queen’s Health Systems. “We look forward to enhancing our already strong and longstanding partnerships with the university to achieve our shared goal of improving the health of our communities, both now and in the future.”

The University of �鶹��ý at ����ԴDz� is among 30 institutions across the U.S. receiving a series of grants from the St. Baldrick’s Foundation, the largest non-government funder of childhood cancer research grants. A total of $1.8 million in grants supports the mentorship of St. Baldrick’s Fellows and Summer Fellows at institutes including at the (JABSOM), where pediatrician and researcher Bruce Shiramizu has mentored summer fellows for 10 years.

This year’s St. Baldrick’s Staff Giving Campaign Summer Fellow is Jessica Natale, a UH ����ԴDz� undergraduate student from Monterey, Calif. Her work will focus on generating a standardized control of Raman spectroscopy scans to detect pediatric Non-Hodgkin Lymphoma.

• Related UH News story: UH reveals screening tool for non-Hodgkin Lymphoma in children, April 9, 2020

“I hope that I can develop an alternative diagnosis for quicker and more efficient turnaround time, thus allowing the cancers to be detected in its earlier stages,” said Natale. Cancer research is especially close to her heart as she remembers being a child and seeing her own mother struggle with Non-Hodgkin Lymphoma.

“I spent a lot of time in and out of hospitals with her (my mother), which drove my interest in medicine. I feel as if I owe my service and contributions to those and the field who kept my mother alive the many times they did,” added Natale, who aspires to become an emergency medicine physician.

“As an undergraduate Honors student in biology, Jessica approached me with an interest and desire to pursue a research opportunity in the laboratory,” said Shiramizu. “I was impressed with her disciplined and hard-working ethics which led to her applying to be considered as a St. Baldrick’s Foundation Summer Fellow at JABSOM. We are excited that she will be funded through the St. Baldrick’s Foundation Summer Fellow program.”

St. Baldrick’s dedication to provide funding to support the most promising research and to train early career scientists has not wavered, even amid the COVID-19 pandemic. Since 2005, the St. Baldrick’s Foundation has put a high priority on building the pipeline of pediatric researchers by supporting the next generation of childhood cancer research experts whose work may lead to new and innovative therapies for kids with cancer.

The University of �鶹��ý (JABSOM) and are working together to help future paramedics gain confidence and skills in handling emergencies involving infants and children.

JABSOM and Kapiʻolani CC faculty have collaboratively developed and conducted the first Pre-Hospital Pediatric Paramedic Training Program to integrate with Kapiʻolani CC’s established . The course was made possible through a grant provided by the �鶹��ý Pediatric Association Research and Education Foundation (HPAREF).

“Pediatric cases are such a small percentage of the cases they (paramedic students) are exposed to,” said Dale Oda, emergency medical services program director at Kapiʻolani CC. “This program gives them the opportunity to practice their skills in a controlled setting and get that kind of experience before they become certified paramedics.”

Gaining experience at SimTiki

As an EMT for the City and County of Honolulu, most of Cyrus Camp’s field experience has involved adults so, for him, learning with infant manikins in the UH medical school’s has boosted his confidence. Camp also appreciates the program’s focus on communication between pre-hospital providers and emergency physicians.

“It’s useful for us (EMTs and paramedics) to get an idea of what the doctors are thinking so that we can adjust what we’re doing to help them with that continuum of patient care,” Camp said.

While working with the future paramedics, Jannet Lee-Jayaram, SimTiki associate director and JABSOM assistant professor, said she saw a spark in the students’ eyes as they realized, “Hey, what I do directly influences what the physicians and nurses are going to do, and what I do is vitally important, so I need to make sure I get all the information and that I can communicate the right information.”

—By Deborah Manog Dimaya

Research by doctors in the at Kapiʻolani Medical Center for Women and Children shows that cat scratch disease is more frequent in �鶹��ý. The doctors examined cases of cat scratch disease affecting children at one medical center over an eight-year period.

“We think it is three and a half times more common here, and why that is, we think we have a higher incidence of the bacteria in our kitten and cat population in �鶹��ý,” said , lead researcher and a �鶹��ý Island native now completing her medical residency in the UH Pediatric Residency Program at Kapiʻolani Medical Center for Women and Children.

Cat scratch disease is caused by the bacteria Bartonella henselae, which is generally benign and doesn’t always trigger the disease. But sometimes—and it is still rare—the bacteria can cause Cat Scratch Fever, which can become very serious. At its worst, the disease can cause bone infections, encephalitis, which can lead to seizures or coma or even blindness.

The disease is difficult to diagnose

Researchers stress that the disease is rare, but because of this, it is also difficult for doctors to diagnose, and once they do, to settle on the recommended treatment and how long to apply it.

Because it is so uncommon, in the eight-year period studied, the researchers only gathered about 20 cases. They hope to collaborate with other U.S. hospitals that primarily serve children, to increase the numbers of cases studied.

“Because there are a variety of tests and imaging that you can use, we’re hoping ultimately that we can give some sort of guidance to clinicians going forward, because it is very rare relative to other diseases that we see,” said Johnson.

People get cat scratch disease from cats, it is spread between cats by fleas. Kittens often have a higher level of the bacteria.

“So one way to hopefully prevent this and not get it, is to make sure you are trying to control the flea population especially with your cats. Maybe avoiding wild cats which oftentimes have more fleas,” said Johnson.

“A lot of times the children have a prolonged fever, and parents and doctors are naturally very nervous,” said Johnson. “They do several different workups trying to figure out what’s going on and that can mean a longer stay in the hospital. If we can get good diagnostic testing and we can start treatment earlier maybe we can avoid some of the expense and emotional stress for families.”

