Nationwide Children's Hospital Annual Report

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NATIONWIDE CHILDREN’S HOSPITAL ANNUAL REPORT Decade Remarkableof Transformation In the last decade, Nationwide Children’s Hospital has grown in all dimensions – in This past year has been a year like none before it. From a global pandemic to continued clinical care and outcomes, in research and innovation, and in our commitment to efforts to end racism and support health equity, Nationwide Children’s has stood with social justice and health equity. Join us as we share our achievements from the past our patients, families and staff as we face these challenges together. We’ve also grown year, highlight a decade of transformation and look toward our future. our team, welcoming a nationally renowned expert in quality and safety as our new chief medical officer, among many other talented new faculty.

HONORS AND ACHIEVEMENTS: Leaders for the New Decade Rank sixth among NIH-funded freestanding MORE THAN pediatric research 1.6 Million facilities in the U.S. PATIENT VISITS $ PER YEAR 54.6 million * Based on CHA survey of utilization Direct NIH Awards and financial indicators

LEADING THE COUNTRY IN QUALITY AND SAFETY

reduction reduction drop in % in serious % in actual % hospital 83 safety 64 harm 38 mortality* events (2009-2019) (2009-2019) *Observed to Expected Mortality (2009-2019) Ratio Based on Pediatric Health Information System® (PHIS) Data

ONCE AGAIN NAMED TO THE HONOR ROLL OF BEST CHILDREN’S HOSPITALS AND RANKED IN ALL 10 SPECIALTIES BY U.S. NEWS & WORLD REPORT

• America’s largest, neonatal network and provider of • Four-time American Nurses Credentialing Center pediatric surgery* Magnet® designation for nursing excellence

• Patients from all 50 states and 54 foreign countries travel • Provide more than $194 million in charity care and to Nationwide Children’s for care community benefit services annually

• More than 104,400 donors contributed nearly • Fully accredited by the Association for the Accreditation $62 million to support the hospital’s mission of Human Research Protection Programs

* Based on Children’s Hospital Association Survey of Utilization and Financial Indicators of Children’s Hospitals

Photographed in the new Nationwide Children’s Hospital Conference Center

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 1 After a Decade of Achievement, Looking Forward Tim Robinson, CEO of Nationwide Children’s Hospital Architects of the Future The 2019-2020 academic year was always going to be a critical one at Nationwide Children’s Hospital. We were opening the largest and most comprehensive facility of its kind in the United States, the Big Lots Behavioral Health Pavilion. We were ending a decade of astonishing growth, surpassing more than 1.6 million annual patient visits from around the globe and expanding an already a thriving research institute, now among the pediatric leaders in National Institutes of Health funding and technology commercialization. We were (and are) approaching the final stages of an organization- wide strategic plan, Journey to Best Outcomes.

With all of this momentum, our eyes were on the next phase. Transformational members of our executive team were retiring, and new leaders — some of our architects of the future — were joining us. This was also my first full year as CEO of Nationwide Children’s, and I could see our nearly limitless potential.

We were motivated for a new era, positioned to take on any challenge a new decade had for us.

Then came 2020. There were the COVID-19 pandemic and the tragic loss of life that accompanied it; financial worries across the United States; a potential change in the health care services paradigm as telehealth expanded; and an overdue national reckoning on issues of race and health equity, compounded by the disparities that COVID-19 Pictured, left to right: John A. Barnard, MD, chief of Pediatrics and president of the Abigail Wexner Research Institute; highlighted. Rustin B. Morse, MD, chief medical officer; Oluyinka O. Olutoye, MD, PhD, surgeon-in-chief; Olivia W. Thomas, MD, chief diversity and health equity officer; Lee Annallace, W RN, MBA, NEA-BC, chief nursing officer No one expected the new decade to begin like this, and yet it has proven what we believed: Nationwide Children’s can not only navigate difficult times; we can be agile through them, aligning our response to actually accelerate our efforts to improve child health and wellbeing. In fact, in some important ways, we made significant headway this year. Nationwide Children’s work on population health and health equity issues has never seemed more vital. Our accountable care organization, Partners For Kids®, which improves health care access and quality for 325,000 We went from having a smattering of telehealth appointments in 2019 to 2,000 per day in April and May. children in south central and southeastern Ohio, expanded in 2020 to the state’s west central region and an Approximately half of those visits came in Behavioral Health, because our deep investments in those services over additional 94,000 children with the collaboration of Dayton Children’s Hospital. Healthy Neighborhoods Healthy the last decade, highlighted by the new Pavilion opening this past February, allowed us to quickly pivot to the new Families, our nationally recognized community partnership to revitalize the South Side of Columbus, has moved into technology. Even when the pandemic ends, it’s clear telehealth will benefit our patients far into the future. another neighborhood, Linden, to begin creating housing, educational opportunities and workforce development programs. Our nearly 15 years of national leadership in pediatric quality and safety gave us the processes and tools to protect our patients and staff from infection, and to safely resume services when it was appropriate. Our recently retired The events of 2020 have convinced us, however, that we must do even more to fight disparity and inequities. Our chief medical officer, Richard Brilli, MD, pioneered the pediatric quality field at Nationwide Children’s; our new new hospital-wide initiative, Stand Against Racism. Stand For Health Equity, will help us improve the outcomes of CMO, Rustin Morse, MD, is a nationally prominent safety leader poised to take us even further. Longtime Chief children everywhere and guide our efforts to create a more equitable world for our staff, our community and the Nursing Officer Linda Stoverock, DNP, RN, also retired this year after guiding us to the prestigious American families we serve. Nurses Credentialing Center’s Magnet Recognition four times; Lee Ann Wallace, RN, MBA, has already become a passionate advocate for nurses and families as our new CNO. Our entire team knows there is a great deal of work remaining, but I am incredibly proud of what we have accomplished at Nationwide Children’s this year. We have done more than weather a challenge. We have continued Extensive research and lab capabilities allowed us to quickly develop in-house COVID-19 testing facilities and to seize opportunities to improve the lives of children through care, research and advocacy – and we are more to begin studies to inform treatments for the coronavirus. Because our research programs continue to expand, optimistic than ever for the future. Nationwide Children’s broke ground on the Abigail Wexner Research Institute’s fourth building. In addition, our expertise in gene therapy has led us to create Andelyn Biosciences, an affiliate company for the manufacture of gene therapy products. Andelyn was established as a freestanding company in 2020 and will expand its manufacturing capacity in a new facility by 2023.

2 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 3 DEAR FRIENDS: Though it seems modest today, Nationwide Children’s Hospital set what was an audacious goal not all that long ago: no child would ever need to leave central Ohio to receive the best medical care. We wanted to give this community’s children access to the highest quality care, right here. Over the past decade we achieved that goal — and set new, higher ones. Today Nationwide Children’s is an international destination pediatric medical center. Life-changing discoveries occur at the Abigail Wexner Research Institute. Our trailblazing commitment to pediatric behavioral health is a national model for treating the whole child. We have become a model for how to improve the health of an entire population. Over the last extraordinary decade Nationwide Children’s has, quite simply, changed what it means to be a children’s hospital by continually looking outside our walls to work for the good of all children. And yet, we have never been more connected to our hometown. The transformational philanthropy of central Ohio’s signature business leaders and companies, including Nationwide and Big Lots, has helped drive our progress. Strong partnerships with our state, county, city and community leaders, and community members themselves have allowed us all to improve housing, education, job opportunities and health care access. Children are safer and healthier because of it. And in this year of COVID-19, work with local public health authorities has brought our infectious disease and epidemiology expertise to school administrators as they navigate the pandemic. At the heart of everything are the people who choose to work at Nationwide Children’s, whose professionalism, compassion and commitment to care has been unwavering. They are an inspiration. Over the last decade, Nationwide Children’s Hospital has firmly established itself as a preeminent pediatric health care and research center because of how deeply rooted we are in central Ohio, and I look forward to so much more in the decade to come.

ALEX R. FISCHER Chair Nationwide Children’s Hospital Inc. Nationwide Children’s Hospital Board of Directors

4 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 5 T A B L E 68 Endocrinology 130 PHYSICAL MEDICINE AND REHABILITATION OF CONTENTS 72 Gastroenterology, Hepatology and Nutrition 132 PSYCHIATRY AND COMMUNITY 78 Genetic and Genomic Medicine BEHAVIORAL HEALTH 136 RADIOLOGY 2 After a Decade of Achievement, Looking Forward 80 Hematology, Oncology & Blood and Marrow Transplant 138 SURGICAL SERVICES 8 Milestones of a Decade 85 Hospital Pediatrics and 139 The Heart Center/Cardiothoracic Surgery 13 Our Journey Adult Hospital Medicine 140 Colorectal and Pelvic Reconstruction 26 Faculty Honors and Grants 88 Infectious Diseases 142 Dentistry 28 New Appointments 94 Neonatology 145 Neurosurgery 100 Nephrology and Hypertension 147 Ophthalmology 104 Neurology 150 Orthopaedics 110 Pediatric Psychology and Neuropsychology 154 Otolaryngology 112 Primary Care Pediatrics, and Healthy 156 Pediatric and Adolescent Gynecology Weight and Nutrition 158 Pediatric Surgery 116 Pulmonary Medicine and Sleep Disorders Center 162 Plastic and Reconstructive Surgery 121 Rheumatology 164 Transplant 123 Sports Medicine 168 Trauma 125 Toxicology 172 Urology 126 ANESTHESIOLOGY AND PAIN MEDICINE 176 ABIGAIL WEXNER RESEARCH INSTITUTE 128 PATHOLOGY AND LABORATORY MEDICINE 178 Battelle Center for Mathematical Medicine 31 DEPARTMENT, SECTION & RESEARCH INSTITUTE REPORTS 179 Biopathology Center 33 PEDIATRICS 181 Center for Biobehavioral Health 34 Residency Programs 182 Center for Cardiovascular Research 36 Adolescent Medicine 183 Center for Childhood Cancer and Blood Diseases 38 Allergy and Immunology 184 Center for Clinical and Translational Research 40 Heart Center 185 Center for Gene Therapy 47 Cardiology 187 Center for Injury Research and Policy 50 Child and Family Advocacy 188 Center for Innovation in Pediatric Practice 52 Clinical Informatics 189 Center for Microbial Pathogenesis 54 Community Pediatrics 191 Center for Perinatal Research 57 Complex Care 192 Center for Regenerative Medicine 59 Critical Care Medicine 193 Center for Vaccines and Immunity 61 Dermatology 194 STEVE AND CINDY RASMUSSEN INSTITUTE 62 Developmental and Behavioral Pediatrics FOR GENOMIC MEDICINE 64 Emergency Medicine

[Photography in this report involves images from 2019-2020, those not reflecting masks or social distancing were taken pre-COVID-19.]

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10. 8 I-71 S I-71 20. I-71 N 44. I-70 - I-70 W 27. A Remarkable Decade 2010 2020 I-70 E AMERICA’S

South 18th Street LARGEST 34. 44. Awarded the 2020 Hearst 9 45. 10. 7-Year Campus 20. Nationwide 27. Named 2016 CHILDREN’S Health Prize for Excellence 1 11b 10 6 5 HOSPITAL* 34. Named 11a Expansion I-70/71 4 3 Foundation Pediatric Leapfrog Top in Population Health 2b 2018 LGBTQ Livingston Avenue Completed – The 7 Innovation Fund at Hospital and 2a Parsons Avenue 1. First Bloodless Grant Avenue Healthcare 45. Stand Against Racism, 46.

Largest Pediatric Livingston Avenue Nationwide Children’s America’s Largest Heart Transplant Equality Stand for Health Equity Expansion Project Established With an Children’s Hospital Performed EXPANDING CARE: RESEARCH: INFRASTRUCTURE: BEHAVIORAL HEALTH PAVILION: Initiative Launched Hospital, building out levels two and seven Research Building III, building out levels two and three Faculty Office Building Behavioral Health Pavilion Leader 1. 5. 7. 11a. in U.S. History 2a. Livingston Ambulatory Center 6. Research Building IV 8. Near East Office Building and Garage 11b. Parking Garage for Behavioral Health Initial $10 Million Gift 2b. Parking Garage for Livingston Ambulatory Center 9. Energy Plant LEED-Certified 3. Childcare Center, renovation 10. Data Center 28. Big Lots and the 2. 4. Livingston Park Enhancements 35. Named to 46. Andelyn Biosciences, an 11. Named Title 12. 21. First-of-its-Kind in the Big Lots Foundation Central Energy Plant Forbes’ 2018 Affiliate Company Dedicated Beneficiary Midwest Adult Fontan Pledge $50 Million Completed America’s Best to the Manufacture of of Columbus Clinic Opens Gift for New Gene Therapy Products 3. The Columbus Fetal 4. Employers List 35. 48. Marathon 22. New State-of-the-Art Behavioral Health 36. for Biotechnology and Medicine 36. Named One of 12. Reaches Facilities Pavilion Pharmaceutical Industries, Collaborative 11. HEALTHY NEIGHBORHOODS the 20 Most 1,000,000 13. Open for Patients 21. 29. Ground Breaks at Formed Forms HEALTHY FAMILIES Innovative Patient Visits to Receive The Residences at 29. 47. 22. 28. Children’s 47. Recognized as BlackDoctor. 4. Ohio Perinatal 1,000,000 PATIENT VISITS Meta-iodobenzylguanidine Career Gateway, 3. 13. First Honor Roll Hospitals org 2019-2020 Top Hospital 49. Research Network (MIBG) Therapy for a $12 Million 1. Designation as a by Parents for Diversity Formed Between 14. Neuroblastoma Low-Income Nationwide Top 10 U.S. News The Center for Magazine 48. Lee Ann Wallace, RN, MBA, & World Report 23. Ground Breaks for the Housing Complex, Children’s and Injury Research 37. $20 Million NEA-BC, Named Chief Best Children’s Faculty Office Building Through Healthy The Ohio State and Policy Expansion Nursing Officer Hospital and Livingston Neighborhoods University 2. of Healthy 49. Big Lots Behavioral Health Ambulatory Center Healthy Families 2010 14. CDC Renews 2012 2014 2016 Neighborhoods 2018 Pavilion — America’s 2020 5. First “Off-Campus” 30. Elaine Mardis, PhD, Designation of the 15. Healthy Families Largest Behavioral Health NICU and Richard Wilson, Center for Injury Through the Facility on a Pediatric 15. Christopher Breuer, MD, and PhD, Announced Research and South Side Medical Campus — Opens Toshiharu Shinoka, MD, PhD, as Leaders of Policy as the Only Renaissance Lead Tissue Engineering the Institute for 50. Conference Center and 50. Pediatric Injury Fund Genomic Medicine State-of-the-Art Simulation Control Research Center Opens Center in the U.S. 16. Research Building III Opens, 51. COVID-19 Response Increasing Research Space to 5. 37. Includes Rapid Testing, 16. More than 500,000 Square Feet 23. 30. Telehealth Ramp-up 51.

38. 39. 6. Surgeons Katherine 17. First-of-Its-Kind 24. Honored by the American 31. Nationwide Children’s 38. Oluyinka O. Olutoye, MD, PhD, Deans, MD, MHSc, Phase I Trial of Hospital Association- Breaks Ground on Big Lots Appointed Surgeon-in-Chief and Peter Minneci, Systemic AAV9- McKesson Quest for Behavioral Health Pavilion 39. Tim Robinson Appointed Chief MD, MHSc, Join Delivered Gene Quality Prize 32. New 7,500 Square Foot Executive Officer Nationwide Children’s Therapy for Spinal 25. Genomics Team Wins cGMP Facility increases Re-designated With American to Co-direct New Muscular Atrophy 40. the International Clarity Capacity for Viral Nurses Credentialing Center Center for Surgical Type 1 Begins Challenge to Solve Vector and Cell Therapy Magnet Recognition® for Fourth Outcomes Research 18. Monarch 1 Takes Undiagnosed Diseases Manufacturing Time 7. Ground Breaks 8. Flight 26. Announcement of the 33. NASCAR Driver Dale First Central Ohio Hospital to for Second Sports 2011 2013 2015 2017 41. 2019 19. Center for Nation’s First Pediatric- Earnhardt, Jr. and Raise Its Minimum Wage to $15 Medicine and 7. Colorectal Focused Quality and Nationwide Children’s per Hour Orthopedic Center 6. and Pelvic Safety Journal, Pediatric Launch the Dale and Amy 31. Reconstruction 19. Quality & Safety Earnhardt Fund 42. Research Institute Rededicated 8. Joins Neonatal LT HEA H • QU Y • AL as Abigail Wexner Research Research Network Established T IT FE Y A • Institute S S • PEDIATRIC A 9. The Center for Y F E T 43. FDA Approves First Ever I T Family Safety and L Y

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F Y E T 41. 26. 32. 43. 24. The Dale and Amy 18. Earnhardt Fund 42. 10 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report 25. 33. NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 11 JourneyOur Nationwide Children’s Hospital has been committed to the Journey to Best Outcomes — the official name of our strategic plan — for the better part of the last decade. Through that journey, we dedicate ourselves to health equity, cutting-edge science and research, quality and safety and much more as we strive to fulfill our promise of best outcomes for all children.

12 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 13 Stand Against Racism, Stand For Health Equity. Nationwide Children’s Hospital Leads With Action to End Racism and Support Health Equity for Patients, Families, Staff and Community Members

Racism and inequity have been part of the fabric of our society for far too long. This year, we have experienced a collective call to the urgent need to come together to stand against racism and stand for health equity.

At Nationwide Children’s our commitment to diversity, inclusion and equity is now further strengthened by our commitment to fight racism in all its forms. Olivia W. Thomas, MD The graphic below represents the intentional actions of our Stand Against Racism, Chief Diversity and Stand For Health Equity. Each part is comprised of a working group led by our senior Health Equity Officer leadership and faculty. This work will expand our vision of diversity, inclusion and health equity for the patients, families and communities we serve, and for our faculty and staff.

In 2020, Nationwide Children’s was the first hospital in our region to ensure that every employee earns a minimum of $15 per hour — a commitment to equitable wages for all.

Our health equity research continues to reveal the challenges under-represented children and families face. One example is a startling study from our Department of Anesthesiology and Pain Medicine that showed seemingly healthy Black children are significantly more likely to die after surgery than seemingly healthy white children. Our health equity research and quality improvement work are focused on identifying these hidden disparities and leading us to solutions and better outcomes.

Just as we care for the whole child — physically, behaviorally, socially and economically — we are addressing racism and inequity holistically. These issues are interconnected and interlocking, and our actions here will ultimately help us better serve children and families.

Read the full story about race and surgical outcomes at PediatricsNationwide.org/Race-Surgery-Outcomes Nafiu O, Mpody C, Kim S, Uffman J, Tobias J. Race, postoperative complications, and death in apparently healthy children.Pediatrics . 20 July 2020. [Epub ahead of print]

Just as we care for the Racism and inequity have been part of the whole child – physically, fabric of our society for far too long. behaviorally, socially and This year, we have experienced a Systemwide Education & economically – we are Social Training collective call to the urgent need to come Justice addressing racism and Clinical & together to stand against racism and Health Equity Programs & inequity holistically. Community Interventions stand for health equity. Engagement Stand Against Racism. & Stand For Health Equity. Partnerships At Nationwide Children’s our commitment Research & Outcome to diversity, inclusion and equity is now Faculty & Metrics Training Talent & further strengthened by our commitment Programs Employee Experience to fight racism in all its forms.

14 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 15 Two Nationwide Children’s Faculty Elected to the Prestigious National Academy of Medicine In October 2019, Elaine R. Mardis, PhD, co-executive Dr. Mardis has been a member of the American Association for director of the Steve and Cindy Rasmussen Institute for Cancer Research (AACR) since 2007, was elected as a Fellow of Genomic Medicine at Nationwide Children’s Hospital, was the Academy of the AACR in 2019 and served AACR elected to the prestigious National Academy of Medicine president in 2019. (NAM). Election to NAM is considered one of the highest honors in the fields of health and medicine and recognizes A world-renowned researcher, Dr. Mendell has been a pioneer individuals who have demonstrated outstanding professional in the care of neuromuscular diseases for more than 40 years. achievement and commitment to service. He was the first to standardize and publish on corticosteroid treatment of Duchenne muscular dystrophy (DMD) that One year later, Jerry R. Mendell, MD, principal investigator preserved ambulation in affected boys. In 2007, he led the in the Center for Gene Therapy at the Abigail Wexner Research first-ever phase 1 clinical trial using AAV, a viral-based gene Institute at Nationwide Children’s Hospital, was also elected to therapy approach in children with muscular dystrophy, NAM. paving a path for this promising approach. More recently, he demonstrated in the first exon-skipping clinical trial in North New members are elected by current members through a America, an alternative method to overcome the gene defect process that recognizes individuals who have made major in a specific variant of DMD. A prolific author of nearly 400 contributions to the advancement of the medical sciences, publications, Dr. Mendell recently co-edited the book, Muscle health care and public health. A diversity of talent among Gene Therapy – Second Edition, published in 2019. NAM’s membership is assured by its Articles of Organization, which stipulate that at least one-quarter of the membership is selected from fields outside the health professions — for “These newly elected members represent the most example, from such fields as law, engineering, social sciences and the humanities. exceptional scholars and leaders whose remarkable work has advanced science, medicine and health “These newly elected members represent the most exceptional scholars and leaders whose remarkable work has advanced science, in the U.S. and around the globe.” medicine and health in the U.S. and around the globe,” says Victor J. Dzau, President of NAM Victor J. Dzau, president of NAM. “Their expertise will be vital to addressing today’s most pressing health and scientific challenges and informing the future of health and medicine for Dr. Mendell led the phase 1/2 clinical trial, which was the first the benefit of us all. I am honored to welcome these esteemed effective gene therapy for SMA type 1, the most severe form of individuals to the National Academy of Medicine.” SMA that typically results in death by age 2. The study, published in the New England Journal of Medicine, was the Dr. Mardis, who is also the Steve and Cindy Rasmussen People’s Choice for Science Magazine’s 2017 Breakthrough of Nationwide Foundation Endowed Chair in Genomic Medicine, the Year. In May 2019, the Food and Drug Administration and a professor of pediatrics at The Ohio tateS University (FDA) approved Zolgensma® for spinal muscular atrophy College of Medicine, joined Nationwide Children’s in 2016. (SMA) for pediatric patients less than 2 years of age, She has authored more than 350 articles in prestigious including those who are pre-symptomatic, recognized by peer-reviewed scientific and medical journals and has written newborn screening. To date, Zolgensma has treated more book chapters for several medical textbooks. than 600 children with SMA worldwide. Honored with the Morton K. Schwartz award from the American Association for Clinical Chemistry in 2016, Dr. Mardis has been listed since 2013 as one of the most highly cited researchers in the world by Thompson Reuters.

Elaine R. Mardis, PhD Jerry R. Mendell, MD

16 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 17 Nationwide Children’s Hospital Welcomes Renowned Quality and Safety Expert Rustin Morse, MD, as Chief Medical Officer

In July 2020, following an extensive national search, Nationwide Children’s welcomed renowned quality and safety expert Rustin Morse, MD, as chief medical officer. He will lead key operational areas in clinical care and medicine, as well as guiding the future of our nationally acclaimed quality and safety program, Zero Hero.

Dr. Morse, who is also a faculty member at The Ohio State University College of Medicine, currently serves on the national Clinical Steering Committee for Solutions for Patient Safety and the Quality and Safety Committee of the Board of Trustees for the Children’s Hospital Association. He is a board-certified pediatric emergency medicine physician who has continued to practice emergency medicine throughout his career and has an outstanding track record leading and advancing quality and safety programs in pediatric health care.

Q: What excites you about joining Nationwide Children’s Hospital? A: While I’ve admired Nationwide Children’s from afar and the quality and safety program established by my predecessor Rich Brilli, MD, throughout my interviews, I was impressed by the culture here. The genuine commitment to and interest in quality and safety came through in every conversation. And the One Team culture was palpable — even before I learned about the One Team values, they were evident. Q: How did you become interested in pediatric quality and safety? A: I started my career as a pediatric emergency medicine physician and aspired to one day run an emergency department. I was in a leadership role very early in my career and was addressing issues, improving processes and systems, and improving outcomes, long before I realized one could have a career focused on quality and patient safety. Through a series of fortuitous opportunities and excellent mentorship, my interest in quality and safety strengthened and my career trajectory changed. I’ve been very fortunate and grateful for the opportunities I’ve had to grow in different positions in quality and safety work. And I’m absolutely thrilled to be bringing that experience to Nationwide Children’s to lead the outstanding program here. Q: What is our organizational responsibility to make quality and safety a priority? A: We owe it to our patients and their families to provide a safe place for them to get the best possible care. We owe it to our staff to provide the safest place for them to work. No one should come to work and get hurt — whether that’s from slipping on a wet floor or being injured by a patient or harassed by a family member. Ensuring safety is at the core of Zero Hero and what we do here at Nationwide Children’s. And we’ll continue to make that a priority. Additionally, we need to evolve and grow quality beyond safety. We owe it to our community and our patients — whether they are from around the corner or across the globe — to continue to be one of the best children’s hospitals in the United States. We must continue to study and refine care delivery, further strengthen our population health activities, and do our part to address racism and health inequities to ensure the best outcomes for all children.

Rustin Morse, MD

18 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 19 Opened March 2020: An Inside Look at the Big Lots Behavioral Health Pavilion America’s Largest Pediatric Behavioral Health Hospital and Research Center The Big Lots Behavioral Health Pavilion is nine stories. 386,000 square feet. It uniquely integrates acute behavioral health services with intensive outpatient programs. The Pavilion prioritizes patient safety in a colorful, friendly environment for those dealing with severe behavioral health concerns. It’s transformational. It’s innovative. It’s stigma-breaking.

The roof is designed with conservation in mind, holding a water reserve of 1,195,237 gallons. This measure is good for the environment, holding the equivalent of 10,865 bathtubs of water for landscape irrigation.

NINTH FLOOR: • Gym • Outdoor Play Deck Construction of the Big Lots Behavioral Health Pavilion required 22.5 million pounds of concrete - the equivalent of EIGHTH FLOOR: 540 fully loaded school buses. • Inpatient Units

FIFTH FLOOR: SEVENTH FLOOR: • Partial Hospitalization • Inpatient Units Program • Ronald McDonald Family Room • Courtyards

SECOND FLOOR: • Mood and Anxiety Program THIRD FLOOR: • Family Based Intensive • Youth Crisis Stabilization Unit Therapy (FBIT) (YCSU) • Center for Suicide Prevention • Behavioral Health and Research Administrative Offices • Outpatient Psychiatry Clinic • Faculty Offices The Big Lots Behavioral Health Pavilion has 610 workstations.

FIRST FLOOR: LOWER FLOOR: • Psychiatric Crisis Department • Cafeteria • Gift Shop with Extended Observation Suite • Conference/Training Rooms • Critical Assessment and Treatment Clinic • Sanctuary

20 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 21 The Growing Pipeline from Discovery to Commercialization — Nationwide Children’s Office of Technology Commercialization Nationwide Children’s Hospital has a remarkable track record of moving discoveries into the marketplace. The hospital’s Office of Technology Commercialization facilitates the transfer of new technologies, research and innovations to outside partners to benefit patients, the local community and the general public.

The Office of Technology Commercialization supports clinicians and researchers alike. Discoveries and inventions ranging from new therapeutics — including the recently approved, first-of-its-kind gene therapy Zolgensma — to biomarkers, diagnostic tools and clinical tools — such as the Comfort Collar, designed to prevent pressure wounds around tracheostomy tubes — are supported through the expert team.

“People might not intuitively think of a nonprofit hospital like Nationwide Children’s as a hotbed for technology commercialization,” says Matthew McFarland, RPh, PhD, vice president, Commercialization and Industry Relations at Nationwide Children’s. “They should. Just like universities, we make substantial investments in commercialization of new discoveries and create job-producing startup companies. But even more importantly, we’re able to expand the benefits of innovation to improve the care and lives of children who may never set foot in our hospital.” Technology Commercialization at Nationwide Children’s: By the Numbers

licensing deals in 2019 clinical inventions startups launched in 2020 (combined between start- developed from idea to based on Nationwide 29 ups and industry) 3 commercially available 3 Children’s inventions

plus, in licensing revenue U.S. patent applications foreign patent $ received in 2019 by the filed in 2019 applications filed in 2019 Office of Technology 37 Commercialization million 101 97

patents issued disclosures submitted awarded internally to in 2019 to our office from 31 $ inventors in 2019 to different departments/ 230,000 fund 4 projects on the centers in 2019 commercialization path 25 88 Matthew McFarland, RPh, PhD

Nationwide Children’s Active Start-Up Companies

Please note the following start-ups have been acquired: AveXis by Novartis, Myonexus by Sarepta, and Celenex by Amicus.

22 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 23 Nationwide Children’s Hospital Awarded Prestigious Hearst Health Prize HEALTHY NEIGHBORHOODS HEALTHY FAMILIES Hearst Health and the Jefferson College of Population Health have announced AFFORDABLE HOUSING Nationwide Children’s Hospital as the winner of the 2020 Hearst Health Prize for Excellence in Population Health. Nationwide Children’s was awarded this prize for its Healthy Neighborhoods Healthy Families (HNHF) initiative and its mission to improve outcomes for children and families by creating healthy, opportunity-rich communities.

The national Hearst Health Prize for Excellence in Population Health is awarded to an institution that demonstrates population health impact by measurable improvement; use of evidence-based interventions and best practices; promotion of communication, collaboration and engagement; scalability and sustainability and innovation. The award comes with a $100,000 cash prize which will be used to further the HNHF mission.

In 2009, Nationwide Children’s joined with community partners to launch Healthy Neighborhoods Health Families. The initiative, composed of faith-based organizations, community development organizations, youth-serving nonprofits and local public schools, seeks to create positive health outcomes in the community. HNHF’s focus began on Columbus’s South Side, the area around the hospital, where it has improved community, family and individual well-being. The initiative has now expanded to the Linden area. The HNHF initiative targets five impact areas: affordable housing, education, health and wellness, community enrichment and economic development.

“This honor is validation of what can be accomplished when a community comes together,” says Tim Robinson, CEO of Nationwide Children’s. “It is a vitally important part of our mission to not only provide high quality care to our patients and families, within the hospital’s walls, but to also address the social determinants of health in the community, as well. We wouldn’t have been able to do it without strong partnerships with Community Development for All People, the United Way, Franklin County and its Commissioners, the City of Columbus and Mayor Andrew Ginther and others, and this prize is as much theirs as ours. We’re grateful for their teamwork and collaboration.”

Since its creation in 2009, HNHF has seen the following major achievements:

More than 370 homes The Residences at Neighborhood vacancy were impacted, Career Gateway rates fell from 25% including full-gut provides 58 units % to 6%, and owner- renovations, new of apartments and occupied home sale Home, before Healthy Home, after builds, and grants townhomes along volumes increased 370 to current residents 58 with on-site career 50 by 50% in the through the Home development training. Southern Orchards Repair Program. neighborhood.

Early childhood Children who are programs have driven Medicaid-eligible In surveys, % kindergarten readiness have experienced residents report scores from 32% to decreases in feeling safer and a 96% for participants, H emergency stronger sense of 79 and graduation rates department use community. increased from 64% in and probability of 2013 to 79% in 2017. inpatient admission.

Bathroom, before Bathroom, after Dining room, before Living room, after “We have demonstrated that equitable community development leads to positive outcomes for children and families,” says Kelly Kelleher, MD, MPH, vice president of Community Health and Community Health Services Research at Nationwide Children’s Hospital, who accepted the Hearst Health Prize today. “To be recognized for this important work is one step closer to addressing social determinants of health on a larger scale.”

24 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 25 FACULTY HONORS AND GRANTS Childhood Cancer Research Team Awarded $10.2 Million Deena Chisolm, PhD, Receives Nationwide Foundation Endowed Chair of Cancer Moonshot Grant Health Equity Research The National Cancer Institute at the National Institutes of Health In 2020, the Nationwide Foundation Pediatric Innovation Fund supported the creation and announced it has awarded one of its Cancer Moonshot grants to funding of the Nationwide Foundation Endowed Chair of Health Equity Research. This chair is Timothy Cripe, MD, PhD, chief of the Division of Hematology, awarded to Deena Chisolm, PhD, director of a Center of Emphasis dedicated to health equity Oncology & Blood and Marrow Transplant, and Elaine Mardis, PhD, research and vice president of Health Services Research at Nationwide Children’s Hospital. co-executive director of the Steve and Cindy Rasmussen Institute for Dr. Chisolm is an epidemiologist whose research is focused on measuring and improving the Genomic Medicine at Nationwide Children’s Hospital. The multiyear effectiveness, efficiency and equity of pediatric health care in at-risk communities. Timothy Cripe, MD, PhD Elaine Mardis, PhD grant supports multiple ongoing projects led by the Pediatric Ohio-New Deena Chisolm, PhD York Cancer (Peds-ONC) Immunotherapy Center. The team includes collaborators at The Ohio State University, the New York College of Medicine and the University of Minnesota. This is the second Cancer Moonshot grant awarded to Jeff Bridge, PhD, Receives Nationwide Foundation Endowed Chair of Innova- researchers at Nationwide Children’s. tion in Behavioral Health Research In 2020, the Nationwide Foundation Pediatric Innovation Fund supported the creation of the $3 Million Grant Awarded to Children’s Hospitals in Ohio, Nationwide Foundation Endowed Chair of Innovation in Behavioral Health Research. This chair Michigan to Establish Regional Disaster Center of Excellence is awarded to Jeff Bridge, PhD, director of the Center for Suicide Prevention and Research at Nationwide Children’s Hospital. This honor recognizes Dr. Bridge’s pioneering work in suicide The Assistant Secretary of Preparedness and Response of the U.S. prevention at the Abigail Wexner Research Institute at Nationwide Children’s. His research Department of Health and Human Services recently awarded a $3 focuses on the epidemiology of suicidal behavior in young people and on improving the quality million grant that will establish The Eastern Great Lakes Pediatric Jeff Bridge, PhD of care for suicidal youth and adolescents who have attempted suicide. Consortium for Disaster Response as a Center of Disaster Excellence. The consortium, which Nationwide Children’s Hospital is a part of, is led by University Hospitals’ Rainbow Babies and Children’s National Pancreas Foundation Center of Excellence Designation Rachel Stanley, MD Ellen McManus, MD Hospital and is accompanied by four other children’s hospitals in Ohio and Michigan. Rachel Stanley, MD, MHSA, chief of Emergency Medicine at Nationwide Children’s will lead the Nationwide Children’s Hospital has been named a National Pancreas Foundation (NPF) Center consortium team at Nationwide Children’s along with Ellen McManus, MD, attending Emergency Medicine physician. of Excellence. In alignment with Nationwide Children’s vision of delivering multidisciplinary care to support best outcomes, the NPF selects hospitals based on their ability to provide a comprehensive pediatric health care delivery system for the treatment of pancreatic disease. Nationwide Children’s Hospital Joins Four Other Top Research Institutions in Joint Initiative Cheryl Gariepy, MD, is the director of the Pancreas Center at Nationwide Children’s. Focused on Single Ventricle Heart Defects The recognition is a credit to the physicians and staff and the center’s capacity to provide comprehensive care and advanced procedures that put us at the forefront of care and outcomes. The Abigail Wexner Research Institute (AWRI) at Nationwide Children’s Hospital is the recipient of a $1 million Cheryl Gariepy, MD Innovation Fund, endowed by the nonprofit foundation Additional Ventures. In receiving this funding, AWRI will join four other research institutions — including Children’s Hospital of Philadelphia, the Gladstone Institutes, Lucille Packard Children’s Hospital Stanford and The Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University — in a large-scale coordinated research effort centered on identifying new avenues to functionally cure patients with single ventricle heart defects. These funds will be used to extend research platforms to include more high- risk, high-reward projects that are often challenging to fund through more traditional grant mechanisms.

26 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 27 NEW APPOINTMENTS Rustin Morse, MD, Chief Medical Officer Maryam Fouladi, MD, MSc, FRCP, Co-Executive Director Neuro-Oncology Program Rustin Morse, MD, joined Nationwide Children’s Hospital as chief medical officer in August 2020. Maryam Fouladi, MD, MSc, FRCP, is a pediatric neuro-oncologist, co-executive director of the Dr. Morse is a nationally recognized leader in pediatric quality and safety and currently serves on pediatric neuro-oncology program at Nationwide Children’s Hospital, and a professor of Pediatrics at the national Clinical Steering Committee for Solutions for Patient Safety and the Quality and Safety The Ohio State University College of Medicine. Dr. Fouladi is an internationally recognized expert Committee of the Board of Trustees for the Children’s Hospital Association. He is a sought-after in pediatric brain tumors and is renowned for her work in phase I clinical trials. She is the founding thought leader on pediatric quality and safety and is regularly recognized by Becker’s Hospital Review director of CONNECT, an international consortium focused on developing and testing novel as one of “50 Experts Leading the Field of Patient Safety.” A board-certified pediatric emergency room therapies in early phase clinical trials. In addition to her roles at Nationwide Children’s and The physician who has continued to practice emergency medicine throughout his career, Dr. Morse has a Ohio State University Wexner Medical Center, Dr. Fouladi serves as the chair of the Collaborative Rustin Morse, MD successful track record leading and advancing quality and safety programs in pediatric health care. Maryam Fouladi, MD, Network for Neuro-Oncology Clinical Trials and CNS Committee of the Children’s Oncology Group. MSc, FRCP Dr. Morse received his medical degree from the State University of New York Health Science Center at Upstate Medical Prior to coming to Nationwide Children’s, Dr. Fouladi served as medical director of the Brain Tumor Center at Cincinnati University. He then completed his pediatric residency at Children’s Hospital of Pittsburgh and his pediatric emergency Children’s Hospital and was also a full professor and the Marjory J. Johnson Endowed Chair in Brain Tumor Translational medicine fellowship at Ann & Robert H. Lurie Children’s Hospital of Chicago. He obtained a master’s degree in Medical Research at the University of Cincinnati. She received her medical degree from the University of Toronto and completed her Management from the University of Southern California, Marshall School of Business. pediatric residency and hematology/oncology fellowship at The Hospital for Sick Children in Toronto. She completed her neuro-oncology fellowship training at St. Jude Children’s Research Hospital followed by additional training in the Molecular Lee Ann Wallace, RN, MBD, NEA-BC, Chief Nursing Officer Pharmacology Department at St. Jude. Following a national search, Lee Ann Wallace, RN, MBA, NEA-BC, former vice president of Neonatal Services at Nationwide Children’s Hospital, was selected senior vice president and chief Shamlal Mangray, MB, BS, Chief of Pathology and Laboratory Medicine nursing officer (CNO). Wallace began her career as a staff nurse at the University of Kentucky Children’s Hospital in 1978. Prior to Nationwide Children’s, she gained nearly three decades of Shamlal Mangray, MB, BS, has been appointed chief of the Department of Pathology and experience as a clinical nurse manager, educator, service line leader and director of women’s and Laboratory Medicine at Nationwide Children’s Hospital. Dr. Mangray, who is also a professor children’s services at four different health systems. of Clinical Pathology at The Ohio State University College of Medicine, joined Nationwide Children’s in 2018 as chief of Anatomic Pathology. Dr. Mangray received his medical degree from Lee Ann Wallace, RN, In 2012, Wallace joined the team at Nationwide Children’s as the Neonatology service line the University of the West Indies and went on to complete residencies at St. Vincent’s Medical MBD, NEA-BC administrator, and in 2016 was promoted to vice president of Neonatology Services. She earned a Center in Connecticut and at Rhode Island Hospital - Brown University. He completed a Surgical bachelor of science in nursing from the University of Kentucky and obtained her master’s in business administration in health Pathology Fellowship at Vanderbilt University Medical Center and a Pediatric Pathology Fellowship care administration from the University of Findlay. Wallace was instrumental in growing Nationwide Children’s Neonatal Shamlal Mangray, MD, BS at Women & Infants Hospital of Rhode Island at Brown University. Dr. Mangray is board certified Network, now nationally recognized as the largest in the country. in Anatomic & Clinical Pathology and Pediatric Pathology.

Katherine Deans, MD, MHSc, Chief Clinical Research Officer Katherine J. Deans, MD, MHSc, a pediatric surgeon and co-founder and former director of the Manmohan Kamboj, MD, Division Chief of Endocrinology Center for Surgical Outcomes Research at Nationwide Children’s Hospital, has been named the first Manmohan K. Kamboj, MD, has been named chief of the Division of Endocrinology at chief clinical research officer at the Abigail Wexner Research Institute at Nationwide Children’s. Nationwide Children’s Hospital. Dr. Kamboj is a nationally recognized figure in pediatric endocrinology quality and safety. Under her leadership, Nationwide Children’s was named one In her new role, she will focus on the development and oversight of clinical research operations of 10 sites in the National Type 1 Diabetes Exchange Quality Improvement Collaborative. She across Nationwide Children’s, with an overall goal of facilitating impactful clinical research has various leadership roles in the Pediatric Endocrine Society (PES), including participation on throughout the organization. Dr. Deans will oversee the full life cycle of the clinical research process, multiple Education Committee initiatives and work as co-chair of the PES Drugs and Therapeutics Katherine Deans, MD, with an emphasis on increasing quality, compliance and efficiency along with promoting a culture of Committee. Dr. Kamboj, who is also a professor of Pediatrics at The Ohio State University College MHSc excellence among investigators and clinical research staff. Manmohan K. Kamboj, MD of Medicine, has authored more than 65 manuscripts, book chapters and peer-reviewed articles. During her career, Dr. Deans has published more than 190 peer-reviewed papers, book chapters and abstracts and has She has co-edited three books. She received her medical degree from Christian Medical College in India and completed her received over $10 million in research funding. She received her medical degree from Dartmouth Medical School and her residency in pediatrics and fellowship in pediatric endocrinology at New York University Medical Center. master’s of health science from the Duke University School of Medicine. She completed residencies at Massachusetts General Hospital, held clinical and research fellowships at the National Institutes of Health and a clinical fellowship at Children’s Hospital of Philadelphia.

30 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 31 Carol Bradford, MD, Newly Appointed Dean of The Ohio State University College of Medicine DEPARTMENT OF PEDIATRICS

In August, The Ohio State University announced The mission of the Department of Pediatrics at Nationwide Children’s Hospital and The Ohio State University is that strong academic leader and well-known to achieve excellence in teaching, research, academics, advocacy and administrative service. With great energy and physician-scientist in the field of otolaryngology enthusiasm, we promote the well-being of children, discover new knowledge to bring to bear on optimal child health — head and neck surgery will lead its College of and provide evidence-based, efficient and compassionate medical care to our patients and their families. Medicine beginning in October.

