Launched in 2024, the Pediatric Mobile Clinic provides free health care services to historically marginalized and underserved populations by partnering with school districts and community-based organizations to reduce barriers to care for children facing access challenges. The clinic currently provides general pediatrics, mental health, developmental-behavioral pediatrics and asthma care in a mobile clinic setting.

This includes acute care, assessments for autism and other neurodevelopmental conditions and care for depression, anxiety and other childhood conditions.

“This program is about meeting families where they are,” said Serena Yang, division chief of general pediatrics and vice chair of community engagement at UC Davis Health. Yang is part of the mobile clinic team made up of clinicians and staff from the MIND Institute, CAARE Diagnostic and Treatment Center and Children’s Hospital. “By bringing specialty services into schools and community spaces, we’re improving access, building trust and supporting children’s health together.” The Pediatric Mobile Clinic is entirely funded by a grant from Children’s Miracle Network at UC Davis Children’s Hospital.

School-based partnership shows early impact

In its first year of regularly scheduled clinics from July 1, 2024 to June 30, 2025, the Pediatric Mobile Clinic established a weekly presence at the Cordova Lane Center in partnership with Folsom Cordova Unified School District. Clinics served children with developmental concerns, mental health needs, asthma and school-entry health requirements – many of whom had not previously accessed specialty care.

Key results from the first year include:

• 52 children received specialty consultations directly at school sites, ranging in age from 3 to 15 years old.
• No-show rates were low (less than 10%), reflecting improved access and reducing transportation barriers to care.
• Nearly half of children served were insured by Medicaid or had pending coverage, but many were not connected to primary care.
• Families rated their experience an average of 4.95 out of 5, citing convenience and support.

Tregs act as immune system "brakes," calming inflammation to prevent overreaction. They are often decreased in autistic individuals.

Previous studies have found higher levels of inflammatory immune cells in the blood, brain and gastrointestinal tissues of people with autism. These increased inflammatory responses are often linked to greater behavioral support needs, while higher levels of Tregs are associated with improved behavioral outcomes. Despite this, Tregs have not been well studied in autistic children, and their potential as a therapeutic target remains largely unexplored.

Altered Tregs in autistic children

The first study, published in the Journal of Neuroinflammation, characterized Tregs in children with autism. It determined if gastrointestinal (GI) issues, a common co-occurring condition, altered Tregs in a unique way.

The researchers found autistic children had altered Tregs both in number and in the genes those cells use. This was compared to typically developing children. All participants were enrolled in the CHARGE study (Childhood Autism Risk from Genetics and Environment), an ongoing study that supports autism research.

The researchers compared the number and type of Tregs in 36 children with autism and 18 typically developing children. They also examined gene expression in Tregs to determine if there were differences between the two groups. In addition, they looked at the relationship between Tregs and gastrointestinal symptoms in autistic children.

The researchers found children with autism showed altered Tregs. Compared to typically developing children, children with autism had:

• A lower number of Tregs. Tregs were generally reduced in autistic children but decreases in specific Treg populations differed depending on whether a child had GI issues. Children with autism and GI issues had fewer Tregs capable of producing anti-inflammatory proteins. Children without GI issues had fewer Tregs capable of dividing after activation.
• Differentially expressed genes. Tregs from autistic children had 213 differentially expressed genes, with 171 upregulated (increased output) and 42 downregulated (decreased output).

The upregulated genes mainly help cells reorganize and repair DNA and adjust how they manage energy and fat metabolism. The downregulated genes were mostly involved in energy production, such as the conversion of oxygen and nutrients into usable energy.

The researchers note that more research is needed, but that these changes in metabolism and DNA organization suggest the identity of Tregs is unstable. One commonality was that having fewer Tregs was associated with more challenging behaviors in both typically developing children and children with autism.

“These differences in Treg populations may help explain the higher levels of inflammation seen in autism and could be linked to both gastrointestinal problems and certain behavioral traits,” said Rachel Moreno, a postdoctoral fellow at the MIND Institute and first author of the study. “This data further supports the idea that the immune system plays an important role in autism in at least some individuals.”

