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A
Central PA's people and perspectives podcast, produced by the Cumulus Harrisburg News Department.
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Good morning and thank you for joining me for today's edition of People and Perspectives. I'm Christine Rookey. And as we recently recognized, Birth Defects Awareness Month. Did you know one in every 33 babies are born with a defect. Here with more on this and life saving surgeries to help some of these babies even before they're born to is Dr. Scott Adzick, surgeon in chief with Children's Hospital Philadelphia and founder and director of CHOPS, Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment. Good morning.
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C
Good morning, Christine.
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B
Now, first, when we're talking about birth defects, just how common in fact are they on the grand scale here?
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C
So birth defects in the US one in every 33 babies is born with a anatomic or genetic birth defects amazingly common. And birth defects are costly. Billions of dollars are required for medical treatment. They're merciless, no parent immune, serious. Most causes of birth defects are unknown, overlooked research is underfunded in my view, and deadly serious birth defects are the leading cause of infant mortality. So on the big scale, each year in the US nearly 150,000 babies are born with birth defects, many so rare even doctors may not recognize them before birth. And too often families never hear about specialized treatment available at centers like ours and or feel overwhelmed alone. And today we're going to fix that.
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B
Well, I hope that people listening understand that CHOP is there. You are, I want to say, ahead of the curve in the knowledge of all these defects that are out there, especially small communities, these doctors just might not have seen it, heard, heard of it. So that's why CHOP has people from all 50 states, from all countries around the globe come to see your services, the services available through chop. So when we're talking too about these birth defects and the help of fetal surgery, why is this so important, that this is an option that some mothers can have?
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C
Well, so we evaluate, I guess each year about 2,000 pregnant mothers carrying babies with brewing birth defects. And only about 10% are carrying babies that might benefit from surgery before birth. Most would benefit waiting until after birth. The ones who need fetal surgery are those have birth defects that cause progressive organ damage before birth such that if we wait till the baby is born, we're too late. I'll give you two examples of the most common, two most common fetal surgical procedures that we performed. One is for spina bifida. So what is that? Spina bifida is a birth defect where before birth the spine and spinal cord don't form properly, leaving a gap or a hole in the backbone. That leads before birth to exposure of those nerves to neurotoxic amniotic fluids. So the nerves are destroyed and subsequently after birth, leads to mobility problems. Also leads before birth to hydrocephalus, or fluid on the brain that causes brain damage. And we can now treat this before birth. Fetal surgery to close the spina bifida defect before birth. We did the first such operation back in 1998. We're about to do our 500th fetal surgery for spina bifida in. Children that had this done before birth have much better outcomes. They're much more likely to be able to walk. They're much less likely to need a shunt tube to treat hydrocephalus, so forth. So that's spina bifida. Second condition I'd like to describe. We do about 100 fetoscopic laser therapies for twin twin transfusion syndrome each year. So twin Twin transfusion syndrome, DGTS, for short, three Ts and S, is a condition in which there are identical twins, each in a separate amniotic fluid sac in the uterus, and they share a single placenta. The placenta is like a disc in which the umbilical cord of the fetus goes into that disc, and that allows to blood exchange and nutrition via the mother. And, you know, in singleton pregnancies, one fetus, one placenta to the mom. But in this condition, there's only one placenta. Twins, two twins. There's an abnormal sharing of blood, such that one twin gets too much blood and goes to heart failure and develops increased amniotic fluid, and the other twin doesn't get enough blood from the mother and develops kidney failure and doesn't produce fetal urine, which is the major component of amniotic fluid, and becomes shrink wrapped in the membranes around it. Those twins will go on to die without therapy. The way to treat this is with a fetoscope 2 millimeters in diameter that's placed through the mother's abdominal wall. Through the uterine wall goes the placenta. The laser fiber to photocoagulate or occlude the abnormal crossing blood vessels from one side of the placenta to the other, such that this sort of pathophysiologic cascade is broken up and greater than 90% of the twins can be saved with this.