DEPARTMENT OF PEDIATRICS PEDIATRICS OF DEPARTMENT The department comprises 27 clinical divisions, the Steve and Cindy Rasmussen Institute for Genomic Medicine and Carol R. Bradford, MD, FACS, will be the 15th 13 research centers of emphasis in the Abigail Wexner Research Institute. Department of Pediatrics faculty members dean of the medical college and vice president have formal appointments in The Ohio State University College of Medicine. for Health Sciences at The Ohio State University Wexner Medical Center, and will hold the Leslie Our faculty has an unwavering commitment to excellence and aspires to the highest levels of professionalism, H. and Abigail S. Wexner Dean’s Chair in humanism, diagnostic acumen, clear communication and compassion. We educate and mentor more than 350 Medicine. third- and fourth-year medical students from The Ohio State University and train approximately 300 residents Dr. Bradford comes to Ohio State from the and subspecialty fellows each year. Our Center for Faculty Development oversees a robust program that strives to University of Michigan, where she was the engage, support and educate our more than 500 faculty. An important mission of our department and hospital is the executive vice dean of academic affairs and the discovery and dissemination of new knowledge related to child health and health care delivery. This discovery mission chief academic officer for Michigan Medicine. is supported by more than $105 million in research funding and we are ranked sixth among free-standing children’s She oversaw education, global initiatives, faculty hospitals in NIH funding. affairs, faculty development, diversity, equity and inclusion and regulatory affairs. A Michigan faculty member since 1992, she also served as chair of the Department of Otolaryngology – Head Photo taken before COVD-19 pandemic. and Neck Surgery, co-director of the Head and Neck Oncology program for Michigan’s Rogel Cancer Center and principal investigator of a major project on the specialized program for research excellence in head and neck cancer. Her many awards include being inducted into the National Academy of Medicine in 2014, a Distinguished Service Award from the American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) in 2007 and a listing in Best Doctors since 2001. She became president of AAO-HNS in September.

32 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 33 2019 – 2020 NATIONWIDE CHILDREN’S RESIDENCY PROGRAM Dear Colleagues: NATIONWIDE CHILDREN’S HOSPITAL | THE OHIO STATE UNIVERSITY COLLEGE OF MEDICINE The Department of Pediatrics promotes child health by providing comprehensive, state-of-the-art care for children in Ohio and worldwide. Our vibrant training programs provide among the most PEDIATRICS RESIDENCY Dr. Kelsey M. Lecerf Dr. Ashleigh J. Slemmer INTERNAL MEDICINE- diverse and preeminent educational experiences in pediatrics available in the United States. And PROGRAM DIRECTOR Dr. Rachael E. Levine Dr. Carly A. Stilphen PEDIATRIC RESIDENTS Rebecca G. Wallihan, MD Dr. Celia E. Ligorski Dr. Cristina Tomatis Souverbielle CHIEF RESIDENTS our outstanding research programs are changing futures for children across the world. Dr. Nina J. Ma Dr. Mark J. Wells Dr. Matthew R. Emery INTERNAL MEDICINE/ As we work to advance optimal health in children, we do not insulate ourselves from real-world Dr. Kristin D. Maletsky Dr. Bianca Zapanta Dr. Mary J. Ryan PEDIATRICS RESIDENCY issues that confront modern society. In response to the spirit of the Black Lives Matter movement Dr. Lauren E. Matera PROGRAM DIRECTOR PL-1 and Nationwide Children’s stand against racism, the Department of Pediatrics is aggressively Dr. Aishwarya S. Navalpakam PGY-4 Margaret Chase, MD Dr. Haley B. Pearlstein Dr. Nadine-Stella E. Achenjang Dr. Katherine F. Ernst confronting racism as a public health crisis. Dr. Michael P. Perisa Dr. Molly J. Austen Dr. Matthew I. Lyons Along with many other initiatives at our hospital, we are working hard to increase year-over-year the number of under- ASSOCIATE PROGRAM Dr. Stephanie T. Quach Dr. Nimisha Bajaj Dr. Sarah M. MacDowell represented minority faculty and trainees in our Department. Through hard work by many people, we have made great DIRECTORS Dr. James B. Reinecke Dr. Megan N. Barcroft Dr. Lucy E. Rosenbaum progress in our residency program. Every Grand Rounds presentation must address some aspect of health equity and PEDIATRICS Dr. Jessica H. Rutsky Dr. Trevor R. Bushong Dr. Brittany S. Shrefler Dr. Jennifer B. Scheer Dr. Kaitlyn D. Cassady Dr. Corey A. Toocheck racism germane to the topic of the day. And we have a rich didactic curriculum and a variety of innovative experiential Mary Kay Kuzma, MD Alexander T. Rakowsky, MD Dr. Louisa Sethi Dr. Michael T. Clark Dr. Akshay B. Vijayaraman learning platforms that focus on diversity, equity and inclusion – all uniquely designed for our faculty. Suzanne M. Reed, MD Dr. Tara J. Shenoy Dr. Nicole M. Davidson Dr. Sneh A. Xavier I hope you enjoy the pages that follow and appreciate the depth of our commitment to achieve best outcomes for children Claire A. Stewart, MD Dr. Livpreet Singh Dr. Samantha J. DeMarsh Dr. Samantha K. Stough Dr. Sabine J. Eid PGY-3 everywhere. INTERNAL MEDICINE/PEDIATRICS Dr. Destiny D. Wilsonao Dr. Maretta H. Fan Dr. Philip Chang Sincerely, Lucas McKnight, MD Dr. Ryan M. Flaherty Dr. Anyelika Delerme Allison Rossetti, MD PL-2 Dr. Gabriella T. Gonzales Dr. Michelle Gillespie John A. Barnard, MD Dr. Collin J. Abbott Dr. Cory W. Gotowka Dr. Robbi Gomez Ann I. Wolfe Chair in Pediatric Research President, PEDIATRIC RESIDENTS Dr. Ruth D. Abrams Dr. Emily M. Grad Dr. Audrey Hiltunen Dr. Keerthi Akubathini Dr. Elizabeth M. Grogan Abigail Wexner Research Institute at Nationwide Children’s Hospital Professor and Chair, CHIEF RESIDENTS Dr. Austin Meyer Dr. Abha H. Athale Dr. Muhammed T. Gunduz Dr. Michelle Moore Padilla Department of Pediatrics The Ohio State University College of Medicine Dr. Hannah J. Elkus Dr. Erika L. Basil Dr. Ezekiel D. Hartman Dr. Nathaniel Sherrer Dr. Taylor H. Jersak Dr. Brianna N. Brun Dr. Ann M. Kebede Dr. Shauna M. Schord Dr. Amanda R. Campbell Dr. Laura K. Lamberta PGY-2 Dr. Megan E. Yanny Dr. Sarah M. Chen Dr. Kara D. Lawson Dr. Nabeeha Ahmad Dr. Becky Zhao DEPARTMENT OF PEDIATRICS VICE CHAIRS Dr. Christian M, Coletta Dr. Rafael Lemus Dr. Kristin Cooper Dr. Zachary D. Daniels Dr. Aaron Maki PL-4 Dr. Rachel D’Amico Dr. Jonathan A. Digby Dr. Corinne C. Mccabe Dr. Michael Diesntbach Dr. April N. Lehman Dr. David W. Drees Dr. Samir Mishra Dr. Mary Hanks Dr. Megan M. Fredwall Dr. Jessica A. Nash PL-3 Dr. Rachael Mangaudis Dr. Christopher Gable Dr. Britney N. Onuma Dr. Timothy Pian Dr. Karen M. Allen Dr. John M. Grisham Dr. Molly J. Osterhage Dr. Daniel Schmitz Dr. Zeenath S. Ameen Dr. Rae Leonor Gumayan Dr. Amudha Pazhanisamy Dr. Savannah Smith Dr. Brett A. Ballard Dr. Monica L. Hoff Dr. Heather Peterson-Schempp Dr. Aisha J. White Dr. Angelique E. Boutzoukas Dr. Anneliese R. Huntzinger Dr. Melonie A. Phillips Dr. Kyle B. Burghgraef Dr. Kelly M. Irwin Dr. Rachel E. Pratt PGY-1 Dr. Lauren N. Carlozzi Kristina Reber, MD Linda Cripe, MD Rebecca Wallihan, MD Dennis Durbin, MD Dr. Megan A. King Dr. Joshua J. Prudent Dr. Cole Bredehoeft Dr. Aila L. Co Vice Chair, Vice Chair, Vice Chair, Vice Chair, Dr. Antonia T. Kopp Dr. Stephanie L. Rinne Dr. Duncan Campbell Dr. Kaci L. Cunningham Department of Pediatrics Academic Affairs Education Research Dr. Megan K. MacGregor Dr. Alexandra E. Sankovic Dr. Jennifer DeSalvo Dr. Laura M. DiScenna Dr. Abigail J. McGinnis Dr. Matthew T. Smith Dr. Dominic Haertling Dr. Maureen M. Faust Dr. Claudia A. Mosquera Vasquez Dr. Brandon S. Stone Dr. Brandi Heinz Dr. Nathaniel H. Forman Dr. Rachel C. Nash Dr. Kristin L. Sundy-Boyles Dr. Michael Neiger Dr. Noga Gal Dr. Jacqueline M. Nicodemo Dr. Rachel L. Thompson Dr. Anthony Sanchez Dr. Sarah J. Gaubatz Dr. Kortney J. Pifher Dr. Charles C. Treinen Dr. Matthew Schreier Dr. Jaclyn R. Giafaglione Dr. Aubrey K. Pizza Dr. Jessica E. P. Williams Dr. Shilpa Sridhar Dr. Lauren M. Gunderman Dr. Melanie C. Ribbeck Dr. Mariah L. Wright Dr. Christopher Woeste Dr. Eric W. Jones Dr. Philip ‘Bucky’ Ribbeck Dr. Jarrod J. Wurm Dr. Shelby C. Jordan Dr. Hector A. Saucedo Dr. Guillermo J. Yepes Junquera Dr. Ajay S. Koti Dr. Isma B. Shah Dr. Jared A. Kusma

ADOLESCENT MEDICINE FAST FACTS The Section of Adolescent Medicine at Nationwide Children’s Hospital provides general and specialty care July 2019 through June 2020 for adolescents. The staff includes experts in all aspects of health care for adolescents, with an emphasis on comprehensive primary care, reproductive health care, eating disorders, LGBTQ youth, substance abuse, Adolescent Medicine Clinic Visits:...... 5,397 Linden Primary Care Adolescent Medicine Clinic Visits:.16 health for incarcerated youth, and adolescents with complex health problems. Adolescent Medicine Eating Disorders Visits:...... 2,921 Total Adolescent Medicine Clinic Visits:...... 9,049 Dublin Adolescent Medicine Clinic Visits:...... 241 Inpatient Consults:...... 39 FACULTY known as BC4Teens, increases accessibility to long- East Broad Adolescent Medicine Clinic Visits:...... 474 acting reversible contraception. The THRIVE Program provides comprehensive care to transgender and gender- nonconforming youth. Physicians in the Section of Adolescent Medicine provide ongoing and consultative 2019 – 2020 NATIONWIDE CHILDREN’S care for adolescents admitted to Nationwide Children’s FELLOWSHIP PROGRAM with diverse medical problems, such as gynecological conditions and complications from eating disorders. An ADOLESCENT MEDICINE Accreditation Council for Graduate Medical Education Maria D. Brown, MD Fellowship in Adolescent Medicine has been in place Ashley M. Ebersole, MD since 2010. Hunter Wernick, DO

Andrea E. Bonny, MD Our faculty members actively participate in research Chief and national leadership. Erin R. McKnight, MD, MPH, and Andrea E. Bonny, MD, are co-investigators on a Elise D. Berlan, MD, MPH National Institutes of Health grant, developing new Gayathri Chelvakumar, MD, MPH statistical approaches for estimating county-level rates of opioid misuse to target areas of highest priority. The Casey B. Cottrill, MD, MPH grant-funded research of Gayathri Chelvakumar, MD, MPH, explores the association between quality of life Fareeda W. Haamid, DO and menstrual suppression in gender minority youth. Cynthia M. Holland-Hall, MD, MPH, was elected to Cynthia M. Holland-Hall, MD, MPH the Executive Committee of the American Academy of Steven C. Matson, MD Pediatrics Section of Adolescent Health, and Elise D. Berlan, MD, MPH, served on the board of directors for Erin R. McKnight, MD, MPH the North American Society for Pediatric and Adolescent Gynecology. The Adolescent Medicine Clinic is located in the Livingston Ambulatory Center on our Columbus SELECTED PUBLICATIONS campus. Primary care is offered, as are consultative Akgul S, Bonny AE, Ford N, Holland-Hall C, Chelvakumar G. Experiences of Gender Minority Youth with the Intrauterine System. The Journal of Adolescent Health. 2019 clinics for adolescents with reproductive health Jul;65(1):32-38.

needs and those who need treatment for addiction. Stull SW, McKnight ER, Matson SC, Bonny AE. Immunity to Hepatitis B is The Medical Clinic at the Franklin County Undetectable in the Majority of Adolescents and Young Adults Seeking Outpatient Medication Treatment for Opioid Use Disorder. The Journal of Addiction Medicine.2020 Juvenile Detention Facility provides health care for Jun 12. [Epub ahead of print] detained youth. The Eating Disorders Program is a Walker KS, Bonny AE, McKnight ER, Nahata MC. Impact of Office-Based Opioid multidisciplinary team involving Adolescent Medicine Treatment on Emergency Visits and Hospitalization in Adolescents with Opioid Use physicians, a psychiatrist, behavioral health therapists, Disorder. The Journal of Pediatrics. 2020 Apri;19:236-242. nurses and dietitians. Three levels of care are available: Wilkinson TA, Kottke MJ, Berlan ED. Providing Contraception for Young People partial hospitalization, intensive outpatient therapy During a Pandemic is Essential Health Care. JAMA Pediatrics. 2020 May 7. and coordinated outpatient visits. The Medication- Assisted Treatment for Addiction Program has been treating adolescents and young adults with opioid addiction using substitution therapy since 2007. The Young Women’s Contraceptive Services Program, also

ALLERGY AND IMMUNOLOGY allergy and immunology organizations and are invited speakers at local, regional, national and international FAST FACTS The Division of Allergy and Immunology at Nationwide Children’s Hospital provides comprehensive conferences. services for the diagnosis and treatment of patients with allergic and immunologic diseases from birth July 2019 through June 2020 through age 21. Clinical activity includes an active outpatient clinic, several multispecialty clinics, an urgent SELECTED PUBLICATIONS Main Campus Allergy Clinic Visits:...... 5,650 referral clinic and inpatient consultation services. The division is also actively involved in both basic science Erwin EA, Navalpakam A, Singla R, Bolender J, Workman LJ, Platts-Mills TAE. J Immunology Clinic Visits:...... 379 and clinical research. Distinct clinical characteristics of boys and girls with eosinophilic esophagitis. The Journal of Allergy and Clinical Immunology: in Practice. 2020 Apr;8(4):1452-1455. Complex Asthma-Allergy Clinic Visits:...... 206 Kraft MT, Prince BT. Atopic dermatitis is a barrier issue, not an allergy issue. Immunology Hilliard Allergy Clinic Visits:...... 609 and Allergy Clinics of North America. 2019 Nov;39(4):507-519. FACULTY This past year, the Division of Allergy and Immunology Westerville Allergy Clinic Visits:...... 484 opened the Food Allergy Treatment Center. This center Kraft MT, Scherzer R, Strothman K, Rogers G, Montgomery T, Grayson MH. Establishing standardized documentation for anaphylaxis treatment in a tertiary care Early Peanut Introduction Clinic Visits:...... 44 provides comprehensive evaluation, diagnosis and pediatric allergy clinic. Pediatric Quality and Safety. 2020 Feb 15;5(2):e261. Total Clinic Visits:...... 7,372 management of food allergies, and is the only center in Mikhail I, Prince BT, Stukus DR. Update on early introduction of peanut to prevent Inpatient Consults:...... 76 central Ohio performing high-risk oral food challenges. allergy development: Challenges with implementation. Current Allergy and Asthma Reports. In addition to our food allergy focus, we remain a 2019 Nov 9;19(11):51.

World Allergy Organization Center of Excellence, and Takeda AJ, Maher TJ, Zhang Y, Lanahan SM, Bucklin ML, Compton SR, Tyler PM, continue to be a Jeffrey Modell Foundation for Primary Comrie WA, Matsuda M, Olivier KN, Pittaluga S, McElwee JJ, Long Priel DA, Kuhns 2019 – 2020 NATIONWIDE CHILDREN’S Immunodeficiencies Diagnostic and Research Center of DB, Williams RL, Mustillo PJ, Wymann MP, Koneti Rao V, Lucas CL. Human PI3Kγ deficiency and its microbiota-dependent mouse model reveal immunodeficiency and tissue FELLOWSHIP PROGRAM Excellence. immunopathology. Nature Communications. 2019 Sep 25;10(1):4364. ALLERGY & IMMUNOLOGY Our providers manage all allergic conditions, including asthma, allergic and nonallergic rhinitis, chronic Basil Kahwash, MD Mitchell H. Grayson, MD Monica Kraft, MD sinusitis, hives, eczema, angioedema, drug and food Division Chief Dylan Timberlake, MD allergies, latex allergy and stinging insect allergy. We Jennifer Yonkof, MD provide allergy skin testing, allergen immunotherapy, asthma education, pulmonary function testing, comprehensive food allergy management (including oral food challenges) and drug allergy testing. We evaluate children with recurrent or unusual infections and provide complete evaluation and management for primary immunodeficiencies. Faculty participate in the Complex Asthma and 22q11 clinics and in multidisciplinary clinics with Hematology/Oncology, Otolaryngology (ENT) and Gastroenterology. We Rebecca Scherzer, MD provide inpatient consultation and immediate assistance Section Chief for health care providers through the physician consult transfer center. Elizabeth A. Erwin, MD A wide array of basic and clinical research is performed Irene J. Mikhail, MD by division faculty, ranging from mechanisms driving Peter J. Mustillo, MD development of asthma and allergies to clinical studies of eosinophilic esophagitis, food allergy, use of technology Benjamin Prince, MD to improve patient outcomes, transition of care, primary Margaret Redmond, MD immunodeficiency, asthma, and allergic and nonallergic Kasey Strothman, MD rhinitis. David R. Stukus, MD The Allergy and Immunology faculty provide clinical and didactic instruction for the Nationwide Children’s Hospital Allergy and Immunology Fellowship Program and Pediatric Residency Program along with students from The Ohio State University College of Medicine. Faculty and fellows have leadership positions in national

38 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 39 The Heart Center Cardiomyopathy in Mothers of Boys With Muscular Dystrophy Female carriers of the genetic defect that causes muscular dystrophy in boys show evidence of cardiac fibrosis. An interdisciplinary team from Nationwide Children’s Hospital reports about half of women who carry the genetic defect responsible for muscular dystrophy show evidence of cardiac fibrosis. The study, published in the International Journal of Cardiology, suggests that cardiac muscle, not skeletal muscle, is predominantly affected in this population.

Duchenne and Becker muscular dystrophies are progressive, neuromuscular diseases caused by mutations in the DMD gene, which encodes the protein dystrophin. About two-thirds of affected boys inherit the mutation in an X-linked recessive pattern from their mothers.

It was thought that female carriers of this mutation would be protected from expressing the disease due to the normal copy of the DMD gene on their second X chromosome. However, some mothers of boys with muscular dystrophy have reported symptoms of muscle weakness and cardiac issues.

In the study, researchers from the departments of cardiology, neurology and psychology collaborated to define this disease and estimate its prevalence. They performed a battery of tests, including cardiac magnetic resonance imaging (MRI) and cardiopulmonary exercise testing, on three groups of women: mothers of sons with muscular dystrophy who were genetically confirmed to carry the mutation, mothers of sons with muscular dystrophy who did not have the mutation and healthy women.

Cardiac MRI revealed that 49% of the genetic carriers had cardiac fibrosis, as opposed to 5% of the noncarriers and none of the healthy controls.

There were no differences between the genetic carriers and the other two groups on treadmill testing, suggesting the genetic defect predominantly affects cardiac muscle and not skeletal muscle in this population.

The researchers also found that, despite cardiomyopathy, the functional capacity of genetic carriers’ heart muscles was maintained.

May Ling Mah, MD, and Kan Hor, MD, cardiology investigators at The Heart Center at Nationwide Children’s, say the findings highlight the importance of genetic testing for mothers of boys with Duchenne and Becker muscular dystrophies.

“We recommend these mothers get gene tested,” Dr. Mah says. “Then, genetically confirmed carriers should have a cardiac MRI by their third decade, and more importantly, a third of them can be reassured.”

This study is part of a larger, longitudinal project funded by a grant from Parent Project Muscular Dystrophy. Dr. Mah says that, together, findings from neuromuscular, cognitive and cardiac tests will provide a detailed picture of this disease, as well as its trajectory. Such research could impact mothers “We recommend these mothers get gene tested, then genetically confirmed carriers should and boys with muscular dystrophy. have a cardiac MRI by their third decade, and more importantly, a third of them can be reassured.” “What we learn in one of these patient populations can help the other,” she says. “With these moms – May Ling Mah, MD who are carriers, we have the opportunity to study the same gene defect in a different way.”

Mah ML, Cripe L, Slawinski MK, Al-Zaidy SA, Camino E, Lehman KJ, Jackson JL, Iammarino M, Miller N, Mendell JR, Hor KN. Duchenne and Becker muscular dystrophy carriers: Evidence of cardiomyopathy by exercise and cardiac MRI testing. International Journal of Cardiology. 2020 May 27. [Epub ahead of print]

THE HEART CENTER Kaitlin E. L’Italien, MD • Expanded regional outreach adult congenital clinics The Heart Center at Nationwide Children’s Hospital combines all clinical and research disciplines under Eric A. Lloyd, MD one umbrella in order to meet our mission: to improve outcomes by discovering the causes of heart disease May Ling Mah, MD • Funded 10 intramural projects and obtained and develop novel therapies for our patients, focusing on each as an individual and providing the state-of- Patrick I. McConnell, MD $2 million in extramural grant funding from National Institutes of Health and Foundation the-art care that all patients deserve, regardless of age. We support the mission of Nationwide Children’s to Christopher T. McKee, DO provide our services in a safe environment focused on family-centered care. Aymen N. Naguib, MD • One of five institutions in nation awarded Innovation Funds through Additional Ventures Deipanjan Nandi, MD FACULTY Aimee K. Armstrong, MD to study single ventricle heart disease Kathryn D. Nardell, MD Carl H. Backes, MD The Heart Center continues to grow in both volume and Julie C. O’Donovan, MD Darren P. Berman, MD capabilities with record numbers of outpatient visits and Christina M. Phelps, MD diagnostic studies in 2019. Brian A. Boe, MD Saurabh Rajpal, MD Our heart failure/transplant section, which has been Jessica L. Bowman, MD renamed the Pediatric & Adult Advanced Cardiac Kerry L. Rosen, MD Elisa A. Bradley, MD Therapies (PAACT) program, saw a nearly 75% increase Daniel G. Rowland, MD Sergio A. Carrillo Melendez, MD in transplant referrals in the last year and completed five Aarthi Sabanayagam, MD heart transplants. We implanted six ventricular assist Steven C. Cassidy, MD devices (VAD) as a bridge to recovery or heart transplant Toshiharu Shinoka, MD, PhD John P. Cheatham, MD and successfully supported an infant over five months Catherine D. Krawczeski, MD Janet M. Simsic, MD before transplant using the Berlin EXCOR VAD, our Kristin M. Chenault, MD longest infant support to date. We anticipate continued Co-Director Corey A. Stiver, MD Chief, Pediatric Cardiology Marco Corridore, MD VAD program growth, meeting the needs of an increasing Karen M. Texter, MD Linda H. Cripe, MD population of older pediatric and young adult patients Andrew Tran, MD with congenital heart disease. We continue to grow a Clifford L. Cua, MD novel cardio-oncology program to provide ongoing Peter D. Winch, MD, MBA Curt J. Daniels, MD cardiac care to long-term survivors of childhood cancers at Andrew R. Yates, MD risk for or developing cardiomyopathy. Stephen M. Druhan, MD Cody M. Young, DO Our cardiac catheterization and interventional therapies Timothy F. Feltes, MD team participates in multiple device trials, including new Richard P. Fernandez, MD NATIONAL AND INTERNATIONAL REPUTATION self-expanding transcatheter pulmonary valves (Harmony and Alterra) to broaden nonsurgical valve replacement Jill A. Fitch, MD Highlights options for many patients. The team has organized the Robert J. Gajarski, MD, MHSA • Continued outstanding surgical outcomes, with first multi-center, prospective, randomized trial for PDA Mark E. Galantowicz, MD Jennifer Gauntt, MD overall surgical mortality 2% or less for last two device occlusion versus medical management in the years premature neonate. Additionally, our catheterization Co-Director Stephen A. Hart, MD Chief, Cardiothoracic Surgery team continues to participate in preclinical research, Don Hayes, MD, MS, MEd • Implemented new protocols, leading to and has worked to refine the first fully bioabsorbable, significant decrease in blood stream infections Kan N. Hor, MD tissue-engineered pulmonary valve in an animal fetus associated with central intravenous lines in and implanted a fully absorbable ASD occluder in Anna N. Kamp, MD, MPH cardiac inpatients a sheep. Through a collaboration among cardiology, John Kelly, MD • Hosted the national 6th Summit on Transparency interventional radiology and hematology, the lymphatic Naomi J. Kertesz, MD and Public Reporting of Pediatric and Congenital disorder program is growing, performing diagnostic and Heart Disease Outcomes interventional procedures for patients with lymphatic Omar M. Khalid, MD disorders. Lastly, the interventional team performed the Sarah Khan, MD • Successfully implemented telemedicine visits to first heart catheterization in the Midwest guided solely by magnetic resonance imaging (MRI). John P. Kovalchin, MD support clinical services during the pandemic As part of a busy clinical arrhythmia service, our Rajesh Krishnamurthy, MD • Returned to full outpatient clinical volume Vidu Garg, MD electrophysiologist (EP) faculty staff a collaborative, in May 2020, maintaining infection control Director of Translational Research Lauren Lastinger, MD inherited arrhythmia clinic, combining the expertise practices, with a record number of referrals in of specialists in cardiology, psychology and genetic Anthony Y. Lee, MD June 2020 counseling. They have developed appropriate use criteria Simon Lee, MD

42 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 43 for implantable cardioverter defibrillators in patients with Congenital Heart Collaborative remains active and is one of The Heart Center and Center for Cardiovascular SELECTED PUBLICATIONS Duchenne muscular dystrophy and implanted the first only a few centers that has performed intervention in a fetus Research continue to be involved in multiple NIH and Armstrong AK, Berger F, Jones TK, Moore JW, Benson LN, Cheatham JP, Turner DR, Rhodes JF, Vincent JA, Zellers T, Lung T-H, Eicken A, McElhinney DB. Association leadless pacemaker in a child in the U.S. As part of Project with pulmonary atresia with intact ventricular septum. industry-funded clinical trials. We participate in multiple Between Patient Age at Implant and Outcomes After Transcatheter Pulmonary Valve Adam Ohio, which is housed at Nationwide Children’s, the interventional cardiology clinical trials and are currently Replacement in the Multicenter Melody Valve Trials. Catheterization and Cardiovascular The Non-Invasive Imaging team initiated an AutoStrain Interventions. 2019 Oct 1;94:607-617. EP staff have met with multiple school districts and have program for detailed echocardiographic evaluation of conducting studies involving four types of transcatheter expanded to virtual teaching and remote drills to certify pulmonary valves. In addition, we actively collaborate Drews JD, Pepper VK, Best CA, Szafron JM, Cheatham JP, Yates AR, Hor KN, Zbinden ventricular function and a Point of Care Ultrasound JC, Chang YC, Mirhaidari GJM, Ramachandra AB, Miyamoto S, Blum KM, Onwuka more schools in a larger radius, working with each school to Program (POCUS) in conjunction with emergency with Dr. Breuer in the Center for Regenerative Medicine EA, Zakko J, Kelly J, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, guide the appropriate placement of and training in the use on the tissue-engineered vascular graft clinical trial for Breuer J, Heuer ED, West TA, Shoji T, Berman D, Boe BA, Asnes J, Galantowicz M, physicians. The team remains active in research with three Matsumura G, Hibino N, Marsden AL, Pober JS, Humphrey JD, Shinoka T, Breuer of automatic external defibrillators. Additionally, EP faculty funded investigators and a dedicated research imaging our patients with single ventricle heart disease. Lastly, we CK. Spontaneous Reversal of Stenosis in Tissue-Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537). are involved in several international multicenter research coordinator. New research programs are studying the have several collaborations with scientists in the Abigail projects, are on national committees and continue research cardiovascular effects of COVID-19 infection, including Wexner Research Institute studying the genetics of Raman SV, Hor KN, Mazur W, Cardona A, He Z, Halnon N, Markham L, Soslow JH, in the identification of arrhythmias in adults with congenital congenital heart disease, physical activity in congenital Puchalski MD, Auerbach SR, Truong U, Smart S, McCarthy B, Saeed IM, Statland JM, myocarditis and the multi-inflammatory syndrome in Kissel JT, Cripe LH. Stabilization of Early Duchenne Cardiomyopathy with Aldosterone heart disease. heart disease patients, and the extent of myocardial injury Inhibition: Results of the Multi-Center AIDMD Trial. Journal of the American Heart children (MIS-C), using imaging techniques. The team Association. 2019 Oct;8(19). The Adult Congenital Heart Disease (ACHD) program is also evaluating the appropriate use criteria in ordering and complications in symptomatic and asymptomatic pediatric COVID-19 patients. Simsic JM, Dolan K, Miller J, Yates AR, Fernandez R, Phelps C, Fitch J, Lee A, Lloyd remains one of the leading programs in the country. echocardiograms. E, Gauntt J, Gajarski R. Guidelines for Diuretic Utilization Reduce Practice Variation and Cost. Pediatric Quality & Safety. 2019 Nov 25;4(6):e237. Clinically, the group added a sixth ACHD cardiologist, Advanced Cardiac Imaging (MRI and CT) has shown Center for Cardiovascular Research: See page 182 for Yates AR, Sutton RM, Reeder RW, Meert KL, Berger JT, Fernandez R, Wessel D, Newth, surpassed 4,500 outpatient visits (largest in the country), steady growth in volume and continued innovation from a information about this center in the Abigail Wexner expanded to Zanesville, Ohio, (our fifth ACHD CJ, Carcillo JA, McQuillen PS, Harrison RE, Moler FW, Pollack MM, Carpenter TC, programmatic and research standpoint. The use of cardiac Research Institute at Nationwide Children’s. Notterman DA, Dean JM, Nadkarni VM, Berg RA and the Eunice Kennedy Shriver outreach location) and maintained surgical and cardiac CT as a complement to echo in neonates and infants has National Institute of Child Health and Human Development Collaborative Pediatric catheterization outcomes significantly better than published Critical Care Research Network. Survival and CPR Hemodynamics Following Cardiac seen remarkable growth with the ability to perform scans GRANTS AWARDED TO HEART CENTER Arrest in Children with Surgical Compared to Medical Heart Disease. Pediatric Critical national benchmarks. Academically, the ACHD program without sedation and with low radiation exposure. New AND CARDIOVASCULAR RESEARCH FACULTY Care Medicine. 2019 Dec;20(12):1126-1136. published 28 articles this past year including studies programs introduced this year in cardiac MRI include 4D JULY 1, 2019 – JUNE 30, 2020 in COVID-19 in ACHD patients. They are primary blood pool contrast imaging with ferumoxytol and use of $2,302,971 investigators on 14 grants including industry, intramural machine learning approaches to rapid reconstruction of cine and NIH funded studies, and have developed national images. The myocardial stress perfusion MR imaging has registries to study the impact of COVID-19 in ACHD seen rapid adoption and integration into the comprehensive patients, pulmonary hypertension and athletes. Finally, one MR-based pediatric myocardial characterization toolkit. FAST FACTS of our ACHD faculty and ACHD fellows also developed Novel research initiatives include creation of a patient- July 2019 through June 2020 a national teaching series to provide education for ACHD specific flow modeling group that incorporates 3D fellows nationally during the COVID -19 surge. printing of physical models from advanced imaging and Heart Center Inpatient/Observation Cardiothoracic Intensive Care Unit (CTICU) physicians biomechanical flow modeling in the MR environment. The Inpatient Discharges:...... 702 Chillicothe Cardiology Clinic Visits:...... 313 are principal or co-investigators on five extramurally funded large animal cardiac imaging program continues to support Observation and Outpatient-in-a-Bed Discharges:...... 443 Dayton Cardiology (PAA) Clinic Visits:...... 176 grants and one intramural grant. In the last academic year, the needs of tissue-engineered vascular graft development Total Discharges:...... 1,129 Dublin Cardiology Clinic Visits:...... 1,026 they authored 19 manuscripts published in peer-reviewed group at Nationwide Children’s. Average Length of Stay*:...... 11.2 Findlay Cardiology Clinic Visits:...... 62 Kawasaki Clinic Visits:...... 59 journals. Twelve of the coauthored manuscripts were part of The Heart Center is currently engaged in 20 active Average Daily Census*:...... 21.1 Lewis Center Cardiology Clinic Visits:...... 1,571 national multicenter studies, including National Emergency quality improvement projects including major projects to Total Patient Days*:...... 7,701 Lima Cardiology (PAA) Clinic Visits:...... 365 Airway Registry for Children (NEAR4KIDS), Therapeutic improve communication between the CTICU and the Cardiac ICU Lima Memorial Cardiology (PAA) Clinic Visits:...... 11 Hypothermia After Pediatric Cardiac Arrest (THAPCA), step-down unit at the time of transfer, improving 14- Inpatient Discharges:...... 757 Acute Rehabilitation for Kids in the PICU (PARK-PICU) Mansfield ACHD Clinic Visits:...... 25 day clinic access for patients and central line-associated Average Length of Stay*:...... 4.7 and Collaborative Pediatric Critical Care Research Network Mansfield Cardiology Clinic Visits:...... 323 blood stream infection (CLABSI) reduction. As a result Average Daily Census*:...... 9.8 (CPCCRN). Additionally, eight abstracts were presented at Marietta Cardiology Clinic Visits:...... 260 of our communications projects, families have reported Total Patient Days*:...... 3,569 national and international scientific meetings. Marion Cardiology Clinic Visits:...... 138 higher satisfaction during their stay, and the completeness Heart Center Clinics The Fetal Cardiology program continues to grow, with over of provider-to-provider handoff for transfer patients has OSU Cardiology (PAA) Clinic Visits:...... 214 Athens Cardiology Clinic Visits:...... 69 1200 visits in 2019 at four sites throughout the region. improved. Optimization of the clinic scheduling process, Portsmouth Cardiology Clinic Visits:...... 225 Blanchard Cardiology (PAA) Clinic Visits:...... 35 Within the Ohio Fetal Medicine Collaborative, the team despite challenges imposed by COVID-19, has resulted Riverside Methodist Cardiology (PAA) Clinic Visits:...... 193 Cardio Diagnostics (PAA) Clinic Visits:...... 1,428 has developed standard-of-care protocols for fetuses with in a significant increase in timely clinic access for our Westerville Cardiology Clinic Visits:...... 270 Cardiology Clinic Visits (Main Campus):...... 10,600 bradycardia and tachycardia and enhanced collaboration patients. Finally, a multi-faceted approach, accentuated by Zanesville Cardiology Clinic Visits:...... 278 Cardiothoracic Surgery Clinic Visits:...... 413 with the Perinatal Palliative Care team. They have been physician engagement, to reduce CLABSIs in our patients *Excludes observation and outpatient-in-a-bed patients. actively involved in the planning and development of a has been very successful as we have gone >1 year and >250 hospital-wide multidisciplinary Fetal Medicine Program. days CLABSI free on our acute care cardiology ward and The fetal cardiac intervention program through the CTICU, respectively.

CARDIOLOGY A Decade of Remarkable Transformation Cardiology is a Section of the Department of Pediatrics and an integral part of The Heart Center at THE HEART CENTER Nationwide Children’s Hospital. See page 40 for complete details.

World's First Hybrid Catheterization Suite and Congenital Heart Fetal Intervention Operating Room Collaborative Launches Program Launches FACULTY Kan N. Hor, MD Anna N. Kamp, MD, MPH John Kelly, MD 2010 2010 2012 2014 20162013 2018 2017 20202017 Naomi J. Kertesz, MD Omar M. Khalid, MD Six-year-old Receives First Preeminent Tissue-Engineering Whole Exome Sequencing John P. Kovalchin, MD Bloodless Heart Transplant Program First in the World to Tissue Used to Identify Causes of Engineer Blood Vessels and Implant Congenital Heart Disease Lauren Lastinger, MD Them in Human Infants for Repair of Congenital Heart Defects Anthony Y. Lee, MD Simon Lee, MD The Heart Center at Nationwide Children’s is one of the nation’s top programs for diagnosis and treatment of congenital Kaitlin E. L’Italien, MD and acquired heart conditions in children. From fetal diagnosis and intervention, to long-term adult congenital care, our Eric A. Lloyd, MD Catherine D. Krawczeski, MD program has remained dedicated to providing the highest quality of comprehensive care. May L. Mah, MD Division Chief, Cardiology Deipanjan Nandi, MD Kathryn D. Nardell, MD Christina M. Phelps, MD Saurabh Rajpal, MD Kerry L. Rosen, MD Daniel G. Rowland, MD Aarthi Sabanayagam, MD Janet M. Simsic, MD Corey A. Stiver, MD Karen M. Texter, MD Robert J. Gajarski, MD, MHSA Andrew Tran, MD Section Chief, Cardiology Andrew R. Yates, MD Aimee K. Armstrong, MD Carl H. Backes, MD GRANTS AWARDED TO HEART CENTER Darren P. Berman, MD AND CARDIOVASCULAR RESEARCH FACULTY Brian A. Boe, MD JULY 1, 2019 – JUNE 30, 2020 Jessica L. Bowman, MD $2,302,971 Elisa A. Bradley, MD Steven C. Cassidy, MD SELECTED PUBLICATIONS John P. Cheatham, MD Armstrong AK, Berger F, Jones TK, Moore JW, Benson LN, Cheatham JP, Turner DR, Rhodes JF, Vincent JA, Zellers T, Lung T-H, Eicken A, McElhinney DB. Association Between Linda H. Cripe, MD Patient Age at Implant and Outcomes After Transcatheter Pulmonary Valve Replacement in the Multicenter Melody Valve Trials. Catheterization and Cardiovascular Interventions. 2019 Oct Clifford L. Cua, MD 1;94:607-617.

Curt J. Daniels, MD Drews JD, Pepper VK, Best CA, Szafron JM, Cheatham JP, Yates AR, Hor KN, Zbinden Timothy F. Feltes, MD JC, Chang YC, Mirhaidari GJM, Ramachandra AB, Miyamoto S, Blum KM, Onwuka EA, Zakko J, Kelly J, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Breuer J, Heuer Richard P. Fernandez, MD ED, West TA, Shoji T, Berman D, Boe BA, Asnes J, Galantowicz M, Matsumura G, Hibino N, Marsden AL, Pober JS, Humphrey JD, Shinoka T, Breuer CK. Spontaneous Reversal Jill A. Fitch, MD of Stenosis in Tissue-Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr Vidu Garg, MD 1;12(537). Raman SV, Hor KN, Mazur W, Cardona A, He Z, Halnon N, Markham L, Soslow JH, Jennifer Gauntt, MD Puchalski MD, Auerbach SR, Truong U, Smart S, McCarthy B, Saeed IM, Statland JM, Kissel Stephen A. Hart, MD JT, Cripe LH. Stabilization of Early Duchenne Cardiomyopathy with Aldosterone Inhibition: Results of the Multi-Center AIDMD Trial. Journal of the American Heart Association. 2019 Oct;8(19).