Exploring Tregs as potential biological therapies

There is growing interest in biological therapies for autism that target Tregs.

In a second study, also published in the Journal of Neuroinflammation, the authors assessed whether increasing Tregs could reduce inflammation and behavioral challenges.

They used a mouse model of altered neurodevelopment, maternal immune activation (MIA), in which offspring exhibit autism-like behaviors.

The team transferred Tregs from healthy mice into male and female MIA mice, and evaluated tissues commonly inflamed in autism, including blood, brain and gut.

They found significant sex differences in the MIA mouse offspring that received the Treg transfer, with males showing greater changes than females.

Necrotizing enterocolitis (NEC) is an intestinal disease that can affect medically fragile infants during their first weeks and months of life. UC Davis Children’s Hospital provides lifesaving care for babies at risk of NEC and the NEC Society is the world’s leading nonprofit advancing NEC research, education and advocacy.

Yolo County residents Jennifer Canvasser and her husband, UC Davis urologic surgeon Noah Canvasser, launched the NEC Society after tragically losing their son, Micah, to the disease.

Funds raised will benefit UC Davis Children’s Hospital.

The event features a 10K, 5K and 2K run/walk at 8 a.m. at the UC Davis Health Stadium in Davis. A virtual run/walk is also offered for those unable to attend in person. 

Register for the race.

The news rocked the community and all who knew him on the baseball diamond.

“The coaches, parents and board were uniquely motivated to make sure they would be prepared to protect their players, coaches, staff and visitors. It was a priority,” said Heather Houston, a Pocket Little League parent. She also happens to be a UC Davis Health cardiovascular research nurse who led the effort to obtain an automated external defibrillator (AED) for the league.

Last fall, Houston contacted two organizations focused on preventing sudden cardiac arrest in youth. First, she got in touch with Project ADAM Sacramento coordinator Rebecca McCormac, who connected her to the Kyle J. Taylor Foundation. Within a month, the Kyle J. Foundation approved her paperwork for the AED. In preparation for the upcoming baseball season, Project ADAM Sacramento then provided CPR and AED training for all coaches and created a cardiac emergency plan.

On opening day, Pocket Little League received the unique distinction of being named the first Heart Safe Youth Sports Program by Project ADAM Sacramento. Houston accepted the new AED and certificate on behalf of Pocket Little League.

Under a state law known as the Navaeh Youth Sports Safety Act, all California youth sports organizations will soon be mandated to provide access to an AED at all games and practices. By Jan. 1, 2027, all coaches must be certified in CPR and AED use, and have a comprehensive emergency response plan in place.

“The Pocket Little League is a model example of what can be done in a short amount of time, with Project ADAM Sacramento’s help,” McCormac said.

McCormac wants to help more youth sports programs become heart safe, in addition to the work she does supporting and training schools and school districts to be better prepared for cardiac emergencies.

“The response from parents, coaches and the community has been so positive. We have seen how much this means to people. Everyone has been so engaged and actively participating in these efforts,” Houston said.

Project ADAM Sacramento is committed to helping schools implement and sustain a CPR and AED program so they can handle cardiac emergencies and save lives. Project ADAM Sacramento was established at UC Davis Children’s Hospital in 2015 and was the first California affiliate of Project ADAM.

Pocket Little League is based in South Sacramento’s Pocket neighborhood, west of Interstate 5. The league supports more than 300 players from as young as age 4 through middle school.

Spina bifida is a congenital condition where spinal tissue fails to fuse properly in the womb, leading to lifelong health problems. Fetoscopic repair is a minimally invasive surgical procedure to address conditions like spina bifida in a fetus. It is a type of laparoscopic surgery, where surgeons make tiny incisions and insert very small tools and a long, thin camera inside the patient’s body.

“Fetal surgery, and fetoscopy for spina bifida in particular, is one of the more technically complex procedures in pediatric surgery, yet there are very few opportunities for surgeons to practice it,” said Payam Saadai, an associate professor of surgery at UC Davis Health. He had the initial idea for a training model.