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B
That's amazing. Yeah. And when we're looking at fetal medicine, fetal diagnosis, especially with birth defects, I know the treatment is constantly evolving. So how is chop, if you will, staying at the future forefront of this
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C
type of medicine treatment, we are at warp speed. I'll mention three things for the future. The future is almost now. First, Dr. William Pronto, Bill Pronto, one of our pediatric surgical scientists and fetal surgeons, has been doing work for several years on in utero gene editing, which involves using CRISPR technology to replace the abnormal gene in single gene disorders such as cystic fibrosis, sickle cell anemia, muscular dystrophy, a whole long list of things that can now be diagnosed by 12 weeks gestation. So it's not quite ready to be applied clinically, but it will. And that will transform. That will save the lives of thousands and thousands of unborn babies. First thing, second thing. Dr. Alan Flake, pediatric surgical scientist and fetal surgeon here at chop, has been working for nearly a decade on the artificial womb. Well, what is that? Well, babies who are born at 23 to 25 weeks gestation, where term is 40 weeks gestation, have a very high mortality rate and those who survive have very high complication rate. So we were like a bridge, which is what the artificial womb is. Carry them from 23 to 25 weeks gestation to 28 to 30 weeks gestation, where the outcomes are dramatically better. Dr. Flake has shown that the artificial room works in fetal sheep. He can maintain them for four to five weeks with normal growth and development through cannulation of the umbilical vessels. He's working closely with the FDA fast track proposal. Get this into clinical trials here at CHOP by the end of this calendar year. So maybe when we talk next year, we can talk a little bit about that. Third area is big data and artificial intelligence. So we've created a clinical outcomes data archive beginning in 2013 called CODA for short, C O D, A first is kind database that combines real time medical records with carefully reviewed clinical information to improve prenatal diagnosis and care. So since 2013, Coda has tracked every mother and every fetus treated in shops, diagnosis and treatment, now holding more than 15 million data points from over 15,000 patients to help clinicians make earlier, better informed decisions. The most current application of this very powerful tool, this artificial intelligence tool, is in the delivery room of the future, led by neonatologist Dr. Natalie Rintoul here at CHOP, who's applied this in the golden hour, when babies are born in the special delivery unit at Chopper, say with serious heart defect or other prenatally diagnosed condition, you can use all that data, other patients with a similar condition, to give the optimal care for that particular baby at that particular time. Very, very, very powerful.
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B
Definitely sounds amazing and I know any mother to be and their child comes to treatment at CHOP is in good hands for sure. So if somebody wanted more information, where do you suggest they go?
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C
Our website, which is based at Children's Hospital Philadelphia, chop is fetalsurgery, one word dot chop chop edu. So fetalsurgery chop edu.
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B
Well, I appreciate your time today. Dr. Scott Adzick, surgeon in chief of Children's Hospital Philadelphia and founder and director of CHOP's Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment. Hope you have a great day.
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C
We'll see you next year.
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D
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B
we continue to recognize Heart Month, there's a new report out that finds while most Americans want to age well, they can often miss hidden heart risks. So joining me now with more ON this is Dr. Milind Desai, Director of the center for Hyperthropic Cardiomyopathy in the Heart Vascular and Thoracic Institute with Cleveland Clinic. Good morning.
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E
Good morning, Christine. Thank you for having me.
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B
Well, thanks for joining me. Now first, let's talk about Cleveland Clinic's new Love youe Heart Survey. Can you share more on the findings here?
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E
Yes, absolutely. This was a survey of about 1,000Americans age 18 and older where they were asked a few pointed questions. And one of the questions was,
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C
how
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E
do they feel about doing something good about their heart health and longevity? And 95% patients said they want to do something about it. So they are thinking about it. But then there were a few other questions that were asked about specific risk factors. That's where we found that about a third of them did not know they were hypertensive. About a quarter of them did not know they were diabetic. One in five did not think stress was a problem. Cholesterol was a problem. In fact, a surprise we found was in 2026, there was still a sizable proportion of people who think smoking or they were not aware that smoking is a Risk factor. So what we found was a disconnect between wanting to do something but realizing that they have risk factors that may create problems down the road.