46 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 47 Simsic JM, Dolan K, Miller J, Yates AR, Fernandez R, Phelps C, Fitch J, Lee A, Lloyd E, Gauntt J, Gajarski R. Guidelines for Diuretic Utilization Reduce Practice Variation and Cost. 2019 – 2020 NATIONWIDE CHILDREN’S Pediatric Quality & Safety. 2019 Nov 25;4(6):e237. FELLOWSHIP PROGRAM Yates AR, Sutton RM, Reeder RW, Meert KL, Berger JT, Fernandez R, Wessel D, Newth, CJ, Carcillo JA, McQuillen PS, Harrison RE, Moler FW, Pollack MM, Carpenter TC, ADULT CONGENITAL HEART DISEASE Notterman DA, Dean JM, Nadkarni VM, Berg RA and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Anudeep Dodeja, MD Research Network. Survival and CPR Hemodynamics Following Cardiac Arrest in Children Marc Lee, MD with Surgical Compared to Medical Heart Disease. Pediatric Critical Care Medicine. 2019 Dec;20(12):1126-1136. ADVANCED NONINVASIVE CARDIAC IMAGING Carmen Kiper, MD

PEDIATRIC CARDIOLOGY Julie Aldrich, MD Jeffrey Bennett, MD Jason Cole, MD Tyler W. Cunningham, MD Christina M. Fink, MD Emily Hayes, MD Brittney Hills, MD Hannah Jacobs, DO Erin Nealon, MD

CHILD AND FAMILY ADVOCACY SELECTED PUBLICATIONS FAST FACTS Bressler CJ, Letson MM, Kline D, McCarthy T, Davis J, Leonard JC. Characteristics The Section of Child and Family Advocacy housed within the Center for Family Safety and Healing at of Neighborhoods Where Emergency Medical Services Encounter Children at Risk for Maltreatment. Prehospital Emergency Care. 2019 Sep-Oct;23(5):672-682. July 2019 through June 2020 Nationwide Children’s Hospital is home to a team of board-certified child abuse pediatricians and advanced- Hornor G, Sherfield J, Tscholl J. Teen Knowledge of Commercial Sexual Exploitation of Clinic Visits:...... 1,528 practice nurse practitioners who are nationally recognized child maltreatment experts with an emphasis Children. The Journal of Pediatric Health Care.2020 May 1;34(3):239-245. Foster Care Clinic Visits:...... 1,448 on physical abuse, sexual abuse and medical child abuse. The Center for Family Safety and Healing is a Letson MM, Davis C, Sherfield J, Beer OWJ, Phillips R, Wolf KG. Identifying Compassion Satisfaction, Burnout, & Traumatic Stress in Children’s Advocacy Centers. Sharon Woods Foster Care Clinic Visits:...... 316 multidisciplinary organization that provides coordinated and comprehensive services in the prevention, Child Abuse & Neglect. 2019 Nov 8;104240. diagnosis and treatment of family violence. As a national leader in this important work, a team of more than Zins ZP, Wheeler KK, Brink F, Armstrong M, Shi J, Groner JI, Xiang H. Trends in US Eastland Foster Care Clinic Visits:...... 220 Physician Diagnosis of Child Physical Abuse and Neglect Injuries. 2006-2014. Child 120 professionals representing medicine, behavioral health, social services, law enforcement, prosecution and Abuse & Neglect. 2019 Dec; 98:104179. Inpatient Consults (Child Abuse Team):...... 553 children services are co-located at the center to address the complex issues of family violence. Non-Accidental TBI Clinic Visits:...... 48 Total Clinic Visits:...... 3,560

FACULTY three different locations and serves as a medical home for children in out-of-home placement. 2019 – 2020 NATIONWIDE CHILDREN’S The section remains committed to providing quality educational experiences for trainees, including medical FELLOWSHIP PROGRAM student and pediatric resident electives. Under the direction of Megan M. Letson, MD, MEd, the Child CHILD ABUSE PEDIATRICS Abuse Pediatrics Fellowship is an Accreditation Council Nicole Barrett, MD for Graduate Medical Education-accredited program Michelle Greene, DO (Combined Child Abuse Pediatrics and continues to attract excellent trainees. Additionally, and Pediatric Emergency Medicine Fellow) in collaboration with Pediatric Emergency Medicine, we are one of a few programs nationally to offer a combined Megan M. Letson, MD, MEd four-year Child Abuse Pediatrics and Pediatric Emergency Chief Medicine Fellowship. Farah W. Brink, MD Members of the section continue to be recognized nationally, including representation on the American Kristin G. Crichton, DO, MPH Board of Pediatrics Sub-board on Child Abuse Pediatrics Catherine M. Huber, MD and on multiple Ray Helfer Society committees. Additionally, faculty continue a tradition of national Jennifer J. Tscholl, MD speaking engagements, including the Huntsville The Section of Child and Family Advocacy provides International Symposium on Child Abuse. During comprehensive evaluation and management of child the past year, faculty work has been presented at the maltreatment, offering inpatient and outpatient services. American Academy of Pediatrics National Conference and Key services include the Child Assessment Center, Exhibition, American Public Health Association, Society Fostering Connections Program, Non-Accidental for Pediatric Radiology Annual Meeting, and the Ray Traumatic Brain Injury Clinic and inpatient consultations. Helfer Society Annual Meeting. The Child Assessment Center offers a coordinated

response to family violence for families through GRANTS AWARDED partnerships with law enforcement, children services and JULY 1, 2019 – JUNE 30, 2020 a range of community resources. Through a collaborative effort with the Emergency Department, we provide $2,585,946 suspected child abuse assessments after clinic hours by utilizing on-call forensic interviewers and pediatric sexual assault nurse examiners in the emergency department setting. As a clinical partnership with Franklin County Children Services, the Fostering Connections Program is offered at

Sezgin E, Noritz G, Elek A, Conkol K, Rust S, Bailey M, Strouse R, Chandawarkar A, CLINICAL INFORMATICS von Sadovszky V, Lin S, Huang Y. Capturing At-Home Health and Care Information for Children with Medical Complexity Using Voice Interactive Technologies: The Division of Clinical Informatics at Nationwide Children’s Hospital aims to transform health care Multi-Stakeholder Viewpoint. The Journal of Medical Internet Research. 2020 Feb through design, implementation and optimization of information and communication systems. Our goal 13;22(2):e14202. Stukus D, Patrick M, Nuss KE. Social Media for Medical Professionals – Strategies for is to enhance patient care activities with safe and reliable information systems, improve individual and Successfully Engaging in an Online World. 2019. Cham, Switzerland: Springer International population health outcomes through the use of technology and digital tools, enable innovation and research Publishing AG; 2019. across the institution, and empower our patients and families with the tools they need to engage effectively 2019 – 2020 NATIONWIDE CHILDREN’S with their health care team and our health care system. FELLOWSHIP PROGRAM

CLINICAL INFORMATICS FACULTY new documentation and decision support tools for Jennifer A. Lee, MD COVID-19. We collaborated on the deployment of the Samuel Yang, MD region’s first pediatric drive-through COVID-19 testing center and rapidly implemented a new telehealth platform across dozens of locations and hundreds of providers so that patients and families could remain safely at home while getting the care they needed. Within two months, we had conducted over 100,000 telehealth visits across a wide array of specialties and services.

At the same time, we provided the new Big Lots Behavioral Health Pavilion staff with technology and Jeffrey M. Hoffman, MD tools to address their unique patient needs. We continued Chief to refine our pediatric sepsis detection model, which the software company Epic adopted as their standard Aarti R. Chandawarkar, MD predictive model, offered free of charge to other children’s Juan D. Chaparro, MD, MS hospitals across the country. We revamped our influenza vaccination decision support tools, which led to 5,000 Jennifer A. Lee, MD more vaccinated children this season than last. Overall, Simon Lin, MD, MS, MBA despite these unprecedented times, we have many great Kathryn E. Nuss, MD accomplishments to celebrate this year, not the least of which is our most recent fellowship graduate, Dr. Jennifer Laura Rust, MD, MPH Lee, who will be joining our division permanently. The faculty and fellows in the Division of Clinical GRANTS AWARDED Informatics work to enhance the effectiveness of our JULY 1, 2019 – JUNE 30, 2020 clinical information systems and to provide expert consultation to operational leaders, clinicians and $72,100 investigators across the institution. We collaborate with other divisions and disciplines to improve tools for clinical SELECTED PUBLICATIONS documentation, patient management, population health, Chaparro JD, Hussain C, Lee JA, Hehmeyer J, Nguyen M, Hoffman J. Reducing Interruptive Alert Burden Using Quality Improvement Methodology. Applied Clinical quality improvement and research. Informatics. 2020 Jan;11(1):46-58.

Gorham TJ, Rust S, Bambach S, Rust L, Hoffman J, Huang Y, Lin S, Bode R, Maa T. No doubt 2020 will be a year to be remembered. In the The Vitals Risk Index-Retrospective Performance Analysis of an Automated and Objective face of a pandemic, our division worked tirelessly with our Pediatric Early Warning System. Pediatric Quality & Safety. 2020 Mar 20;5(2):e271. colleagues to provide the best patient care and the safest Mezoff EA, Minneci PC, Hoyt RR, Hoffman JM. Toward an Electronic Health Record working environment possible. Within a few weeks, our Leveraged to Learn from Every Complex Patient Encounter: Health Informatics Considerations with Pediatric Intestinal Rehabilitation as a Model. The Journal of division worked with clinical and IT teams to develop Pediatrics. 2019 Dec;215:257-263.

COMMUNITY PEDIATRICS Megan E. Heitzman, MD Bruce P. Meyer, MD Phillip N. Simon, MD David E. Henderson, MD Leslie C. Meyers-Joseph, MD Rebecca M. Slaunwhite, MD The Section of Community Pediatrics at Nationwide Children’s Hospital includes community physicians Christopher B. Houts, MD Cameron K. Miller, MD Brandi F. Spitler, DO in pediatrics and internal medicine/pediatrics who are affiliated with Nationwide Children’s. Many Elizabeth M. Jacob, MD Bruce R. Mirvis, MD Donna L. Sterling, MD of these physicians participate in the Pediatric Education in Community Sites (PECS) program. This Julie R. Javorek, MD Stacy L. Morran, MD Nicholas S. Stevens, MD provides residents with a very different kind of outpatient experience than that of a traditional hospital- Ranee M. Jostpille, MD Matthew J. Morrison, MD Wendy K. Stevens, MD based practice. Beginning in their first or second year, each resident is assigned to an additional half-day Enaas F. Kasheer, MD Mark A. Muresan, MD Kathleen C. Stiles, MD continuity experience in a private practice. This offers thorough exposure to general pediatric practice and Stephen L. Kebe, MD Jill A. Neff, DO Miller J. Sullivan, Jr., MD reinforces the relationship between Nationwide Children’s and the community physicians. Lisa A. Kelch, MD Mary-Lynn Niland, MD Nazhat Taj-Schaal, MD Andrew M. Keller, MD Autumn M. O’Brien, MD Ellen R. Tamburello, MD Kimberly K. Blazer, MD Kevin M. Dickerson, MD Sara M. Kelly, MD Adebomi A. Omikunle, MD Katrina S. Tansky, MD Denise L. Blocker, MD Bradley E. Dickson, MD Richard A. Kern, MD Janet S. Orr, MD Renee S. Taylor, MD Eileen C. Bolton, MD Dawn C. Dillinger, DO Anja Kiel, MD Lilliam I. Ortiz, MD Amy Rachelle A. Teleron- Wanda C. Boudinot, MD Kent W. Doherty, DO Cheryl K. Kirkby, MD Laura E. Osthaus, MD Khorshad, MD Sandra L. Boyle, MD Lorna F. Donovan, MD Adam M. Kirkland, MD Jennifer Killion Overbey, MD Timothy A. Teller, MD Richard J. Breen, MD Dennis M. Doody, MD Elizabeth L. Kirkland, MD Divya S. Parikh, MD Mark A. Thoma, MD Steven Randall Brown, MD James R. Dorado, MD William E.C. Knobeloch, MD Melissa M. Parsons, MD Craig R. Thompson, MD James A. Bryant, MD Julie M. Dunlea, MD Irene P. Koesters, MD Jacqueline S. Pennywitt, MD Kristin E. Thompson, MD Michelle S. Buendia, MD Kimberly A. Eilerman, DO Stephen C. Koesters, MD Michael A. Perry, MD John D. Toth, MD Robert W. Snyder, MD Kyle Burghgraef, MD Alicia D. Fenn, MD Maureen P. Kollar, DO Richard A. Petrella, MD Bonny M. Tsai, MD Chief Jennifer L. Burkam, MD Emily T. Ferguson, MD Andrew S. Korcal, MD Brad T. Pfau, MD Ahmed J. Turjoman, MD Shari L. Burns, MD Lenora A. Fitton, DO Wahida B. Abaza, MD Katherine J. Krueck, MD Laura D. Phillips-Chou, MD H. Scott Tyson, MD Bethany J. Caldwell, MD Patricia A. Francis, MD Nikola T. Al-ain, MD Justin K. Krueger, MD Domenico Pietropaolo, MD Sean M. Vellucci, MD Mitchell R. Camp, MD Michael R. Franks, MD Ilona B. Albrecht, DO Lisa A. Krumm, MD Phyllis Jo Polas, DO Victoria N. Vinsant, MD Jennifer H. Campbell, MD Brad E. Fuller, MD Benjamin P. Almasanu, DO Celina M. LaBrec-Salmons, MD L. Robert Polster, MD Diana T. Wagner, MD Patricia A. Cannon, MD Kathleen T. Fulop, MD Lacey J. Althausen, MD Robert C. LaMonte, MD Danielle S. Pottinger, MD Laura E. Walawender, MD Stephen M. Canowitz, MD Patricia T. Gabbe, MD Mary S. Applegate, MD Kristina M. Lehman, MD M. Bonnie Pugh, MD James D. Ward, MD Ali M. Carine, DO Raju R. Gaglani, MD Nardia S. Ataman, MD Michael J. Leymaster, MD Blake J. Randolph, MD Lawrence B. Watkins, MD Jennifer B. Carlos, MD Barbara B. Galantowicz, MD Jennifer E. Bachman, MD Bradley A. Lisko, MD Barbara B. Rayo, MD Olivia N. Westhoven, MD Mary B. Cass, MD Jessica M. Gefvert, MD Taylor A. Ballenger, MD Elizabeth A. Little, MD Teresa R. Recker Gross, DO Ray S. Wheasler, III, MD Benjamin W. Cole, MD Monica C. Gilbert, MD Richard A. Baltisberger, MD Anne D. Littleton, MD Robert D. Reis, MD Elizabeth R. Whitaker, MD Kathleen A. Costlow, MD Kathryn L. Ginocchi, MD Lauren C. Bar-Lev, MD Michael C. Loar, MD Darryl A. Robbins, DO Jennifer R. White, MD Sidney L. Couling, MD Jumana C. Giragos, MD Carrie J. Barnes-Mullett, MD William W. Long, MD Ann M. Rogers, MD Matthew M. White, MD Jeffrey W. Crecelius, MD Charles M. Goddard, MD Brent M. Barson, DO Tricia W. Lucin, MD J. Tyler Rogers, MD Melissa D. Winterhalter, MD Elizabeth A. Crickard, DO Erin L. Goist, MD Ryan M. Barson, MD Eileen M. Maher, MD Patricia A. Ryan, MD Kathleen M. Wodarcyk, MD Ann M. Croft, MD Michelle C. Golla, MD Courtney R. Bartsch, MD Michele V. Mahoney, MD Purbi S. Sahai, MD Lindsay A. Wylie, MD Camilla Curren, MD Anna C. Gray, MD Steven M. Bass, DO Jason W. Mailloux, MD Timothy R. Savage, MD Michelle E. Yaw, MD Omolara Y. Dairo, MD Emily K. Gray, MD Heather A. Battles, MD Gwynette M. Marschall, MD Erin K. Schaffner, MD Becky Zhao, MD Virginia K. De Verteuil, MD Patrick J. Gross, DO Stephen R. Bauer, DO Jennifer J. Mastruserio, MD Elizabeth A. Schloss, MD Amy E. Deibel, MD Dawn S. Hackshaw, MD Sarah A. Behrens, MD Derek A. McClellan, MD Dana J. Schultz, MD Antonio J. DelRosario, MD Dana L. Hamilton, DO Anne M. Bever, MD Donna J. McDonald, MD W. Andrew Searcy, MD Traci A. DeVoe, MD Daniel J. Heinmiller, MD Cynthia J. Black, MD Meera R. Mehta, MD Eileen H. Sheets, MD Praveena V. Dhawale, MD John S. Heintz, MD Kathleen D. Blake, MD George M. Messick, MD Larry M. Shepherd, MD Michael T. DiBartola, MD Lawrence P. Heiny, MD

FAST FACTS COMPLEX CARE July 2019 through June 2020 The Division of Complex Health Care at Nationwide Children’s Hospital provides comprehensive, Inpatient Discharges:...... 82 Average Daily Census*:...... 1.2 coordinated and holistic care to children and adults with neurodevelopmental disabilities. For some patients Observation and Outpatient-in-a-Bed Discharges:...... 160 Patient Days*:...... 456 with complex issues, we are their primary care doctor and “medical home.” For others, we partner with their medical home and specialists to provide expert neurodevelopmental care. Our services include the Total Discharges:...... 241 *Excludes observation and outpatient-in-a-bed patients. comprehensive Cerebral Palsy Program, and the comprehensive Feeding and Swallowing Program. Our Average Length of Stay*:...... 5.6 faculty participate in the interdisciplinary Spinal Muscular Atrophy Clinic, the Early Developmental Clinic, the Adult Down Syndrome Clinic at the Nisonger Center, and provide medical care to the residents of the 2019 – 2020 NATIONWIDE CHILDREN’S Heinzerling Foundation. FELLOWSHIP PROGRAM FACULTY program. She is an internationally recognized expert CLINICAL FELLOWSHIP IN QUALITY & SAFETY LEADERSHIP in the medical care of children with cerebral palsy and Tara Cosgrove, MD other disabilities. Veronica M. Mruk, MD Anja Zann, MD The comprehensive Cerebral Palsy Program at Nationwide Children’s is the lead site for the Cerebral Palsy Research Network. By linking 28 centers in the United States and Canada, we are working to improve treatments and outcomes for people with cerebral palsy through high-quality clinical research and quality initiatives. In partnership with the nationally recognized Early Development Clinic, where early diagnosis of Garey Noritz, MD cerebral palsy is a priority, we have improved the clinical Chief transition for patients with cerebral palsy from infancy through childhood. We also run one of the few adult cerebral palsy clinics in the United States.

The comprehensive Pediatric Feeding and Swallowing Program at Nationwide Children’s provides evaluation and treatment of complex feeding disorders and is one of only a handful in the country to offer an intensive feeding program. One of the major outcomes is reduction in the need for enteral tube feeding. Other outcomes focus on increased enjoyment in eating, family stress reduction and nutritional optimization.

Laurie Glader, MD Our faculty continue to be a sought-after resource for Section Chief mentoring and education, with invited lectures locally, nationally and internationally. Our non-physician Rukshana Ahmed, MD staff are leaders in training their colleagues in nursing, Wendy Burdo-Hartman, MD nutrition, pharmacy, social work and allied therapies in the provision of family-centered care for children and Derek Fletcher, MD adults with disabilities. Elizabeth Lucas, MD Members of our faculty have leadership positions at Katherine Steingass, MD leading national organizations, including the American Joy Walton, MD Academy of Pediatrics, the Society for Developmental and Behavioral Pediatrics, the Pediatric Feeding This year, we welcomed Laurie Glader, MD, as our Consortium and the American Academy for Cerebral section chief and medical director of the Cerebral Palsy Palsy and Developmental Medicine.

SELECTED PUBLICATIONS CRITICAL CARE MEDICINE Begley KA, Braswell LE, Noritz GH, Murakami JW. Salivary gland ablation: introducing an interventional radiology treatment alternative in the management of sialorrhea. Pediatric Radiology Journal. 2020;50(6):869-76. The Section of Critical Care Medicine at Nationwide Children’s Hospital provides in-house faculty coverage Hart LC, Crawford M, Crawford P, Noritz G. Practical Steps to Help Transition Pediatric of the Pediatric Intensive Care Units (PICUs) 24 hours a day and is dedicated to the care of children who Patients to Adult Care. The Journal of Pediatrics.2019;144(6). have, or are at risk for, life-threatening illnesses across the spectrum of pediatric disease. This service also Lucas E. Medical Management of Neurogenic Bladder for Children and Adults: A Review. Topics in Spinal Cord Injury Rehabilitation. 2019;25(3):195-204. contributes actively to the vital missions of research and advanced training in the field of pediatric critical Lucas E, Leber A, Ardura MI. Broad-range PCR Application in a Large Academic Pediatric Center: Clinical Value and Challenges in Diagnosis of Infectious Diseases. The care medicine. This service cares for approximately 3,000 patients per year, covering up to 54 PICU beds Pediatric Infectious Disease Journal. 2019;38(8):786-90. at Nationwide Children’s and contributing to the coverage of the 20-bed cardiothoracic ICU. Therapies Statter MB, Noritz G, Committee On Bioethics Council on Children with Disabilities. Children With Intellectual and Developmental Disabilities as Organ Transplantation such as extracorporeal membrane oxygenation, high frequency oscillatory ventilation, and continuous renal Recipients. The Journal of Pediatrics.2020;145(5). replacement therapies are available at all times. We continue to boast one of the lowest rates of hospital- acquired infection and preventable harm of any PICU in the country. We also staff the Assessment and Consultation Team, a multidisciplinary rapid response team, and the Pediatric Analgesia and Sedation Service. FAST FACTS

July 2019 through June 2020 FACULTY Jill A. Fitch, MD Inpatient Discharges:...... 349 Patient Days*:...... 2,395 W. Joshua Frazier, MD Observation and Outpatient-in-a-Bed Discharges:...... 46 Inpatient Consults:...... 43 Jennifer M. Gauntt, MD Average Length of Stay*:...... 6.90 Complex Health Care Clinic Visits:...... 6,775 Samantha W. Gee, MD, FAAP Average Daily Census*:...... 6.56 *Excludes observation and outpatient-in-a-bed patients. Todd J. Karsies, MD, MPH Anthony Y. Lee, MD, FAAP Ada T. Lin, MD, FAAP Eric A. Lloyd, MD Marlina E. Lovett, MD Mark W. Hall, MD, FAAP, FCCM Jeffrey E. Lutmer, MD Division Chief Tensing Maa, MD, FAAP Christopher P. Montgomery, MD Jennifer A. Muszynski, MD, MPH, FCCM Nicole F. O’Brien, MD Danna W. Qunibi, MD Claire A. Stewart, MD, MEd Markita L. Suttle, MD Joseph D. Tobias, MD

Nadeem Khan, MD, FAAP Andrew R. Yates, MD Section Chief The section remains a leader in pediatric critical Onsy S. Ayad, MD, FAAP care research, with robust ongoing participation in Richard J. Brilli, MD, FAAP, MCCM single- and multi-center studies. In 2019, Nationwide Children’s Hospital continued its participation as Margaret A. Chase, MD one of only eight sites in the country in the National Melissa G. Chung, MD Institutes of Health-funded Collaborative Pediatric Critical Care Research Network. Division Chief Megan C. Daniel, MD Mark W. Hall, MD, is a national leader in the field Maria H. Estrada, DO, FAAP of immunobiology research and led two multicenter

clinical trials of immunostimulation in the setting of FAST FACTS DERMATOLOGY pediatric critical illness and injury in 2019. Examples of other areas of research focus for the pediatric critical July 2019 through June 2020 The Section of Dermatology at Nationwide Children’s Hospital sees outpatients from birth through age care medicine faculty include Staphylococcus aureus PICU Admissions:...... 3,216 21 for both common and rare disorders of the hair, skin and nails. microbiology (Montgomery), cerebral malaria and global Average Length of Stay*:...... 4 health (O’Brien), transfusion science (Muszynski), FACULTY Other highlights of the 2019-2020 academic year respiratory infections (Karsies), anesthesiology (Tobias), Average Daily Census*:...... 33 include the acquisition of an excimer laser for our resuscitation (Yates), and quality and safety (Brilli, Total Patient Days*:...... 12,167 phototherapy program, providing another treatment Ayad). With this broad scientific portfolio, an in-situ Inpatient Discharges:...... 3,267 option for families with vitiligo and psoriasis. research laboratory within the PICU, and four divisional Number of Beds:...... 54 research coordinators, the section remains at the Additionally, the division began offering treatment with forefront of innovation in the field. *Excludes observation and outpatient-in-a-bed patients. the CO2 laser, a useful treatment for scars and some birthmarks. Our Accreditation Council for Graduate Medical Education-approved Pediatric Critical Care Medicine SELECTED PUBLICATIONS 2019 – 2020 NATIONWIDE CHILDREN’S Fellowship provides rigorous clinical and academic Amigo M, Milani-Nejad N, Mosser-Goldfarb J. Periocular Tinea Faciei. The Journal of training for the next generation of ICU faculty, FELLOWSHIP PROGRAM Pediatrics. 2020 Jun;221:255-256. accepting four fellows per class in our three-year Bjorklund KA, Fernandez Faith E. Branching Hypopigmentation Following Intralesional program. The Critical Care Medicine faculty participate Patricia M. Witman, MD Corticosteroid Injection: Case Report and Review of the Literature. Pediatric Dermatology. PEDIATRIC CRITICAL CARE MEDICINE 2020 Jan; 37(1):235-236. in instruction for the pediatric and surgical residency Austin Biggs, MD Chief Milani-Nejad N, Mosser-Goldfarb J. Congenital Onychodysplasia of Index Fingers: Iso- programs, as well as multiple other fellowship programs. Katherine Bline, MD Esteban Fernández Faith, MD Kikuchi Syndrome. The Journal of Pediatrics. 2020 Mar;218:254-254.e1 A PICU elective is also provided for fourth-year medical Claire Christian, MD Katya Harfmann, MD Reichert B, Fernandez Faith E, Harfmann K. Weight Counseling in Pediatric students. Loren Farley, MD Hidradenitis Suppurativa Patients. Pediatric Dermatology. 2020 May;37(3):480-483. Holly Gillis, MD Joy Lynn Mosser-Goldfarb, MD Ring N, Craiglow B, Panse G, Antaya R, Ashack K, Ashack R, Fernandez Faith GRANTS AWARDED Kelley Groves, MD E, Paller A, McNiff J, Chaote K, Ko C. Histopathologic Findings Characteristic of JULY 1, 2019 – JUNE 30, 2020 Will Guider, MD CARD14-Associated Papulosquamous Eruption. Journal of Cutaneous Pathology. 2020 Although 2020 was the year we originally planned May;47(5):425-430. $1,128,271 Hunter Johnson, MD to launch telemedicine services in the section of Takaharu Karube, MD Dermatology, the challenges brought by the COVID-19 SELECTED PUBLICATIONS Taylor Nickerson, MD pandemic accelerated that plan tremendously. FAST FACTS Lovett ME, Maa T, Moore-Clingenpeel M, O’Brien NF. Transcranial Doppler Ultrasound Rachel Poeppelman, MD Fortunately, the visual nature of dermatology is Findings in Children with Moderate-to-Severe Traumatic Brain Injury Following Abusive Sara Sanders, MD Head Trauma. Child’s Nervous System. 2020 May;36(5):993-1000. especially well-suited for telemedicine, and we were able July 2019 through June 2020 to rapidly implement video visits in April 2020, leading Si Y, Zhao F, Beesetty P, Weiskopf D, Li Z, Tian Q, Alegre ML, Sette A, Chong AS, Canal Winchester Dermatology Clinic Visits: ...... 635 only to a temporary partial interruption in dermatology Montgomery CP. Inhibition of Protective Immunity Against Staphylococcus Aureus Infection Dermatology Clinic Visits: ...... 7,140 by Mhc-Restricted Immunodominance is Overcome by Vaccination. Scientific Advances. services when the pandemic hit Ohio. Now in the 2020 Apr 1;6(14):eaaw7713. fine-tuning stages, we plan to continue telemedicine as Dublin Dermatology Clinic Visits: ...... 2,513 Sribnick EA, Weber MD, Hall MW. Innate Immune Suppression after Traumatic Brain a valuable addition to the in-person outpatient clinics Westerville Dermatology Clinic Visits: ...... 689 Injury with Hemorrhagic Shock in a Juvenile Rat Model of Polytrauma. The Journal of that are now open again. In fact, families now enjoy the Neuroimmunology. 2019 Dec 15;337:577073. Total Clinic Visits: ...... 10,977 ability to choose either a telemedicine or in-person visit Ziemba KJ, Kumar R, Nuss K, Estrada M, Lin A, Ayad O. Clinical Decision Support Tools for most problems when making an appointment in Inpatient Consults: ...... 164 and a Standardized Order Set Enhances Early Enteral Nutrition in Critically Ill Children. Nutrition in Clinical Practice. 2019 Dec;34(6):916-921. Dermatology. In 2019-2020, we also began offering the option for Child Life Services to assist children while having procedures performed at our main campus outpatient clinic. This service, which utilizes the expertise of a dedicated Child Life specialist, helps to make procedures performed in the dermatology clinics less anxiety- provoking and more pleasant. We also continue to offer the option for children to have procedures performed under general anesthesia at either the Westerville Surgery Center or the Main Campus Surgery Center.

DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS FAST FACTS 2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM The mission of the Division of Developmental and Behavioral Pediatrics at Nationwide Children’s Hospital July 2019 through June 2020 is to achieve best outcomes for children with developmental and behavioral needs through evidence-based, Child Development Center Visits:...... 2,041 family-centered, interprofessional practice. Outpatient services include comprehensive care delivered by DEVELOPMENTAL BEHAVIORAL PEDIATRICS developmental and behavioral pediatricians and advanced nurse practitioners in partnership with pediatric Developmental Disabilities Clinic Visits:...... 112 SECOND YEAR Juan Lozano, MD psychology and other health care professionals. Areas of expertise include the evaluation and management Myelomeningocele Clinic Visits:...... 625 FIRST YEAR of complex ADHD, Autism Spectrum Disorders and developmental delay. Additional focus areas include Developmental Behavioral Pediatrics Clinic Visits:....5,377 Elizabeth Barnhardt, DO myelomeningocele, neonatal follow-up, Down syndrome and Williams syndrome. The division often Rohan Patel, MD provides care in collaboration with programs through Nationwide Children’s Hospital’s Behavioral Health Services.

FACULTY including medical directorship of the Autism Treatment Network. Rebecca Baum, MD, also held multiple roles on national committees related to pediatric mental health. Anita R. Narayanan, MD, leads the division’s quality improvement efforts to reduce environmental stressors faced by Developmental and Behavioral Pediatrics patients and reduce missed appointments. Lindsay Bartram, DO, leads a QI initiative to improve transition to adult care for DBP patients. Jennifer Walton, MD, MPH, is co-director of the Nationwide Children’s Williams Syndrome Clinic and chair of the pediatrics section of the National Medical Association. Amy Newmeyer, MD Katherine Steingass, MD, serves as medical director of Interim Chief the Nationwide Children’s Myelomeningocele Clinic and as a PI on the National Spina Bifida Patient Registry. Lindsay Bartram, DO Patricia L. Nash, MD, serves as medical director of the Nationwide Children’s Down Syndrome Program. Daniel L. Coury, MD Anita R. Narayanan, MD The division continues to support a robust fellowship program led by Dr. Katherine Steingass. The fellowship Patricia L. Nash, MD is integrated with The Ohio State University’s Leadership Katherine Steingass, MD Education in Neurodevelopmental Disabilities program Jennifer Walton, MD, MPH at the Nisonger Center, with Dr. Walton serving as the program’s associate director.

GRANTS AWARDED The Division of Developmental and Behavioral JULY 1, 2019 – JUNE 30, 2020 Pediatrics at Nationwide Children’s is led by Amy Newmeyer, MD. A visiting associate professor of $279,778 pediatrics at The Ohio State University College of Medicine, Dr. Newmeyer serves on the American Board SELECTED PUBLICATIONS of Psychiatry and Neurology NDD Committee and as Barnhardt E, Baum R, Winerman M, Vandana P, Tabern KB, Augustyn M. When to Raise Our White Flag-A Discussion of Scope of Practice in a Resource Scarce World. the Nationwide Children’s site medical co-director for Journal of Developmental and Behavioral Pediatrics. 2020 Feb/Mar;41(2):157-160.

the Autism Learning Health Network. Bartram LA, Lozano J, Coury DL. Aripiprazole for treating irritability associated with autism spectrum disorders. Expert Opinion on Pharmacotherapy. 2019 Aug;20(12):1421- Faculty in the division contribute at the local and 1427. national levels to improve clinical outcomes and Santoro SL, Cannon S, Capone G, Nash P, Steingass K, et al. Unexplained regression in Down syndrome: 35 cases from an international Down syndrome database. Genetics in reduce avoidable harm. Daniel L. Coury, MD, holds Medicine. 2020 Apr;22(4):767-776. multiple national administrative and research roles,

EMERGENCY MEDICINE Manuel Lugo, MD East Columbus, Hilliard, Marysville and Westerville. Timothy Mcclung, MD The Emergency Department is a hub for medical The Emergency Department at Nationwide Children’s Hospital is one of the nation’s highest-ranked and education in the acute care of children, adolescents and Ellen McManus, MD busiest pediatric emergency departments (based on Children’s Hospital Association benchmarking data selected adults. Medical students and more than 300 and Parents magazine). Emergency Medicine features a Level I Pediatric Trauma Center and ED staffed by Jennifer Melvin, MD residents from Emergency Medicine, Family Practice, board-certified/eligible pediatric emergency medicine subspecialists 24 hours a day. Leah Middelberg, MD Internal Medicine/Pediatrics and Pediatrics programs are educated in all aspects of pediatric emergencies. In Leslie Mihalov, MD addition, Nationwide Children’s has a large, vibrant Jennifer Mitzman, MD FACULTY Brian Bowden, MD Pediatric Emergency Medicine Fellowship program. Rustin Morse, MD Members of the Section of Emergency Medicine are Mary Bowman, MD Jennifer Mrozek, MD active leaders and participants in the residency program Beth Bubolz, MD at Nationwide Children’s and at The Ohio State Kathy Nuss, MD Michael Chua, MD University College of Medicine. Nkeiruka Orajiaka, MD Cullen Clark, MD The Department of Emergency Medicine was integral Jimisha Patel, MD Beth Claxton, MD in the successful opening of the Psychiatric Crisis Michael Patrick, MD Department at the Big Lots Behavioral Health Daniel Cohen, MD Pavilion (BHP) in 2020. Concurrently with the BHP Jan Perry, MD Melanie Copenhaver, DO opening, Emergency Medicine successfully navigated Jonathan Price, MD Carrie DeHoff, MD the challenges presented by COVID-19 by playing a Sheela Rao, MD significant role in the implementation of a drive-up Lori Deschene, MD Rachel M. Stanley, MD, MHSA Maegan Reynolds, MD COVID-19 testing facility. Division Chief Meghan Dishong, MD Laura Rust, MD In addition to providing clinical, operational and Michael Dunn, MD educational excellence, Emergency Medicine has a Mary Ryan, MD Meika Eby, MD strong history of clinical research. We lead the federally Daniel Scherzer, MD Emile Elshammaa, MD funded Great Lakes node of the Pediatric Emergency Betsy Schmerler, MD Care Applied Research Network (PECARN), a large Joelle Farlow, MD Emily Sentman, MD 18-hospital research network. We have developed Rachel Feldkamp, MD research collaborations with the Columbus Division Bashar Shihabuddin, MD Aarti Gaglani, MD of Fire and other emergency medical service agencies John Sotos, MD regionally and nationally. The section is committed to Adam Garlock, MD Sandra Spencer, MD the ongoing improvement of health care delivery in the Yaffa Gewirtz, MD Emergency Department and in clinical outcomes. Gregory Stewart, MD Delia Gold, MD Kristin Stukus, MD GRANTS AWARDED Michael Stoner, MD Angela Harris, MD Jerry Stultz, MD JULY 1, 2019 – JUNE 30, 2020 Section Chief Karla Hauersperger, MD Kathleen Sugrue, MD $1,806,663 Alana Albano, MD Todd Holman, MD Bethany Uhl, MD SELECTED PUBLICATIONS Barbara Amakye, MD Daniela Humphrey, MD Rishi Verma, MD Bressler CJ, Letson MM, Kline D, McCarthy T, Davis J, Leonard JC. Characteristics Adjoa Andoh, MD Maya Iyer, MD of Neighborhoods Where Emergency Medical Services Encounter Children at Risk for Tracey Wagner, MD Maltreatment. Prehospital Emergency Care Journal. 2019;23(5):672-682. Srikanth Aravapalli, MD Iram Jafri, MD Jordee Wells, MD Chamberlain JM, Kapur J, Shinnar S, Elm J, Holsti M, Babcock L, Rogers A, Barsan Brett Ballard, MD Chris Jones, DO W, Cloyd J, Lowenstein D, Bleck TP, Conwit R, Meinzer C, Cock H, Fountain Jessica Wilson, MD NB, Underwood E, Connor JT, Silbergleit R, Neurological Emergencies Treatment Terry Barber, MD Simmi Dogra Kulkarni, MD Trials; Pediatric Emergency Care Applied Research Network investigators. Efficacy of Morgan Wurtz, MD Levetiracetam, Fosphenytoin, and Valproate for Established Status Epilepticus by Age Robert Baun, MD Catherine Lambert, MD Group (ESETT): A Double-Blind, Responsive-Adaptive, Randomized Controlled Trial. Jennifer Wyse, MD The Lancet.2020 Apr 11;395(10231):1217-1224. Berkeley Bennett, MD Marc Leder, MD Anita Yalamanchi, DO Kapur J, Elm J, Chamberlain JM, Barsan W, Cloyd J, Lowenstein D, Shinnar S, Conwit Luciana Berg, MD Julie Leonard, MD R, Meinzer C, Cock H, Fountain N, Connor JT, Silbergleit R, for the NETT and PECARN investigators. Randomized Trial of Three Anticonvulsant Medications for Status Deborah Blackwell, MD Rachel Levine, MD The Emergency Department provides expertise in Epilepticus. The New England Journal of Medicine.2019 Nov 28;381(22):2103-2113. Alan Bleiberg, MD Celia Ligorski, DO pediatric advanced life support and resuscitation, as Lo CB, Bridge JA, Shi J, Ludwig L, Stanley RM. Children's Mental Health Emergency well as evaluation and treatment in every area for acute Department Visits: 2007-2016. Pediatrics. 2020 Jun;145(6):e20191536. Bema Bonsu, MD Seth Linakis, MD medical and surgical conditions. Off-site urgent care Wagner TL, Dunn MW, Iyer MS, Buckingham D, Spencer SP. A Quality Improvement Initiative to Increase the Number of Pediatric Resident Laceration Repairs. The Journal of Traci Bouchard, MD Julia Lloyd, MD services are provided at Nationwide Children’s Close Graduate Medical Education. 2020 Feb;12(1):51-57. To HomeSM Centers in Canal Winchester, Dublin,

64 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 65 2019 – 2020 NATIONWIDE CHILDREN’S FAST FACTS FELLOWSHIP PROGRAM July 2019 through June 2020 ED Visits (Includes All Visits Regardless of Disposition): 84,852. PEDIATRIC EMERGENCY MEDICINE Bridget Bonaventura, MD Urgent Care Visits Crista Cerrone, MD Main Campus Urgent Care: ...... 42,109 Courtney Coyle, MD Kristol Das, MD Canal Winchester Urgent Care: ...... 13,649 Nathaniel Forman, MD Dublin Urgent Care: ...... 9,712 Michelle Greene, DO East Broad Urgent Care: ...... 20,377 Nita Gupta, MD Lia Holzman, MD Hilliard Urgent Care: ...... 15,113 Yamin Jadcherla, MD Marysville Urgent Care: ...... 9,311 Chelsea Kadish, MD Jennifer Nystrom, MD Westerville Urgent Care: ...... 24,598 Alan Potts, MD Total Urgent Care Visits:...... 134,869 Jason Toews, MD Kellya Ubokudom, DO Taylor White, MD

66 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 67 Endocrinology Using Metrics to Improve the Delivery of Optimal Care for Children With Type 1 Diabetes Pediatric type 1 diabetes (T1D) necessitates a coordinated, multidisciplinary effort to deliver optimal standards of diabetes care, as outlined by the American Diabetes Association (ADA) and International Society for Pediatric and Adolescent Diabetes (ISPAD).

Tracking care delivery can identify shortfalls and encourage specific interventions to improve delivery of quality care.

Kathryn Obrynba, MD, a pediatric endocrinologist at Nationwide Children’s Hospital, and her research team designed a novel T1D care index (T1DCI) to track the delivery of optimal T1D care within the hospital’s diabetes program.

“An overall improvement was observed by tracking the index,” Dr. Obrynba says, “meaning there were fewer missed opportunities to deliver care.”

Using ADA and ISPAD guidelines, Dr. Obrynba and her team first identified 11 elements of optimal diabetes care, then grouped the elements into three categories: patient-centered multidisciplinary care, monitoring for co-morbidities/preventive screening and psychosocial support.

For the study’s baseline period (January to December 2017), the research team reviewed the electronic medical records (EMR) of patients with T1D to tally the number of missed opportunities to deliver optimal diabetes care. During the intervention period (January to December 2018), the cumulative number of missed opportunities was tallied for each care element each month.

By the end of the intervention period, there was a 26% overall reduction in the number of missed care opportunities.

“Tracking opened our eyes to how care processes were being implemented to provide optimal care,” Dr. Obrynba says.

Several care elements demonstrated marked reductions during the intervention period. The largest reduction (74%) was observed with clinic accessibility, attributed to automatically scheduling follow- up appointments at check-in. The second-largest reduction (53%) was observed with the after-clinic summary, attributed to autopopulating the summary in the EMR.

Some missed opportunities increased during this period, however. For example, missed opportunities for depression screenings increased by 129% because of a shortage of social workers to perform the screenings.

“Near the end of intervention period, we instituted a process change to flag when patients were due for their depression screenings,” Dr. Obrynba says.

These patients completed the screening at check-in, independent of a social worker. Several high-level “Tracking opened our eyes to how care processes were being implemented changes were also implemented such as an electronic dashboard within each patient’s EMR to track to provide optimal care.” delivery of care. – Kathryn Obrynba, MD Although not all 11 care elements demonstrated a reduction in missed opportunities, Dr. Obrynba says that the index’s real success was the ability to track delivery of care and identify these missed opportunities.

REFERENCE: Obrynba KS, Indyk JA, Gandhi KK, Buckingham D, Kamboj MK. The diabetes care index: A novel metric to assess delivery of optimal type 1 diabetes care. Pediatric Diabetes. 2020;21:637–643.

ENDOCRINOLOGY The Section of Endocrinology at Nationwide Children’s Hospital provides comprehensive primary and FAST FACTS consultative services for the diagnosis and treatment of endocrine/hormone disorders and diabetes mellitus July 2019 through June 2020 in children and adolescents. These include, but are not limited to, type 1 and type 2 diabetes mellitus, prediabetes, obesity, metabolic syndrome, hypoglycemia, polycystic ovarian syndrome, disorders of growth Inpatient Discharges:...... 370 Dublin Endocrinology Clinic Visits:...... 1,425 and puberty, thyroid gland disorders, thyroid nodules and cancers, adrenal gland disorders, disorders of Observation and Outpatient-in-a-Bed Discharges:...... 231 East Broad Endocrinology Clinic Visits:...... 595 bone metabolism, genetic syndromes with hormone disturbances, diabetes insipidus, and differences of Total Discharges:...... 595 Endocrinology Clinic Visits:...... 9,777 sexual development and gender identification. Average Length of Stay*:...... 2.2 Westerville Endocrinology Clinic Visits:...... 2,045 Average Daily Census*:...... 2.2 Lima Endocrinology Clinic Visits:...... 41 Patient Days*:...... 794 Prader-Willi Clinic Visits:...... 105 FACULTY include Metabolic Bone Disease, Cystic Fibrosis-Related Diabetes, Prader-Willi Syndrome Clinic, Bone Marrow Inpatient Consults:...... 449 *Excludes observation and outpatient-in-a-bed patients. Transplant Long-term Follow-up Clinic, Muscular Canal Winchester Endocrinology Clinic Visits:...... 276 Dystrophy Clinic, Thyroid Nodule/Cancer, Type 2 Diabetes clinics, fertility consultations, Sickle Cell Clinic, Young Adult Diabetes Transition Clinic, and the 2019 – 2020 NATIONWIDE CHILDREN’S THRIVE program (differences of sexual development). FELLOWSHIP PROGRAM The section maintains a robust quality improvement portfolio that includes over 15 active projects designed to achieve best outcomes for patients with diabetes PEDIATRIC ENDOCRINOLOGY mellitus and endocrine disorders. As a member of Cecilia Damilano, MD the National T1D Exchange Quality Improvement Alissa M. Guarneri, MD Nisha Patel, MD Manmohan K. Kamboj, MD Collaborative, the section participates in initiatives to Division Chief further expand the reach of quality improvement best practices nationally. Sasigarn A. Bowden, MD Monika Chaudhari, MD The Section of Endocrinology is a major referral center A Decade of Remarkable Transformation for children and adolescents in and beyond central Ohio Kajal Gandhi, DO and is a consultative resource for the Ohio Department ENDOCRINOLOGY Rohan K. Henry, MD, MS of Health Newborn Screening Program for congenital Juan Sotos, MD, Honored for Dedication and Vast hypothyroidism and congenital adrenal hyperplasia. Developed Diabetes Calculator for Contributions to the Field of Manmohan Kamboj, MD, Robert P. Hoffman, MD Kids — First-of-Its-Kind Electronic Tool Pediatric Endocrinology Named Division Chief Justin A. Indyk, MD, PhD GRANTS AWARDED Leena Mamilly, MD JULY 1, 2019 – JUNE 30, 2020 $344,567 2010 2013 2014 2015 20182013 2019 2017 2020 Leena Nahata, MD SELECTED PUBLICATIONS Kathryn Obrynba, MD New THRIVE Program Specializes Nationwide Children’s Bowden SA, Connolly AM, Kinnett K, Zeitler PS. Management of Adrenal Insufficiency in Care for Differences of Sexual Joins T1D Exchange Quality Juan F. Sotos, MD (Emeritus) Risk After Long-term Systemic Glucocorticoid Therapy in Duchenne Muscular Development, Complex Urological Improvement Collaborative Dystrophy: Clinical Practice Recommendations. Journal of Neuromuscular Diseases. Problems and Gender Concerns Aurelia C.H. Wood, MD 2019;6(1):31-41. Glick BA, Hong KMC, Buckingham D, Moore-Clingenpeel M, Salvator A, Kamboj Over the last 10 years, Endocrinology has expanded to provide comprehensive programs for pediatric and adolescent The Section of Endocrinology currently has 11 active MK. Validation of a Risk Screening Tool for Pediatric Type 1 Diabetes Patients: A endocrine care including Prader Willi disease, fertility, gender diversity, and difference of sex development. The division pediatric endocrinologists, five advanced practitioners Predictor of Increased Acute Health Care Utilization. Journal of Pediatric Endocrinology & Metabolism. 2019 Oct 25;32(10):1155-1162. has also become a national leader in diabetes quality improvement initiatives by joining the T1D Exchange Quality and four pediatric endocrinology fellows. The section Hoffman RP,Copenhaver MM, Zhou D, Yu CY. Increased Body Fat and Reduced Improvement Collaborative. presently conducts 15,000 outpatient appointments per Insulin Sensitivity are Associated with Impaired Endothelial Function and Subendocardial year. In 2019, there were over 330 patients diagnosed Viability in Healthy, Non-Hispanic White Adolescents. Pediatric Diabetes. 2019 with new-onset diabetes, and over 2,000 patients Nov;20(7):842-848. with diabetes mellitus being followed at Nationwide Nahata L, Morgan TL, Lipak KG, Olshefski RS, Gerhardt CA, Lehmann V. Romantic Relationships and Physical Intimacy Among Survivors of Childhood Cancer. Journal of Children’s on a regular basis. Adolescent and Young Adult Oncology. 2020 Jun;9(3):359-366.