One of the biggest benefits of fetoscopic repair over similar treatments for spina bifida is that it allows the mother to have a vaginal delivery in the future, due to its minimally invasive nature.

From idea to rough sketch to fully realized tool

Saadai passed his idea on to laboratory supervisor Christopher Pivetti and surgical research resident Elizabeth Reynolds, who both work in Professor of Biomedical Engineering and Surgery Aijun Wang’s lab at Aggie Square in Sacramento. Aggie Square is UC Davis’ innovation district where researchers, industry professionals and entrepreneurs work side by side.

Also at Aggie Square, on the first floor of the district’s flagship building is Tech Foundry, a 7,500-square-foot device development facility. This set up an ideal situation to collaborate.

When Pivetti and Reynolds had more time to sit and think about Saadai’s idea, they sketched out notes and diagrams on graph paper. As they developed the idea for the fetoscopy model, they brought in pediatric neurosurgeons Cameron Sadegh and Marike Zwienenberg, both members of the fetal surgery team at the UC Davis Health Fetal Care and Treatment Center, for their expertise in fetal closure of spina bifida. Then, they brought their sketch to Tech Foundry to see if the team there could bring the idea into reality.

For Valerie Quiroz, the development engineer who took on the project, the sketch was all she needed. She transformed the sketch and medical jottings into a working prototype featuring 3D-printed, silicone-cast and laser-cut components.

A Teaching Model

The model simulates a fetus suspended in amniotic fluid inside the uterus. It features a chamber that can be filled with liquid and holds a small doll. It also includes a dome with small holes through which laparoscopic instruments can fit.

On the backside of the doll is a raised area of skin, almost like a balloon. This is to mimic fetal myelomeningocele, the most severe form of spina bifida. It’s when the fetus’s spine and spinal canal remain open at the bottom of the spinal column, creating a bulge of skin.

“The raised area will be a consumable part that will be replaced for the next user,” Quiroz said. “[It] is intended to mimic multiple layers of tissue, such as skin, dura mater and placode, and allow surgeons to practice surgical techniques, including suturing.”

Due to the small area of skin on the fetus, and the fine laparoscopic tools, fetoscopic repair is one of the most technical and delicate pediatric procedures. With the new teaching model, pediatric surgeons at UC Davis Health can now practice and perfect the technique for treating spina bifida before ever entering the operating room.

“The fetal operation requires technical precision and is only available at a few centers in the world,” Saadai said, “so the fetal model directly supports this work by creating a safe, reproducible environment where our team can train and refine these techniques, dramatically shortening the learning curve for such a complex operation.”

Advancing the CuRe

Thanks to the teaching model, fetoscopic surgery will be an option alongside the CuRe trial at UC Davis Health. The CuRe Trial, or Cellular Therapy for In Utero Repair of Myelomeningocele, is a groundbreaking treatment using a stem cell patch to repair spina bifida tissue.

The trial is led by Wang and Distinguished Professor and chair of the Department of Surgery Diana Farmer , with Pivetti, Reynolds and Saadai as members of the clinical research team. The trial is a world first and was recently found to be safe in a paper published in The Lancet, but requires invasive surgery.

“For the CuRe Trial, we use an open surgical approach to treat the fetus, meaning we make a larger cut on the uterus and float the baby's defect to that opening for repair. The disadvantage to this approach is that these moms cannot have a standard vaginal delivery again,” Pivetti said.

Pivetti explained that the training model will be used in the next stage of the CuRe trial. The goal is to replace the open surgery with a minimally invasive fetoscopic surgery. During the procedure, a surgeon would administer the small stem cell patch with laparoscopic tools before closing the incision to allow the tissue to regenerate.

“By developing not just fetoscopic techniques but also the training infrastructure, which we have never had at UC Davis before, we position our health center as one that is advancing the next generation of both fetal therapy and surgical innovation,” Saadai said.

The Feb. 18-20 training was led by pediatric critical care physicians Jennifer Lee and Jessica Signoff at the UC Davis Health Center for Simulation and Education Enhancement.