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B
Right. And especially looking at the fact that you started with 18 year olds, not just older adults. Because everyone at every age should be mindful and conscious of what they need to do for their heart health if they want to have a long, healthy life. So when you're talking also about these risk factors for heart related conditions, why is it so important for that person to know that they fall into this category?
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E
Absolutely. So the guidelines for the record suggest that your discussions related to risk factor modification should start at 20 years of age and there is no upper limit of cutoff. Now, why is it important? Some of these risk factors, Diabetes, hypertension, cholesterolemia, a family history of inherited heart disease, sleep apnea, all these things, they do not manifest as symptoms at the beginning. They work in the background till it reaches a state where things start to happen in terms of an event. And what are the events we are looking at? You're looking at a heart attack, you're looking at stroke, you're looking at vascular dementia, you may be looking at sudden cardiac death. So in order to prevent or minimize the risk of all these, we have to recognize these risk factors early so that we can act on it. What I tell patients all the time is you need to own your risk factors before your risk factors own you.
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B
Right. Talking about your own patients. Because the survey show that people have this gap of what they want to do for their health and not taking care of their heart health. So do you see a similarity between your patients and the survey?
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E
Oh, absolutely. There is a major disconnect. You know, the body may be 55 years of age, but the mind still thinks they are hovering in their 20s and 30s. That's a very common phenomenon. And often it is just denial. Sometimes it is putting everybody else's welfare ahead of yours, meaning family, kids, career, etc. Sometimes it's just lack of understanding as new risk factors evolve. So it is a multifactorial problem. Absolutely. But we see this all the time in our practice.
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B
Right. And there might be people that just have the mentality like, well, I have to do this today. Whether it's work stress, taking care of the kids, and maybe even, as you mentioned, smoking. Smoking is my stress reliever, so isn't that really helping? And of course it's not. But what should people be taking away to improve their heart health here?
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E
So what I tell patients, when we are having these conversations as follows. Physical activity, aerobic activity, there's no upper limit to it and there's no lower or upper age limit to it. Having. And then as one ages, we tend to lose muscle mass, become frail. So doing things to help improve muscle mass or maintain muscle mass is important. So strength training, exercise, a healthy balance of adequate protein, complex carb, diet, avoiding as much as possible the ultra processed foods, minimizing alcohol intake, working on stress mitigation strategies. If you have some risk factors for sleep apnea, for example, then you need to work on that, recognizing that. And another important thing is if you have a familial history of something inherited cardiac disease, recognize that, talk to your doctor so that we can figure out a strategy of screening for that and taking steps to mitigate any complications, eliminate any complications.
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B
Right. And the goal is not just the longevity, but a healthy longevity with your life, correct?
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E
Absolutely. It is not just getting to the destination, but getting there in style with some level of quality of life, not some, a high level of quality of life.
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B
I like that statement, getting there. Not just getting to the destination, but getting there in style. I hope everybody heeds this word and gets there in style. So if somebody wanted more information on what we're talking about, where do you suggest they go?
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E
I think they can check out ccf.org
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B
terrific. Anything else you'd like to add for my audience today?
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E
No, I think, you know, look, again, I will repeat the statement. You need to own your risk factors before they own you, I think, and there are ways of, simple ways of doing that. Aerobic activity is at the top of my thought process.
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B
Great. Well, I thank you for all this vital information today. Dr. Mila Desai, Director of the center for Hyperthropic Cardiomyopathy and the Heart Vascular and Thoracic Institute with Cleveland Clinic. Hope you have a great day.
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E
Thank you for having me. Hope you have a great day, too.