Obrynba KS, Indyk JA, Gandhi KK, Buckingham D, Kamboj MK. The Diabetes The section collaborates closely with other disciplines Care Index: A Novel Metric to Assess Delivery of Optimal Type 1 Diabetes Care. Pediatr to offer endocrine expertise in the multidisciplinary Diabetes. 2020;21(4):637-643. clinic format to facilitate patient care. At present, these

70 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 71 Gastroenterology, Hepatology and Nutrition Comparing Treatments for Intractable Functional Constipation Most kids respond to traditional treatments for constipation, including behavioral interventions and laxatives, but a sizable number continue to have problems with intractable constipation that can lead to fecal incontinence.

For these children, treatment options include minimally invasive surgical procedures such as antegrade continence enemas (ACE) and sacral nerve stimulation (SNS). However, there is little data comparing these procedures and guidelines for their use are lacking, leading to variation in treatment practices.

In a new study, researchers compared the efficacy and safety of ACE and SNS in children with intractable functional constipation. The objective was to compare the treatments to help clinicians better decide on the best option for each patient.

The team, led by Peter Lu, MD, MS, a pediatric gastroenterologist at Nationwide Children’s Hospital, found that both ACE and SNS led to durable improvement of functional constipation in children, although the two treatments had different effects on specific symptoms.

“It was clear from our data that SNS works well for stool accidents, even though it did not make a huge difference for other factors, like bowel movement frequency and abdominal pain,” says Dr. Lu, also an assistant professor of Clinical Pediatrics at The Ohio State University College of Medicine. “ACE helped with stool accidents, though not to the same degree as SNS, but was better for making bowel movements more regular and decreasing abdominal pain.”

Dr. Lu and his colleagues say this study is the first step toward being able to decide on an ideal treatment option based on a child’s symptoms.

“Our takeaway from this study is that if the child’s main symptom is fecal incontinence, and especially if they have urinary symptoms too, SNS may be a good option,” Dr. Lu says. “Whereas if fecal incontinence is secondary to not being able to go and having a lot of pain, ACE may be the better option.”

Dr. Lu says that larger, randomized, prospective studies are needed to gather more evidence for the optimal uses of these two treatments. Future studies could also examine other treatment options considered for these patients, such as surgically removing part of the colon.

“This research is only possible with a multidisciplinary team like the one here at Nationwide Children’s, comprised of people from gastroenterology, surgery and urology who are passionate about these problems and understand the impact they can have,” Dr. Lu says. “These are kids “This research is only possible with a multidisciplinary team like the one here at Nationwide who deserve our attention and care.” Children’s, comprised of people from gastroenterology, surgery and urology who are passionate REFERENCE: about these problems and understand the impact they can have.” Vriesman MH, Wang L, Park C, Diefenbach KA, Levitt MA, Wood RJ, Alpert SA, Benninga MA, Vaz K, Yacob D, Di Lorenzo C, Lu P. Comparison of antegrade continence enema treatment and sacral nerve stimulation for children with severe functional constipation and fecal incontinence. – Peter Lu, MD, MS Neurogastroenterology and Motility. 2020;e13809.

GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION MD, and Jennifer Dotson, MD, is a leader in providing GRANTS AWARDED standardized care for children with Crohn’s disease and JULY 1, 2019 – JUNE 30, 2020 Consistently ranked as a top 10 digestive disorders program by U.S. News & World Report, the Division of ulcerative colitis and boasts one of the highest remission $70,053 Gastroenterology, Hepatology and Nutrition at Nationwide Children’s Hospital provides comprehensive care for rates in the country. The Intestinal Rehabilitation Service, a broad range of gastrointestinal, liver, pancreatic and nutritional problems. The division strives for excellence led by Molly Dienhart, MD, and Ethan Mezoff, MD, SELECTED PUBLICATIONS follows a large cohort of children with intestinal failure Gupta SR, Crandall WV, Donegan A, Johnson M, Drobnic B, Oates M, Boyle B, Maltz in research, teaching and clinical care and maintains a team of physician-scientists committed to the creation RM, Dotson JL. A Quality Improvement Approach to External Infliximab Infusions in and has some of the best outcomes in the country in Pediatric Inflammatory Bowel Disease. Journal of Pediatric Gastroenterology and Nutrition. of new knowledge in the discipline. Our physicians work with pediatric nurse practitioners to diagnose and the care of children with short bowel syndrome. The 2019 Nov;69(5):544-550. treat gastrointestinal, pancreatic and liver disorders while collaborating with other specialists, such as dietitians, Celiac Disease Center, led by Tracy Ediger, MD, and Maltz RM, Keirsey J, Kim SC, Mackos AR, Gharaibeh RZ, Moore CC, Xu J, Somogyi A, Bailey MT. Social Stress Affects Colonic Inflammation, the Gut Microbiome, and Short- behavioral and developmental psychologists and surgeons to provide comprehensive, coordinated care for each Section Chief Ivor Hill, MD, is a leader in providing chain Fatty Acid Levels and Receptors. Journal of Pediatric Gastroenterology and Nutrition. child. more standardized care to improve long-term outcomes 2019;68:533-540. for children with celiac disease. In addition, Steven Mezoff EA, Minneci PC, Hoyt RR, Hoffman JM. Toward an Electronic Health Record Leveraged to Learn from Every Complex Patient Encounter: Health Informatics Erdman, MD, is a world leader in the care of children The Journal of FACULTY Monique Goldschmidt, MD Considerations with Pediatric Intestinal Rehabilitation as a Model. with polyposis syndromes. A comprehensive Liver Pediatrics. 2019 Dec;215:257-263. Jennifer Lee, MD Disease Center, including a liver transplant program, is Sparks B, Salman S, Shull M, Trout A, Kiel A, Hill I, Ediger T, Boyle B. A Celiac Care Index Improves Care of Pediatric Patients Newly Diagnosed with Celiac Disease. The Peter Lu, MD led by Alex Weymann, MD, and includes hepatologists Journal of Pediatrics. 2020 Jan;216:32-36.e2. Monique Goldschmidt, MD, Carol Potter, MD, and Vriesman MH, Wang L, Park C, Diefenbach KA, Levitt MA, Wood RJ, Alpert SA, Ross Maltz, MD Cheryl Gariepy, MD, and a highly skilled transplant Benninga MA, Vaz K, Yacob D, Di Lorenzo C, Lu PL. Comparison of antegrade continence enema treatment and sacral nerve stimulation for children with severe Hilary Michel, MD surgeon, Ken Washburn, MD. The Pancreas Center is functional constipation and fecal incontinence. Neurogastroenterology and Motility. 2020 Aug;32(8):e13809. [Epub ahead of print] Ethan Mezoff, MD accredited by the National Pancreas Foundation and is directed by Cheryl Gariepy, MD. It provides state-of- Carol J. Potter, MD the-art multidisciplinary care for infants, children and John M. Russo, MD teens suffering from diseases of the pancreas. The division also provides specialized care with dedicated clinics for Ala K. Shaikhkhalil, MD children with esophageal eosinophilic disease, autism and Carlo Di Lorenzo, MD Karla K. Vaz, MD gastrointestinal disorders, muscular dystrophy, congenital Division Chief Rajitha Venkatesh, MD heart diseases, cystic fibrosis and aero-digestive disorders. Alex Weymann, MD FAST FACTS Kent C. Williams, MD Frederick W. Woodley, PhD July 2019 through June 2020 Desale Yacob, MD Inpatient Discharges:...... 558 GI Allergy Clinic Visits:...... 63 Observation and Outpatient-in-a-Bed Discharges:...... 330 Gastroenterology Clinic Visits:...... 15,137 The Division of Gastroenterology, Hepatology Total Discharges:...... 883 Mansfield Gastroenterology Clinic Visits:...... 296 and Nutrition at Nationwide Children’s provides comprehensive care through multiple multidisciplinary Average Length of Stay*:...... 6.1 Schrock Road Gastroenterology Clinic Visits:...... 132 clinics and services for children from all over the world. Average Daily Census*:...... 9.3 Westerville Gastroenterology Clinic Visits:...... 1,276 It has consistently been ranked among the top 10 Ivor D. Hill, MD Patient Days*:...... 3,289 Lima Gastroenterology Clinic Visits:...... 293 programs in the country for the past 10 years by U.S. Section Chief News & World Report, and is nationally recognized for Total Surgical Procedures:...... 2,780 Total GI Clinic Visits:...... 18,459 Neetu Bali, MD its expertise in a number of gastrointestinal disorders. Dublin Gastroenterology Clinic Visits:...... 1,262 *Excludes observation and outpatient-in-a-bed patients. The Motility Center remains a national leader in caring John A. Barnard, MD for children with neuro-gastrointestinal and functional Brendan M. Boyle, MD, MPH disorders. Motility Center leadership includes Carlo Di 2019 – 2020 NATIONWIDE CHILDREN’S Lorenzo, MD, chief of Gastroenterology, and Desale Steve L. Ciciora, MD FELLOWSHIP PROGRAM Yacob, MD, the center’s medical director, as well as Molly C. Dienhart, MD Karla Vaz, MD, Neetu Bali, MD, Peter Lu, MD, and PEDIATRIC GASTROENTEROLOGY Salman S. Salman, MD Zeyad Abdulkader, MD Raul Sanchez, MD Jennifer L. Dotson, MD, MPH Ashley Kroon Van Diest, PhD. In partnership with the Center for Colorectal and Pelvic Reconstruction at Madelyn Cohen, MD Monica Shukla-Udawatta, MD Tracy R. Ediger, MD, PhD Nationwide Children’s, the Motility Center provides Colleen Flahive, MD Shivani Gupta, MD GI MOTILITY Steven H. Erdman, MD an exceptionally high level of comprehensive medical Kathryn Hawa, MD Nancy Swiader, DO and surgical services for children with complex motility Cheryl E. Gariepy, MD Grant Morris, MD disorders. The Inflammatory Bowel Disease Center at Jonathan M. Gisser, MD Nationwide Children’s, co-directed by Brendan Boyle,

Center For Colorectal & Pelvic NASPGHAN Honors John First Use of Wireless Reconstruction is World’s First Barnard, MD, With Harry Motility Capsule in to Formally Integrate Clinical Shwachman Award for Pediatric Patient and Surgical Specialties Lifelong Contributions 20102011 2012 2013201220172013 2018 2017 2020

First Rumination Syndrome Carlo Di Lorenzo, Liver Transplant Center Treatment Program in MD, is NASPGHAN Launched Pediatrics President-Elect

The past decade has seen expansion in advanced neuromodulation therapies (gastric pacing, modulation of sacral, posterior tibial and auricular nerves) to help children with multiple types of functional and motility problems. The division has also instituted more than 20 quality improvement initiatives aimed at improving outcomes and has published results for many of them.

SELECTED PUBLICATIONS Meyer AP, Roggenbuck J, LoRusso S, Kissel J, Smith RM, Kline D, Arnold WD. GENETIC AND GENOMIC MEDICINE Genotype-Phenotype Correlations and Characterization of Medication Use in Inherited Chaudhari BP, Manickam K, McBride KL. A Pediatric Perspective on Genomics and Myotonic Disorders. Frontiers in Neurology. 2020 Jun 26;11:593. Prevention in the Twenty-First Century. Pediatric Research. 2020 Jan;87(2):338-344. The mission of the Division of Genetic and Genomic Medicine at Nationwide Children’s Hospital is to deliver Mihalic Mosher T, Zygmunt DA, Koboldt DC, Kelly BJ, Johnson LR, McKenna DS, Koboldt DC, Hickey SE, Chaudhari BP, Mihalic Mosher T, Bedrosian T, Crist E, Kaler Hood BC, Hickey SE, White P, Wilson RK, Martin PT, McBride KL. Expansion of compassionate, family-centered care via genetic/genomic diagnostic and therapeutic services while providing SG, McBride K, White P, Wilson RK. Early-onset Wilson Disease Caused by ATP7B B4GALT7 Linkeropathy Phenotype to Include Perinatal Lethal Skeletal Dysplasia. Exon Skipping Associated with Intronic Variant. Cold Spring Harbor Molecular Case European Journal of Human Genetics. 2019 Oct;27(10):1569-1577. counseling, education, research and advocacy to improve the lives of individuals with genetic conditions. We Studies. 2020 Jun 12;6(3):a005306. treat inborn errors of metabolism and genetic conditions across the ages from preconception and prenatal Malinowski J, Miller DT, Demmer L, Gannon J, Pereira EM, Schroeder MC, Scheuner MT, Tsai AC, Hickey SE, Shen J, on behalf of the ACMG Professional Practice and through childhood and well into adulthood. Clinical services are supported partly by the Ohio Department of Guidelines Committee. Systematic Evidence-Based Review: Outcomes From Exome and Genome Sequencing for Pediatric Patients with Congenital Anomalies or Intellectual Health as a Regional Genetics Center of the state of Ohio, Region IV. Research partners include the Steve and Disability. Genetics in Medicine. 2020 Jun;22(6):986-1004. Cindy Rasmussen Institute for Genomic Medicine and Centers for Gene Therapy and Cardiovascular Research. FAST FACTS FACULTY Our division has had an excellent year and notable July 2019 through June 2020 achievements in all our core mission areas. Services and counseling continue to grow. We welcomed Inpatient Discharges:...... 27 Outpatient Visits two academic physicians to the division: Dr. Bimal Observation and Outpatient-in-a-Bed Discharges:...... 19 Athens Genetics Clinic Visits:...... 15 Chaudhari (also in Neonatology and IGM) and Dr. Total Nationwide Children’s Discharges:...... 46 Cardiogenetics Clinic Visits:...... 200 Stephen Kaler (Gene Therapy). Our solid group of Average Length of Stay*:...... 3.7 Genetics (Main Campus) Clinic Visits:...... 2,449 genetic counselors was recently rounded out to include Average Daily Census*:...... 0.3 Dublin Genetics Clinic Visits:...... 102 10 in genetics, one in cardiology, one in developmental Patient Days*:...... 101 Lima Genetics Clinic Visits:...... 53 pediatrics, two in neurology, one in neuromuscular, Inpatient Consults:...... 230 Marietta Genetics Clinic Visits:...... 15 and two shared with the Steve and Cindy Rasmussen Westerville Genetics Clinic Visits:...... 163 Institute for Genomic Medicine. We also launched a *Excludes observation and outpatient-in-a-bed patients. new clinic for Menkes disease by nationally known Zanesville Genetics Clinic Visits:...... 15 Kim L. McBride, MD, MS Dr. Kaler. Education continues for genetic counseling Division Chief students. We had an excellent year for our genetics residency, graduating two and recruiting three new residents for 2020, and we were successful in adding 2019 – 2020 NATIONWIDE CHILDREN’S a Medical Biochemical Genetics Fellowship to our FELLOWSHIP PROGRAM program (directed by Dr. Bartholomew, Dr. Hickey and Dr. Mori). Our group continues to influence the field MEDICAL GENETICS at the national level through the creation of practice April Lehman, MD guidelines on exome sequencing (Hickey), management Bianca Zapanata, MD of phenylketonuria (PKU) in pregnant women (Rink) and guidance on treatment of Hunter syndrome (McBride), in addition to leading efforts in genome sequencing of neonates (Chaudhari). Our division and Dennis W. Bartholomew, MD the Institute’s Rare Disease Program has had success in Section Chief both describing new manifestations of genetic disorders and also describing novel mechanisms of disease, best exemplified by a publication on Wilson disease that FULL-TIME NATIONWIDE CHILDREN’S FACULTY brought together our newest faculty, existing geneticists Bimal Chaudhari, MD, MPH and Institute faculty. Finally, we continue to advocate and lobby at the state and federal level for recognition of Scott E. Hickey, MD genetic counselors as Centers for Medicare & Medicaid Stephen G. Kaler, MD Services providers. Kandamurugu (Murugu) Manickam, MD GRANTS AWARDED TO Mari Mori, MD CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 Kristin Truxal, MD $463,698 PART-TIME NATIONWIDE CHILDREN’S FACULTY Britton D. Rink, MD

78 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 79 Hematology, Oncology & Blood and Marrow Transplant Childhood Cancer Research Team Awarded $10.2 Million Moonshot Grant This award is the second Cancer Moonshot grant awarded to researchers at Nationwide Children’s Hospital.

The National Cancer Institute at the National Institutes of Health awarded one of its Cancer Moonshot grants to Timothy Cripe, MD, PhD, chief of the Division of Hematology, Oncology & Blood and Marrow Transplant and Elaine Mardis, PhD, co-executive director of the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital, Nationwide Foundation Endowed Chair of Genomic Medicine at Nationwide Children’s and professor of pediatrics and investigator with the Pelotonia Institute for Immuno-Oncology at The Ohio State University. This is the second Cancer Moonshot grant awarded to researchers at Nationwide Children’s.

“We are extremely grateful and honored to receive this grant, as it enables us to continue advancing important work to one day find a cure for cancer,” says Dr. Cripe, who is also a Gordon Teter Endowed Chair in pediatric cancer at Nationwide Children’s, and a professor of pediatrics and an investigator in the Pelotonia Institute for Immuno-Oncology at Ohio State. “Our work is never finished until there is a cure.”

Dr. Cripe’s project aims to deepen the understanding of how an oncolytic (or tumor-targeting) virus interacts with a tumor’s “immune system” to develop treatments that make tumors more susceptible to these viruses.

“Dr. Cripe, Dr. Mardis and their talented team are pioneers in the field of cancer immunotherapeutics,” says John Barnard, MD, president of the Abigail Wexner Research Institute (AWRI) at Nationwide Children’s. “This grant will accelerate their momentum in developing more effective treatments for pediatric cancers.”

The Moonshot grant will also provide funding to two other Nationwide Children’s research projects led by Kevin Cassady, MD, clinical virologist and principal investigator in the Center for Childhood Cancer and Blood Diseases at AWRI, and Dean Lee, MD, PhD, director of the joint Cellular Therapy and Cancer Immunology Program at Nationwide Children’s and Ohio State’s Comprehensive Cancer Center, DiMarco Family Endowed Chair in Cell Based Therapy at Nationwide Children’s and professor of pediatrics at Ohio State.

Dr. Cassidy is investigating modifying a next generation oncolytic herpes simplex virus (oHSV) to express known, tumor-selective cell surface proteins to convert an anti-viral immune response into an anti-tumor immune response. Dr. Lee’s project focuses on natural killer (NK) cells, known as the “executioner” cell of the immune system, and how they are attracted to tumors.

“This grant will accelerate their momentum in developing more effective treatments for pediatric cancers.” – Timothy Cripe, MD, PhD

HEMATOLOGY, ONCOLOGY & BLOOD AND MARROW TRANSPLANT Anthony D. Villella, MD Our large young adult population within our Andrea Wojtowicz, PhD Hemophilia Treatment Center, coupled with the The Division of Hematology, Oncology & Blood and Marrow Transplant at Nationwide Children’s hospital’s research infrastructure and experience Hospital treats patients with any one of a full array of blood diseases, cancers, immunodeficiency disorders, Nicholas D. Yeager, MD administering gene therapy trials, made us an ideal site bone marrow failure syndromes and inherited metabolic storage diseases. Our clinical team oversees the Tammi K. Young-Saleme, PhD for these trials. comprehensive evaluation, multidisciplinary diagnosis, treatment and long-term management of children, Kristin Zajo, MS, LGC Regionally, we’ve fostered our collaboration with adolescents and young adults with blood diseases and cancer, as well as other diseases treated by cellular Dayton Children’s Hospital. Our cancer, blood diseases and bone marrow transplant collaborative enhances therapies or apheresis. In addition to clinical care, through our integrated programs within the Abigail FELLOWS services and creates more research opportunities for Wexner Research Institute’s Center for Childhood Cancer and Blood Diseases, the Steve and Cindy First Year both institutions. Further, it allows more patients Rasmussen Institute for Genomic Medicine, and the Biopathology Center, we seek to transform the way Eman Abdelghani, MD from the Dayton region to stay closer to home during patients with cancer and blood diseases are cared for by fully integrating research, cutting-edge therapies and Nicole Kendel, MD treatment, which is extremely important to patients and their families, who can endure medical treatment multidisciplinary teams. Laura Tyrrell, MD over several years. Second Year In 2019, we realized almost two-fold growth in FACULTY Jonathan L. Finlay, MB, ChB Ashleigh Kussman, MD international referrals. We anticipate continued Molly Gardner, PhD Lynda Villagomez, MD program growth, with Maryam Fouladi, MD, recently named the co-executive director of the Cynthia A. Gerhardt, PhD Third Year Neuro-Oncology Program at Nationwide Children’s Terri L. Guinipero, MD Jennifer Belsky, DO Hospital. Dr. Fouladi will continue her extensive Jennifer Hansen-Moore, PhD Kyle Davis, MD work on diffuse intrinsic pontine gliomas (DIPGs) alongside Jeffrey Leonard, MD, co-executive director Amanda Jacobson-Kelly, MD Brian Tullius, MD of the Neuro-Oncology Program and chief of the Bryce A. Kerlin, MD Fourth Year (BMT) Department of Pediatric Neurosurgery at Nationwide Riten Kumar, MD Margaret Lamb, MD Children’s. Dr. Fouladi is the founding director of the Collaborative Network for Neuro-Oncology Clinical Dean Lee, MD, PhD Fourth Year (Hemostasis & Thrombosis) Trials (CONNECT), an international consortium that Penelope Sandiford, MD Timothy P. Cripe, MD, PhD Kathleen L. Lemanek, PhD works to develop and test novel therapies in early phase Division Chief Steve Lessnick, MD, PhD Fourth Year (Neuro-Oncology) clinical trials. Margaret Shatara, MD Erin Meyer, DO, MPH Dr. Fouladi is also the founding chair of the Fourth Year (Sarcoma) International Diffuse Intrinsic Pontine Glioma (DIPG) Sarah H. O’Brien, MD, MS Ajay Gupta, MD and Diffuse Midline Glioma (DMG) registries and Diana S. Osorio, MD has served as the chair of CONNECT and the CNS Through research, patient care and psychosocial Veronika Polishchuk, MD Committee of the Children’s Oncology Group. support, the Division of Hematology, Oncology Mark A. Ranalli, MD & Blood and Marrow Transplant provides a strong Through our clinical and research work, driven by the best and brightest physicians and staff, we vow to Hemalatha G. Rangarajan, MD foundation for our patients, families and care teams. For seven straight years, we’ve ranked in the top 10 of remain on the cutting edge of solutions for our patients Suzanne M. Reed, MD U.S. News & World Report. Our discoveries, clinical worldwide. Ryan D. Roberts, MD, PhD trials and new treatments offer new hope for patients Center for Childhood Cancer: See page 183 for Randal S. Olshefski, MD Melissa J. Rose, DO and families, not only at Nationwide Children’s but information about the Center for Childhood Cancer Section Chief around the world. in the Abigail Wexner Research Institute at Nationwide Claire Russell, PhD We were honored to be selected as one of only a few Children’s Hospital. Mohamed AbdelBaki, MD Amanda Sankar, MD dozen sites worldwide to host three new hemophilia GRANTS AWARDED TO CENTER AND Rolla F. Abu-Arja, MD Bhuvana A. Setty, MD gene therapy clinical trials for adults. Hemophilia DIVISION CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 Anthony N. Audino, MD Nilay D. Shah, MD is a congenital bleeding disorder caused by lack of a clotting protein. Patients with severe hemophilia Natalie Slone, DO $15,198,205 Jeffery J. Auletta, MD require frequent, lifelong intravenous infusions of Rajinder P. Bajwa, MD, MBBS Keri A. Streby, MD clotting factor concentrate to protect them from Nabanita Bhunia, MD Kathryn Vannatta, PhD bleeding. The trials each seek to engineer the patient’s own liver to produce normal clotting factor so that Elizabeth Varga, MS, LGC Susan E. Creary, MD patients no longer need regular medication infusions. Amy L. Dunn, MD Susan I. Vear, MD

SELECTED PUBLICATIONS Of Young Children With Nodular Desmoplastic Medulloblastoma Treated On "Head Start" III: A Multi-Institutional, Prospective Clinical Trial. Neuro-Oncology. 2020 Apr HOSPITAL PEDIATRICS AND ADULT HOSPITAL MEDICINE Brown P, Inaba H, Annesley C, Beck J, Colace S, Dallas M, DeSantes K, Kelly K, 18;noaa102. Kitko C, Lacayo N, Larrier N, Maese L, Mahadeo K, Nanda R, Nardi V, Rodriguez The Section of Hospital Pediatrics at Nationwide Children’s Hospital, which also includes newborn and V, Rossoff J, Schuettpelz L, Silverman L, Sun J, Sun W, Teachey D, Wong V, Yanik Jaffray J, Witmer C, O'Brien SH, Diaz R, Ji L, Krava E, Young G. Peripherally G, Johnson-Chilla A, Ogba N. Pediatric Acute Lymphoblastic Leukemia, Version Inserted Central Catheters Lead to a High Risk of Venous Thromboembolism in adult hospital medicine, is home to a diverse group of physicians who specialize in the care of hospitalized Children. Blood. 2020 Jan 16;135(3):220-226. 2.2020, NCCN Clinical Practice Guidelines in Oncology. The Journal of National newborns, children, adolescents and adults. The section supports Nationwide Children’s commitment Comprehensive Cancer Network. 2020 Jan;18(1):81-112. Roberts RD, Lizardo MM, Reed DR, Hingorani P, Glover J, Allen-Rhoades W, Fan T, Creary S, Chisolm D, Stanek J, Hankins J, O'Brien SH. A Multidimensional Khanna C, Sweet-Cordero EA, Cash T, Bishop MW, Hegde M, Sertil AR, Koelsche C, to providing the highest-quality care to all children and their families regardless of ability to pay, and Electronic Hydroxyurea Adherence Intervention for Children with Sickle Cell Disease: Mirabello L, Malkin D, Sorensen PH, Meltzer PS, Janeway KA, Gorlick R, Crompton Single-Arm Before-After Study. JMIR Mhealth and Uhealth. 2019 Aug 8;7(8):e13542. BD. Provocative Questions In Osteosarcoma Basic And Translational Biology: A specifically aims to set the standard in the provision of high-value, quality inpatient care, the intentional and Report from the Children's Oncology Group. Cancer. 2019 Oct 15;125(20):3514- Dhall G, O’Neil SH, Ji L, Haley K, Whitaker AM, Nelson MD, Gilles F, Gardner SL, 3525. thoughtful education of future generations of doctors, and the production of useful and influential clinical, Allen JC, Cornelius AS, Pradhan K, Garvin JH, Olshefski RS, Hukin J, Comito M, Goldman S, Atlas MP, Walter AW, Sands S, Sposto R, Finlay JF. Excellent Outcome educational and quality-improvement research.

FAST FACTS FACULTY Nancy N. Liao, MD July 2019 through June 2020 Beth W. Liston, MD, PhD Inpatient Discharges:...... 1,419 BMT Long-term Follow-up Clinic Visits:...... 67 Jamie R. Macklin, MD Observation and Outpatient-in-a-Bed Discharges:...... 271 Anticoagulation Clinic Visits:...... 219 Kathleen Matic, MD Daniel J. McFarlane, MD Total Discharges:...... 1,690 Dublin Hematology Clinic Visits:...... 121 Gerd B. McGwire, MD, PhD Patient Days*:...... 9,370 East Broad Sickle Cell Clinic Visits:...... 122 Lucas V. McKnight, MD Average Length of Stay*:...... 6.7 Mansfield Hematology/Oncology Clinic Visits:...... 43 Christy Mulligan, MD Average Daily Census*:...... 25.7 Chillicothe Hematology/Oncology Clinic Visits:...... 19 Mohammed Najjar, MD Sajithya Perera, MD Inpatient Consults:...... 485 Dayton Hematology/Oncology Clinic Visits:...... 2 Ryan S. Bode, MD Michael Perry, MD Total Surgical Procedures:...... 893 Zanesville Hematology/Oncology Clinic Visits:...... 49 Chief Laura Plachta, MD BMT Transplants:...... 82 Surgical Oncology Clinic Visits:...... 109 Seth Agyeman-Berko, PA Charles R. Redman, MD Apheresis and Photopheresis Procedures:...... 832 Hematology/Oncology Clinic Visits:...... 10,322 Sean Ankrom, MD Allison Rossetti, MD BMT Clinic Visits:...... 3,486 Portsmouth Hematology/Oncology Clinic Visits:...... 8 Joshua D. Black, MD Christine A. Schmerge, MD Jessica Bockenstedt, MD Shauna Schord, MD *Excludes observation and outpatient-in-a-bed patients. Carrie Cacioppo, MD Eric R. Schumacher, DO, MBA Sharon Clark, MD Claire Sevov, MD A Decade Remarkable Transformation Vignesh Doraiswamy, MD Catherine C. Sinclair, MD of Samuel W. Dudley, MD Melissa L. Skaug, MD HEMATOLOGY, ONCOLOGY & BLOOD AND MARROW TRANSPLANT Christian Earl, MD Isaac Spears, MD

Established Host Defense Established NEXT Neuro-Oncology Team Brings Lauren Finnegan, NP Ansley Splinter, MD Program Specifically Designed Consortium to Expand Childhood Cancer Research CONNECT Consortium and Clinical to Address the Needs of Expedited Advance Treatments Team Awarded $10.2 Million Trials in High-Risk Pediatric Brain Emily Graham, MD Anuja Sriparameswaran, MD Immunocompromised Patients for Hem/Onc/BMT Conditions Moonshot Grant Tumors to Nationwide Children’s Kelly Grannan, MD Matthew Suer, MD Rakhi Gupta-Basuray, MD Devon Swick, DO 2010 2012 2013 2015 2016 20132018 2018 2017 20202017 Cara Harasaki, MD Kimberly M. Tartaglia, MD Allison C. Heacock, MD The Section of Hospital Pediatrics and Adult

Launched MIBG Therapy Established Cellular Certified Treatment Center Shawn Jacquemin, MD Hospital Medicine provides inpatient care across the – Innovative Treatment for Therapy and Cancer for Novartis CAR-T Cell continuum to patients and families at Nationwide Patients with High-Risk Immunology Program Therapy Kymriah™ Rena Kasick, MD Children’s. Newborn hospitalists manage full- Neuroblastoma Jillian S. Kunar, DO term and late preterm newborns and the associated Stephanie Kwon, DO common conditions, including hyperbilirubinemia, Over the past decade, the Division of Hematology, Oncology and Blood & Marrow Transplant has received 2 NIH Cancer Stephanie Lauden, MD feeding and nutrition, infections, neonatal abstinence Moonshot grants totaling $16.4 million, created first-in-pediatric resources like the Good Manufacturing Practice Facility, Kristina Lehman, MD syndrome, and newborn screening and anticipatory and established itself as a consistent top 10 program ranked by U.S. News &World Report. Kristen S. Lewis, MD guidance. Pediatric hospitalists provide inpatient care

84 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 85 for common pediatric illnesses such as bronchiolitis, We are dedicated and committed to the education of asthma and failure to thrive, as well as undifferentiated future pediatricians with an emphasis and excellence and/or multisystem diseases, coordinating and in the clinical teaching for both medical students facilitating care, and ensuring a safe transition back and family practice and pediatric residents. Faculty to primary care providers. In addition, in conjunction serve as important mentors for these learners in with the Section of Child Psychiatry, hospitalists work their educational, clinical, research and professional collaboratively to provide medical care for children development. Our faculty continue to get recognized and adolescents facing acute mental health crises on an annual basis with prestigious teaching awards, including in the new Big Lots Behavioral Health including being ranked as the No. 1 inpatient rotation Pavilion. Internal medicine-trained adult hospitalists this past academic year by the pediatric residents. serve as consultants for adult patients with congenital and childhood-onset chronic illnesses admitted to SELECTED PUBLICATIONS Nationwide Children’s. Gorham TJ, Rust S, Rust L, Kuehn S, Yang J, Lin JS, Hoffman J, Huang Y, Lin S, McClead R, Brilli R, Bode R, Maa T. The Vitals Risk Index-Retrospective Performance The section experienced significant growth and program Analysis of an Automated and Objective Pediatric Early Warning System. Pediatric Quality development in all facets — clinical, educational, safety, and Safety. 2020 Mar 20;5(2):e271. quality improvement and research. Clinical encounters Kasick RT, Melvin JE, Perera ST, Perry M, Black J, Bode R, Groner J, Kersey K, Klamer B, Bai S, McClead R. A Diagnostic Time-Out to Improve Differential Diagnosis in and average daily census increased over the prior Pediatric Abdominal Pain. Diagnosis. 2019 Nov 2. [Epub ahead of print]

academic year by approximately 20%. We continued Mecham C, Mirea L, Bode R, McGreevy J. Trends in Adult Patients Presenting to to recruit new and talented faculty. Publications have Pediatric Emergency Departments. The American Journal of Emergency Medicine.2020 Apr increased by 40% each of the past three years. 8;38(9):1884-1889. Perry MF, Macias C, Chaparro JD, Heacock AC, Jackson K, Bode RS. Improving Early Pediatric Hospital Medicine has recently been Discharges with an Electronic Health Record Discharge Optimization Tool. Pediatric Quality and Safety. 2020 May 18;5(3):e301. recognized by the American Board of Pediatrics as Webber S, Lauden SM, Fischer PR, Beyerlein L, Schubert C; Midwest Consortium of a board-certified specialty. Our Pediatric Hospital Global Child Health Educators S-PACK Workgroup. Predeparture Activities Curricular Medicine Fellowship Program began in July 2018. This Kit (PACK) for Wellness: A Model for Supporting Resident Well-Being During Global Child Health Experiences. Academic Pediatrics. 2020 Jan-Feb;20(1):136-139. past year, we were successful in obtaining Accreditation Council for Graduate Medical Education (ACGME) program accreditation and graduated our first fellow. FAST FACTS The section is involved in a multitude of patient safety, quality improvement and research initiatives with July 2019 through June 2020 demonstrated outcomes that include: Inpatient Discharges: ...... 2,788 • Patient Centered Outcomes Research Institute Observation Discharges: ...... 3,109 (PCORI) funded grant investigating the safety and efficiency of hospital direct admissions Total Discharges: ...... 5,853 versus Emergency Department admissions Average Length of Stay*: ...... 3 • Agency for Healthcare Research and Quality Average Daily Census*: ...... 23 (AHRQ) funded grant investigating the Patient Days*: ...... 8,317 unnecessary utilization of pulse oximetry in hospitalized bronchiolitis patients Complex Health Care Clinic Visits: ...... 3,407 • Clinical pathway development using evidence- *Excludes observation and outpatient-in-a-bed patients. based practice leading to improved patient outcomes 2019 – 2020 NATIONWIDE CHILDREN’S • Identifying and eliminating diagnostic errors FELLOWSHIP PROGRAM • Enhanced patient safety, including 24/7 inhouse attending coverage and the innovative “Safety HOSPITAL MEDICINE FELLOWSHIP Officer and Watchstander Program” leading to Hilary Lin, MD a decrease in unrecognized clinical deterioration Melanie Marsh, MD on the floor, ICU transfers and patient mortality

86 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 87 Infectious Diseases Revealing Clinical Phenotypes in Infants With Respiratory Syncytial Virus Infection Through Systems Analyses RSV disease severity is influenced by innate immune responses, viral loads and patient age.

Respiratory syncytial virus (RSV) is a leading cause of hospitalization in children, although most cases result in mild disease. A better understanding of the different clinical, immunologic and virologic factors present in infants with mild versus severe RSV disease will enable the development of effective antivirals and vaccines.

In a new study funded by the National Institute of Allergy and Infectious Diseases, researchers at Nationwide Children’s Hospital sought to identify the “safe and protective” immunoprofile induced by natural RSV infection that might protect infants from developing severe disease. Using a systems analysis approach, the researchers integrated blood transcriptional profiling and immune cell phenotyping with measurement of viral loads and clinical data from infants and young children with RSV infections of varying severity.

“We identified complex interactions among RSV viral loads, the innate immune response and patients’ age influencing disease severity,” says Asuncion Mejias, MD, PhD, senior author of the study, infectious disease specialist and principal investigator in the Center for Vaccines and Immunity at Nationwide Children’s and associate professor of Pediatrics at The Ohio State University College of Medicine.

Dr. Mejias and her colleagues demonstrated that children with mild disease, managed as outpatients, had higher RSV loads measured in the upper respiratory tract. Those with more severe disease were managed as inpatients and had increased numbers of poorly activated monocytes. Older children with mild disease showed greater expression of interferon genes compared with inpatients with severe disease, who showed greater activation of inflammation genes irrespective of age.

“Our data suggest that mild RSV infection is characterized by robust interferon expression, adequate monocyte activation and higher viral loads,” says co-senior author Octavio Ramilo, MD, chief of Infectious Diseases and principal investigator in the Center for Vaccines and Immunology at Nationwide Children’s.

Dr. Ramilo, also the Henry G. Cramblett Chair in Medicine and professor of Pediatrics at The Ohio State University College of Medicine, says their findings show the importance of both disease severity and age in children with RSV infection.

“A robust interferon response appears to play a protective role, while an uncontrolled inflammatory response is detrimental,” he says.

Drs. Mejias and Ramilo hope their findings can be used to help design and evaluate new vaccines and antivirals directed against RSV and inform research into other infectious diseases.

REFERENCE: “We identified complex interactions among RSV viral loads, the innate immune Heinonen S, Velazquez VM, Ye F, Mertz S, Acero-Bedoya S, Smith B, Bunsow E, Garcia-Mauriño C, Olivia S, Cohen DM, Moore-Clingenpeel M, Peeples ME, response and patients’ age influencing disease severity.” Ramilo O, Mejias A. Immune profiles provide insights into respiratory syncytial virus disease severity in young children.Science Translational Medicine. 2020 Apr 22;12(540):eaaw0268. – Asuncion Mejias, MD, PhD

INFECTIOUS DISEASES The Division of Infectious Diseases continues to clinical trials aimed to optimize clinical outcomes in expand clinical activities to patients with complex immunocompromised hosts (Monica Ardura, MD; The specialists in the Division of Infectious Diseases at Nationwide Children’s Hospital provide expertise infections in different settings across the hospital, Jeffrey Auletta, MD; Christopher Ouellette, MD; in the diagnosis and management of children with all types of acute and chronic infections in both including the specialized Infectious Diseases inpatient Masako Shimamura, MD; Eunkyung Song, MD). immune-competent and immune-compromised children. Our physicians provide direct care for patients unit, the Infectious Diseases consult service, and in admitted to the Nationwide Children’s Infectious Diseases Unit and clinical consultation for patients with a number of specialized outpatient clinics (General Research: See page 189 for information about the complicated infectious diseases throughout the hospital, in close partnership with their primary care teams. ID, Host Defense, HIV, Neonatal Infectious Disease, Center for Microbial Pathogenesis, and page 193 for the Tuberculosis, Kawasaki and PANDAS). With plans We have developed close clinical and research collaborations with physicians in Hematology/Oncology Center for Vaccines and Immunity, in the Abigail Wexner to add an additional faculty member and a nurse Research Institute at Nationwide Children’s Hospital. & Bone Marrow Transplant, Pediatric Critical Care, Cardiology, Lung, Heart and Liver Transplantation, practitioner, we continue to expand our team to Neonatology and the various surgical departments in order to optimize the infectious diseases-related care of optimize the preventive and therapeutic care of GRANTS AWARDED TO ALL INFECTIOUS patients. Patients are also evaluated in the ambulatory setting following referral to the Infectious Diseases, immunocompromised children through our Host DISEASES CLINICAL AND RESEARCH FACULTY Tuberculosis, Neonatal Infectious Disease, Host Defense, PANDAS, and the Family AIDS Clinic Education Defense Program. Plans to open a Vaccine Clinic JULY 1, 2019 – JUNE 30, 2020 Services (FACES) Program Clinics located on the Nationwide Children’s main campus. Additionally, our specifically designed for these patients were placed on $3,631,180 hold because of the COVID-19 pandemic. division offers consultation to external providers and their patients through the Nationwide Children’s SELECTED PUBLICATIONS Hospital Physician Consult and Transfer Center. Research is conducted through the division and in The COVID-19 pandemic brought challenges to Auletta JJ, Sánchez PJ, Meyer EK, O'Donnell LC, Cassady KA, Ouellette CP, Hecht collaboration with our colleagues from the Clinical Microbiology Laboratory, the Center for Microbial S, Diaz A, Pavlek LR, Salamon DP, Gallagher CL, Bradbury H, Welfley SL, Magers J, the Section of Infectious Diseases in early 2020. Armbruster DL, Lamb MG, Nakkula RJ, Bosse K, Lee DA. Adjuvant Haploidentical Pathogenesis, the Center for Vaccines and Immunity and other centers in the Abigail Wexner Research However, these challenges presented opportunities to Virus-Specific T Lymphocytes for Treatment of Disseminated Adenovirus Infection in a Premature Infant. The Journal of Allergy and Clinical Immunology. 2019 Aug;144(2):594- Institute at Nationwide Children’s, as well as national and international collaborators. improve patient care. Our five-bed Special Pathogens 597.e4.

