ASCI / Emerging-Generation Awards, 2023

Joshua Sheak, MD, PhD met his first Navajo man when he was five years old. This man was his grandfather, who taught him about hozhó. Hozhó is a philosophy that all life and experience is a cyclical and holistic continuum. As a student in the University of New Mexico MD/PhD program, a pediatric resident in the Integrated Research Pathway at Cincinnati Children’s Hospital Medical Center (CCHMC), and now as a neonatology fellow at CCHMC, Dr. Sheak has seen and studied the incredible and complex work accomplished by newborn infants. Clinical and research experiences during training helped me to see hozhó in being a member of the medical team that supports the health and survival of infants in their transition to the post-natal world. Foundational to this transition is lung function. Impaired lung function can lead to high pulmonary blood pressures and resistance to pulmonary blood flow in a disease called pulmonary hypertension. 

Mechanisms underlying the development and maintenance of neonatal pulmonary hypertension are poorly understood. Increased understanding of factors important to neonatal pulmonary hypertension can improve therapies for infants. As a graduate student, Dr. Sheak identified a novel role of enhanced nitric oxide-dependent pulmonary vasodilation to limit the degree of pulmonary hypertension in neonatal rats (PMID 28733445). He also demonstrated a role of PKCbeta and oxidant signaling to contribute to enhanced pulmonary arterial vasoconstriction in neonatal rats with pulmonary hypertension (PMID 31922892). As a pediatrics resident, Dr. Sheak investigated mechanisms of lung injury and repair in a Rhesus macaque model of chorioamnionitis (PMID 35353543), a risk factor for neonatal lung disease and neonatal pulmonary hypertension. His hope is that his work improves understanding of pulmonary hypertension and creates possibilities for new therapies for infants. Improved understanding facilitating therapeutic options for infants with pulmonary hypertension reflects a continuum of care and applies hozhó in medicine.