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B
On another topic, when it comes to the disease and viruses that are spreading all around us, particularly during these winter months, did you know there's a way to track it all by what's happening underground, so to speak? Joining me now with more is Dr. Marlene Wolf, Assistant professor with Emory University and program director at Wastewater Scan. Good morning.
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F
Good morning.
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B
Now, wastewater scan, basically meaning you're scanning the wastewater. So how does this work?
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F
Yeah, the name is pretty on point. So we are using wastewater or sewage as a way to investigate what diseases are circulating in a community. It's a way that we can contribute to regular public health monitoring of infectious disease by taking A single sample of wastewater that's collected from all of everything that's gone down the drains and the toilets in the whole community and testing that for the particular viruses that we're interested in and understanding the disease patterns in the area.
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B
So at this time of the year, you're typically looking at rsv, flu, Covid, but you could be looking at other things that are causing a buzz, if you will, with illnesses across the U.S. correct?
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F
That's right, yeah. So our program is an academic led program. You know, I'm a professor at Emory, and so our goal is that we are able to develop a lot of tools for monitoring different kinds of disease and put those into practice with the help of all of our partners and deliver that data to public health. So we have 147 sites in 40 states where we do monitoring and where we're continually looking at ways that we can improve and add new diseases that we can monitor to make sure that we get the most information that we can out of wastewater to serve public health. So that includes things like flu and RSV and Covid that we see consistently all the time. And then that also includes potential rare outbreak diseases that we want to keep an eye out for. And so we're always looking at new things that we can add. And it's pretty amazing to see all the things that we can do through wastewater.
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B
Right. And one of those diseases right now that's on the forefront is the measles, making a return, if you will, to the U.S. what are we dealing with when you're looking at the wastewater for things like that?
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F
Yeah, that's right. Measles is one of the things that we're monitoring. And although it's very rare, you know, we aren't seeing very many samples that are positive for measles. And where we're detecting measles in the wastewater, it's been less than 1% of all the samples that we've tested since we started doing this work in May of 2025. But, you know, although it's rare, although it's not common, it has become more common. And we have had positive detections in a number of communities that then do have cases and outbreaks of measles. And so it's a really good way for us to help keep our sort of finger to the wind of understanding what's happening with these outbreaks and giving us a sense of what's going on around the country so that then other methods can be used to follow up, investigate further, and really do something about those outbreaks as they occur.
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B
So saying that, what should our health officials here in PA and across the US Be paying attention to with your data sampling?
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F
Yeah. Wastewater monitoring has increasingly become a normal part of public health practice over the last few years. The CDC has the National Wastewater Surveillance System. We submit all of our data to that system, and states and locals that are monitoring wastewater as well contribute data so that we can get both a local picture of, you know, our site that we have in Harrisburg, we have data on data.wastewaterscan.org and so people from the public can go and actually look at that data themselves and get the weather report for what's happening with infectious disease. But also, we pass this information to the public health officials, who then make decisions about how to recommend what actions communities might take and prepare response for outbreaks. Whether, again, it's your yearly influenza outbreak, we always expect to have. But we need information about how that's happening, you know, year to year, in order to respond, or whether it's something more unusual, like a possible measles outbreak.
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B
Great. And there might be some people that are kind of skeptical, like, you're looking at my wastewater. Is that an invasion of privacy? What would you say to that?
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F
I mean, it does feel a little weird. It is a little gross. You know, I mean, I do have to come and talk a lot about sewage as part of this job, which is not what I expected out of my career. Exactly. But it's actually a strategy that is really helpful for protecting privacy while also making sure we understand the entirety of what's going on in a community, because it is an entirely anonymous process. You know, by the time we're testing this wastewater, it's mixed up with tens of thousands to millions of other people's contributions altogether, and we can't identify individuals. So it's a really good way to get information about what's happening in a community as a whole without actually collecting any personal, private information. So it's certainly a little unusual, and it's something that's probably new for people to get used to in the last few years. But that's one of the great advantages of it, is that we're testing this composite sample of everyone together.