Unit was activated and has been caring for those Coss SL, Torres-Cornejo A, Prasad MR, Moore-Clingenpeel M, Grakoui A, Lauer GM, patients admitted to Nationwide Children’s with Walker CM, Honegger JR. CD4+ T cell restoration and control of hepatitis C virus FACULTY Megan Brundrett, MD replication after childbirth. The Journal of Clinical Investigation.2020 Feb 3;130(2):748- confirmed SARS-CoV-2 infection. This unit offers 753.

Kevin Cassady, MD an environment that affords the best possible care for Hecht SM, Ardura MI, Yildiz VO, Ouellette CP. Central venous catheter management these patients in the safest manner possible for their in high-risk children with bloodstream infections. The Pediatric Infectious Disease Journal. Juan Chaparro, MD hospital caregivers. Seriously ill patients requiring 2020 Jan;39(1):17-22. Guliz Erdem, MD ventilatory assistance are cared for in this protected Ouellette CP, Sánchez PJ, Xu Z, Blankenship B, Zeray F, Ronchi A, Shimamura M, Chaussabel D, Lee L, Owen KE, Shoup AG, Ramilo O, Mejias A. Blood genome Charitha Gowda, MD, MPH environment by our Pediatric Intensive Care Unit expression profiles in infants with congenital cytomegalovirus infection. Nature (PICU) staff. We have also developed an outpatient Communications. 2020;11(1):3548. Jonathan R. Honegger, MD COVID-19 clinic so that these patients can be Wang H, Diaz A, Moyer K, Mele-Casas M, Ara-Montojo MF, Torrus I, McCoy K, Mejias A, Leber A. Molecular and clinical comparison of two outbreak periods of W. Garrett Hunt, MD, MPH, DTM&H followed in an outpatient setting that facilitates their enterovirus D68 among hospitalized pediatric patients in central Ohio: 2014 and 2018. Emerging Infectious Diseases; 25 (11): 2019. Su Jin Joo, MD participation in research. We continue to maintain our strong research collaborations with colleagues Maria Asuncion Mejias, MD, PhD, MSCS in the Center for Microbial Pathogenesis and the Octavio Ramilo, MD Christopher Ouellette, MD Center for Vaccines and Immunity in the Abigail Division Chief Pablo J. Sánchez, MD Wexner Research Institute at Nationwide Children’s, as well as the Clinical Microbiology Laboratory. We Masako Shimamura, MD maintain clinical translational research programs Eunkyung Song, MD regarding a variety of conditions, including hepatitis Rebecca Wallihan, MD (Jonathan Honegger, MD; Chris Walker, PhD; Charitha Gowda, MD), adenovirus (Amy Leber, Matthew Washam, MD, MPH PhD; Eunkyung Song, MD), cytomegalovirus (Pablo Joshua Watson, MD Sanchez, MD; Asuncion Mejias, MD; Masako Shimamura, MD), pneumococcus (William Barson, CLINICAL MICROBIOLOGY MD; Guliz Erdem, MD), tuberculosis and Global Amy Leber, PhD Health (W. Garrett Hunt, MD), RSV-vaccine William J. Barson, MD Director development (Asuncion Mejias, MD; Octavio Section Chief Sophonie Jean, PhD Ramilo, MD; Mark Peeples, PhD), pediatric Assistant Director pneumonia (Rebecca Wallihan, MD; Octavio Ramilo, FULL-TIME NATIONWIDE CHILDREN’S FACULTY MD), and translational and diagnostic/therapeutic Huanyu Wang, PhD Monica Ardura, DO, MSCS Assistant Director Jeffrey Auletta, MD

July 2019 through June 2020 Inpatient Discharges:...... 2,577 Tuberculosis Clinic Visits Observation and Outpatient-in-a-Bed Discharges:...... 547 Dublin Tuberculosis Clinic Visits:...... 15 Total Discharges:...... 3,099 Hilltop Tuberculosis Clinic Visits:...... 7 Average Length of Stay*:...... 3 Northland Tuberculosis Clinic Visits:...... 16 Average Daily Census*:...... 18 Sharon Woods Tuberculosis Clinic Visits:...... 10 Patient Days*:...... 6,577 Tuberculosis Clinic Visits:...... 506

Inpatient Consults:...... 619 *Excludes observation and outpatient-in-a-bed patients. Infectious Disease Clinic Visits:...... 2,076 Immunodeficient Clinic Visits:...... 1,247

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

PEDIATRIC INFECTIOUS DISEASES Alejandro D. Diaz, MD Shaina Hecht, MD Ana Quintero, MD Rouba Sayegh, MD Stephanie Smith, MD Jeanette Taveras, DO

92 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDENATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | |2019-20 2019-20 Annual Annual Report Report | |N ationwideChildrens.org/2020-ReportNationwideChildrens.org/2020-Report | 93 Neonatology How a Network of Hospitals Reduced Average Age at Cerebral Palsy Diagnosis to 9.5 Months A network of hospitals, led by Nationwide Children’s Hospital, reduced the average age of diagnosis from 19.5 months to 9.5 months after less than a year of guideline implementation work.

More than 50% of all eventual cerebral palsy (CP) cases spend time in the Neonatal Intensive Care Unit, making early CP evaluation a crucial element of any hospital’s high-risk follow-up program. When children are diagnosed early, they may also have early access to evidence-based interventions, which can improve CP-related developmental outcomes substantially. In the United States, the average age of diagnosis for CP has been about 2 years, compared to the target of 12 months of age or younger.

Now, five hospital systems in the United States have become the first in the world to successfully implement, in clinical practice, international CP diagnosis guidelines that were released in 2017. After just nine months of guideline implementation work, their efforts resulted in improving the average age at diagnosis from 19.5 months to 9.5 months.

The endeavor was proposed and funded by the Cerebral Palsy Foundation. The lead institution — Nationwide Children’s Hospital, which had participated in the development of the international guidelines and was the first hospital to implement the guidelines clinically — trained and collaborated with experts at four other institutions eager to reduce age at CP diagnosis: UCLA Mattel Children’s Hospital, Los Angeles; the University of Texas Health Science Center at Houston; University of Utah Health, Salt Lake City; and Kennedy Krieger Institute, Baltimore.

“Working as a network made this effort much more impactful,” says Nathalie Maitre, MD, PhD, director of the NICU Follow-Up Program at Nationwide Children’s and principal investigator on the network project. “Everyone has been transparent, communicative and respectful, allowing us all to learn from each other and see how others navigate guideline implementation with their unique cultures and resources.”

The guidelines involve neonatologists, developmental pediatricians, therapists and other developmental specialists. Dr. Maitre says neurologists were also instrumental in successfully implementing and evaluating the assessments and neuroimaging for early diagnosis. All institutions required significant training to implement the guideline-based neuroimaging and neurologic screenings, which were combined with motor function assessments, biomarkers and clinical history to determine a diagnosis.

Now, Dr. Maitre and Rachel Byrne, executive director of the Cerebral Palsy Foundation, are developing systematic engagement and education efforts for primary care providers and hospitals in underserved communities. Dr. Maitre believes that network-based propagation and widespread implementation of the guidelines is the first step toward globalized clinical detection of CP during infancy — with the follow-up goal that ever-improving early intervention efforts will then become the new standard of CP care. “Everyone has been transparent, communicative and respectful, allowing us all REFERENCES: to learn from each other and see how others navigate guideline implementation Byrne R, Noritz G, Maitre NL, Nationwide Children’s Hospital Early Developmental Group. Implementation of early diagnosis and intervention guidelines for with their unique cultures and resources.” cerebral palsy in a high-risk infant follow-up clinic. Pediatric Neurology. 2017;76:66-71. Maitre NL, Burton VJ, Duncan AF, Iyer S, Ostrander B, Winter S, Ayala L, Burkhardt S, Gerner G, Getachew R, Jiang K, Lesher L, Perez CM, Moore-Clingenpeel – Nathalie Maitre, MD, PhD M, Lam R, Lewandowski DJ, Byrne R. Network implementation of guideline for early detection decreases age at cerebral palsy diagnosis. Pediatrics. 2020 April 8;145(5):e20192126.

9494 | |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | |2019-20 2019-20 Annual Annual Report Report | |N ationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 95 Department of Pediatrics

NEONATOLOGY Ish Gulati, MD Richard Moraille, MD Nationwide Children’s Hospital is home to one of the largest networks of clinical neonatal care in the Jennifer Haase, MD Apurwa S. Naik, MD United States. The Section of Neonatology at Nationwide Children’s is an integral component of the Jason Jackson, DO Mitali Pakvasa, MD neonatal program, which includes a full range of family-centered newborn care and innovative clinical and Jason Kovalcik, MD Brooke Redmond, MD translational research programs, conducted through the Division of Neonatology and in collaboration with J. Wells Logan, MD Christopher Regan, DO the Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s. Nathalie Maitre, MD, PhD John H. Seguin, MD Daniel Malleske, MD Teresa L. Seto, MD FACULTY Craig A. Nankervis, MD Michael Shoemaker, MD Mary L. Neel, MD Gary E. Snyder, MD Ahmed Osman, MD Anthony R. Theile, DO Leeann Pavlek, MD Youness Tolaymat, MD Pablo J. Sanchez, MD Peri Ulema, DO Amy L. Schlegel, MD Allison Vasileff, MD Ruth B. Seabrook, MD Natalie O. White, DO Vanessa L. Shanks, MD Jonathan R. Wispe, MD Jonathan L. Slaughter, MD, MPH Leif D. Nelin, MD Sudarshan Jadcherla, MD NEONATOLOGY ADMINISTRATION Michael R. Stenger, MD Division Chief Associate Division Chief for Academics Marissa E. Larouere, MBA, BSN, RN Christopher J. Timan, MD Vice President Neonatal Services Jennifer K. Trittmann, MD, MPH Lawrence Baylis, MHA Sheria D. Wilson, MD Service Line Administrator Heather Larson COMMUNITY-BASED FACULTY Business Manager Craig W. Anderson, MD NEONATAL NETWORK DIRECTORS Gary Bixler, MD Renee Gardikes-Gingery, MSN, RN Sarah J. Corriveau, MD Melissa Hamms, MBA, BSN, RN Ene Fairchild, MD Kristina M. Reber, MD Valencia P. Walker, MD, MPH Jennifer Thompson, MBA, BSN, RN Angela Firestine, MD Associate Division Chief Associate Division Chief for Health Equity and Inclusion DIRECTOR OF NEONATAL ADVANCED PRACTITIONERS Joshua H. Goldberg, MD Erin Keels, DNP, APRN, NNP-BC FULL-TIME NATIONWIDE CHILDREN’S FACULTY Barry Halpern, MD Ehab I. Ahmed, MD Nancy B. Hansen, MD The Section of Neonatology is dedicated to providing integrated perinatal care and research throughout Carl H. Backes, MD Juli Kern, MD the patient life cycle to reduce infant mortality and Molly K. Ball, MD Jeffrey S. Keyes, MD morbidities so that children are able to reach their Roopali V. Bapat, MD Michelle Lash, MD full potential. To achieve this, the section not only provides outstanding neonatal care, but has also Thomas Bartman, MD, PhD Corin Cozzi Linsey, MD implemented a variety of innovative, unique programs Kristen L. Benninger, MD Wendy A. Luce, MD that bring together multidisciplinary groups to provide advanced clinical care and research targeting the most Edward G. Shepherd, MD Elizabeth M. Bonachea, MD Maclain Magee, MD common and most debilitating causes of mortality and Section Chief Erica Braswell, MD Benjamin A. McDonald, MD morbidity in these babies. These programs include the Bernadette Chen, MD Randy R. Miller, MD comprehensive Center for Bronchopulmonary Dysplasia, the Infant Feeding Disorders Program, the Small Baby Jana Erner, MD Avante Milton, MD Program, the Congenital Infections Program and the Omid Fathi, MD

96 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 97 Neurodevelopmental Follow-up Program. The Center Lewandowski DJ, Byrne R. Network Implementation of Guideline for Early Detection Decreases Age at Cerebral Palsy Diagnosis. Pediatrics. 2020 May;145(5):e20192126. for Bronchopulmonary Dysplasia has the only dedicated CLINICAL FAST FACTS (CONTINUED) Pishevar N, Fathi O, Backes CH, Shepherd EG, Nelin LD. Predicting survival in infants unit (C4A) for the care of infants with BPD in the born at <27 weeks gestation admitted to an all referral neonatal intensive care unit: a pilot country. The BPD unit draws patients from all over study. Journal of Perinatology. 2020 May;40(5):750-757. July 2019 through June 2020 the United States including as far away as California, Ronchi A, Zeray F, Lee LE, Owen KE, Shoup AG, Garcia F, Vazquez LN, Cantey JB, Newborn Intensive Care Unit at Grant Medical Center Average Length of Stay*:...... 10 Oregon and Utah. The BPD unit has excellent outcomes Varghese S, Pugni L, Mosca F, Sánchez PJ. Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection. Journal of Perinatology. 2020 Total Discharges:...... 255 Average Daily Census*:...... 4.1 including a very low mortality rate and tracheostomy Jan;40(1):89-96. Average Length of Stay*:...... 19.2 rate. Furthermore, the neurodevelopmental outcomes of Patient Days*:...... 1,496 2019 – 2020 NATIONWIDE CHILDREN’S Average Daily Census*:...... 13.4 patients taken care of by the BPD unit were published Newborn Intensive Care Unit at St. Ann’s Hospital and we found that 56% of patients have no evidence of FELLOWSHIP PROGRAM Patient Days*:...... 4,888 Total Discharges:...... 326 neurodevelopmental impairment, despite the fact that Newborn Intensive Care Unit at Doctor’s Hospital West 78% of the patients in this cohort had severe BPD. The NEONATAL-PERINATAL MEDICINE Average Length of Stay*:...... 17.9 Inpatient Discharges:...... 125 Infant Feeding Disorders Program provides advanced Amy Brown, MD Average Daily Census*:...... 15.9 care and treatment to optimize outcomes for infants with Julie A. Dillard, MD Observation and Outpatient-in-a-Bed Discharges:...... 2 Patient Days*:...... 5,811 feeding disorders. The Infant Feeding Disorders Program Lindsey Korbel, MD Alexandra Medoro, MD Total Discharges:...... 127 published outcomes of their ongoing QI initiative — the Newborn Intensive Care Unit at Avante D. Milton, MD Average Length of Stay*:...... 13.7 feeding enhancement program — and demonstrated The Ohio State University Wexner Medical Center Clifford Mueller, MD Average Daily Census*:...... 4.7 significant and sustained shortened length of time for Leeann R. Pavlek, MD Inpatient Discharges:...... 651 preterm infants to achieve full oral feeds, which resulted Zubin Shah, MD Patient Days*:...... 1,717 Total Discharges:...... 655 in a significant shorter length of stay. The Small Baby George Ziegler, MD Program continues to positively impact the outcomes Newborn Special Care Nursery Observation and Outpatient-in-a-Bed Discharges:...... 4 of extremely preterm infants (those born at <27 weeks CLINICAL FAST FACTS at Dublin Methodist Hospital Average Length of Stay*:...... 17.6 gestation). This year the small baby program found that Inpatient Discharges:...... 150 July 2019 through June 2020 Average Daily Census*:...... 31.4 using a novel algorithm with data available at the time Observation and Outpatient-in-a-Bed Discharges:...... 4 Patient Days*:...... 11,479 of admission that survival in this high-risk population Main Campus Total Discharges:...... 154 *Excludes observation and outpatient-in-a-bed patients. could be predicted. The Congenital Infections Program, Inpatient Discharges:...... 1,092 a multidisciplinary program targeting babies born with Observation and Outpatient-in-a-Bed Discharges:...... 1 congenital viral infections, has implemented universal screening for congenital cytomegaloviral infections in the Total Discharges:...... 1,093 Nationwide Children’s Neonatal Network. Finally, for Average Length of Stay*:...... 38.1 A Decade of Remarkable Transformation our patients to reach their full potential requires longer Average Daily Census*:...... 113.1 NEONATOLOGY term outpatient neurodevelopmental care available Patient Days*:...... 41,278 through our Neonatal Follow-up Program, which Guidelines Developed Positive touch in the NICU: Study Prediction of Short-Term this year published results that demonstrate that their Fetal Medicine Collaborative Clinic Visits:...... 201 for Extremely Premature Led by Nathalie Maitre, MD, PhD, Neonatal Complications In Infants Proven to be Reinforces Touch Helps Shape Preterm Infants Using Exome- novel, multi-component, upper-extremity intervention Neonatology Clinic Visits:...... 3,163 Life-Changing Preterm Babies’ Brains Wide Genetic Variation improved motor function in patients with cerebral palsy. Neonatology BPD Clinic Visits:...... 965 Perinatal Research: See page 191 for information about Neonatal Abstinence Syndrome Clinic Visits:...... 117 the Center for Perinatal Research in the Abigail Wexner 2010 2012 2014 2016 20172013 2019 2017 20202017 Research Institute at Nationwide Children’s. Newborn Intensive Care Unit at Riverside Methodist Hospital GRANTS AWARDED TO NEONATOLOGY Comprehensive BPD Neonatal Aerodigestive Congenital Infections Inpatient Discharges:...... 483 Center Established Using Program Launched Program Established CLINICAL AND RESEARCH FACULTY Innovative Multidisciplinary Combining High Quality JULY 1, 2019 – JUNE 30, 2020 Approach With Demonstrated Clinical Care With Cutting Observation and Outpatient-in-a-Bed Discharges:...... 3 Improvements in Survival Edge Research $5,562,391 Total Discharges:...... 486 and Outcomes Average Length of Stay*:...... 27.3 SELECTED PUBLICATIONS Throughout the past decade, we have made great strides in clinical care and research for neonates. Advancing strong Bapat R, Gulati IK, Jadcherla S. Impact of SIMPLE Feeding Quality Improvement Average Daily Census*:...... 36.1 collaborations, digging deeper into the treatment and prevention of prematurity, and leading in research and innovation, Strategies on Aerodigestive Milestones and Feeding Outcomes in BPD Infants. Hospital Pediatrics. 2019 Nov;9(11):859-866. Patient Days*:...... 13,164 has enabled the size and strength of our program to be unmatched. Caring for more than 3,000 babies each year, we are

Bauer SE, Schneider L, Lynch SK, Malleske DT, Shepherd EG, Nelin LD. Factors the nation’s largest neonatal center. Associated with Neurodevelopmental Impairment in Bronchopulmonary Dysplasia. The Journal of Pediatrics. 2020 Mar;218:22-27.e2.

Maitre NL, Burton VJ, Duncan AF, Iyer S, Ostrander B, Winter S, Ayala L, Burkhardt S, Gerner G, Getachew R, Jiang K, Lesher L, Perez CM, Moore-Clingenpeel M, Lam R,

98 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 99 Nephrology and Hypertension RNase 7: Paving the Way for Natural, Antibiotic-Free Treatment for Urinary Tract Infections The latest in the body of antimicrobial peptide research suggests RNase7 may be a prognostic marker and potential therapeutic option for UTIs.

Building on their body of research focused on the naturally occurring antimicrobial peptides in the urinary tract, clinician-scientists at Nationwide Children’s Hospital have now confirmed the suspected role of Ribonuclease 7 (RNase 7) in E. coli-based infection risk. Human patients, tissue cultures and humanized mouse models all indicate that higher levels of RNase 7 in the urinary tract are associated with lower risk of infection, and lower levels of RNase 7 are associated with increased susceptibility to infection.

According to the research team, this suggests a potential role for RNase 7 in the prediction of infection risk or severity as well as in the development of novel, non-antibiotic treatments — even for drug-resistant UTIs.

“For the first time, we’ve shown that female children with UTIs have lower levels of the antimicrobial peptide RNase 7 compared to healthy controls,” says John David Spencer, MD, chief of the Division of Nephrology and Hypertension at Nationwide Children’s and senior author on the study, published in the Journal of the American Society of Nephrology.

The study’s 29 girls who had a UTI history had an average urinary RNase 7 concentration 1.5 times lower than the 29 healthy control girls.

Additionally, the publication included findings from human tissue cultures showing that silencing RNase 7 allowed a multi-drug resistant strain of E. coli (known as uropathogenic E. coli or UPEC) to bind more effectively to human bladder cells, while overexpressing RNase 7 led to decreased bacterial binding.

The team also developed a humanized mouse model to express high and low levels of RNase 7 in the urinary tract in order to study its biological activity. This first-ever manipulation of RNase 7 in vivo revealed that mice with RNase 7 present had low susceptibility to infection when challenged with UPEC.

“This study represents a key step in trying to evaluate the biological activity and safety profile of RNase 7 manipulation,” says Dr. Spencer, whose work on antimicrobial peptides is supported by funding through the National Institutes of Health. “Our research suggests that if you can find a way to overexpress the RNase 7 protein, it could be a therapy. It also further validates that if you have lower levels of RNase 7, you may be at greater risk for infection.”

REFERENCES: Eichler T, Bender K, Murtha MJ, Schwartz L, Metheny J, Solden L, Jaggers RM, Bailey MT, Gupta S, Mosquera C, Ching C, La Perle K, Li B, Becknell B, Spencer JD. Ribonuclease 7 Shields the Kidney and Bladder from Invasive Uropathogenic Escherichia coli Infection. J Am Soc Nephrol. 2019 Aug;30(8):1385-1397. “For the first time, we’ve shown that female children with UTIs have lower levels Murtha MJ, Eichler T, Bender K, Metheny J, Li B, Schwaderer AL, Mosquera C, James C, Schwartz L, Becknell B, Spencer JD. Insulin receptor signaling regulates renal collecting duct and intercalated cell antibacterial defenses. The Journal of Clinical Investigation. 2018 Dec of the antimicrobial peptide RNase 7 compared to healthy controls.” 3;128(12):5634-5646. – John David Spencer, MD

100100 | |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | |2019-20 2019-20 Annual Annual Report Report | |N ationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 101 Department of Pediatrics

NEPHROLOGY AND HYPERTENSION multicenter study funded by the NIH to identify markers of SELECTED PUBLICATIONS glomerular disease and evaluate how new therapies impact Ching C, Schwartz L, Spencer JD, Becknell B. Innate Immunity and Urinary Tract The Division of Nephrology and Hypertension at Nationwide Children’s Hospital provides specialized disease progression. Infection. Pediatric Nephrology. 2020 Jul;35(7):1183-1192. primary and consultative care for children with kidney and urinary tract problems through age 21. Disorders Eichler T, Bender K, Murtha MJ, Schwartz L, Metheny J, Solden L, Jaggers RM, Bailey Research done by the clinical and research faculty was MT, Gupta S, Mosquera C, Ching C, La Perle K, Li B, Becknell B, Spencer JD. (2019). treated include acute kidney injury, chronic kidney disease, congenital anomalies of the kidneys and urinary presented at several national academic meetings, including Ribonuclease 7 Shields the Kidney and Bladder from Invasive Uropathogenic Escherichia coli Infection. The Journal of the American Society of Nephrology.2019 Aug;30(8):1385-1397. tract, glomerular disorders, tubular disorders, urinary tract infection, kidney stones, electrolyte disorders, the American Society of Nephrology Kidney Week, the Pediatric Academic Societies meeting and multiple specialized Hari P, Khandelwal P, Smoyer WE. Dyslipidemia and Cardiovascular Health in Childhood Nephrotic Syndrome. Pediatric Nephrology. 2020 Sep;35(9):1601-1619. [Epub 2019 Jul 13] hypertension and metabolic bone disease. A full range of renal replacement therapy services are available, international research symposia. Nephrology faculty had over including hemodialysis, peritoneal dialysis, continuous renal replacement therapy, aquapheresis and kidney 40 unique, peer-reviewed publications, some of which are Kallash M, Smoyer WE, Mahan JD. Rituximab Use in the Management of Childhood Nephrotic Syndrome. Frontiers Pediatrics. 2019 May 10;7:178. highlighted here. transplantation. McLeod DJ, Sebastião YV, Ching CB, Greenberg JH, Furth SL, Becknell B. Longitudinal Research: See page 184 for information about the Center Kidney Injury Biomarker Trajectories in Children with Obstructive Uropathy. Pediatric Nephrology. for Clinical and Translational Research in the Abigail Wexner 2020 May 22. FACULTY In the 2019-2020 academic year, the division welcomed Research Institute at Nationwide Children’s. two new nephrologists: Tahagod Mohamed, MD, and Diana Zepeda-Orozco, MD, MS. Dr. Mohamed is a junior GRANTS AWARDED FAST FACTS nephrologist who completed her Nephrology Fellowship JULY 1, 2019 – JUNE 30, 2020 at the University of Virginia. Dr. Mohamed is developing July 2019 through June 2020 $4,400,892 a national reputation in neonatal nephrology and acute Inpatient Discharges:...... 171 kidney injury. Dr. Zepeda-Orozco joined our team after 2019 – 2020 NATIONWIDE CHILDREN’S serving as the director of the kidney transplantation Observation and Outpatient-in-a-Bed Discharges:...... 106 program at the University of Iowa for nearly 10 years. Dr. FELLOWSHIP PROGRAM Total Discharges:...... 274 Zepeda-Orozco is a National Institutes of Health (NIH)- Average Length of Stay*:...... 4.0 funded physician scientist who is investigating mechanisms PEDIATRIC NEPHROLOGY Average Daily Census*:...... 1.8 of acute kidney injury. Dr. Zepeda-Orozco will serve as the Jessamyn Carter, MD (Medicine/Pediatrics) director of the acute kidney injury program at Nationwide Jessica M. Greco, MD (Medicine/Pediatrics) Patient Days*:...... 669 John David Spencer, MD Children’s. The division continues to work closely and in Emily Stonebrook, MD (Pediatrics) Nephrology Clinic Visits:...... 4,211 Division Chief collaboration with multiple clinical and surgical divisions. Jason P. Thomas, MD (Pediatrics) Clinical operations in the Urology/Nephrology Combined Dublin Nephrology Clinic Visits:...... 230 Clinic have nearly doubled. While doing so, we have Kidney Transplants:...... 6 standardized clinical care for children with urinary tract obstruction and integrated preclinical and translational *Excludes observation and outpatient-in-a-bed patients. research efforts into nearly every patient visit. Additionally, we have increased patient volumes in our multidisciplinary Metabolic Bone Clinic, as well as the Lupus Clinic, which is managed in collaboration with the Division of A Decade of Remarkable Transformation Rheumatology. NEPHROLOGY AND HYPERTENSION The Division of Nephrology and Hypertension maintains an active and highly funded research program in the Nephrologists Invest in Patient Abigail Wexner Research Institute at Nationwide Children’s Advocacy by Becoming John E. Lewy New Multidisciplinary Lupus Division Rebranded to Hiren P. Patel, MD (JELF) Scholars through American Clinic Starts in Collaboration with Division of Nephrology and Hospital. Four of our physician-scientists maintain actively Society of Pediatric Nephrology Rheumatology Hypertension Section Chief funded NIH research programs. This past winter, Brian Brian Becknell, MD, PhD Becknell, MD, PhD, was awarded his first R01 application from the NIH to study mechanisms of obstructive kidney Ray Bignall II, MD disease. Additionally, our division participates in over 2010 2012 2013 2017 20132019 2020 2017 Mahmoud Kallash, MD 50 Institutional Review Board-approved clinical and translational studies that are supported by five clinical New Multidisciplinary First Simultaneous John D. Mahan, MD Nephro-Urology and Kidney Liver-Kidney Transplant at research coordinators. These studies investigate mechanisms Stone Clinic Starts in Nationwide Children’s Tahagod Mohamed, MD and outcomes of urinary tract infection, obstructive Collaboration with Urology uropathy, chronic kidney disease, bacterial peritonitis, William E. Smoyer, MD renal transplantation, glomerular diseases, metabolic bone In the past decade, the Division of Nephrology and Hypertension has received national recognition and awards for clinical Beth A. Vogt, MD disorders and medical education. Many of these studies are research. The Nephrology and Urology Research Affinity Group (NURAG) at Nationwide Children’s has received over performed in conjunction with the Pediatric Nephrology Amy Wright, NP $18.7 million in extramural funding between 2015-2020. Research Consortium (PNRC). John D. Mahan, MD, Diana Zepeda-Orozco, MD, MS serves as this consortium’s president. This past year, William E. Smoyer, MD, received added funding to spearhead the Cure Glomerulonephropathy Network (CureGN), a

102 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 103 Neurology First Report of Systemic Delivery of Micro-dystrophin Gene Therapy in Children With Duchenne Muscular Dystrophy One-year data from the first four patients to receive a single dose of the rAAVrh74.MHCK7.micro- dystrophin gene therapy is published in JAMA Neurology.

Researchers from Nationwide Children’s Hospital have published results in JAMA Neurology from the first four children with Duchenne muscular dystrophy (DMD) treated in the first clinical trial of systemic delivery of micro-dystrophin gene therapy in children. Initial findings suggest that the therapy can provide functional improvement that is greater than that observed under the standard of care.

DMD is a fatal neuromuscular disease that occurs in approximately one in every 5,000 males worldwide and is caused by a mutation in the gene that encodes for dystrophin. The dystrophin gene itself is too large to fit into the adeno-associated viral vector used in the gene therapy technology utilized by the study. Researchers have developed micro-dystrophin as a microgene that provides function while still fitting in the vector.

“Duchenne muscular dystrophy is difficult to treat, and gene therapy offers a needed option having the potential to alter the course of the disease,” says Jerry Mendell, MD, the study’s co-author and principal investigator with the Center for Gene Therapy in the Abigail Wexner Research Institute at Nationwide Children’s.

Four ambulatory participants, aged 4 to 7 years at time of infusion, were treated with a single dose of 2.0 x 1014 vg/kg rAAVrh74.MHCK7.micro-dystrophin (SRP-9001 micro-dystrophin, Sarepta Therapeutics), which was infused through a peripheral limb vein. All treatment-related events were mild to moderate and there were no serious adverse events.

“We are very pleased to report successful delivery of the micro-dystrophin transgene to the nuclei – corresponding to robust gene expression and proper localization of micro-dystrophin. This coincides with improvements in functional measurements in all study participants who received SRP-9001,” Dr. Mendell says.

Participants had confirmed vector transduction and showed functional improvement of North Star Ambulatory Assessment (NSAA) scores. The NSAA is a 17-item measure of ambulatory functions with a score range from 0 to 34.

“The publication of these results further supports the potential for SRP-9001 to provide clinically meaningful functional improvements in terms of speed and magnitude for DMD patients,” says Louise Rodino-Klapac, PhD, senior vice president of gene therapy at Sarepta Therapeutics. “We look forward to advancing our ultimate goal of profoundly improving the lives of as many patients living with DMD as possible.”

Sarepta has exclusive rights to the gene therapy program initially developed at AWRI at “Duchenne muscular dystrophy is difficult to treat, and gene therapy offers a needed Nationwide Children’s. option having the potential to alter the course of the disease.” CITATION: – Jerry Mendell, MD Mendell JR, Sahenk Z, Lehman K, Nease C, Lowes LP, Miller NF, Iammarino MA, Alfano LN, Nicholl A, Al-Zaidy S, Lewis S, Church K, Shell R, Cripe LH, Potter RA, Griffin DA, Pozsgai E, Dugar A, Hogan M, Rodino-Klapac LR. Assessment of Systemic Delivery of rAAVrh74.MHCK7.micro-dystrophin in Children With Duchenne Muscular Dystrophy: A Nonrandomized Controlled Trial. JAMA Neuroogyl. 2020 Jun 15;77(9):1–10.

104104 | |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | |2019-20 2019-20 Annual Annual Report Report | |N ationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 105 Department of Pediatrics

NEUROLOGY The Neurology division includes 31 physicians Research: See page 185 for information about the and 12 advanced health care providers who oversee Center for Gene Therapy in the Abigail Wexner Research The Division of Neurology providers at Nationwide Children’s Hospital deliver comprehensive care for children comprehensive programs for children with epilepsy, Institute at Nationwide Children’s. with a wide variety of disorders. These include simple and complex epilepsy, primary and secondary headache headache, movement disorders, neurodegenerative Neurosurgery: See page 145 to learn about the and migraine, tics and movement disorders, neuroinflammatory conditions, muscular dystrophy, spinal disorders and neuromuscular diseases. For children Department of Neurosurgery at Nationwide Children’s. muscular atrophy and neuropathy (acquired and genetic). In order to correctly identify and safely treat these with complex disorders, we use a multidisciplinary clinical approach. In 2019, we added two additional GRANTS AWARDED TO CENTER FOR GENE THERAPY children, state-of-the-art neurophysiological diagnostic testing and intraoperative monitoring is used. Our multidisciplinary clinics: the Neuroimmunology clinic AND NEUROLOGY CLINICAL AND RESEARCH FACULTY mission is to achieve the best outcomes for all children and adolescents with neurological illness. (led by Dr. Melissa Hutchinson) and the center of JULY 1, 2019 – JUNE 30, 2020 excellence for Charcot Marie Tooth (CMT) (led by Dr. $17,070,837 FACULTY Zarife Sahenk). Additional ongoing multidisciplinary Monica P. Islam, MD SELECTED PUBLICATIONS programs include the Batten Disease Center of Excellence, Latif Khuhro, MD Albert DVF, Moreland JJ, Salvator A, Moore-Clingenpeel M, Haridas B, Cole JW, Pediatric Intracranial Hypertension (pseudotumor Glynn P, Fults M, Dawson MZ, Moreland P, Patel AD. Seizure Action Plans for Pediatric Neil Kulkarni, MD cerebri) Clinic, Muscular Dystrophy Clinic, Brain Tumor Patients with Epilepsy: A Randomized Controlled Trial. Journal of Child Neurology. 2019 Oct;34(11):666-673 Warren D. Lo, MD Program, Cerebrovascular Disease Clinic, Concussion Clinic, Epilepsy Clinic, Epilepsy Surgery Program, Mendell JR, Sahenk, Z, Lehman K, Nease C, Lowes LP, Miller NF, Iammarino MA, Jennifer McKinney, MD Alfano LN, Nicholl A, Al-Zaidy S, Lewis S, Church K, Shell R, Cripe LR, Potter RA, Muscular Dystrophy Clinic, Spinal Muscular Atrophy Griffin DA, Pozsgai E, Dugar A, Hogan M, Rodino-Klapac Lr. Assessment of Systemic Delivery of rAAVrh74.MHCK7.micro-dystrophin in Children with Duchenne Muscular Jerry Mendell, MD Clinic, Stroke Clinic and Tuberous Sclerosis Clinic. Dystrophy A Nonrandomized Controlled Trial. JAMA Neurology. 2020 Jun 15 [Epub John Mytinger, MD The section offers outstanding residency and fellowship ahead of print] programs. The Child Neurology Residency program Miller KE, Koboldt DC, Schieffer KM, Bedrosian TA, Crist E, Sheline A, Leraas K, Adam Ostendorf, MD Magrini V, Zhong H, Brennan P, Bush J, Fitch J, Bir N, Miller AR, Cottrell CE, Leonard (certified by Accreditation Council for Graduate Medical J, Pindrik JA, Rusin JA, Shah SH, White P, Wilson RK, Mardis ER, Pierson CR, Ann Pakalnis, MD Education) includes five residents per year with options Ostendorf AP. Somatic SLC35A2 mosaicism correlates with clinical findings in epilepsy Anne M. Connolly, MD brain tissue. Neurology Genetics. 2020 Jun 17;6(4):e460. Margie Ream, MD, PhD for clinical- or research-focused educational tracks. Division Chief Neurology also offers pediatric fellowship training in Mytinger JR, Albert DVF, Twanow JD, Vidaurre J, Tan Y, Grock GN, Ostendorf, AP. Sean Rose, MD Compliance with Standard Therapies and Remission Rates after Implementation of an clinical and surgical neurophysiology, gene therapy, Infantile Spasms Management Guideline. Pediatric Neurology. 2020 Mar;104:23-29. Zarife Sahenk, MD, PhD headache, neuromuscular disease, neuromuscular Nizon M, Laugel V, Flanigan KM, Pastore M, Waldrop MA, Rosenfeld JA, Marom R, pathology and stroke. Faculty members conducted both Xiao R, Gerard A, Pichon O, Caignec CL, Gerard M, Dieterich K, Cho MT, McWalter Laurel Slaughter, MD K, Hiatt S, Thompson ML, Bezieau S, Wadley A, Wierenga KJ, Egly JM, Isidor B. basic and clinical research and published numerous Variants in MED12L, encoding a subunit of the mediator kinase module, are responsible Chang-Yong Tsao, MD journal articles and book chapters in 2019. for intellectual disability associated with transcriptional defect. Genetics in Medicine. 2019 Dec;21(12):2713-2722. Jaime-Dawn Twanow, MD Jorge Vidaurre, MD Megan Waldrop, MD CLINICAL FAST FACTS

Pedro Weisleder, MD, PhD July 2019 through June 2020 Anup D. Patel, MD In 2020, the neurology section welcomed two new faculty Neurology Findlay Neurology Clinic Visits:...... 43 Section Chief members and one new advanced practitioner. Dr. Sylvia Inpatient Discharges:...... 200 Heinzerling Neurology Clinic Visits:...... 28 Awadalla joined in early January and brings deep expertise Dara Albert, DO Observation and Outpatient-in-a-Bed Discharges:...... 507 in headache and movement disorders. Dr. Darrah Haffner Neurology Clinic Visits:...... 11,151 Sylvia Awadalla, MD joined in August after completing fellowship training in Total Discharges:...... 704 Mansfield Neurology Clinic Visits:...... 53 William D. Arnold, MD neonatal neurology and neurodevelopment. Ms. Alison Average Length of Stay*:...... 3.0 Westerville Neurology Clinic Visits:...... 1,241 Remy joined our APP group in August and will be Kristen Arredondo, MD Average Daily Census*:...... 1.6 Total Neurology Clinic Visits:...... 16,460 focusing on childhood epilepsy. Shawn Aylward, MD Patient Days*:...... 595 After the U.S. Food and Drug Administration approval Neuromuscular Disorders Inpatient Consults:...... 1,163 Melissa Chung, MD (February 2019) of gene transfer for infants with spinal MDA Clinic Visits:...... 645 Blanchard Neurology (PAA) Visits:...... 8 Emily De Los Reyes, MD muscular atrophy (SMA), we have delivered gene transfers Westerville Neuromuscular Clinic Visits:...... 19 for more than 20 children. Ongoing research continues Complex Concussion Clinic Visits:...... 308 John L. Eickholt III, MD to develop gene therapy for older children with SMA, Neuromuscular Disorders Clinic Visits:...... 885 Stroke Clinic Visits:...... 209 Kevin Flanigan, MD muscular dystrophy (Duchenne and limb girdle) and Spinal Muscular Atrophy Clinic Visits:...... 273 Dublin Neurology Clinic Visits:...... 2,740 Mariam L. Freimer, MD CMT. Additional work has led to improvements in the Total Neuromuscular Clinic Visits:...... 1,822 care and understanding of children with infantile spasms, East Broad Neurology Clinic Visits:...... 679 Darrah Haffner, MD status epilepticus and complex epilepsy. *Excludes observation and outpatient-in-a-bed patients. Melissa Hutchinson, MD

RESIDENCY PROGRAMS FELLOWSHIP PROGRAMS CHILD NEUROLOGY GENE TRANSFER FELLOWSHIP CLINICAL NEUROPHYSIOLOGY Daniel Clark, MD Nicolas Abreu, MD Stephanie Ahrens, DO Alexandra B. Kornbluh, MD Daniel Freedman, DO Matthew Martin, MD NEUROMUSCULAR GENETIC Thomas Murray, DO THERAPEUTICS Lisa Pabst, MD Renatta Knox, MD, PhD Melissa D. Squires, MD Whitney Woodhull, MD

A Decade of Remarkable Transformation NEUROLOGY

Dr. Jerry Mendell and Team Results of First Successful Named Batten Disease Publish SMA-1 Gene Therapy Gene Therapy for DMD Led Center of Excellence by First Dedicated Program Results in NEJM; Paves Way for by Dr. Mendell and Team BDSRA for Infantile Spasms FDA’s 2019 Approval Published in JAMA Neurology 2010 2010 2012 2014 2017 2019 2020 20202017

First Intracranial Columbus and Nationwide Children's Named CMT Center of Hypertension Program for Host Child Neurology Society Annual Excellence by Charcot-Marie- Pediatric Patients Meeting Tooth Association

During the past decade Neurology faculty have developed many groundbreaking clinical programs and led scientific discoveries for previously fatal diseases. The faculty increased by more than 70% to the current staff of 33 neurologists and for the past four consecutive years, U.S. News & World Report has ranked Nationwide Children’s in the top seven for Neurology and Neurosurgery.