Johnson worked closely with , assistant professor of at the UH and Pediatrics Division Chief at Kapiʻolani Medical Center, the training hospital partner for pediatrics at JABSOM. Johnson also was advised during her research by , a �鶹��ý pediatric infectious disease physician at Kapiʻolani Medical Center.

—By Tina Shelton

student Mark Brisco will be working this summer to devise a better way to diagnose cancer in children. But first he will get an extreme haircut.

Brisco, who is studying , is the recipient of the 2018 , which will allow him to take part in pediatric cancer research at the (JABSOM). His mentor will be JABSOM‘s , pediatrician and researcher.

And that’s where the haircut comes in.

Shiramizu is a proud supporter of the annual Shave-Off fundraising event orchestrated by the St. Baldrick’s Foundation to raise money to fight childhood cancer. Along with Shiramizu and thousands of other people around the country, Brisco will be introducing his thick locks of hair to a razor.

The Shave-Off is a festive event, leaving the fundraisers with shiny bald pates and, for a few weeks at least, recognizable proof that they support the cause.

The 2018 St. Baldrick’s Foundation event in Honolulu is set for April 22. Shiramizu’s Laboratory Team, “Shaven Things,” is .

Brisco said he is thrilled with the research opportunity that awaits him during his summer fellowship in Shiramizu’s lab.

“To give children a fair chance at life for the first time in their lives is a truly unique and momentous opportunity,” he said. “This experience will not only alter my life course, but I hope can alter the life courses of many others through the findings of this research.”

An aspiring medical student, Brisco said his research will center on cancer cell recognition inside the human body, where he hopes to discover a better technique for recognizing and diagnosing cancer in children.

Read the full story on the .

—By Tina Shelton

With a $400,000 grant from the National Institutes of Health, infectious disease scientist , of the (JABSOM), will investigate the Zika virus in pregnant women. His goal is to develop strategies to prevent transmission of the disease to the fetus.

“We want to understand how the Zika virus is transmitted to the fetus, how the virus affects pregnancies and how Zika infection can impair infants, causing developmental delays and physical disorders,” said Kumar, an assistant professor with the at ����ԴDz� JABSOM . He also will examine whether the timing of Zika virus infection during pregnancy affects the ability of the virus to cause fetal developmental abnormalities.

Kumar’s study builds upon his recent discovery that guinea pigs are susceptible to infection by a recent American strain of the Zika virus. His lab’s development of a guinea pig model is important because it indicates that Zika studies using guinea pigs should provide outcomes similar to those in humans.

“Ultimately, if the mechanisms by which the Zika virus transmits to the fetus and causes microcephaly are clarified, we can find a way to prevent in utero transmission of the Zika virus,” said Kumar.

�鶹��ý at risk for transmission

�鶹��ý is particularly at risk for transmission of Zika virus due to its year-round tropical climate favoring abundant mosquitoes, and attracting a high influx of visitors from all over the world including countries where Zika virus is endemic. Several cases of Zika virus have been reported in �鶹��ý. It is believed that these cases did not initially occur in �鶹��ý, yet the risk of mosquito transmission is real.

JABSOM scientists previously documented the first case of congenital Zika infection in the United States (born in �鶹��ý) in December 2015. In this case, a Zika virus-infected mother delivered a baby with microcephaly. The data also suggest the presence of Zika virus-positive cases and associated microcephaly in �鶹��ý as early as 2009, i.e., before the disease was medically recognized.

“The Zika virus research by Kumar and his tropical disease and pediatrics colleagues at the medical school is quite important for the health of the people and economy of �鶹��ý,” said , JABSOM dean. “We are very proud of these investigators’ dedication to reducing the devastating effects of Zika in unborn children around the world. And we are grateful for the support of �鶹��ý’s Congressional delegation to secure funding to promote this urgent goal.”

For full story please visit .

—By Tina Shelton

Children in �鶹��ý will directly benefit from a seven-year, $157 million initiative called launched by the . The ECHO program will investigate how exposure to a range of environmental factors in early development—from conception through early childhood—influences the health of children and adolescents.

The University of �鶹��ý at Mānoa’s has been selected to build state-of-the art pediatric clinical research networks in rural and medically underserved areas, so that children from these communities can participate in clinical trials. The medical school will partner with the and and UH professor and community pediatrician May Okihiro of .

“We think this is going to transform the availability of clinical trials to benefit infants, children and adolescents with the most need in �鶹��ý,” said Principal Investigator Bruce Shiramizu, professor of at the school of medicine.

Three main focus areas

Initially, three main areas of emphasis for the �鶹��ý site will be the health of infants before and after birth, obesity in children and adolescents and respiratory diseases, including asthma suffered by children and teens. Future plans will be to include clinical trials involving neurocognition. These four areas are the initial key focus areas for ECHO.

University physicians in the John A. Burns School of Medicine , assisted by those in the , will collaborate with their peers on a national level to develop new clinical trials that will involve the children of �鶹��ý. The first of the clinical trials could happen within a year of the four-year grant awarded this week.

Clinical trials

When they begin, the clinical trials will be open to children and adolescents in �鶹��ý at the greatest risk for health problems—Native Hawaiians, part-Hawaiians, other Pacific Islanders, Filipinos and other Asians as well as children and teens of low-income families and underserved communities. Few clinical trials in the past have targeted children from these ethnic backgrounds or Islands.

For more on information, read the .

NIH ECHO Program overview

—By Tina Shelton