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B
Great. And looking to the future, how does this act as an early warning system for viruses?
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F
Yeah, I mean, whenever we're looking at information about infectious disease outbreaks, it requires that people typically go to a doctor or clinic, get seen, get a test done, have their symptoms counted, and then that information is pulled together and compiled so that we can understand how much of A disease is circulating. With this approach, we can take one sample and we can test it for the amount of the virus that's in there. Look at that over time. And that's a very quick process. So, you know, it can be really helpful for us to get that quick information from one sample instead of waiting for all the other data to be compiled. And the two sources of data work really well together. Right. We want to understand that information directly from healthcare settings about what they're dealing with, and we also want to sense what's going on out in the community so that we can help prepare healthcare settings for what they're going to see soon.
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B
Great. And I know you mentioned the website, but what is the website again, if people want to check it out for more information?
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F
Yeah, it's data.wastewaterscan.org and you can see all of the recent data and information that we have on these diseases there, as well as a lot of more background information, resources about the program and
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how it all works.
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B
Great. And anything else then you'd like to add from my audience today? Dr. Wolf, I think, you know, one
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F
thing I'll say is that we are using this information about disease from wastewater, and we are not looking at transmission of disease through wastewater. We really hope people are not going out there and contacting sewage because it's not safe. Right. We use a lot of really careful strategies to manage the samples that we get to protect the health of everybody in the lab. What we're really looking for is this as a source of information, turning trash to treasure, using sewage to get data on disease and not looking at it as a source of infection. Right. This is. This is a weather report for infectious disease based on what's happening in the sewers.
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B
I like everything you said right there, especially turning trash into treasure and giving us that weather report on infectious disease. I appreciate your time today. Dr. Marlene Wolf, Assistant professor with Emory University and program director at Wastewater Scan. Hope you have a great day.
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F
Thank you. You, too.
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B
And finally, when it comes to our health and wellness, when using the Internet, there's always things we could be mindful of, especially when trying to rein in our children. Joining me now with more this is Dr. Garth Graham, head of YouTube Health. Good morning.
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G
Good morning, Christine. Thank you for having me.
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B
Well, thanks for Joining me now, Dr. Graham. As we recently recognized, Safer Internet Day, it does serve as a reminder for all days throughout the year what we need to do for a safer, even more respectful and better Internet for all, particularly when it comes to our children and youth. So let's talk about this. How can we be responsible as technology users and keep our children in check at the same time?
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G
Yeah, see, you said it exactly right. So I would say the real goal is to think through how we can help our children navigate within the digital world, not necessarily from the digital world, given that so many of our children now are digital first and have grown up with it. So a couple of things we emphasize so one is set boundaries. You can do this within the context of an overall family plan. We have a number of tools for instance on YouTube that allow parents to set of boundaries. So you know, one like, you know, setting the amount of time you want your children to be viewing short form video is another example. Or you know, when they should take a break or go to sleep, you know, some of those reminders. So we have a lot of those tools help for parents to really set boundaries and that and in that certainly within the context of an overall plan. And then the other thing, Christine, that's really important is age appropriate experiences. So not all kids are all at the same or even within, you know, families. They're just different kids evolving at different ages and times and so selecting and setting up the right age appropriate experience for your kids. So we allow that on YouTube where you're able to, you know, set your experience from your, you know, your 9 to your 13 year old as opposed to your 13 year old and older. And then for smaller kids actually YouTube kids platform which is a more curated experience for children as well. And because of that or a part of that, we made it a lot easier for parents to set up accounts for their, for their children within the supervised experience. So the take home message I would say here is you know again setting those boundaries but then also helping to guide your children through the right experience. That that's for their age.