PEDIATRIC PSYCHOLOGY AND NEUROPSYCHOLOGY Kathleen L. Lemanek, PhD Andrea Wojtowicz, PhD Pediatric Psychology and Neuropsychology is a Section of the Department of Pediatrics at Nationwide Ann Levine, PhD Jacqueline Wynn, PhD Children’s Hospital that concentrates clinical services in three primary areas: Pediatric Psychology provides Barbara Mackinaw-Koons, PhD Heather L. Yardley, PhD specialized assessment and intervention services that focus on the relationship between cognitive, social Laura M. Mackner, PhD Tammi K. Young-Saleme, PhD and emotional functioning and physical health, typically for children with co-occurring medical conditions Marilee Martens, PhD GRANTS AWARDED (e.g., cancer, diabetes, sickle cell disease); Pediatric Neuropsychology performs specialized evaluations Hannah McKillop, PhD JULY 1, 2019 – JUNE 30, 2020 for children and adolescents with a range of medical and neurological disorders that impact thinking or $524,626 Kelly A. McNally, PhD behavior (e.g., brain tumors, epilepsy, seizure disorders, traumatic brain injury); Pediatric Psychiatric Acute Margaret Mehling, PhD Care Psychology provides services to support the acute care continuum in the Big Lots Behavioral Health SELECTED PUBLICATIONS David Michalec, PhD Butz C, Castillo A, Gallup J, Valleru J, Butter E. Timely Access to Mental Health Services Pavilion; and Intellectual and Developmental Disability/Autism Spectrum Disorder Psychology provides for Patients with Pain. Pediatric Quality & Safety. 2019 Dec 6;4(6):e240. specialized assessment and intervention services for children and adolescents impacted by various genetic Alana Moses, PhD Johnson B, Leibowitz S, Chavez A, Herbert SE. Risk Versus Resiliency: Addressing Depression in Lesbian, Gay, Bisexual, and Transgender Youth. Child & Adolescent and neurodevelopmental disabilities, including autism spectrum disorders. See page 132 for details and for James A. Mulick, PhD Psychiatric Clinics of North America. 2019 Jul;28(3):509-521. information about all Behavioral Health services. Caroline Murphy, PhD Mazurek MO, Carlson C, Baker-Ericzen M, Butter E, Norris M, Kanne S. Construct Validity of the Autism Impact Measure (AIM). Journal of Autism & Developmental Disorders. Emily Newton, PhD 2020 Jul;50(7):2307-2319. FACULTY Jackie Doxie-King, PhD Butter E, Megan Norris, PhD Ramtekkar U, Bridge J, Thomas G, Reese J, Logan E, Lin S, Axelson D. Pediatric Christine Eichelberger, PhD Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19. Jessica Palila, PhD JMIR Mental Health. 2020; 10:10. Anya Froelich, PsyD Ari Rabkin, PhD Lauren Garbacz, PhD Natalie Raff, PhD Molly Gardner, PhD FAST FACTS Whitney Raglin-Bignall, PhD Cynthia A. Gerhardt, PhD Courtney Rice, PsyD July 2019 through June 2020 Shannon Gilespie, PhD Claire Russell, PhD Inpatient Consultations: ...... 4,164 Alana Goldstein-Leever, PhD Jessica Scherr, PhD Psychology Clinic Visits:...... 14,241 Amy Hahn, PhD Rose Schroedl, PhD Psychology Medical Clinic Eric M. Butter, PhD Jane Hamel-Lambert, PhD Visits/Outpatient Consultation Visits:...... 15,149 Chief Ashley Showalter, PhD Jennifer Hansen, PhD Micheline Silva, PhD Charles Albright, PhD Sharnita Harris, PhD Tyanna Snider, PsyD Jessica Bailey, PhD Rebecca Hellenthal, PhD Janet Souder, PsyD Amy E. Baughcum, PhD Jessica Hoehn, PhD Jack H. Stevens, PhD Doug Bodin, PhD Ariana Hoet, PhD Karen Tabern, PhD Shalonda Brooks, PhD Kristen E. Hoskinson, PhD H. Gerry Taylor, PhD Catherine Butz, PhD Cody Hostutler, PhD Kristen Trott, PhD Jennifer E. Cass, PhD Parker Huston, PhD Natalie Truba, PhD Eileen Chaves, PhD Cara Inglis, PsyD Kathryn A. Vannatta, PhD Sarah Connolly, PhD Jamie Jackson, PhD Lindsey Vater, PhD Andrea Coppens, PhD Katie Johanning Gray, PhD Sarah N. VerLee, PhD Canice Crerand, PhD Oula Khoury, PhD Bethany Walker, PhD Anne Dawson, PhD Chrissie Koterba, PhD Jonathan Wilkins, PhD Ashley Debeljak, PhD Ashley Kroon Van Diest, PhD Camille Wilson, PhD Nicole Dempster, PhD Elizabeth Kryszak, PhD Robert M. Dempster, PhD Mary Wojnaroski, PhD

PRIMARY CARE PEDIATRICS Douglas J. McLaughlin, MD array of conditions, including anemia, asthma, Melissa A. Meyer, MD attention deficit-hyperactivity disorder, depression Pediatricians in the Division of Primary Care Pediatrics at Nationwide Children’s Hospital staff the Belinda M. Mills, MD and obesity. The division also focuses on ensuring all 12 Nationwide Children’s Hospital Primary Care Centers located throughout the Columbus area. A children and adolescents receive timely preventive Alana Milton, MD multidisciplinary staff provides comprehensive primary care services for a diverse and underserved services, including well-child visits and immunizations. Asma Mobin-Uddin, MD population of patients. The division also houses the Center for Healthy Weight Mary A. Nelin, MD and Nutrition, a national model for multidisciplinary Barbara Oettgen, MD comprehensive care for children and adolescents with FACULTY Katharine Coffman, MD Michele Oyortey, MD obesity. In 2019, the division expanded its focus on Frances Comer, DO adolescent preventive services, including screening for Cheryl B. Pippin, MD Duane R. Copenheaver, DO depression and suicide risk. To address the needs of Quiana Pollock, MD Kimberly Dean, MD patients and families during the COVID-19 pandemic, Stephanie Quach, MD the division expanded access through telemedicine in Emily A. Decker, MD Alexander T. Rakowsky, MD addition to regular, in-person visits. Tanya Dedyo, MD Jessica Retzke, MD Robyn Dennis, MD The Division of Primary Care Pediatrics provides Jennifer Ricciardo, MD Sarah Denny, MD training and education for The Ohio State University Nathan Richards, MD College of Medicine students, as well as residents in Ihuoma U. Eneli, MD Richard E. Rodenberg Jr., MD Pediatrics, Family Medicine and combined Internal Maureen Faust, DO Allison Rossetti, MD Medicine-Pediatrics. Research focuses on a broad Alex R. Kemper, MD, MPH, MS Ashley Fernandes, MD range of preventive services, smoking cessation, Andrea Sattler, MD Division Chief Susan Friedman, MD obesity prevention and treatment, health literacy, and Sara Schroder, MD Sean P. Gleeson, MD transition from pediatric to adult health care services. Amina Smajlovic, MD Judith A. Groner, MD GRANTS AWARDED Kimberly Stettler, MD Uma Gupta, MD JULY 1, 2019 – JUNE 30, 2020 Lisa Stone, DO Malika Haque, MD $1,972,014 Melissa Swanson, MD Laura Hart, MD Patricia Temple Gabbe, MD SELECTED PUBLICATIONS Stephen J. Hersey, MD Olivia W. Thomas, MD Ghastine L, Kerlek AJ, Kopechek JA. Childhood sexual abuse: a call to action in pediatric Lisa Humphrey, MD primary care. Pediatrics. 2020;4:e20193327. Gina R. Thompson, DO Aurelia J. Jackson, MD Hart LC, Crawford M, Crawford P, Noritz G. Practical steps to help transition pediatric Jagadisharaje K. Urs, MD patients to adult care. Pediatrics. 2019;144(6):e20190373. Sinimol James, MD Jose Vargas, MD Kemper AR, Kelleher KJ, Allen S, Sander C, Brilli RJ. Improving the health of all children Dane A. Snyder, MD Angela V. Jones, MD in our community: The Nationwide Children’s Hospital and Franklin County Ohio, Shravani Vundavalli, MD Pediatric Vital Signs Project. Journal of Pediatrics. 2020;222:227-230. Section Chief Tabitha Jones-McKnight, DO Caroline Weingart, MD Khalsa AS, Copeland KA, Misik L, Brown CL, Kharofa RY, Olderbing NJ. Maternal Mary Ann Abrams, MD Shelby Jordan, MD body dissatisfaction and accuracy of infant weight perception in families from low-income Mark Winerman, MD backgrounds. Academic Pediatrics. 2020;20(6):793-800. Oghenevwiroro Akpovwa, MD Tatyana Karakay, MD Rachael Zanotti-Morocco, DO Walley SC, Wilson KM, Winickoff JP, Groner J. A public health crisis: electronic cigarettes, Razan Alkhoury, MD Amrik Singh Khalsa, MD vape, and JUUL. Pediatrics. 2019;143(6): e20182741. Zeenath Ameen, MD Lindsay Kneen, MD The Primary Care centers provide comprehensive care primarily for children from birth to 21 years Akua A. Amponsah, MD Jack A. Kopechek, MD FAST FACTS Ajay Koti, MD of age. Available services include preventive care, Kristen Beck, MD chronic disease management and acute care, with both July 2019 through June 2020 Alicia Kuper, DO Stefanie R. Bester, MD scheduled and same-day, walk-in access. In addition Primary Care Network Visits:...... 188,273 Sara Bode, MD Mary Kay Kuzma, MD to pediatricians and pediatric nurse practitioners, Courtney Brown, MD Gilbert Liu, MD the clinics include a wide array of other individuals Unique Patients Treated to support the needs of patients and their families, Megan Brundrett, MD Benjamin Levinson, MD in Entire Primary Care Network:...... 84,594 Jonathan T. Lucas, MD including health coaches, pharmacists, psychologists Nicole V. Caldwell, MD and social workers. Combined adult and pediatric adult Shengyi Mao, MD Milagro P. Castaneda-Viduarre, MD health services are available at one clinic site. Aarti Chandawarkar, MD Laura Martin, MD The division’s quality improvement initiatives continue Linda E. Chun, MD Lucas McKnight, MD to focus on improving care for patients with a broad

112 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 113 HEALTHY WEIGHT AND NUTRITION FAST FACTS weight management. In addition, the center offers adolescent bariatric surgery and is accredited by the July 2019 through June 2020 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. The center leads the Bariatric Clinic Visits:...... 576 Primary Care Obesity Network (PCON), a program Healthy Weight and Nutrition Clinic Visits:...... 2,219 that supports primary care practices with training and Hilliard Healthy Weight Clinic Visits:...... 399 resources. Westerville Healthy Weight Clinic Visits:...... 928 The center remains committed to providing educational opportunities with a fourth-year medical student elective, a residency elective rotation, and a childhood obesity and adolescent bariatric surgery fellowship, in Ihuoma U. Eneli, MD, MS, FAAP addition to serving as an expert to obesity programs Director around the United States and internationally. The center has federal, industry and foundation research funding. It participates in three National Institutes of Health (NIH) multicenter studies on the long-term outcomes of adolescent bariatric surgery, modeling obesity program attrition and the use of family behavioral therapy to address childhood obesity in the primary care setting. In addition, the center serves as the coordinating center for an international registry on rare disorders of genetic obesity.

Through leadership roles at the National Academy of Marc P. Michalsky, MD, FACS, FAAP Medicine (NAM) Roundtable on Obesity Solutions, Surgical Director American Society for Metabolic and Bariatric Surgery (ASMBS) and American Academy of Pediatrics (AAP) Eileen Chaves, PhD Institute for Healthy Childhood Weight (IHCW), our Jane Hamel-Lambert, PhD work led to the first AAP policy on bariatric surgery and Dominique Williams, MD, MPH, FAAP, Dipl ABOM the NAM obesity public workshops. Jinyu Xu RD, MPH, PhD GRANTS AWARDED Research Scientist JULY 1, 2019 – JUNE 30, 2020 Keigo Yada, MD, PhD, FACS $285,835 Childhood Obesity and Adolescent Bariatric Surgery Fellow SELECTED PUBLICATIONS

Bolling CF, Armstrong SC, Reichard KW, Michalsky MP, Section on Obesity, Section on The Center for Healthy Weight and Nutrition at Surgery. Metabolic and Bariatric Surgery for Pediatric Patients with Severe Obesity. The Nationwide Children’s Hospital offers a comprehensive Journal of Pediatrics. Dec 2019;144(6):e20193224. approach to weight management with programs for the Eneli I, Xu J, Tindall A, Watowicz R, Worthington J, Tanner K, Pratt K, Walston M. prevention and treatment of children and young adults, Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents with Severe Obesity: A Pilot Study. The International Journal of Environmental Research ages 2 to 21 years, with obesity. The center’s mission is to and Public Health. 2019 Aug 23;16(17):3061. empower children and families to establish a foundation Williams D, Chaves E, McKnight E, Eneli I. Diagnostic and Treatment Challenges of for healthy lifestyles through clinical care, education, Eating Disorders After Adolescent Bariatric Surgery: A Case Report. Clinical Obesity. 2020;10(4):e12367. research, community engagement and advocacy. Zeller MH, Reiter-Purtill J, Jenkins TM, Kidwell KM, Bensman HE, Mitchell JE, Courcoulas AP, Inge TH, Ley SL, Gordon KH, Chaves E, Washington GA, Austin HM, The Center for Healthy Weight and Nutrition offers Rofey DL. Suicidal Thoughts and Behaviors in Adolescents who Underwent Bariatric assessment clinics for evaluation of children and young Surgery. Surgery for Obesity and Related Disease. 2020 Apr;16(4):568-580. adults with obesity and a variety of multidisciplinary programs with a physician, psychologist, dietitian, physical therapist and athletic trainer for intensive

114 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 115 Pulmonary Medicine A Major Milestone in Cystic Fibrosis Treatment A triple medication combination could be life-changing for the majority of patients with cystic fibrosis.

A Phase III clinical trial shows that elexacaftor added to ivacaftor and tezacaftor improves lung function and quality of life in cystic fibrosis patients with the most common genetic mutation, F508del. The triple therapy, known as Trikafta, could effectively treat 90% of people with cystic fibrosis.

“Even though we treated a relatively small number of patients, the magnitude of the effect of this medicine is so huge that it took only small groups to be able to say we have extraordinarily significant results,” says Karen McCoy, MD, chief of the Division of Pulmonary Medicine at Nationwide Children’s Hospital and an author of the study. “We could tell within hours of starting the medication that something had changed in the patients’ bodies. Patients felt better and had appetites. It transformed the way their bodies worked.”

In a study published in The Lancet, Dr. McCoy and her colleagues report the results of a Phase III clinical trial evaluating a next generation CFTR modulator, elexacaftor, in combination with two currently used CFTR modulators, ivacaftor and tezacaftor. The randomized, double-blind trial was completed at 44 sites in four countries. More than 100 patients with cystic fibrosis ages 12 years and older who had two copies of the F508del mutation were randomly assigned to receive the triple therapy or receive ivacaftor plus tezacaftor alone.

Treatment with the triple therapy resulted in profound improvements in lung function, sweat chloride concentration and respiratory-related quality of life compared with ivacaftor plus tezacaftor alone, along with a favorable safety profile. Though the trial was only four weeks long, systemic effects were also noted, with rapid improvements in body weight and body mass index.

The findings parallel results from a concurrent phase III trial of the triple therapy in cystic fibrosis patients with a single F508del mutation published in The New England Journal of Medicine.

“This therapy is a major breakthrough that will provide life-changing therapy for nearly all patients with cystic fibrosis. The results that I observed in our patients during the trial, in cases of compassionate use and now after approval are compelling,” Dr. McCoy says, who is also professor of Pediatrics at The Ohio State University College of Medicine. “We will ultimately be able to change the course of this disease dramatically for the vast majority of patients with cystic fibrosis.” “Even though we treated a relatively small number of patients, the magnitude of the REFERENCE: Heijerman HGM, McKone EF, Downey DG, Van Braeckel E, Rowe SM, Tullis E, Mall MA, Welter JJ, Ramsey BW, McKee CM, Marigowda G, Moskowitz effect of this medicine is so huge that it took only small groups to be able to say we have SM, Waltz D, Sosnay PR, Simard C, Ahluwalia N, Xuan F, Zhang Y, Taylor-Cousar JL, McCoy KS. Efficacy and safety of the elexacaftor plus tezacaftor plus ivacaftor combination regimen in people with cystic fibrosis homozygous for theF508del mutation: a double-blind, randomized, phase 3 extraordinarily significant results.” trial. Lancet. 2019 Oct 31;394(10212):1940-1948. – Karen McCoy, MD

PULMONARY MEDICINE Our nationally accredited Cardiopulmonary GRANTS AWARDED Rehabilitation Program is led by our team of physicians, JULY 1, 2019 – JUNE 30, 2020 The mission of the Division of Pulmonary Medicine at Nationwide Children’s Hospital is to provide dietitians, social workers, nurses and respiratory, massage $979,443 outstanding clinical care for children and adults with congenital and acquired respiratory disorders, and exercise therapists to provide our patients with the including asthma, cystic fibrosis (CF), sleep-related breathing disorders, lung transplant, advanced lung tools necessary to resume normal living after a serious SELECTED PUBLICATIONS cardiopulmonary event or if they become deconditioned. Al-Zaidy S, Pickard AS, Kotha K, Alfano LN, Lowes L, Paul G, Church K, Lehman disease care and management of chronic mechanical ventilation, environmental exposures and vaping- K, Sproule DM, Dabbous O, Maru B, Berry K, Arnold WD, Kissel JT, Mendell JR, As evidence of our center having helped hundreds Shell R. Health outcomes in spinal muscular atrophy type 1 following AVXS-101 gene related injuries. The care model is multidisciplinary. Our mission also includes education of medical and of patients regain their independence, we received replacement therapy. Pediatric Pulmonology. 2019 Feb;54(2):179-185. allied health professional trainees and involvement in cutting-edge clinical, basic and translational research. Heijerman HGM, McKone EF, Downey DG, Van Braeckel E, Rowe SM, Tullis E, reaccreditation in 2016 by the American Association of Mall MA, Welter JJ, Ramsey BW, McKee CM, Marigowda G, Moskowitz SM, Waltz Cardiovascular and Pulmonary Rehabilitation. D, Sosnay PR, Simard C, Ahluwalia N, Xuan F, Zhang Y, Taylor-Cousar JL, McCoy KS; VX17-445-103 Trial Group. Efficacy and safety of the elexacaftor plus tezacaftor FACULTY plus ivacaftor combination regimen in people with cystic fibrosis homozygous for the The division also has a robust quality improvement F508del mutation: a double-blind, randomised, phase 3 trial. The Lancet. 2019 Nov portfolio, conducts clinical and translational research 23;394(10212):1940-1948. with a broad group of basic-science collaborators and Kopp BT, Thompson R, Kim J, Konstan R, Diaz A, Smith B, Shrestha C, Rogers LK, Mark L. Splaingard, MD Hayes D Jr, Tumin D, Woodley FW, Ramilo O, Sanders DB, Groner JA, Mejias A. Rohan A. Thompson, MD exhibits steadily climbing research productivity with Secondhand smoke alters arachidonic acid metabolism and inflammation in infants and numerous faculty publications. children with cystic fibrosis. Thorax. 2019 Mar;74(3):237-246. Lisa Ulrich, MD

Pulmonary Medicine clinicians provide care at the FAST FACTS Nationwide Children’s main campus in Columbus and at regional Ohio locations in Westerville, Dublin July 2019 through June 2020 SM and Lima Close To Home Centers. Our 19 physicians Inpatient Discharges:...... 891 Lung Transplant Clinic Visits:...... 71 collaborate to complete over 10,000 outpatient visits Observation and Outpatient-in-a-Bed Discharges*:.... 1,972 Pulmonary Clinic Visits:...... 7,631 at these four locations. Ranked sixth in the U.S. News Karen S. McCoy, MD & World Report, the program excels in patient care, Total Discharges:...... 2,850 Pulmonary Rehab Clinic Visits:...... 375 Division Chief training programs and research. Average Length of Stay†:...... 5.5 Total Pulmonary Clinic Visits:...... 11,492 † The cornerstone of the Division of Pulmonary Medicine Average Daily Census :...... 13.2 Westerville Pulmonary Clinic Visits:...... 2,152 is our nationally recognized Cystic Fibrosis Care Patient Days†:...... 4,822 Dublin Pulmonary Diagnostics Clinic Visits:...... 7 Center, which is a designated Therapeutic Development Inpatient Consults:...... 315 Pulmonary Diagnostics Clinic Visits:...... 238 Center site. The center collaborates with our colleagues Cystic Fibrosis Patients:...... 540 Westerville Pulmonary Diagnostics Clinic Visits:...... 18 in Endocrinology, Gastroenterology, Hepatology, Dublin Pulmonary Clinic Visits:...... 542 Otolaryngology, Psychology and Psychiatry to provide Total Pulmonary Diagnostics Clinic Visits:...... 263 the best clinical outcomes for our pediatric and Lima Memorial Pulmonary Clinic Visits:...... 32 *Excludes sleep studies. adult CF patients. A strong collaboration, Cure CF Lima Pulmonary Clinic Visits:...... 149 †Excludes observation and outpatient-in-a-bed patients. Columbus (C3), has also formed with clinicians and basic researchers at The Ohio State University and the Abigail Wexner Research Institute. This collaboration Richard D. Shell, MD is funded as a Research and Development Program A Decade of Remarkable Transformation Section Chief through the Cystic Fibrosis Foundation. This work is PULMONARY MEDICINE focused on immune dysfunction and infection in CF. $2 Million Grant Continues Elizabeth D. Allen, MD Huge advances have been made with our most unstable Multiple Regional Outreach Doctors Develop AsthmaCare Development of Cure CF John Heintz, MD patients with asthma. In our Complex Asthma Clinic, Clinics for Pulmonary and App Designed for Children Columbus (C3) Research Sleep Medicine and Teens and Development Program Melissa Holtzlander, MD we collaborate with our school-based asthma therapy Stephen E. Kirkby, MD (SBAT) program to provide quality medical care and consistent treatment therapies. A reduction in urgent Benjamin T. Kopp, MD 2013 2017 care and emergency department visits by these medically 2010 2012 2013 2016 2018 2019 20202017 Kavitha Kotha, MD fragile patients is a noticeable benefit of these two Katelyn Krivchenia, MD Keep Me Well Asthma Quality Team Performs First Cure CF Columbus (C3) Ranked #6 by U.S. News programs. Improvement Initiative Successful Cross-Country Collaboration with Clinicians & World Report — Ninth Anne E. May, MD Launched Transfer for Pediatric and Researchers at The Ohio Consecutive Year in Top 10 Our department has a collaborative relationship with Lung Transplant State University Launched Sabrina Palacios, MD specialists caring for children with bronchopulmonary Alpa V. Patel, MD dysplasia (BPD), sickle cell and aerodigestive disorders. In the past decade, Pulmonary Medicine has been at the forefront of groundbreaking research and scientific discoveries in Grace R. Paul, MD We also have a reputation as a center of care focused cystic fibrosis. Nationwide Children’s serves as a translational research center for the Therapeutics Development Network on the respiratory health of patients with all forms of Swaroop Pinto, MD (TDN) of the Cystic Fibrosis Foundation. As a translational research center for TDN, our patients have access to some of neuromuscular disorder. Shahid I. Sheikh, MD the latest advances in cystic fibrosis treatment.

SLEEP DISORDERS CENTER Children’s, pediatric subspecialists in pulmonology, neurology RHEUMATOLOGY and psychiatry, who are also board-certified in sleep medicine, review all polysomnographic studies to determine both Our mission is to improve the lives of children with rheumatic disease through high-quality and innovative diagnosis and potential therapies that would benefit each care, education and research. Rheumatology at Nationwide Children’s Hospital provides comprehensive, child. Further evaluation and treatment is available through compassionate, evidence-based clinical care to children with musculoskeletal and rheumatic diseases, the outpatient Sleep Disorders Clinic. conducts research on these diseases and educates students, residents, fellows and pediatricians. The division Staff of the Sleep Disorders Center have collaborated on is involved in several quality improvement projects to improve outcomes for children with rheumatic disease research projects with Nationwide Children’s investigators and partners with patients and families in these efforts. from Anesthesiology, Critical Care, Gastroenterology, Endocrinology, Neonatology, Neurology, Otolaryngology, Pediatric Surgery, Psychiatry, Psychology, Pulmonary, FACULTY rheumatology at The Ohio State University and with Plastic Surgery, the Center for Injury Research and Policy at multiple pediatric subspecialists at Nationwide Children’s Mark L. Splaingard, MD Nationwide Children’s and the Department of Mathematics promote collaborative clinical care and research. Medical Director at The Ohio State University. Recently completed studies A. Latif Khuhro, MD include CDC-funded research of effectiveness of different Rheumatology is engaged in clinical and basic science alarm signals in awakening children and adults during sleep, research projects and participates in several national Robert Kowatch, MD, PhD using OSA screening questionnaires to predict postoperative and international collaborative studies of childhood Lenora M. Lehwald, MD outcomes and examining the utility of sleep studies shorter rheumatic diseases. Basic scientist Chack-Yung Yu, than four hours in infants and sleep disturbances in pediatric DPhil, has an appointment in Rheumatology focusing Anne E. May, MD intracranial hypertension. on the relationship between complement genetics and Grace R. Paul, MD SELECTED PUBLICATIONS rheumatic diseases. Rheumatology participates in the Swaroop Pinto, MD Kornbluh AB, Thompson K,Mcmahen G, Aylward S, Lehwald L. Sleep Disturbance in Childhood Arthritis and Rheumatology Research Alliance Pediatric Intracranial Hypertension. J Clin Sleep Med. 2020;jc-19-00636. [Epub ahead and Pediatric Rheumatology Collaborative Study Group Jack Stevens, PhD Stacy Payne Ardoin, MD, MS of print] clinical research networks. We also participate in the Chief Rohan Thompson, MD Raman V, Geyer E, Miller R, Tumin D, Splaingard M, Jatana K, Tobias J. Pediatric OSA quality improvement initiative, Pediatric Rheumatology screening questionaire and postoperative outcomes: a prospective observational study. Int Shoghik Akoghlanian, MD Care and Outcomes Improvement Network. Accredited by the American Association of Sleep Medicine, J Pediatr Otorhinolaryngol. 2019;127:109661. the Sleep Disorders Center at Nationwide Children’s Fatima Barbar-Smiley, MD GRANTS AWARDED Hospital provides inpatient and outpatient consultations and Smith GA, Chounthirath T, Splaingard M. Comparison of the effectiveness of female voice, male voice, and hybrid voice-tone smoke alarms for sleeping children. Pediatr Res. Kyla Driest, MD JULY 1, 2019 – JUNE 30, 2020 treatment for children with a wide variety of sleep-related 2020;10. [Epub ahead of print] problems. Most referrals are for evaluation of abnormal Gloria C. Higgins, MD (Emeritus) $176,632 Splaingard M. breathing during sleep. Other symptoms may include Smith GA, Chounthirath T, Do Sleeping Children Respond Better to a Smoke Alarm That Uses Their Mother’s Voice?. Acad Pediatr. 2020;20(3):319-326. Edward Oberle, MD SELECTED PUBLICATIONS insomnia, unusual movements at night and excessive daytime sleepiness. As part of the Sleep Medicine Fellowship Program Vidya Sivaraman, MD Amarilyo G, Rothman D, Manthiram K, Edwards KM, Li SC, Marshall GS, Yildirim- FAST FACTS Toruner C, Haines K, Ferguson PJ, Lionetti G, Cherian J, Zhao Y, DeLaMora P, Syverson at The Ohio State University College of Medicine, the center G, Nativ S, Twilt M, Michelow IC, Stepanovskiy Y, Thatayatikom A, Harel L, Akoghlanian The Rheumatology Clinic at Nationwide Children’s S, Tucker L, Marques MC, Srinivasalu H, Propst EJ, Licameli GR, Dedeoglu F, Lapidus provides two months of clinical training to sleep medicine July 2019 through June 2020 serves children with diseases, including juvenile idiopathic S; CARRA PFAPA Consensus Treatment Plan Workgroup. Consensus Treatment Plans fellows each year, which includes didactic lectures, supervised for Periodic Fever, Aphthous Stomatitis, Pharyngitis and Adenitis Syndrome (PFAPA): A clinical experience and interpretation of infant and child Main Campus Sleep Clinic Visits:...... 424 arthritis, systemic lupus erythematosus, juvenile Framework to Evaluate Treatment Responses from the Childhood Arthritis and Rheumatology polysomnographic studies. dermatomyositis, spondyloarthropathy, vasculitis, Research Alliance (CARRA) PFAPA Work Group. Pediatric Rheumatology Online Journal. Dublin Sleep Clinic Visits:...... 505 2020 Apr 15;18(1):31. scleroderma, autoinflammatory conditions and painful The Sleep Disorders Center participates in the training Westerville Sleep Clinic Visits:...... 471 de Jesus AA, Hou Y, Brooks S, Malle L, Biancotto A, Huang Y, Calvo KR, Marrero B, Moir S, musculoskeletal problems. The clinic conducts more Oler AJ, Deng Z, Montealegre Sanchez GA, Ahmed A, Allenspach E, Arabshahi B, Behrens E, of medical students; residents in Pediatrics, Neurology, Total Sleep Clinic Visits:...... 1,400 than 6,000 outpatient visits annually. Our fellowship Benseler S, Bezrodnik L, Bout-Tabaku S, Brescia AC, Brown D, Burnham JM, Caldirola MS, Otolaryngology, Physical Medicine and Rehabilitation and includes three categorical pediatric fellows and one Carrasco R, Chan AY, Cimaz R, Dancey P, Dare J, DeGuzman M, Dimitriades V, Ferguson I, Radiology; as well as pediatricians, psychiatrists and graduate Ferguson P, Finn L, Gattorno M, Grom AA, Hanson EP, Hashkes PJ, Hedrich CM, Herzog 2019 – 2020 NATIONWIDE CHILDREN’S internal medicine-pediatrics fellow. This year, with R, Horneff G, Jerath R, Kessler E, Kim H, Kingsbury DJ, Laxer RM, Lee PY, Lee-Kirsch MA, students at The Ohio State University. Over the past 13 our neurology colleagues, we established a Neuro- Lewandowski L, Li S, Lilleby V, Mammadova V, Moorthy LN, Nasrullayeva G, O'Neil KM, years, more than 50 sleep medicine and pediatric subspecialty FELLOWSHIP PROGRAM Onel K, Ozen S, Pan N, Pillet P, Piotto DG, Punaro MG, Reiff A, Reinhardt A, Rider LG, fellows have completed required rotations in pediatric Immunology Clinic with collaborators from psychiatry, Rivas- Chacon R, Ronis T, Rösen-Wolff A, Roth J, Ruth NM, Rygg M, Schmeling H, Schulert psychology and neuropsychology. We continue to have G, Scott C, Seminario G, Shulman A, Sivaraman V, Son MB, Stepanovskiy Y, Stringer E, sleep medicine at the center. Center physicians lecture PEDIATRIC PULMONOLOGY Taber S, Terreri MT, Tifft C, Torgerson T, Tosi L, Van Royen-Kerkhof A, Wampler Muskardin widely throughout The Ohio State University on a variety Anas Al-Turki, MD very busy multidisciplinary Lupus and Hypermobility T, Canna SW, Goldbach-Mansky R. Distinct Interferon Signatures and Cytokine Patterns Clinics. Edward Oberle, MD, leads our Musculoskeletal Define Additional Systemic Autoinflammatory Diseases. Journal of Clinical Investigation. 2020 of topics, including sleep and performance. In 2019, the Ashish George, MD Apr 1;130(4):1669-1682. center performed over 2,250 polysomnographic studies and Courtney A. Gushue, DO Ultrasound Clinic. Laura Ballenger, MD, who has evaluated over 1,350 children in outpatient sleep clinics. The Daniel Malleske, MD expertise in musculoskeletal ultrasound, joined our faculty center has 23 registered polysomnographic technicians and Eric Mull, MD in August 2020. Our close collaborations with adult two full-time pediatric nurse practitioners. At Nationwide Robin Ortenberg, MD Ben Wisniewski, MD

Peters E, Tompkins MK, Knoll MAZ, Ardoin SP, Shoots-Reinhard B, Meara AS. Despite High 2019 – 2020 NATIONWIDE CHILDREN’S Objective Numeracy, Lower Numeric Confidence Relates to Worse Financial and Medical SPORTS MEDICINE Outcomes. Proceedings of the National Academy of Sciences of the United States of America. 2019 FELLOWSHIP PROGRAM Sep 24;116(39):19386-19391. Sports Medicine at Nationwide Children’s Hospital includes a team of experts who specialize in the Sivaraman V, Wise KA, Cotton W, Barbar-Smiley F, AlAhmed O, MacDonald D, Lemle treatment and prevention of sports-related injuries in the pediatric and adolescent athlete. The focus of S, Yildirim-Toruner C, Ardoin SP, Ardura MI. Previsit Planning Improves Pneumococcal PEDIATRIC RHEUMATOLOGY Vaccination Rates in Childhood-Onset SLE. Pediatrics. 2020 Jan;145(1). Ohoud Al-Ahmed, MD the department is prevention, diagnosis and treatment of youth and adolescent sports injuries, including Ting TV, Vega-Fernandez P, Oberle EJ, De Ranieri D, Bukulmez H, Lin C, Moser D, Christine Bacha, MD concussions. Barrowman NJ, Zhao Y, Benham HM, Tasan L, Thatayatikom A, Roth J; Childhood Arthritis Laura R. Ballenger, MD and Rheumatology Research Alliance Juvenile Idiopathic Arthritis Ultrasound Workgroup. Veronica Mruk, MD Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee. Arthritis Care & Research (Hoboken). 2019 Jul;71(7):977-985. FACULTY

Highlights: FAST FACTS • Provided care for just under 17,000 patients at our eight locations July 2019 through June 2020 • Provided medical services at more than 2,100 Inpatient Discharges:...... 48 Inpatient Consults:...... 132 events, affecting more than 200,000 athletes Observation and Outpatient-in-a-Bed Discharges:...... 84 Main Campus Rheumatology Clinic Visits:...... 4,840 • Developed an Adaptive Sports Medicine Program Total Discharges:...... 129 Dublin Rheumatology Clinic Visits:...... 849 for athletes with special physical needs Average Length of Stay*:...... 5.3 Total Rheumatology Clinic Visits:...... 5,689 • Served as team physicians for Ohio Dominican University and several central Ohio high schools Average Daily Census*:...... 0.7 *Excludes observation and outpatient-in-a-bed patients. Thomas L. Pommering, DO and middle schools Chief Patient Days*:...... 243 • Faculty named over 50 times in publications, Steven C. Cuff, MD abstracts and national podium and poster Drew Duerson, MD presentations Anastasia N. Fischer, MD Services available at Nationwide Children’s Sports Medicine include: James P. MacDonald, MD • Diagnosis and treatment of all sports-related Jonathan Napolitano, MD injuries Reno Ravindran, MD • Sports Concussion Clinic Richard E. Rodenberg, MD • Adaptive Sports Medicine Clinic Amy E. Valasek, MD • Limb Deformity Clinic in collaboration with Orthopedics We provide team-centered sports medicine care. • Point of service musculoskeletal ultrasound for Our clinical staff works with the athlete’s team, diagnostic and therapeutic treatment which includes the patient, family, athletic trainer, • Injury rehabilitation school nurse, coach and primary care physician, • Specialized rehabilitation and injury prevention to assist in the recovery of the injury, development programs for swimmers, throwers, dancers, of a treatment plan and recommendations for runners and athletes in other sports successful participation in future sports activities. • Sports Nutrition Counseling Our department also helps patients navigate their • Sports Performance Training care through our partners in other departments within Nationwide Children’s including Radiology, • Play Strong (supervised exercise program for children with medical conditions) Orthopaedics, Physical Therapy, Cardiology, Healthy Weight and Nutrition, Pulmonary Medicine, • Sports Medicine Fellowship Training Program Neuropsychology/Psychology, Emergency Medicine, • Central Ohio EMS Community Outreach and Primary Care, Sports Nutrition, Education and any Education for Care of Athletes Injured on the Field of Play other necessary outside services. • Partnerships with schools, and youth and club sport organizations

• Coordination of care with patient’s primary care Stumph J, Young J, Singichetti B, Yi H, Valasek A, Bowman E, MacDonald J, Yang J, Fischer A. Effect of Exercise Recommendation on Adolescents with Concussion. Journal of TOXICOLOGY physician and other Nationwide Children’s services; Child Neurology. 2020 Feb;35(2):95-101. The Section of Toxicology at Nationwide Children’s Hospital provides teaching, patient care and research educational resources and training to physicians, Suryavanshi JR, Goto R, Jivanelli B, Aberdeen J, Duer T, Lam KC, Franklin CC, athletic trainers, school nurses, patients/families MacDonald J, Shea KG, Fabricant PD. Age-Appropriate Pediatric Sports Patient-Reported to improve the outcome for poisoned patients. We provide medical supervision for the Central Ohio Poison Outcome Measures and Their Psychometric Properties: A Systematic Review. American and coaches journal of sports medicine. 2019 Nov;47(13): 3270-3276. Center (COPC) and the toxicology consult service in the treatment of poisoned patients and management of adverse drug reactions. Our research investigates drug and toxicant effects, as well as poison prevention SELECTED PUBLICATIONS 2019 – 2020 NATIONWIDE CHILDREN’S and population-based poison control. We provide important consultation resources to hospital-based and Coven SL, Bibart M, Frost R, Gallagher T, Guinipero T, Valasek AE, Olshefski R. A FELLOWSHIP PROGRAM community physicians across Ohio, supporting them as they continue to treat poisoned patients in their Quality Improvement Approach to Increase Exercise Assessment in Survivors of Childhood Leukemia. 2019. Pediatric Quality and Safety. Jul 29 4(4) e198 1-7. own communities. PEDIATRIC SPORTS MEDICINE Schilling, S, Mansour A, Sullivan L, Ding K, Pommering T, Yang J. Symptom Burden and Profiles in Concussed Children With and Without Prolonged Recovery. International Journal Francis Comer, DO of Environmental Research and Public Health. 2020 Jan;17:351. Kayla Daniel, MD FACULTY With our nationally recognized Be Poison Smart!® Selhorst M, Fischer A, MacDonald J. Prevalence of Spondylolysis in Symptomatic public education program, the COPC works to reduce Adolescent Athletes: An Assessment of Sport Risk in Nonelite Athletes. Clinical Journal of Sport Medicine. 2019 Sep;29(5):421-425. the incidence of childhood poisonings throughout Ohio. Our Be Poison Wise!SM program helps older adults prevent poison exposures and medication mistakes. The COPC plays an important role in FAST FACTS toxicosurveillance, communications and emergency professional education in preparation for and during July 2019 through June 2020 a community disaster. Research to describe important Top 10 Principal Final Diagnoses at the Sports poisoning hazards and to reduce the incidence of Main Campus Sports Medicine Clinic Visits:...... 1,522 poisoning is conducted with the Center for Injury Medicine Clinics: Canal Winchester Sports Medicine Clinic Visits:...... 1,394 Research and Policy in the Abigail Wexner Research Knee Pain/Injury:...... 1,520 Institute at Nationwide Children’s Hospital. Dublin Sports Medicine Clinic Visits:...... 3,301 Marcel J. Casavant, MD, FACEP, FACMT, FAACT Concussion:...... 1,260 East Broad Sports Medicine Clinic Visits:...... 827 Chief GRANTS AWARDED Ankle Sprain:...... 836 Hilliard Sports Medicine Clinic Visits:...... 1,213 Alexandra R. Funk, PharmD, DABAT JULY 1, 2019 – JUNE 30, 2020 Low Back:...... 718 Marysville Sports Medicine Clinic Visits:...... 489 Hannah L. Hays, MD, FACEP $488,138 Foot Pain:...... 359 Michael T. Kelley, MD, MPH, FACMT New Albany Sports Medicine Clinic Visits:...... 1,171 SELECTED PUBLICATIONS Patellofemoral Pain:...... 345 Jason Russell, DO Westerville Sports Medicine Clinic Visits:...... 3,850 Chang A, Schnall AH, Law R, Bronstein AC, Marraffa JM, Spiller HA, Hays HL, Funk AR, Mercurio- Henry Spiller, MS, DABAT Zappala M, Calello DP, Aleguas A, Borys DJ, Boehmer T, Svendsen E. Cleaning and disinfectant chemical Tendonitis:...... 318 exposures and temporal associations with COVID-19. National Poison Data System, United States, January Strain:...... 308 Medical and pharmacy students, and physicians from 1, 2020-March 31,2020. Morbidity and Mortality Weekly Report. 2020 Apr 24;69(16):496-498. Kamboj A, Spiller HA, Casavant MJ, Kistamgari S, Chounthirath T, Smith GA. Household cleaning Shoulder Pain/Injury:...... 301 emergency medicine, pediatrics, internal medicine, product-related ocular exposures reported to the United States poison control centers. The Royal College of pediatric emergency medicine and child abuse Ophthalmologists. 2019 Dec 9;34(9):1631-1639. Apophysitis:...... 297 training programs, benefit from rotations — now all O’Neill-Dee C, Spiller HA, Casavant MJ, Kistamgari S, Chounthirath T, Smith GA. Natural psychoactive substance-related exposures reported to United States poison control centers, 2000-2017. Clinical Toxicology. Spondylolysis/Spondylolisthesis:...... 275 remote in the era of COVID-19 — with the Section 2019 Nov 25;1-8. Salter Harris Fracture:...... 255 of Toxicology and the COPC. We teach the public Spiller HA, Ackerman JP, Smith GA, Kistamgari S, Funk AR, McDermott MR, Casavant MJ. Suicide through frequent media interviews and programs. attempts by self-poisoning in the United States among 10-25 year olds from 2000 to 2018: substances used, Dislocation/Subluxation:...... 249 temporal changes and demographics. Clinical Toxicology. 2019 Oct 6;58(7):676-687. We also help local, county and state governments Townsend JA, Spiller H, Hammersmith K, Casamassimo PS. Dental local anesthesia-related pediatric cases and agencies prepare to respond effectively to mass- reported to U.S. poison control centers. Pediatric Dentistry. 2020 Mar 15;42(2):116-122. casualty events and to terrorism involving biological, chemical and radiological hazards, and have been FAST FACTS a critical partner to the public health response to COVID-19. The section is an important resource for July 2019 through June 2020 Ohio’s childhood lead poisoning prevention program. Inpatient Toxicology Consults:...... 392 The COPC serves the citizens of 64 Ohio counties. Toxicology Clinic Visits:...... 4 The 19 specially trained, nationally certified nurses and pharmacists handle poison-exposure cases from the Peer Consults:...... 2,395 public, health care professionals, health departments Toxicology Poison Center Consults:...... 4,261 and emergency medical services. Certified by the Poison Control Exposure Cases:...... 38,197 American Association of Poison Control Centers, the COPC has been improving the care of poisoned patients for 62 years.