Lee and Signoff designed the simulation-based training program to prepare senior pediatric critical care fellows for their transition into attending physician roles.

UC Davis is one of only three institutions in the country offering this standardized senior-level bootcamp. The other programs are at Johns Hopkins and Children’s Wisconsin.

“The curriculum focused on high-yield, low-occurrence critical care scenarios, allowing fellows to practice complex decision-making, crisis management, procedural skills and leadership skills in a realistic simulation environment,” said Mandeep “Mandy” Chahal, assistant nurse manager of the Pediatric and Cardiac Intensive Care Unit at UC Davis Children’s Hospital.

The event brought together fellows and faculty from institutions across the region and country, creating a collaborative learning experience for emerging pediatric critical care leaders.

“Overall, we hosted 13 PICU fellows from UC Davis Health, Stanford, UCSF Health, Children’s Wisconsin, Children’s Hospital of Orange County and Loma Linda, and 17 faculty from the programs above as well as UC San Diego Health, Seattle Children’s Hospital, Advocate Children’s Hospital and Johns Hopkins,” Lee said.

UC Davis faculty from several specialties helped lead training sessions:

Rajeev Wadia and Niroop Ravula from Pediatric Anesthesia; Jamie Funamura and Aditi Bhuskete from Pediatric Ear, Nose and Throat; Erk Laurin, Verena Schandera and Pranav Shetty from the Emergency Department taught key procedures. Facultyfrom other subspecialties also trained fellows on procedures such as needle cricothyrotomies, intubating difficult airways with fiberoptic scopes, surgical chest tubes placement and pericardiocentesis. 

Organizers said the bootcamp was made possible with the expertise of various departments whose members contributed significantly to the fellows’ learning. Additional support was provided by:

• PICU nurses: Genie Dizon, Ashley Wood, Mandy Chahal, Christina Horan, Megan McCaffrey, Carlye Miller, Ashley Donkerbrook, Monica Flores, Nicole Appezzato, Kristina Ison, Rosa Solis, Ashley Sozzi, Annie Randolph, Bianca Celiz-Gutierrez and Erin Dame Lewis
• Pediatric critical care transport nurses: Kyle Irwin, Peter Kesling
• ECLS nurses: Jerry Kerekes, Sam Daddow
• Respiratory therapists: Ally Cahill, Stephanie Carranza
• Pediatric cardiology faculty: Timothy Pirolli, Mohammad Alnoor
• Simulation specialists: Francisco Ramirez, Andrea Vivar, Ian Julie, Danier Ong, Brandon Phong and Drew Robinett
• Pediatric critical care medicine fellowship coordinator: Julia Weiland 

Through simulation-based education and interdisciplinary teaching, the bootcamp highlights UC Davis Health’s commitment to advancing pediatric critical care training and preparing the next generation of PICU leaders.

The program also strengthens collaboration among teams who care for critically ill children and their families.

The bike race takes place May 14-17. The public is invited to donate or participate.

The race starts May 14 in the Sacramento area and takes riders to a basecamp location at the Yuba-Sutter Fairgrounds. The next two days of riding feature challenging routes that start and end at basecamp. On May 17, the race will end at the West Lawn of the California State Capitol in Sacramento.

“Because of the generosity of the NorCal AIDS Cycle community and the hard work they put into this race each year, we can continue providing care and support to the children and families who need it most in our clinic,” said Tami Enslie, clinical resource nurse with the UC Davis Pediatric Specialty Clinics. “We are deeply grateful for their commitment to making a difference and continuing to make UC Davis Pediatric Infectious Diseases a beneficiary of their cause.”

Last year’s race raised $3,000 for the UC Davis Pediatric Infectious Diseases clinic.

The Division of Infectious Diseases at UC Davis Children's Hospital is dedicated to treating infants, children and adolescents with infectious diseases such as HIV. Physicians specializing in infectious diseases also conduct clinical research studies with new vaccine and HIV treatments.

For more information about the NorCal AIDS Cycle, visit https://norcalaidscycle.org/.