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B
Right. And only other thing I'm thinking as you're talking about this is you mentioned the children of nowadays they're, they've grown up with this technology. Myself as a parent did not like how do we kind of stay ahead of the curve like because they're learning things probably faster than us because they're on it.
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G
Yeah. So there's two things I advise parents. So one is co viewing, you know, looking and seeing the things that they're doing, you know, and understanding their experience is really important and you know, especially when you start to look at the kind of content your kids are, if you get a sense of again not just what their interests are but what their online journey is as well. And the second thing is, and it's alludes to what I was saying earlier, you know, getting really familiar with these kind of tools that allow you to set the boundaries because, Christine, you may not know about that particular piece of content or activity they're engaging in. What you do know is what you've set for the amount of time or engagement that you want your children to have. So again, setting those boundaries and then engaging with them, I think is particularly important.
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B
Setting boundaries is always a good thing. And perhaps also as a parent, setting an example.
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G
Yes. Oh, my goodness. Thank you. You brought up the other really good point. That's exactly true. Being an example, you know, and for parents, it's rough. I will just say this parent myself is hard to be, you know, managing all these things. And so that's why we try to make it simpler. One important thing you point out, Christine, is, is being, setting an example, you know, being, you know, showing your kids about rest and balance and time online and time offline and importance of a time offline as well. And so, yeah, being a good example is a big part of helping your kids shape their safer digital habits.
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B
Right. And then it could lead to a healthier wellness journey in general for everyone in the household.
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G
Yeah, yeah, yeah. You know, that's what I use. I always say, you know, use it as opportunities to set your bigger vision for your family as well, you know, linked to this so that everything ladders up and the kids can see what, you know, how their behavior helps to contribute to the family. So that's definitely a part of it, as you said, Christine.
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B
And just to touch upon, like with cybersecurity, because sometimes the kids might be scrolling on their own, even adult scrolling on their own, and maybe a pop up or something comes up. What should somebody be mindful of with that?
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G
You know, always be, be careful about what you're clicking into every click. Attachments, additional things that pop up, just understanding the source, as well as being familiar with the source as well as understanding how that pop up got there or how that email attachment or all of these things. So I always say to my kids, just the same way, you don't open the door of your house just any and everybody. The same way you don't open the door to your digital ecosystem to just any and everybody. So just, you know, looking and understanding who that is that's knocking on the door.
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B
That's a great analogy. Thank you. And if somebody listening to the program today, Dr. Graham, wanted more information about what you've been talking about, do you have a slide you suggest.
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G
Yeah. So, yeah, earlier this week we published a blog at blog that goes into a little more detail on some of these tips. And so it's a great place to go and then, you know, look and then see a little bit of these tips about how to navigate online.
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B
Well, thank you for all this great information as we recognize SAFER Internet Day. Dr. Garth Graham, head of YouTube Health. Hope you have a great day.
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G
Okay, thanks, Christine.
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B
And I'm Christine Rookey. That's today's edition of People in Perspective.
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A
Thanks for listening to Central PA's people in perspectives podcast. Each week, the Q Cumulus Harrisburg News Department will explore another topic that affects the people of central Pennsylvania. Finding great candidates to hire can be like, well, trying to find a needle in a haystack. Sure, you can post your job to some job board, but then all you can do is hope the right person comes along. Which is why you should try ZipRecruiter for free at ZipRecruiter.com Zip ZipRecruiter doesn't depend on candidates finding you. It finds them for you. Its powerful technology identifies people with the right experience and actively invites them to apply to your job. You get qualified candidates fast. So while other companies might deliver a lot of hay, ZipRecruiter finds you what you're looking for. The needle in the Haystack. See why 4 out of 5 employers who post a job on ZipRecruiter get a quality candidate within the first day. ZipRecruiter the smartest way to hire. And right now, you can try ZipRecruiter for free. That's right. Free at ZipRecruiter.com Zip that ZipRecruiter.com Zip ZipRecruiter.com Zip.