ANESTHESIOLOGY AND PAIN MEDICINE in anesthesiology and pediatric anesthesiology by the In response to the COVID-19 crisis, the perioperative American Board of Anesthesiology. Additional board team has put into place measures to effectively allow The Department of Anesthesiology and Pain Medicine at Nationwide Children’s Hospital consists of certification is held in pediatric critical care medicine the safe continuation of all operating room and pain fellowship-trained, board-certified pediatric anesthesiologists. The department provides anesthesiology and (two faculty), pain medicine (eight faculty) and management activities. We anticipate that our surgical pain-management services for pediatric patients of all ages, from neonates through adolescents, requiring general pediatrics (four faculty). An attending pediatric cases will see continued growth into the fall and winter all types of surgical procedures, procedural sedation outside the operating room, acute and chronic pain anesthesiologist is present in the hospital at all times for months. An additional operating room site will be emergency cases. There is a division of cardiac anesthesia opened in the spring of 2021 to allow for expansion of management, and palliative care. that includes six physicians dedicated to the care of our surgical volumes to meet the demands of newly hired patients with acquired and congenital heart disease. surgical colleagues. We anticipate increases in the solid

ANESTHESIOLOGY AND MEDICINE PAIN We also have an active acute pain service that provides organ transplantation program and the development of a FACULTY Senthil G. Krishna, MD pain management services, including patient-controlled fetal surgery program. There will be continued growth of David Martin, MD analgesia and regional anesthesia. The department also chronic pain initiatives, including expansion of palliative Gregory Maves, MD provides palliative care and hospice services with four care services, the inpatient rehabilitation program for full-time palliative care physicians. patients with complex pain issues and the chronic pain Christopher McKee, DO clinic. Renata Miketic, MD The fellowship program provides subspecialty training in pediatric anesthesiology for fellows in both an ACGME- SELECTED PUBLICATIONS Alok Moharir, MD accredited program and international fellows from Cartabuke RS, Anderson BJ, Elmaraghy C, Rice J, Tumin D, Tobias JD. Hemodynamic Olubukola Nafiu, MD all over the world. Advanced subspecialty training is and pharmacokinetic analysis of oxymetazoline use during nasal surgery in children. The offered in pediatric cardiac anesthesia, pediatric regional Laryngoscope. 2019 Dec;129(12):2775-2781. Aymen Naguib, MD anesthesia, quality improvement and safety, acute pain Hodge AB, Thornton BA, Gajarski R, Hersey D, Cannon M, Naguib AN, Joy BF, Vanessa Ng, MD McConnell PI. Quality improvement project in congenital cardiothoracic surgery patients: management, chronic pain management and palliative reducing surgical site infections. Pediatric Quality & Safety. 2019 Jul 22;4(4):e188. Joseph D. Tobias, MD care. Priyal Patel, DO Miller R, Tumin D, Hayes D Jr, Uffman JC, Raman VT, Tobias JD.Unmet need for Chief care coordination among children with special health care needs. Population Health Vidya Raman, MD Departmental research initiatives are led by a Vice-Chair Management. 2019 Jun;22:255-261. Emmanuel Alalade, MD Leila Reduque, MD for Academic Affairs and supported by two postdoctoral Nafiu OO,Mpody C, Kim SS, Uffman JC, Tobias JD. Race, postoperative complications research scientists, two full-time clinical research and death in apparently healthy children. Pediatrics. 2020 Aug;146:e20194113. [Epub Graciela Argote-Romero, MD ahead of print] Lance Relland, MD nurses, a data analyst and two research associates. Rita Banoub, MD Pfaff KE, Tumin D, Miller R, Beltran RJ, Tobias JD, Uffman JC. Perioperative Devin Sanders, MD The department participates in an active clinical aspiration events in children: A report from the Wake-Up Safe Collaborative. Pediatric Ralph Beltran, MD research program with numerous ongoing prospective Anesthesia. 2020 Apr 22. [Epub ahead of print] Brian Schloss, MD Jason Bryant, MD investigations in various areas of pediatric anesthesiology, Erica Sivak, MD including novel approaches to airway management, 2019 – 2020 NATIONWIDE CHILDREN’S Candice Burrier, MD Ashley Smith, MD techniques of regional anesthesia, perioperative FELLOWSHIP PROGRAM Gregory Cambier, MD implications of comorbid conditions, including Steven Smith, MD obstructive sleep apnea and COVID-19, the use of Richard Cartabuke, MD ANESTHESIOLOGY AND PAIN MEDICINE Timothy Smith, MD novel pharmacologic agents in the pediatric population, Emmanuel Alalade, MD Kristin Chenault, MD Ahsan Syed, MD outcomes research and quality improvement initiatives. Sorochi Esochaghi, MD Marco Corridore, MD The department published more than 50 manuscripts Grant Heydinger, MD Arlyne Thung, MD in peer-reviewed journals and presented more than 50 Teresa Murray-Torres, MD Olamide Dairo, MD Joshua Uffman, MD abstracts at national meetings last year. Steven Zadora, MD Ajay D’Mello, MD Giorgio Veneziano, MD Sujana Dontukurthy, MD Brittany Willer, MD Nicole Elsey, MD Peter Winch, MD Seth Hayes, MD The Department of Anesthesiology and Pain Renee Heng, MD Medicine includes 43 pediatric anesthesiologists, four Grant Heydinger, MD palliative care physicians and 50 certified registered Lisa Humphrey, MD nurse anesthetists who provide care at 43 sites per day. Last year, the department provided anesthetic Natalie Jacobowski, MD care and sedation services for approximately 40,000 Sarah Khan, MD procedures. Members of the faculty are fellowship- trained in pediatric anesthesiology and board certified

PATHOLOGY AND LABORATORY MEDICINE The department includes more than 25 pathologists and PhD, director of Diagnostic Immunology Laboratory, doctoral scientists with subspecialty expertise in pediatric was the recipient of the Carl R. Jolliff Award for Lifetime The Department of Pathology and Laboratory Medicine at Nationwide Children’s Hospital provides a pathology and laboratory medicine. This professional Achievement in Clinical or Diagnostic Immunology. wide range of pediatric diagnostic services for hospitalized and ambulatory infants, children and adolescent staff is supported by more than 400 technical staff who patients. Laboratory services are provided through the main campus anatomic and clinical pathology provide 24/7 coverage in critical patient care areas. As GRANTS AWARDED JULY 1, 2019– JUNE 30, 2020 laboratories, as well as multiple outpatient/reference laboratory testing facilities, Nationwide Children’s an integral part of Nationwide Children’s operations, SM our team provides specimen collection and diagnostic $1,185,529 Close To Home and Urgent Care centers, and our freestanding Emergency Department. services in multiple service centers across Ohio. SELECTED PUBLICATIONS In the last year, the Anatomic Pathology Laboratory FACULTY Selene Koo, MD, PhD Conces MR, Hughes A, Pierson CR. Neuropathology of Mowat-Wilson Syndrome.

PATHOLOGY AND LABORATORY MEDICINE AND LABORATORY PATHOLOGY processed close to 10,000 surgical cases, 1,300 cytology Pediatric and Developmental Pathology. 2020;23(4):322-325. Amy L. Leber, PhD specimens and 90 autopsies. Clinical laboratories Liu H, Guinipero TL, Schieffer KM, et al. De novo Primary Central Nervous System performed more than 3.1 million tests in various Pure Erythroid Leukemia/Sarcoma with t(1;16)(p31;q24) NFIA/CBFA2T3 Translocation. Huifei Liu, MD, PhD Haematologica. 2020;105(4):e194-e197. subspecialty areas. As part of our core mission, we were Rachel Mariani, MD actively involved in undergraduate and graduate medical Miller CR, Lee K, Pfau RB, Reshmi SC, Corsmeier DJ, Hashimoto S, Dave-Wala A, Jayaraman V, Koboldt D, Matthews T, Mouhlas D, Stein M, McKinney A, Grossman T, Erin K. Meyer, DO, MPH education, and our faculty served in multiple leadership Kelly BJ, White P, Magrini V, Wilson RK, Mardis ER, Cottrell CE. High Frequency of roles locally and on the national scene. Faculty highlights Disease-Associated Mosaic Variation in Clinical Exome Sequencing: A Two-Year Pediatric Jeffery Papiernik, MD Tertiary Care Cohort Experience. Cold Spring Harbor Molecular Case Studies. 2020 Jun include the appointment of Shamlal Mangray, MB, BS, 12;6(3):a005231.

Christopher R. Pierson, MD, PhD as chief of Pathology and Laboratory Medicine; Kathy Sacco KA, Smith MJ, Bahna SL, Buchbinder D, Burkhardt J, Cooper MA, Hartog NL, Nicol, MD, as medical director; Miriam Conces, MD, Kobrynski L, Patel KP, Abraham RS. NAPDH Oxidase-Specific Flow Cytometry Allows Vinay Prasad, MD for Rapid Genetic Triage and Classification of Novel Variants in Chronic Granulomatous as director of surgical pathology; and Selene Koo, MD, Disease. The Journal of Clinical Immunology.2020 Jan;40(1):191-202. Amy L. Pyle-Eilola, PhD PhD, as director of autopsy pathology. Additionally, two Wang H, Diaz A, Moyer K, Mele-Casas M, Ara-Montojo MF, Torrus I, McCoy K, Mejias Shamlal Mangray, MB, BS Nilsa Del Carmen Ramirez-Milan, MD anatomic pathologists and three molecular pathologists A, Leber AL. Molecular and Clinical Comparison of Enterovirus D68 Outbreaks among Chief, Pathology and Laboratory Medicine were recruited in the last year. Hospitalized Children, Ohio, USA, 2014 and 2018. Emerging Infectious Diseases. 2019 Section Chief, Anatomic Pathology Archana Shenoy, MD Nov;25(11):2055-2063. Diana Thomas, MD Dustin Bunch, PhD, who joined our team as assistant director of clinical chemistry, is also assistant director of Huanyu Wang, PhD laboratory informatics. Dr. Bunch has made enormous AFFILIATED FACULTY contributions to our laboratory informatics initiatives and coordinated efforts between the laboratory and Biochemical Genetics Nationwide Children’s Clinical Informatics teams in the Dennis W. Bartholomew, MD short time he has been here.

Kim L. McBride, MD, MS Most recently, Amy Leber, PhD, Huanyu Wang, PhD, and Sophonie Jean, PhD, worked feverishly with their Steve and Cindy Rasmussen Institute for Genomic microbiology team to make Nationwide Children’s the Medicine Clinical Laboratory first hospital in central Ohio to go live with COVID-19 Kathleen K. Nicol, MD Catherine Cottrell, PhD polymerase chain reaction (PCR) testing. In addition, Medical Director they helped other institutions with trouble-shooting to Jesse Hunter, PhD Section Chief, Clinical Pathology get testing online. This team also brought on COVID-19 Kristy Lee, PhD antibody testing. Kathy Nicol, MD, and Roshini Roshini Abraham, PhD Marco Leung, PhD Abraham, PhD, coordinated with our clinical team for Peter B. Baker III, MD the administration of convalescent plasma as part of the Mariam Mathew, PhD treatment regimen for one of our patients. Jade Wilson Laura Biederman, MD Ruthann B. Pfau, PhD MBA, MT (ASCP), has worked closely with leaders Daniel R. Boue, MD, PhD in epidemiology and administration to support the Shalini C. Reshmi, PhD Dustin Bunch, PhD Nationwide Children’s response to the pandemic. Matthew Schultz, PhD Catherine Chung, MD Many of our faculty serve in professional committees at Neuromuscular Pathology Miriam R. Conces, MD the level including leadership roles. Nilsa Ramirez, MD, Zarife Sahenk, MD, PhD director of the Biopathology Center, was the recipient Bonita R. Fung, MD of the College of American Pathologists Lifetime Sophonie Jean, PhD Achievement Award for 2019, and Roshini Abraham, Samir Kahwash, MD

PHYSICAL MEDICINE AND REHABILITATION The Section of Physical Medicine and Rehabilitation at Nationwide Children’s Hospital specializes in the diagnosis and management of children with physically disabling conditions. Our physicians are board- certified specialists in Physical Medicine and Rehabilitation with additional certification in pediatric rehabilitation medicine and are members of the departments of Pediatrics, and Physical Medicine and Rehabilitation at The Ohio State University College of Medicine. In addition, Carl D. Gelfius, MD, is board certified in electrodiagnostic medicine. Carl D. Gelfius, MD, Karl Klamar, MD, and Reginald D. Talley, MD, are board certified in brain injury medicine. PHYSICAL MEDICINE AND REHABILITATION PHYSICAL MEDICINE FACULTY service and the following outpatient clinics: general rehabilitation, myelomeningocele, botulinum toxin, concussion, gait lab, neuro-oncology and non- accidental traumatic brain injury.

FAST FACTS

July 2019 through June 2020 Inpatient Discharges:...... 101 Observation and Outpatient-in-a-Bed Discharges:...... 3 Michelle A. Miller, MD Total Discharges:...... 106 Chief Average Length of Stay*:...... 23.8 Carl D. Gelfius, MD Average Daily Census*:...... 6.7 Karl W. Klamar, MD Patient Days*:...... 2,451 Wilawan Nopkhun, MD Inpatient Consults:...... 419 Number of Beds:...... 12 Jonathan S. Pedrick, MD Physical Medicine Clinic Visits:...... 5,329 Nathan S. Rosenberg, MD Myelomeningocele (Spina Bifida) Clinic Visits:...... 626 Reginald D. Talley, MD School-based Seating Clinic Visits:...... 11

Physical Medicine and Rehabilitation was actively *Excludes observation and outpatient-in-a-bed patients. involved in the teaching of medical students, medical residents and fellows over the past year. We offer a pediatric rehabilitation rotation to the Physical 2019 – 2020 NATIONWIDE CHILDREN’S Medicine and Rehabilitation residents from Larkin FELLOWSHIP PROGRAM Community Hospital and the Palm Spring Branch of Larkin. Presentations on pediatric rehabilitation, concussion, neuromuscular disorders, musculoskeletal PEDIATRIC REHABILITATION MEDICINE disorders, spasticity management and pediatric Amy Hiller, DO traumatic brain injury were made at local, regional, Noel Pristas, MD national and international levels.

Clinically, we provide services to the multidisciplinary brachial plexus team, the wheelchair seating and equipment clinic, and the EMG laboratory. We also continue services to our CARF (Commission on Accreditation of Rehabilitation Facilities)-accredited inpatient rehabilitation unit, the inpatient consult

BIG LOTS BEHAVIORAL HEALTH SERVICE LINE based treatment, education, research and advocacy for See page 110 for a list of faculty, selected publications and David A. Axelson, MD children diagnosed with autism spectrum disorder. Services grants awarded. Medical Director of Behavioral Health Services and Chief, Psychiatry and Behavioral Health, include intensive behavioral intervention and consultation, Psychiatry and Community Behavioral Health is the Nationwide Children’s Hospital school support and educational consultation, Asperger’s largest and most clinically diverse section of Behavioral Chief, Division of Child and Family, Department of Psychiatry and Behavioral Health, counseling, social skills groups, parent teaching, advocacy Health Services. This integrated program of care for The Ohio State University and community education. pediatric mental disorders spans a comprehensive Pediatric Psychology and Neuropsychology provides spectrum, from prevention services to inpatient psychiatric Big Lots Behavioral Health hospital in the country, with over 250,000 outpatient clinical services in two primary areas: Pediatric Psychology units. Services currently available include pediatric crisis Services at Nationwide visits completed in the last year. Clinical services within provides specialized assessment and intervention services assessment and treatment within an expanded Youth Children’s Hospital is a behavioral health serve as a setting for training a wide that focus on the relationship between cognitive, social, and Crisis Stabilization Unit, consultation-liaison services for comprehensive service line range of disciplines. Associated training programs include emotional functioning and physical health, typically for youth who are hospitalized at Nationwide Children’s, dedicated to children and pre-professional internships in psychology, social work children with co-occurring medical conditions (e.g., cancer, psychiatric inpatient beds at Nationwide Children’s, adolescents affected by mental illness and problems of and clinical counseling; fellowships in developmental diabetes, sickle cell disease); Pediatric Neuropsychology Partial Hospital Program, multiple levels of care for eating emotion, behavior, development, thought and adaptation behavioral pediatrics; postdoctoral psychology fellowships performs specialized evaluations for children and disorders in collaboration with Adolescent Medicine, to life challenges, including those associated with physical in Pediatric Psychology, Neuropsychology, Intellectual and adolescents with a range of medical and neurological intensive outpatient services within the Mood and Anxiety PSYCHIATRY AND COMMUNITY HEALTH BEHAVIORAL PSYCHIATRY illness and trauma. We are committed to partnering with Developmental Disabilities, and Autism Treatment; Child disorders that impact thinking or behavior (e.g., brain Program, intermediate levels of behavioral health care in patients, families and referring primary care clinicians and Clinical, a post-graduate fellowship program in child and tumors, epilepsy, seizure disorders, traumatic brain the community courts and school, specialized services for specialists to deliver services of public health relevance and adolescent mental health for advanced practice nurses; and injury). The section provides care throughout the hospital, early child mental health, outpatient treatment clinics to achieve the best possible clinical outcomes. Because no externships for psychiatric and mental health advanced including inpatient medical units, medical specialty and a novel program to integrate mental health service single discipline or professional can adequately address practice nurses, clinical counselors, social workers, family outpatient clinics and the Psychology Clinic at Nationwide delivery in primary care settings. Over the past year, the the needs of every child, our approach is deliberately therapists and psychologists. In addition, medical students, Children’s. focus has been on the opening of the Big Lots Behavioral multidisciplinary and collaborative. residents in psychiatry, pediatric and family-practice, and Psychologists act as liaisons to divisions within the Health Pavilion. See page 134 for a list of faculty, selected publications and grants awarded. Care is typically delivered by a team composed of a nursing students all have training experiences and rotations Departments of Pediatrics and Psychiatry to provide within the service line. The service line supports a diverse combination of child and adolescent psychiatrists, expertise in clinical care and to assist in development of Center for Biobehavioral Health: portfolio of clinical research studies, many of which are See page 181 for developmental and behavioral pediatricians, psychologists research and quality initiatives around the psychosocial care information about the Center for Biobehavioral Health and neuropsychologists, nurses, social workers, family led by investigators from the Center for Biobehavioral for patients and families. In 2019, Pediatric Psychology Health, the Center for Innovation in Pediatric Practice, the in the Abigail Wexner Research Institute at Nationwide therapists and counselors. By working together, we aim had continued growth in patient volume for both Children’s Hospital. to deliver team-based care that transcends the work of Center for Suicide Research and Prevention, and the Child inpatient consultation and liaison and outpatient services. individual professionals, incorporating evidence-based Development Center Research Program. One area of continued expansion has been integrating GRANTS AWARDED TO practices into active clinical settings and establishing high By integrating clinical, educational, research and advocacy pediatric psychologists into our Primary Care Centers CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 standards of quality, safety and customer satisfaction. efforts, we strive to improve the lives of children and with new integration sites added in 2019. Also, Pediatric Faculty from the Department of Pediatrics and the Child families in central Ohio and beyond. The programs within Psychology realized growth in integrated care within $4,176,057 and Adolescent Division of the Department of Psychiatry Behavioral Health Services are described below. our Nephrology, GI, Complex Care and Neonatology services. Neuropsychology expanded to support integrated and Behavioral Health provide clinical care for the service The Child Development Center and Center for Autism services in our Rheumatology clinics. Psychologists also line. Spectrum Disorders provide services to individuals with began preparing for integration into psychiatric acute In March 2020, Nationwide Children’s opened the Big Lots intellectual and developmental disabilities, including those FAST FACTS care services on a larger scale with the opening of the Big Behavioral Health Pavilion, a new facility fully dedicated to with autism spectrum disorders. The Child Development Lots Behavioral Health Pavilion; three psychologists, two children and adolescents with mental and behavioral health Center offers a wide range of services to address the July 2019 through June 2020 psychology fellows, and a psychology intern/resident are conditions. As the most comprehensive pediatric facility of developmental and behavioral needs of children, adolescents not part of the Psychiatric Acute Care Service. Additionally, Child Development Center and Center for Autism its kind nationally, the Pavilion houses integrated behavioral and families of those with autism spectrum disorders and there is a history of psychologists providing leadership Spectrum Disorders health services, including inpatient psychiatric beds, a other developmental disabilities. in several programs within the Department of Pediatrics psychiatric crisis evaluation center with observation beds, Child Development Center Visits: ...... 10,628 These services include interdisciplinary assessment and at Nationwide Children’s, with roles such as director of a crisis stabilization unit, a partial hospital, and intensive Child Development Center Medical treatment, psychological evaluation and treatment, family Psychosocial Services for the Division of Hematology, outpatient and outpatient programs. The Pavilion will Clinic/Outpatient Consultation Visits: ...... interventions, advocacy support and care coordination Oncology & Blood and Marrow Transplant, psychosocial 1,432 serve as a place to conduct trainings on the wide range of with medical, speech and additional services. The Child leadership in areas of gastrointestinal care and the Center for Autism Spectrum Disorders Visits: ...... 38,628 disciplines in pediatric mental and behavioral health, as well Development Center provides integrated care in more Newborn Intensive Care Unit, program leadership in the as foster collaboration with Nationwide Children’s research Behavioral Health than a dozen pediatric subspecialty clinics. It also serves as interdisciplinary feeding program for children with feeding teams and community partner agencies. a site for the Autism Speaks Autism Treatment Network, a aversions, and the comprehensive interdisciplinary pain Total Outpatient Visits/Consults: ...... 250,748 In addition to being one of the largest outpatient service network of 13 sites across the United States and Canada. program. In 2019, Pediatric Psychology began providing Total Inpatient Consults: ...... 5,501 lines at Nationwide Children’s, we are also the largest The Center for Autism Spectrum Disorders provides clinical program leadership in Nationwide Children’s new Total Inpatient Discharges: ...... 1,568 pediatric behavioral health network of any children’s comprehensive, multidisciplinary care focusing on evidence- Intensive Pain Rehabilitation and Education Program. Total Inpatient Days: ...... 9,104

PSYCHIATRY AND COMMUNITY BEHAVIORAL HEALTH GRANTS AWARDED FAST FACTS JULY 1, 2019 – JUNE 30, 2020 Psychiatry and Community Behavioral Health at Nationwide Children’s Hospital is the largest and most $ 1,013,189 July 2019 through June 2020 clinically diverse section of Behavioral Health. This integrated program of care for pediatric mental health SELECTED PUBLICATIONS Psychiatry Inpatient Consultations:...... 1,337 conditions spans a comprehensive spectrum of care from prevention services to inpatient psychiatric units. Axelson D. Meeting the Demand for Pediatric Mental Health Care. Pediatrics. 2019 Psychiatry Inpatient Unit Discharges:...... 570 The Child and Family Division in The Ohio State University Department of Psychiatry and Behavioral Dec;144(6):e20192646. Johnson B, Leibowitz S, Chavez A, Herbert SE. Risk Versus Resiliency: Addressing Community-Based Visits:...... 44,646 Health has faculty at Nationwide Children’s and The Ohio State University. See page 132 for details and for Depression in Lesbian, Gay, Bisexual, and Transgender Youth. Child & Adolescent Psychiatric Clinics of North America. Outpatient Therapy Visits:...... 88,264 information about all Behavioral Health services. 2019;28(3): 509-521. Ramtekkar U, Bridge J, Thomas G,Butter E, Reese J, Logan E, Lin S, Axelson D. Partial Hospital/Intensive Outpatient Program Visits:...2,979 Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19. JMIR Mental Health. 2020; 10:10. FACULTY Robert A. Kowatch, MD, PhD Psychiatry Clinic Visits:...... 29,201 Waheed A, Sadhu JM, Kerlek AJ, Lee OC. The Biopsychosocial Model of Program Self-Evaluation: an Innovative and Holistic Approach to Enhance Child and Adolescent Youth Crisis Stabilization Unit Discharges:...... 998 Rajeev Krishna, MD, PhD, MBA Psychiatry Training and Recruitment. Academic Psychiatry. 2019; 43(5): 542-546. Psychiatric Crisis Department\PEEC:...... 5,580 Scott Leibowitz, MD Petronella Mbu, MD Molly Meers, PhD Jennifer Munoz, PhD Maura Munoz, MD. MA Mary Ann Murphy, MD, PhD Sarah Nayeem, MD David A. Axelson, MD Ujjwal Ramtekkar, MD, MBA, MPE Chief Jennifer Reese, PsyD Nadine Schwartz, MD John Ackerman, PhD Lacramioara Spetie, MD Benjamin Albrecht, DO Maria Stamatakos, MD Kento Akasaka, DO Griffin A. Stout, MD Jeffrey A. Bridge, PhD Glenn Thomas, PhD Meredith Chapman, MD Raymond Troy, MD Joyce Chen, MD Pankhuree Vandana, MD Nancy Cunningham, PsyD Elizabeth Vickery, PhD Ben Fields, PhD Kelly Wesolowski, PsyD Michael Flores, PhD Kris West, PhD Bela M. Gandhi, MD Richard H. Gilchrist, MD Charles J. Glawe, MD Jocelyn Hart, MD Karah Harvey, MD, MPH Joseph Hatcher, PhD Geeta Ilipilla, MD Natalie Jacobowski, MD Kristina R. Jiner, MD Anna Kerlek, MD

RADIOLOGY Jerome Rusin, MD College of Radiology’s (ACR) Innovation Fund for the The Department of Pediatric Radiology at Nationwide Children’s Hospital is one of the nation’s premier Summit Shah, MD creation of “I-ROAR: Imaging Registry for Orphan And Rare Disease.” imaging programs for children, with subspecialty expertise in abdominal, cardiac, chest, fetal/neonatal, Sally Smith, DO interventional, musculoskeletal, neuroimaging and nuclear imaging. We provide expert care in image- Rajesh Krishnamurthy, MD, was elected to the board of Benjamin Thompson, DO the Society of Pediatric Radiology in 2020, and is the guided diagnosis and therapy. Our mission is to improve children’s lives through innovative imaging. The Patrick Warren, MD current chair of the ACR Pediatric Imaging Research major philosophical consideration that drives our mission is that children are not small adults. Technology Section Chief, Interventional Imaging Committee. must be adapted to meet the needs of pediatric patients to create imaging biomarkers specific for pediatric Cody Young, DO disease. Our vision of the reinvented imaging department, the Children’s Imaging Biomarker Alliance SELECTED PUBLICATIONS Nicholas Zumberge, MD Begley KA, Braswell LE, Noritz GH, Murakami JW. Salivary gland ablation: introducing (CIBA), was born with the following goals: an interventional radiology treatment alternative in the management of sialorrhea. Pediatric • Develop and validate imaging biomarkers specific to pediatric disease Radiology has had several clinical advancements over the Radiology. 2020 May;50(6):869-876. past year. Most notably, we have grown subspecialized Hu HH, Branca RT, Hernando D, Karampinos DC, Machann J, McKenzie CA, Wu HH, Yokoo T, Velan SS. Magnetic resonance imaging of obesity and metabolic • Determine quality, safety and cost-effectiveness of validated imaging biomarkers for discrete patient programs to include: disorders: Summary from the 2019 ISMRM Workshop. Magnetic Resonance in Medicine. care pathways 2020;83(5):1565-1576. • Cardiac Imaging: especially neonatal/infant Mendell JR, Sahenk Z, Lehman K, Nease C, Lowes LP, Miller NF, Iammarino MA, Alfano • Integrate imaging biomarkers across the basic/translational /clinical spectrum LN, Nicholl A, Al-Zaidy S, Lewis S, Church K, Shell R, Cripe LH, Potter RA, Griffin DA, cardiac CT, new blood pool contrast program and Pozsgai E, Dugar A, Hogan M, Rodino-Klapac LR. Assessment of Systemic Delivery of • Integrate pediatric research across departments, imaging modalities and populations myocardial stress perfusion program rAAVrh74.MHCK7.micro-dystrophin in Children With Duchenne Muscular Dystrophy: A Nonrandomized Controlled Trial. JAMA Neurol. 2020 Jun 15:e201484. [Epub ahead of The imaging infrastructure is located in the Pediatric Advanced Imaging Resource (PAIR), which brings print]. • Musculoskeletal Imaging: with a new Ultrasound Molossi S, Agrawal H, Mery CM, Krishnamurthy R, Masand P, Sexson Tejtel SK, Noel together strategic partnerships and shared cutting-edge resources with optimized distribution of imaging contrast program and joint injections in CV, Qureshi AM, Jadhav SP, McKenzie ED, Fraser CD Jr. Outcomes in Anomalous Aortic Origin of a Coronary Artery Following a Prospective Standardized Approach. Circulation: technology and skilled personnel, an integrated model of imaging informatics, a robust quality and safety collaboration with Rheumatology Cardiovascular Interventions. 2020;13(2):e008445. [Epub ahead of print].

infrastructure and an advanced image-processing program which includes 3D modeling and 3D printing for Schooler GR, Squires JH, Alazraki A, Chavhan GB, Chernyak V, Davis JT, Khanna G, • Oncologic Imaging: utilizing Tumor Metrics to Krishnamurthy R, Lungren MP, Masand PM, Podberesky DJ, Sirlin CB, Towbin AJ. personalized treatment planning and creation of patient-specific devices. Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: quantify tumor mass and novel targeted antibody Consensus Imaging Recommendations from American College of Radiology Pediatric Liver treatment Reporting and Data System (LI-RADS) Working Group. Radiology. 2020;296(3):493-497. FACULTY Eric Diaz, MD Stephen Druhan, MD • Neuroimaging: with the utilization of Emergent 2019 – 2020 NATIONWIDE CHILDREN’S Stroke Programs FELLOWSHIP PROGRAM Elizabeth Hingsbergen, MD

Mai-Lan Ho, MD • Vascular Anomalies: creating new lymphatic PEDIATRIC RADIOLOGY Mark Hogan, MD channel imaging and intervention programs Nathan Fagan, MD (Interventional Radiology Fellow) Eric Morgan, MD (Pediatric Cardiovascular Imaging Fellow) Jeremy Jones, MD Section Chief, Neuroradiology Imaging We successfully organized and hosted a hands-on workshop and the largest international meeting Anna Lillis, MD on pediatric cardiovascular magnetic resonance in Lisa Martin, MD October 2019 at Nationwide Children’s, partnered with 3D Imaging for Interventional Catheterization Rajesh Krishnamurthy, MD Aaron McAllister, MD Radiologist-in-Chief interventional cardiology group. Through a unique Kathryn Milks, MD collaboration with the World Federation of Pediatric Brent H. Adler, MD James Murakami, MD Imaging (WFPI), we furthered the education and training of radiologists in Argentina, Philippines, David Gregory Bates, MD Becky Murray, MD Nigeria and India. We also welcomed our first fellow in Adam Bobbey, MD Julie O’Donovan, MD Pediatric Cardiac Imaging. Section Chief, Nuclear Medicine and Molecular Imaging Andrew Rabe, DO Finally, we have several advancements in research. Our Leah Braswell, MD Mitch Rees, MD research team is now led by Mai-Lan Ho, MD. Our Associate Section Chief, Interventional Imaging Diana Rodriguez, MD Interventional Radiology team is administering targeted Ellen Chung, MD gene delivery to support gene therapy research. We have Associate Radiologist-in-Chief Lynne Ruess, MD been a key imaging partner for the tissue engineering group. We are the grant award recipient of the American

THE HEART CENTER / CARDIOTHORACIC SURGERY SURGICAL SERVICES The Cardiothoracic Surgery Program at Nationwide Children’s Hospital is dedicated to the treatment of all patients, from fetus to adulthood, with congenital heart defects ranging from the most straightforward to the extremely complex. As part of The Heart Center, we offer a comprehensive approach to heart care that is based on a multidisciplinary team model, which enables our team to constantly monitor quality of care and patient safety pre-and post-surgery to assure the best possible outcomes. See page 40 for details about The Heart Center.

FACULTY

Oluyinka O. Olutoye, MD, PhD Surgeon-in-Chief

SURGICAL SERVICES Mark E. Galantowicz, MD Sergio A. Carrillo, MD Patrick I. McConnell, MD Toshiharu Shinoka, MD, PhD Nationwide Children’s Hospital’s surgical departments have come together with a single, clear focus — to Chief, Cardiothoracic Surgery Pediatric Cardiothoracic Director, Cardiopulmonary Director, Cardiovascular Tissue provide optimal outcomes for every child — inside and outside the walls of the operating room. This work Co-Director, Heart Center Surgeon Mechanical Assist Program Engineering Program is predicated on three core pillars — providing advanced clinical care, performing ground-breaking research and offering industry-leading training programs — that combine to provide the best care for every child. GRANTS AWARDED TO HEART CENTER Our faculty are helping to improve the care provided to children around the world by training the next AND CARDIOVASCULAR RESEARCH FACULTY generation of surgeons. Our departments offer the most surgical residency and fellowship programs of any JULY 1, 2019 – JUNE 30, 2020 free-standing pediatric hospital in the United States. Training programs are also offered to other surgeons, $2,302,971 providing opportunities for them to advance their skills in more advanced techniques such as minimally invasive laparoscopic and robot-assisted surgery. SELECTED PUBLICATIONS Galantowicz M. Hybrid Procedures: A Surgeon’s Viewpoint on the Next 10 Years. Pediatric Cardiology. 2020 Mar;41(3):514-521. SURGICAL SUBSPECIALTIES Kiper C, Cua CL, Baker P 3rd, McConnell P. Mitral Valve Replacement in Pediatrics Using an Extracellular Matrix Cylinder Valve: A Case Series. Pediatric Cardiology. 2020 • Cardiothoracic Surgery • Ophthalmology • Pediatric Surgery Jun 30. [Epub ahead of print] • Colorectal and Pelvic • Orthopaedics • Plastic and Miyachi H, Tara S, Otsuru S, Yi T, Lee YU, Nakayama H, Miyamoto S, Sugiura T, Shoji T, Breuer CK, Shinoka T. Platelet-derived growth factors promote neotissue formation Reconstruction • Otolaryngology Reconstructive Surgery during vascular remodeling in an arterial bioresorbable vascular graft. Journal of Vascular Surgery: Vascular Science. 2020; 1©:57-67. • Dentistry • Pediatric and Adolescent • Transplant • Neurosurgery Gynecology • Trauma • Urology

138138 | | NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | | 2019-20 2019-20 Annual Annual Report Report | | N NationwideChildrens.org/2020-ReportationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 139 Surgical Services

COLORECTAL AND PELVIC RECONSTRUCTION PROGRAM MANAGER SELECTED PUBLICATIONS Stephanie Vyrostek, BSN, RN Ahmad H, Halleran DR, Maloof E, Baek J, Gasior AC, Langer JC, Levitt MA, Wood The Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s Hospital is leading the way RJ. Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal in providing high-quality care for children diagnosed with colorectal and pelvic conditions. There is a direct malformations. Journal of Pediatric Surgery. 2020 Jun 1:S0022-3468(20)30360-2. CLINICAL LEADERS Ahmad H, Nordin AB, Halleran DR, Kenney B, Jaggi P, Gasior A, Weaver L, Sanchez correlation between the number of patients a clinical program sees and the high-quality outcomes they can AV, Wood RJ, Levitt MA. Decreasing surgical site infections in pediatric stoma closures. Marissa Condon, BSN, RN deliver to their patients. Colorectal and Pelvic Reconstruction is the busiest program of its kind anywhere Journal of Pediatric Surgery. 2020 Jan;55(1):90-95. Natalie Rose, BSN, RN Halleran DR, Ahmad H, Maloof E, Paradiso M, Lehmkuhl H, Minneci PC, Levitt MA, in the world, having performed more than 764 operations last year. Every child diagnosed with a colorectal Wood RJ. Does Hirschsprung-Associated Enterocolitis Differ in Children With and Without Down Syndrome? Journal of Surgical Research. 2020 Jan;245:564-568. or pelvic condition is handled with an individualized treatment plan. Because of the complexity of many ADVANCE PRACTICE NURSE COORDINATORS Vilanova-Sanchez A, Halleran DR, Reck CA, McCracken K, Hewitt G, Gasior AC, conditions, most children require care throughout their life. Our team is committed to providing optimal Weaver L, Ahmad H, Akers A, Jaggers J, Rentea RM, Levitt MA, Wood RJ. Factors Kristina Booth, MSN, CFNP outcomes and quality of life for patients ranging from newborns, through toilet training, puberty and predicting the need for vaginal replacement at the time of primary reconstruction of a Onnalisa Nash, MS, CPNP-PC cloacal malformation. Journal of Pediatric Surgery. 2020 Jan;55(1):71-74. adulthood, including bowel, urinary, sexual function and childbearing. Wood RJ, Halleran DR, Ahmad H, Vilanova-Sanchez A, Rentea RM, Stallings P, Ganesh N, Gasior A, Levitt MA. Assessing the benefit of reoperations in patients who suffer from The Center for Colorectal and Pelvic Reconstruction fecal incontinence after repair of their anorectal malformation. Journal of Pediatric Surgery. complex reconstruction program, working closely 2020 Jun;17:S0022-3468(20)30423-1. with urologists, gynecologists and gastroenterologists, continues to help children from around the world, thus far providing guidance and surgery for children from all 2019 – 2020 NATIONWIDE CHILDREN’S 50 states and 73 countries. The use of minimally invasive FELLOWSHIP PROGRAM surgery has expanded as well, offering both robot-assisted and pure laparoscopic surgical treatment of complex PEDIATRIC COLORECTAL RESEARCH conditions, including bladder neck reconstruction, and Hira Ahmad, MD appendicovesicostomy and/or Malone procedures for FACULTY Karla Vaz, MD severe incontinence, both urinary and fecal, and offering PEDIATRIC COLORECTAL SURGERY Kent C. Williams, MD unique opportunities to share tissues such as a shared Yousef El-Gohary, MD appendix used for both procedures. The Colorectal and Desale Yacob, MD Pelvic Reconstruction team travels to provide surgical INTERNATIONAL PELVIC RECONSTRUCTION Motility Director, Colorectal and Pelvic Reconstruction education across the globe. Surgeons train fellow Marion Arnold, MBChB, MMed surgeons and nurses train nurses. (Red Cross War Memorial Children’s Hospital, South Africa) DIAGNOSTIC RADIOLOGY Clare Skerritt, MD Brent H. Adler, MD The Center for Colorectal and Pelvic Reconstruction has a growing transition of care program for children as (Bristol Royal Hospital for Children, United Kingdom) David Gregory Bates, MD they become young adults and move into adulthood. Benjamin P. Thompson, DO With the expertise of Alessandra Gasior, DO, the first surgeon in the world trained in both pediatric and adult NEUROSURGERY colorectal surgery, this unique program will collaborate Richard J. Wood, MD with The Ohio State University Wexner Medical Center. Chief Jeffrey R. Leonard, MD The center has changed the lives of many adult patients through our collaborative approach to care. PEDIATRIC AND ADOLESCENT GYNECOLOGY COLORECTAL AND PELVIC RECONSTRUCTIVE SURGERY Geri D. Hewitt, MD Karen A. Diefenbach, MD Gynecology Director, Colorectal and Pelvic Reconstruction Allesandra Gasior, DO Katherine A. McCracken, MD Transitional Care Director UROLOGY Ihab Halaweish, MD Daniel G. DaJusta, MD GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION Urology Director, Colorectal and Pelvic Reconstruction Neetu Bali, MD Molly Fuchs, MD Carlo Di Lorenzo, MD V. Rama Jayanthi, MD Peter Lu, MD

DENTISTRY Benjamin Kwok, DDS, MS In the past year, the department has continued to provide Joshua M. Leavitt, DMD, MS access for patients, including children with special The Department of Dentistry at Nationwide Children’s Hospital is comprised of dedicated professionals health care needs. Although altered operations due to in the fields of pediatric dentistry, orthodontics, oral surgery, endodontics, periodontics, general dentistry, Jeffrey S. Lee, DDS the COVID-19 pandemic decreased the number of dental hygiene, and dental assisting who provide comprehensive preventive, therapeutic, urgent, and Sean E. Lindsey, DDS patient visits, the department provided continuous care for children with urgent and emergent needs in clinic, emergency oral health care services for infants, children, and adolescents, including those with special Eileen M. Martinez, DDS emergency department, and operating room settings. health care needs. Our mission is to optimize oral health for the children who need us most through Monte E. Masonbrink, DDS, MS The department has been a leader in how to continue a balanced program dedicated to providing quality clinical care and specialty services while advancing Yoon-Mi L. Matracia, DMD, MS patient care and training activities during COVID-19 knowledge through research, advocacy, and community partnerships within a premier educational with a nationwide shared resident curriculum and four environment. Scientific discoveries focus on caries prevention, behavior management, oral microbiome, Jeffrey T. Milton, DDS, MS publications on our experiences. To continue to improve and dental trauma outcomes. Kara M. Morris, DDS, MS clinical access to care and to promote scholarly activity in the department, Beau Meyer, DDS, MPH, has been Cecilia A. Moy, DDS. MS hired in a joint recruitment effort with The Ohio State FACULTY Peter E. Larsen, DDS Andrea M. Myers, DDS University College of Dentistry. Section Chief, Oral and Maxillofacial Surgery Scott W. Nieman, DDS Dennis J. McTigue, DDS, MS Additional highlights: DaAdrian T. Norman, DDS Ana M. Mercado, DMD, MS, PhD National and local faculty and resident recognitions: Colleen C. Orellana, DDS, MS Beau Meyer, DDS, MPH • Homa Amini, DDS, MS, MPH, received an Andree-Anne Page, DMD additional year of funding for Ohio Medicaid, Gregory M. Ness, DDS Sachin S. Parulkar, DDS Medicaid Equity Simulation Project, "MEDTAPP: Diego A. Solis, DDS Access to Dental Care for Immigrant Families." Monica R. Patel, DMD, MS COMMUNITY-BASED FACULTY • Ehsan Azadani, DDS, MS, was appointed as Nira S. Patel, DDS a graduate faculty member at The Ohio State Ashley E. Anderson, DDS Matthew L. Pingel, DMD College of Dentistry. Janice A. Townsend, DDS, MS Carolyn A. Barber, DDS Chief Jessica Pizano, DMD • Paul Casamassimo, DDS, was awarded the Gustav O. Kruger Career Achievement Award from Janet J. Brown, DDS Mindy A. Price, DDS, MS FULL-TIME NATIONWIDE CHILDREN’S FACULTY Georgetown University on May 28, 2020. Jennifer Bryk-Hechko, DDS, MS Sidney D. Price, DDS, MS • Dan Claman, DDS, completed the Quality Homa Amini, DDS, MS, MPH Emily R. Burns, DDS, MS Joel J. Richards, DDS Improvement Education Course. Ehsan Azadani, DDS, MS Alexis Capeci, DDS, MS Shaun A. Rotenberg, DMD, MS • Ann Griffen, DDS, MS, was appointed chair of Paul S. Casamassimo, DDS, MS Andre Carranco, DDS, MS Avneet K. Sandhu, DDS the Graduate Studies Committee at the Ohio State Daniel B. Claman, DDS University College of Dentistry. George Chen, DMD, MS Marlina M. Shah, DDS, MS Kimberly Hammersmith, DDS, MPH, MS Jackson Cockley, DDS • Erin Gross, DDS, MS, was appointed chair-elect Program Director Anuradha Shelar, DDS of the faculty council at The Ohio State University Joseph DePalo, DMD, MS Ashok Kumar, BDS, MS David S. Silverglade, DDS, MS College of Dentistry. Johnathan W. Draney, DDS, MS Director of Clinical Operations and General Anesthesia David A. Smeltzer, DDS • Kim Hammersmith, DDS, MPH, MS, was Rosa Ortega, DDS, MS Kylene H. Fernandez, DDS, MS Randall M. Speer, DDS awarded $2,250,000 by the U.S. Department Timothy J. Frey, DDS of Health and Human Services for the Health OSU-AFFILIATE FACULTY Mallary St. John, DDS, MS Resources and Services Administration Lucia C. Gerstmann, DDS, MS postdoctoral training in general, pediatric and Hany A. Emam, BDS, MS Rob S. Steiner, DMD Kimberly M. Gill, DDS, MS public health dentistry and dental hygiene. Henry W. Fields, DDS, MS, MSD Heidi Steinkamp, DDS, PhD • Beau Meyer, DDS, MPH, was awarded the Olav Section Chief, Orthodontics Jillian N. Gray, DDS Kumar Subramanian, DDS, MS Alvares Award for Early Career Scholars who Marcus Heffner, DDS Ann L. Griffen, DDS, MS Claire E. Towning, DDS Published Outstanding Articles in the Journal of Erin L. Gross, DDS, PhD, MS Mitzi L. Hines, DDS Eric C. Van Gilder, DDS Dental Education in 2019 by the American Dental Education Association. Courtney A. Jatana, DDS, MS, FACS Gary M. Judis, DDS Kevin T. Weitzel, DMD, MS Patrick M. Kennedy, DDS • Ashok Kumar, DDS, MS, completed the Kelly S. Kennedy, DDS, MS Stephen Wilson, Phd, DMD "Communicate With Me" training course. Nicholas M. Kerns, DDS, MS

NEUROSURGERY • Janice Townsend, DDS, MS, was a contributor to 2019 – 2020 NATIONWIDE CHILDREN’S Ranked sixth in the country by U.S. News & World Report, the Department of Pediatric Neurosurgery the surgeon general’s report. RESIDENCY PROGRAM at Nationwide Children’s Hospital provides evaluation and treatment for problems of the central nervous Research (funded) highlights: PEDIATRIC DENTISTRY system in patients from birth through 21 years of age and in selected adults with congenital neurological • Improved Access to Care with Homa Amini, DDS, disorders. The staff works closely with members of the departments of Anesthesia, Hematology, Oncology MPH, MS Seth Bradbury, DDS Madeleine DiPaolo, DDS & Blood and Marrow Transplant, Neurology, Physical Medicine and Rehabilitation, Pediatric Surgery, • Oral Microbiome Studies with Ann Griffen, DDS, Joshua Evans, DDS Plastic and Reconstructive Surgery, and many other pediatric disciplines. MS, and research team, The Ohio State University Taylor Harlan, DDS College of Dentistry Kaitlin Laxer, DDDS • Postdoctoral Training Grant with Kimberly Shayna Mattox, DDS Hammersmith, DDS, MPH, MS Jamie Molina, DDS Elizabeth Paulsen, DDS Mitch Poole, DDS Enrique Ramirez, DDS SELECTED PUBLICATIONS Adam Richardson, DDS Fenning RM, Steinberg-Epstein R, Butter EM, Chan J, McKinnon-Bermingham K, Victoria Tran, DDS Hammersmith K, Moffitt J, Shui AM, Parker RA, Coury DL et al. Access to Dental Andrew Vo, DDS Visits and Correlates of Preventive Dental Care in Children with Autism Spectrum FACULTY Disorder. The Journal of Autism and Developmental Disorders. 2020 Feb 27. Stormi Winter, DDS growth. Outreach efforts have been successful, as the team has provided care to patients from all around Sulyanto RM, Thompson ZA, Beall CJ, Leys EJ, Griffen AL. The Predominant Chloe Wong, DDS Oral Microbiota is Acquired Early in an Organized Pattern. Scientific Reports. 2019 Misa Yoshioka, DDS the world, including 31 states and nine countries. The Jul;9(1):10550. pediatric epilepsy surgery program is steadily expanding Townsend JA, Spiller H, Hammersmith K, Casamassimo PS. Dental Local Anesthesia- and is on pace to perform over 50 epilepsy cases this Related Pediatric Cases Reported to U.S. Poison Control Centers. Pediatric Dentistry. 2020 March;42(2):116-122. year. The Selective Dorsal Rhizotomy Program continues to FAST FACTS provide comprehensive care for patients with spastic July 2019 through June 2020 cerebral palsy, including care provided by colleagues in Physical Medicine and Rehabilitation, as well as in Inpatient Discharges:...... 2 Therapy Services. Our program is one of very few in the Observation and Outpatient-in-a-Bed Discharges:...... 16 Jeffrey R. Leonard, MD country that perform this procedure with great success. Total Discharges:...... 19 Chief Our out-of-state referrals have grown significantly, as demonstrated by increases in new patient clinic visits, Average Length of Stay*:...... 1.0 FULL-TIME NATIONWIDE CHILDREN’S FACULTY inpatient hospital days and case volume. Patient Days*:...... 2 Annie I. Drapeau, MD Dental Clinic Visits:...... 35,586 The scholarly output of the program has increased Jonathan A. Pindrik, MD markedly with over 30 publications (journals, chapters Mobile Dental Unit Visits:...... 85 and manuscripts) and 20 presentations in national and Dental Clinic and Sedation:...... 366 Ammar Shaikhouni, MD, PhD international meetings. We have enrolled over 600 Total Surgical Procedures:...... 4,289 Eric A. Sribnick, MD, PhD patients in either clinical trials or registry projects, and as a member of the Hydrocephalus Clinical Research *Excludes observation and outpatient-in-a-bed patients. OSU-AFFILIATE FACULTY Network (HCRN), we continue to participate in John M. McGregor, MD multi-institutional studies focusing on the treatment of hydrocephalus. In addition, the department is a part Ehud U. Mendel, MD of many other research endeavors, studying Chiari I Shahid Nimjee, MD malformations, cerebral palsy, epilepsy and brain tumors. Ciaran J. Powers, MD, PhD Jonathan A. Pindrik, MD, is co-director of the Epilepsy Surgery Program and the site principal investigator for Daniel Prevedello, MD the HCRN. Eric A. Sribnick, MD, PhD, continues Patrick Youssef, MD a basic science research program on the role of immunology in traumatic brain injury and is the trauma With over 850 surgical cases and more than 5,500 clinic liaison for the department. Both have submitted and visits performed in 2019 alone, the Department of presented multiple abstracts at national meetings over Pediatric Neurosurgery has continued with significant

OPHTHALMOLOGY the last year. Annie I. Drapeau, MD, is Neurosurgery collaboration dedicated to treatment of cerebral palsy co-director of the craniosynostosis program, as part in the pediatric and adult populations. He also serves The Department of Ophthalmology at Nationwide Children’s Hospital is dedicated to providing of the Center for Complex Craniofacial Disorders. on the editorial boards and the scientific peer review comprehensive eye care for children and adults. The department includes the Eye Clinic and the She is the medical co-director of the Neurology/ panel for SRA International, the Journal of Pediatric Electrophysiology Testing Laboratory. The Eye Clinic serves in-house patient referrals, provides Neurosurgery inpatient floor and is Neurosurgery's Neurology and World Neurosurgery, and is associate quality improvement lead. Dr. Drapeau has several editor of neurosurgery for Pediatrics. comprehensive outpatient eye care and offers special testing on the patients of community-based physicians. research and quality improvement projects focusing The clinic staff includes pediatric ophthalmologists, optometrists, a pediatric ophthalmology fellow and on optimizing care for craniosynostosis patients. Our SELECTED PUBLICATIONS ophthalmology residents from The Ohio State University College of Medicine, as well as low vision and 2018-19 fellow, Ammar Shaikhouni, MD, PhD, is rehabilitation specialists. In addition, the Eye Clinic offers specialty clinics staffed by ophthalmologists a faculty member working with both Nationwide Dornbos D, Monson C, Look A, Huntoon K, Smith L, Leonard J, Dhall S, Sribnick E. Validation of the Surgical Intervention for Traumatic Injury Scale in the Pediatric and other subspecialists and eye care professionals for patients with issues related to glaucoma, retina, Children’s and The Ohio State University Wexner Population. The Journal of Neurosurgery.2020 Apr 10;1-6. oculoplastics, cornea and external disease, intracranial hypertension and low vision. Medical Center. He has a clinical and research focus on Drapeau A, Walz PC, Eide JG, et al. Pediatric Craniopharyngioma. Child’s Nervous both adult and pediatric epilepsy, movement disorders System. 2019 Nov;35(11):2133-2145. and stereotactic surgery for gene and drug delivery. Pindrik J, Riva-Cambrin J, Kulkarni AV, et al. Surgical Resource Utilization After FACULTY Megan M. Chambers, MD Initial Treatment of Infant Hydrocephalus: Comparing ETV, Early Experience of ETV with Choroid Plexus Cauterization, and Shunt Insertion in the Hydrocephalus Clinical Raymond I. Cho, MD Chief Jeffrey Leonard, MD, continues his focus on Research Network. The Journal of Neurosurgery. 2020 Jun 19;1-9. Louis J. Chorich, III, MD spasticity, cerebral palsy and improving treatment for Sribnick EA, Hensley J, Moore-Clingenpeel M, Muszynski JA, Thakkar RK, Hall childhood brain tumors. He is currently participating MW. Nosocomial Infection Following Severe Traumatic Injury in Children. Pediatric Frederick H. Davidorf, MD as the neurosurgical lead for a multi-institutional Critical Care Medicine. 2020 May;21(5):443-450. Jill A Foster, MD Andrew J. Hendershot, MD FAST FACTS Charles J. Hickey, MD July 2019 through June 2020 Steven E. Katz, MD Inpatient Discharges:...... 582 Patient Days*:...... 3,293 Curtin G. Kelley, MD Observation and Outpatient-in-a-Bed Discharges:...... 196 Total Surgical Procedures:...... 720 David L. Rogers, MD Johnstone M. Kim, MD Total Discharges:...... 766 Neurosurgery Main Campus Clinic Visits:...... 5,517 Chief Average Length of Stay*:...... 6 *Excludes observation and outpatient-in-a-bed patients. Dino D. Klisovic, MD FULL-TIME NATIONWIDE CHILDREN’S FACULTY Average Daily Census*:...... 9 Rebecca A. Kuennen, MD Don L. Bremer, MD 2019 – 2020 NATIONWIDE CHILDREN’S Carrie A. Lembach, MD Cybil B. Cassady, MD FELLOWSHIP PROGRAM Cameron B. Nabavi, MD Richard P. Golden, MD Matthew P. Ohr, MD PEDIATRIC NEUROSURGERY Hilliary E. Inger, MD Tyler Oostry, MD Jillian Ploof, DO Catherine Olson Jordan, MD Daniel G. Straka, MD Julie M. Lange, MD Ana M. Suelves Cogollos, MD Mary Lou McGregor, MD A Decade of Remarkable Transformation Michael B. Wells, MD NEUROSURGERY Gary L. Rogers, MD Joined Hydrocephalus New Craniofacial The Department of Ophthalmology supports research Clinical Research Network Disorders Center Provides Amanda L. Way, MD Jeffrey Leonard, MD, Named (HCRN) as 1 of only 13 Sites Multidisciplinary Care for and teaching programs that ensure delivery of the Neurosurgery Chief in North America Craniosynostosis highest quality pediatric care for our patients, now OSU-AFFILIATE FACULTY and in the future. We are participating in amblyopia, Sayoko Moroi, MD, PhD cataract, myopia and retinopathy of prematurity 2010 2014 2015 2016 20172013 2019 2017 20202017 Chair, Ophthalmology and Visual Sciences (ROP) studies sponsored by the Pediatric Eye Disease N. Douglas Baker, MD Investigator Group. We are actively engaged in studies focused on preserving vision in children with Batten New Neurosurgical OR Selective Dorsal Rhizotomy Among First in U.S. to Provide Ranked in Top 7 by U.S. Dominic M. Buzzacco, MD Equipped with iMRI and Program Helps Children with Responsive Neurostimulation News & World Report 4th disease. Research continues on projects concerning Stereotactic Guidance Spasticity from Across U.S. Therapy for Children With Consecutive Year Kenneth V. Cahill, MD infantile cataracts, intracranial hypertension, secondary Intractable Epilepsy Colleen M. Cebulla, MD intraocular lens placement, pediatric drusen and From the recruitment of highly skilled neurosurgeons with diverse experience to the launch of a pediatric neurosurgery children with cystic fibrosis. We are also one of 15 fellowship the past decade has seen exceptional growth for Neurosurgery. The program has risen to national prominence, recognized in the top seven by U.S. News & World Report for four consecutive years.

146 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 147 sites currently participating in the multicenter Artisan GRANTS AWARDED Aphakia Lens study. The Artisan Aphakia lens is unique JULY 1, 2019 – JUNE 30, 2020 because it is fixed to the iris and therefore allows for $586,310 lens implantation in patients who do not have the support structure for a traditional implant. Without SELECTED PUBLICATIONS an implant lens, these children must wear extremely Crouch ER, Kraker RT, Wallace DK, Holmes JM, Repka MX, Collinge JE, Bremer DL, Gray ME, Smith HA, Steinkuller PG. Writing committee for Pediatric Eye Disease strong and cosmetically unappealing glasses or highly Investigator Group. Secondary 12-month Ocular Outcomes of a Phase 1 Dosing customized, and often poorly tolerated, hard contact Study of Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmology. 2020 Jan lenses. These patients now have an option to live with 1;138(1):14-20. Dsouza S, Aylward BS, Rogers DL. Aylward SC. Presenting Symptomatology and much more normal visual function. These lenses are Risk Factors in Pediatric Secondary Intracranial Hypertension due to Venous Sinus not FDA approved, and we expect this study will help Thrombosis. Pediatric Neurology. 2019 Dec;101:53-56. gain future FDA approval. Inger HE, Jordan CO, Yanoga F, Rogers DL. Equivalence of Oral Fluorescein Angiography to Intravenous Fluorescein Angiography in Evaluating Pediatric Optic Nerve The Visual Electrophysiology Clinic at Nationwide Pathology. Journal of Pediatric Ophthalmology and Strabismus. 2019 Dec 9;56:e68-e72. Children’s is led by Julie Racine, PhD. This Kornbluh AB, Thompson K, Memahen G, Rogers DL, Jordan CO, Aylward SC, Lehwald LM. Sleep Disturbance in Pediatric Intracranial Hypertension. The Journal of clinic performs electroretinograms, multifocal Clinical Sleep Medicine. 2020 Mar 24. [Epub ahead of print]

electroretinograms, electro-oculograms and visual Wallace DK, Kraker RT, Freedman SF, Crouch ER, Bhatt AR, Hartnett ME, Yang MB, evoked potential on patients of all ages, including Rogers DL, Hutchinson AK, VanderVeen DK, Haider KM, Siatkowski RM, Dean TW, Beck RW, Repka MX, Smith LE, Good WV, Kong L, Cotter SA, Holmes JM; Pediatric adults, to assess retinal and retino-cortical function. Eye Disease Investigator Group (PEDIG). Short-term Outcomes After Very Low-Dose The department also manages and acts as the physical Intravitreous Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmology. 2020 location for the office of the Ohio Amblyope Registry Jun 1;138(6):698-701. program (funded by the Ohio Department of Health’s Save Our Sight Fund), the first and only statewide FAST FACTS program in the United States designed to serve the needs of children with amblyopia. It is a voluntary July 2019 through June 2020 registration program to increase knowledge about Inpatient Discharges: ...... 1 amblyopia, its causes, treatment and prevention. It also provides free eye patches and other important services Observation and Outpatient-in-a-Bed Discharges: ...... 12 to help families of children with amblyopia. Total Discharges: ...... 13 Total Surgical Procedures: ...... 1,684 The department is equipped with state-of-the-art technology for utilization in standard dilated eye Inpatient Consults: ...... 2,692 exams and for specialty testing, including ultrasound Eye Clinic and Low Vision Eye Clinic Visits: ...... 8,088

(A/B scans), retinal photography, visual field, optical *Excludes observation and outpatient-in-a-bed patients. coherence tomography (OCT), intravenous and oral fluorescein angiography, autorefraction, tonometry, color vision and contrast sensitivity testing. We are proud to serve patients from across the country and the world.

148 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 149 Orthopaedics Finding the Best Treatment for Stable but Severe Slipped Capital Femoral Epiphysis A novel comparison of the modified Dunn procedure for children with stable versus unstable slipped capital femoral epiphysis (SCFE) has identified a new target to improve surgical outcomes.

The modified Dunn procedure was controversial for many years due to the high rate of avascular necrosis after surgery, which many studies found to be as high as 60%. Surgeons at Nationwide Children’s Hospital managed to achieve far lower than average postsurgical avascular necrosis rates for unstable SCFE cases, however (~6%, which they published in 2018 in the Journal of Pediatric Orthopedics). In an attempt to offer better future mobility outcomes for other patients as well, they then extended the use of the modified Dunn procedure to severe cases of stable, chronic SCFE.

In the first known comparison of outcomes for patients with stable versus unstable slipped SCFE undergoing the modified Dunn procedure, surgeons at Nationwide Children’s found that the procedure can effectively treat both acute and chronic SCFE. However, those with stable SCFE had a higher postsurgical complication rate, primarily due to the co-occurrence of avascular necrosis and postoperative instability. In patients without postoperative instability of the hip, however, avascular necrosis risk was similar across the groups.

“The modified Dunn procedure is very effective and relatively safe in acute unstable slips, but it needs to be used more cautiously in stable chronic cases — especially those with a more severe slip,” says Kevin E. Klingele, MD, chief of Orthopaedic Surgery at Nationwide Children’s and senior author on the latest study, also published in the Journal of Pediatric Orthopedics. “Avoiding postoperative instability may be the key to lowering complication or avascular necrosis rates in this procedure to a more acceptable level for severe, stable slip patients.”

Since conducting the research, Dr. Klingele and the team’s other orthopedic surgeons have attempted to eliminate postoperative instability using relative femoral neck lengthening, longer postoperative leg bracing and motion restrictions, and capsulorrhaphy (suturing to tighten the hip joint). They have had no postoperative slips in patients with chronic, stable SCFE since.

“For patients with severe stable slips, outcomes from in situ screw fixation alone are not good, but we now also know that the modified Dunn procedure for these cases is different than using it for acute, unstable SCFE — you have to be more careful to avoid postoperative complications,” Dr. Klingele says. “If we can eliminate that additional risk, though, we will be on our way to reaching the ideal treatment outcome: minimal complications with the best long-term hip function.”

REFERENCES: Davis RL 2nd, Samora WP 3rd, Persinger F, Klingele KE. Treatment of unstable versus stable slipped capital femoral epiphysis using the modified Dunn procedure. Journal of Pediatric Orthopedics. 2019;39(8):411-415. Persinger F, Davis RL 2nd, Samora WP, Klingele KE. Treatment of unstable slipped capital epiphysis via the modified Dunn procedure.Journal of Pediatric Orthopedics. 2018;38(1):3-8. “If we can eliminate that additional risk, though, we will be on our way to reaching the ideal treatment outcome: minimal complications with the best long-term hip function.” – Kevin E. Klingele, MD

ORTHOPAEDICS Research efforts were highlighted by two projects being SELECTED PUBLICATIONS recognized at this year’s Pediatric Orthopaedic Society Abousamra O, Deliberato D, Singh S, Klingele KE. Closed vs Open Reduction in The Department of Orthopaedics at Nationwide Children’s Hospital provides diagnosis, evaluation and Developmental Dysplasia of the Hip: The Short-Term Effect on Acetabular Remodeling. The of North America Annual 2020 meeting. “Reverse Journal of Clinical Orthopaedics and Trauma. 2020 March;11(2):213-216. treatment for all orthopedic conditions and disorders in infants, children and adolescents. Inpatient, dynamization accelerated bone healing in a large animal Davis RL, Samora WP, Persinger F, Klingele KE. Treatment of Unstable Versus Stable Slipped outpatient and emergency services are provided to patients with a wide range of developmental, congenital, osteotomy model” via senior author Christopher Iobst, Capital Femoral Epiphysis Using the Modified Dunn Procedure. The Journal of Pediatric Orthopedics. 2019 Sep;39(8):411-415. neuromuscular and posttraumatic problems of the musculoskeletal system, trauma and fractures, scoliosis MD, achieved runner-up as best basic science paper. “Probability analysis of sequential SCFE (PASS score)” via Iobst CA, Singh S, Yang JZ. Opioid Prescription Patterns for Pediatric Orthopaedic Fracture Patients. The Journal of Clinical Orthopaedics Trauma. 2020 Mar;11(2):286-290. and other spinal abnormalities. senior author Kevin Klingele, MD, achieved runner-up as best clinical paper. Both projects were enabled by Baruch Samade R, Lin JS, Popp JE, Samora JB. Delayed Presentation of Seymour Fractures: Faculty members participate in the education of health care professionals at several levels. Residents, A Single Institution Experience and Management Recommendations. Hand. 2019 Oct Danino, MD, who completed his year as the department’s 9:1558944719878846. medical students and nurses from The Ohio State University Wexner Medical Center, OhioHealth, and first international exchange research scholar. Mount Carmel Health System receive all of their pediatric orthopedic experience at Nationwide Children’s. The Accreditation Council for Graduate Medical Education-accredited fellowship program rounds out the FAST FACTS extensive educational program. July 2019 through June 2020 FACULTY Craig N. Dimitris, MD Inpatient Discharges:...... 437 Canal Winchester Orthopaedic Clinic Visits:...... 378 Jonathan B. Feibel, MD Observation and Outpatient-in-a-Bed Discharges:.... 527 Dublin Orthopaedic Clinic Visits:...... 10,216 Total Discharges:...... 959 East Broad Orthopaedic Clinic Visits:...... 788 Robert T. Gorsline, MD Average Length of Stay*:...... 3.5 Hilliard Orthopaedic Clinic Visits:...... 293 James E. Popp, MD Average Daily Census*:...... 4.1 New Albany Orthopaedic Clinic Visits:...... 1,886 Desmond J. Stutzman, DO Patient Days*:...... 1,490 Westerville Orthopaedic Clinic Visits:...... 8,240 Corey L. Van Hoff, MD Total Surgical Cases:...... 2,640 Orthopaedic Oncology Clinic Visits:...... 590 Inpatient Consults:...... 286 Total Orthopaedic Clinic Visits:...... 37,096 Raymond K. Wurapa, MD Main Campus Orthopaedic Clinic Visits:...... 14,705 *Excludes observation and outpatient-in-a-bed patients. In 2019, the Department of Orthopedics maintained its stature as a top 10 ranked pediatric orthopedic 2019 – 2020 NATIONWIDE CHILDREN’S Kevin E. Klingele, MD provider, developed surgically innovative techniques Chief and protocols, and flourished within a very active FELLOWSHIP PROGRAM research division. Recruiting efforts were highlighted FULL-TIME NATIONWIDE CHILDREN’S FACULTY with the addition of Reid Chambers, DO, and Craig PEDIATRIC ORTHOPEDICS Allan C. Beebe, MD Smith, MD. Dr. Chambers partnered within a very Michael Fisher, DO Matthew C. Beran, MD busy spine program and Dr. Smith joined the Center for Limb Lengthening and Reconstruction as well as Reid C. Chambers, DO quickly built a successful hip arthroscopy program A Decade of Remarkable Transformation Christopher A. Iobst, MD within the Center for Hip Preservation. ORTHOPAEDICS John R. Kean, MD The Spine Program officially expanded to become the Nationwide Children's Launches Dr. Christopher Iobst Joins to Both the Center for Hip Jan E. Klamar, MD Center for Comprehensive Spine Care (CCSC). Under Kevin Klingele, MD, Head the New Center for Limb Preservation and the Center for Named Chief of Orthopaedics Lengthening and Reconstruction Julie Balch Samora, MD, PhD, MPH the direction of Allan Beebe, MD, the CCSC provides Comprehensive Spine Care team-centered care for patients with spinal deformity, Walter P. Samora III, MD ranging from newborns with congenital anomalies to Craig A. Smith, MD adults with chronic conditions. Such a comprehensive 2010 2013 2016 2016 2017 2019 2020 approach, built with collaboration among many Amanda T. Whitaker, MD services, including Neurosurgery, Pain Services, and Nationwide Children's Gift from Honda Helps Ranked #8 by U.S. News OSU-AFFILIATE FACULTY the Honda Center for Gait Analysis and Mobility Develops Orthopaedic Quality Build Center for Gait & World Report — Fourth Enhancement, ensures optimal outcomes for our Improvement and Research Analysis and Mobility Consecutive Year in Top 10 Hisham M. Awan, MD Divisions Enhancement patients. The CCSC holds an outstanding track record Joel L. Mayerson, MD within quality improvement and dual surgeon operative From limb lengthening to hip preservation, from comprehensive spine care to sports medicine and adaptive sports Thomas J. Scharschmidt, MD techniques, producing one of the lowest infection rates within the country, as well as very low complication medicine, and from advanced care for musculoskeletal oncology patients to basic science research that moves the field COMMUNITY-BASED FACULTY and reoperation rates. forward, the Department of Orthopaedics has established a designated initiative to solve the most complex programs of the field over the last decade. Brent A. Bickel, MD

OTOLARYNGOLOGY Blaize A. O’Brien, MD rate has decreased, as has our rate of hemorrhage. In David M. Powell, MD addition, we continue to reduce our use of opioids The Department of Pediatric Otolaryngology, Head and Neck Surgery at Nationwide Children’s Hospital following surgery. Otolaryngology has been the provides comprehensive diagnosis and treatment for children who have diseases of the ears, nose and throat. Cherie Ryoo, MD surgical leader with reduction of new prescriptions for These problems include congenital and acquired diseases of the head and neck, hearing loss, ear infections, John M. Ryzenman, MD narcotics. tonsillitis, sinusitis, acute and chronic nasal problems, airway disorders, voice disorders, sleep apnea, skull Ashish Shah, MD GRANTS AWARDED base tumors, salivary gland problems and many other related diseases. Thomas M. Shirck, DO JULY 1, 2019 – JUNE 30, 2020 Stephen P. Smith Jr., MD $313,165 FACULTY Brandon Kim, MD Adam C. Spiess, MD Leslie R. Kim, MD, MPH SELECTED PUBLICATIONS Evan J. Tobin, MD Dharmadhikari S, Liu L, Shontz K, Wiet M, White A, Goins A, Akula H, Johnson Jameson K. Mattingly, MD J, Reynolds SD, Breuer CK, Chiang T. Deconstructing Tissue Engineered Trachea: Andrew Tompkins, MD Assessing the Role of Synthetic Scaffolds, Segmental Replacement and Cell Seeding on Aaron C. Moberly, MD Graft Performance. Acta Biomaterialia. 2020 Jan 15;102:181-191. Darryl N. Willett, MD Essig GF Jr, Sheehan CC, Niermeyer WL, Lopez JJ, Elmaraghy CA. Treatment of Facial Matthew O. Old, MD Dog Bite Injuries in the Emergency Department Compared to the Operating Room. The department continues its clinical growth of services OTO Open. 2019 Jul 11;3(3):2473974X19858328. Bradley A. Otto, MD with over 32,000 clinic visits and over 9,000 surgical King A, Elmaraghy C, Lind M, Tobias JD. A Review of Dexamethasone as an Adjunct Robert S. Pema, DO procedures. The department has grown both clinically to Adenotonsillectomy in the Pediatric Population. The Journal of Anesthesia. 2020 Jun;34(3):445-452. Minka L. Schofield, MD and academically. New clinical programs include our Martyn L, Sethia R, Chon R, Novotny L, Goodman SD, Elmaraghy C, Bakaletz LO. same-day ear tube surgery pilot program that allows Antibodies Against the DNABII Protein Integration Host Factor (IHF) Inhibit Sinus COMMUNITY-BASED FACULTY for a single visit for evaluation and surgery. We have Implant Biofilms. Laryngoscope. 2020 Jun;130(6):1364-1371. Charles A. Elmaraghy, MD, FAAP, FACS Patrick L. Bockenstedt, MD published over 50 original research manuscripts in Chief peer-reviewed journals and numerous other national Jacob P. Burkhart, DO FULL-TIME NATIONWIDE CHILDREN’S FACULTY presentations. We have developed a new protocol based Roberto J. Castellon, MD on an initiative to reduce post-operative complications Oliver F. Adunka, MD, FACS following tonsillectomy. As a result, our readmission Daniel W. Chase, MD Ethan Bassett, MD Subinoy Das, MD Tendy Chiang, MD Timothy P. Drankwalter, DO FAST FACTS Jonathan M. Grischkan, MD, FAAP, FACS Alexander A. Farag, MD Kris R. Jatana, MD, FAAP, FACS July 2019 through June 2020 Alfred J. Fleming Jr., MD Spencer Lindsey, MD Inpatient Discharges:...... 56 Lima ENT Clinic Visits:...... 95 Akash Gupta, MD Prashant S. Malhotra, MD, FAAP, FACS Observation and Outpatient-in-a-Bed-Discharges:..... 1,866 Mansfield ENT Clinic Visits:...... 377 Joseph E. Hall, MD Meredith Merz-Lind, MD, FAAP, FACS Total Discharges:...... 2,607 Marysville ENT Clinic Visits:...... 448 Jeffrey B. Hiltbrand, MD Average Length of Stay*:...... 3.8 Pediatric Aerodigestive Disorders Clinic Visits:...... 68 James M. Ruda, MD Steven M. Hirsch, MD Average Daily Census*:...... 0.8 Rhinology Clinic Vists:...... 51 Patrick C. Walz, MD Clifton R. Hood, DO Patient Days*:...... 275 Springfield ENT Clinic Visits:...... 300 Gregory J. Wiet, MD, FAAP, FACS Richard T. Irene, MD Total Surgical Cases:...... 9,457 Westerville ENT Clinic Visits:...... 7,954 OSU-AFFILIATE FACULTY Scott T. Kramer, MD Inpatient Consults:...... 792 Total ENT Clinic Visits:...... 35,792 Amit Agrawal, MD Michael J. Loochtan, MD Dublin ENT Clinic Visits:...... 8,198 *Excludes observation and outpatient-in-a-bed patients. Eugene Ge-Hink Chio, MD James D. Lowery, MD ENT (Main Campus) Clinic Visits:...... 14,852 Brad W. deSilva, MD Michael D. Martyn, MD Edward E. Dodson, MD Douglas D. Massick, MD 2019 – 2020 NATIONWIDE CHILDREN’S Garth F. Essig Jr., MD Timothy J. Nash, DO FELLOWSHIP PROGRAM L. Arick Forrest, MD Stephen J. Nogan, MD PEDIATRIC OTOLARYNGOLOGY Erin Hamersly, DO Gustavo Rangel, MD

PEDIATRIC AND ADOLESCENT GYNECOLOGY multidisciplinary care in both traditional and centering obstetrical care models. The Department of Pediatric and Adolescent Gynecology at Nationwide Children’s Hospital provides comprehensive reproductive health services for patients and their families from birth through early SELECTED PUBLICATIONS Hewitt GD. Dysmenorrhea and Endometriosis: Diagnosis and Management in adulthood. These services are provided within a wide array of clinical services including: Adolescents. Clinical Obstetrics and Gynecology. 2020 Sep;63(3): 536-543.

Hewitt GD, Yoost, J. ACOG Committee Opinion No. 806: Gynecologic Management • Pediatric and Adolescent Gynecology • Fertility and Reproductive Health Program of Young Women and Adolescents with Seizure Disorders. Obstetrics & Gynecology. 2020 May;135(5):1242-3. • Center for Colorectal and Pelvic • Teen and Pregnant Program O’Brien SH, Stanek JR, Kaur D, McCracken K, Vesely SK. Laboratory monitoring Reconstruction • THRIVE Program (differences of sexual during pregnancy and post-partum hemorrhage in women with VonWillebrand disease. Journal of Thrombosis and Haemostasis. 2019 Dec 5. • Endometriosis and Chronic Pain Program development and complex urological and • Family AIDS Clinic and Education Services gender concerns) (FACES) FAST FACTS FACULTY Patrick Schneider, MD July 2019 through June 2020 Cynthia S. Shellhaas, MD Downtown Teen and Pregnant Clinic Visits:...... 1,282 Stephen F. Thung, MD, MSCI Dublin Pediatric and Courtney Ware, MD Adolescent Gynecology Clinic Visits:...... 625 Linden Teen and Pregnant Clinic Visits:...... 283 Pediatric and Adolescent Gynecology at Nationwide Children’s continues to grow in all aspects of medical Main Campus Pediatric and services provided: ambulatory and telehealth visits, Adolescent Gynecology Clinic Visits:...... 2,542 in-patient consultations and surgical procedures Westerville Pediatric and performed. The geographic region we serve continues Adolescent Gynecology Clinic Visits:...... 765 to expand as well. Total Pediatric and Geri D. Hewitt, MD Adolescent Gynecology Clinic Visits:...... 5,497 Chief Gynecology continues to work collaboratively within CCPR to address the reproductive health needs of Total Surgical Procedures:...... 352 Pediatric and Adolescent Gynecology females born with anorectal malformations across their Geri D. Hewitt, MD lifespan. This work encompasses direct surgical and medical patient care, research projects and educational Dana Lenobel, APN initiatives. We also work collaboratively with the ARM Kate A. McCracken, MD transitional program at OSUMC.

Teen and Pregnant Program The Endometriosis and Chronic Pelvic Pain program Kara Malone, MD provides streamlined, comprehensive care for patients Lesley Manson, WHNP-BC with chronic pelvic pain. The multidisciplinary collaboration includes providers from numerous Natasha Reno, WHNP disciplines across the medical center working together Family AIDS Clinic and Education Services to enhance quality of life and reproductive outcomes for these patients. Maggie Rosen, MD

Maternal-Fetal Medicine Staff The Fertility and Reproductive Health Program provides clinical services and best practices for patients Michael P. Cackovic, MD at risk of diminished fertility. Nationwide Children’s is Maged Costantine, MD part of the international Oncofertility Consortium, and Heather Frey, MD we continue to offer ovarian tissue cryopreservation and cancer survivorship care. Mark Landon, MD Kara Rood, MD The Teen and Pregnant Program clinic continues to serve pregnant patients in central Ohio offering Philip Samuels, MD

156 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 157 Pediatric Surgery Midwest Pediatric Surgery Consortium Finds Antibiotics Alone Successfully Treat Uncomplicated Appendicitis in Children New research demonstrates that nonoperative management of uncomplicated appendicitis is a safe and effective option in a variety of health care systems.

Appendicitis is the most common cause for emergency abdominal surgery in childhood, affecting 80,000 children in the United States each year, but nonoperative treatment options are viable. A study performed by the Midwest Pediatric Surgery Consortium, led by Peter Minneci, MD, and Katherine Deans, MD, co-founders and directors of the Center for Surgical Outcomes Research at Nationwide Children’s Hospital, found that nonoperative management of uncomplicated appendicitis is a safe and effective option in a variety of health care systems.

Of 1,068 patients from 10 health centers enrolled in the study, 67.1% of those who elected to initially manage their care through antibiotics alone experienced no harmful side effects and did not later require an appendectomy by their one-year follow-up. Patients in this group experienced an average of 6.6 disability days, compared to the 10.9 days in the surgery group. Nonoperative management was also associated with fewer disability days for caregivers.

“With surgery, patients will definitely experience postoperative pain and disability,” says Dr. Minneci, principal investigator of the studies with Dr. Deans. “Treatment-related disability is important to kids, because it means missing activities in their lives that may directly affect their development and quality of life such as school, athletics and vacations," Dr. Deans notes.

Additionally, the study, which focused on children who were hospitalized for uncomplicated appendicitis — who experienced abdominal pain for no more than 48 hours, had a white blood cell count below 18,000 and underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 centimeter thick or smaller with no evidence of an abscess or fecalith — found that both the patients who elected to undergo surgery and those who chose nonoperative management with antibiotics alone reported similar health care satisfaction at 30 days and quality of life at 1 year.

Drs. Minneci and Deans say that future research could study how to disseminate these results and translate them into pediatric clinical practice so that more patients can be informed of the two options and the risks and benefits of each.

“Culture change and rethinking how we treat patients is always hard,” says Dr. Deans. “Surgeons tend to be passionate about operations, and an appendectomy is a well-tested and trusted procedure. However, some patients want to avoid surgery at all costs, and the results “Treatment-related disability is important to kids, because it means missing of our study allows us to move away from a one-size-fits-all model of appendicitis care and treat each child based on his or her values and preferences.” activities in their lives that may directly affect their development and quality of REFERENCES: life such as school, athletics and vacations.” Minneci PC, Hade EM, Lawrence AE, Sebastiao YV, Saito JM, Maki GZ, Fox C, Hirschi RB, Gadepalli S, Helmrath MA, Kohler JE, Leys CM, Sato – Katherine Deans, MD TT, Lal DR, Landman MP, Kabre R, Fallat ME, Cooper JN, Deans KJ for the Midwest Pediatric Surgery Consortium. Association of nonoperative management using antibiotic therapy vs laparoscopic appendectomy with treatment success and disability day in children with uncomplicated appendicitis. JAMA. 2020 July 27 [Epub ahead of print].

158158 | | NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | | 2019-20 2019-20 Annual Annual Report Report | | N NationwideChildrens.org/2020-ReportationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 159 Surgical Services

PEDIATRIC SURGERY The department continues to have one of the busiest SELECTED PUBLICATIONS robotic surgery programs of any children’s hospital in Bolling CF, Armstrong SC, Reichard KW, Michalsky MP, Section on Obesity, Section on Surgery. Metabolic and Bariatric Surgery for Pediatric Patients with Severe Obesity. Pediatrics. 2019 The mission of the Department of Pediatric Surgery at Nationwide Children’s Hospital is to provide the United States. This year the hospital acquired a new, Dec;144(6):e20193224. collaborative, comprehensive and multidisciplinary care for infants, children and adolescents with surgical state-of-the-art Da Vinci Xi Robot, which will allow us Drews JD, Pepper VK, Best CA, Szafron JM, Cheatham JP, Yates AR, Hor KN, Zbinden JC, Chang YC, Mirhaidari GJM, Ramachandra AB, Miyamoto S, Blum KM, Onwuka EA, Zakko J, Kelly J, disorders. The members of the department are all full-time faculty of the Department of Surgery at The to perform more diverse, complex operations on even Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Matsuzaki Y, Breuer J, Heuer ED, smaller children. Our original robot will be housed in West TA, Shoji T, Berman D, Boe BA, Asnes J, Galantowicz M, Matsumura G, Hibino N, Marsden Ohio State University College of Medicine and are committed to excellence in clinical care, surgical AL, Pober JS, Humphrey JD, Shinoka T, Breuer CK. Spontaneous Reversal of Stenosis in Tissue- the new Nationwide Children’s Hospital Conference Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537):eaax6919. education and research. and Simulation Center, and will be a wonderful addition Fabia R, Gallagher J, Wheeler KK, Johnson M, Cadelski K, Armstrong M, Pilato T, Heffernan J, Thakkar RK, Sales S, Giles S, Jeng JC. Efforts to Catalogue Non-Governmental Organizations with to the numerous simulation and training opportunities A Role in Global Burn Relief. Burns. 2020 Jun;46(4):804-816. available for faculty, staff and visitors. In addition, FACULTY Kristine Orion, MD Lawrence AE, Gonzalez DO, Fallat ME, Aldrink JH, Hewitt GD, Hertweck SP, Onwuka A, laparoscopic training simulation devices have been Bence C, Burns RC, Dillon PA, Ehrlich PF, Fraser JD, Grabowski JE, Hirschl RB, Kabre R, Kohler JE, Lal DR, Landman MP, Leys CM, Mak GZ, Sato TT, Scannell M, Sujka JA, Minneci PC, Amer Rajab, MD, PhD produced in our department and represent unique Deans KJ. Factors Associated with Management of Pediatric Ovarian Neoplasms. Pediatrics. 2019 training tools for surgeons. Jul;144(1):e20182537. Timur Sarac, MD Minneci PC, Hade EM, Lawrence AE, Saito JM, Mak GZ, Hirschl RB, Gadepalli S, Helmrath MA, Leys CM, Sato TT, Lal DR, Landman MP, Kabre R, Fallat ME, Fischer BA, Cooper JN, Deans KJ. Jean E. Starr, MD The Burn Program at Nationwide Children’s uses state- Multi-institutional Trial of Non-Operative Management and Surgery for Uncomplicated Appendicitis in Children: Design and Rationale. Contemporary Clinical Trials. 2019 Aug;83:10-17. Patrick S. Vaccaro, MD of-the-art techniques to accelerate burn wound healing and reduce pain. One of the newest techniques being used William K. Washburn, MD is using Re-cell, a technique that uses a small sample of FAST FACTS the patient's own skin to produce spray-on skin cells that The Department of Pediatric Surgery is one of the cover an area 30 times larger than previous methods and July 2019 through June 2020 largest and most diverse departments of its kind. The improves pigmentation. Other new products being used department maintains active clinical programs focused Inpatient Discharges:...... 1,274 include the skin substrate biodegradable transient matrix Gail E. Besner, MD on general pediatric surgery, minimally invasive surgery, (BTM), which promotes the formation of granulation Observation and Outpatient-in-a-Bed Discharges:...... 909 Chief robotic surgery, surgical oncology, surgical endocrinology, tissue over very deep burn wounds, and Suprathel, an Total Discharges:...... 2,629 trauma, burns, chest wall deformities, bariatric surgery, absorbable microporous membrane that decreases pain FULL-TIME NATIONWIDE CHILDREN’S FACULTY inflammatory bowel disease, hepatobiliary surgery, Average Length of Stay*:...... 5 in the treatment of burns and donor sites. Use of a new neuromodulation and pediatric colorectal surgery. The Jennifer H. Aldrink, MD smart phone virtual reality game is used as a distraction Average Daily Census*:...... 23 Trauma Program has been verified by the American Christopher K. Breuer, MD technique to reduce pain during dressing changes. Patient Days*:...... 8,504 College of Surgeons as a Level 1 Trauma Program since Total Surgical Procedures:...... 4,616 David R. Brigstock, PhD 1991, and the Burn Program has been verified by the The research conducted in the department is broad and Katherine J. Deans, MD, MHSc American Burn Association as a verified Burn Center since encompasses a range of basic, clinical, translational and Inpatient Consults:...... 981 2003. outcomes research projects. The department continues as a Karen A. Diefenbach, MD Colorectal Clinic Visits:...... 2,274 leader in the nation in presentations at national academic Each of the 16 faculty members in the department bring Dublin Surgery Clinic Visits:...... 251 Renata B. Fabia, MD, PhD meetings. For the ninth year in a row, our research trainees individual strengths and talents to the department, and have received prestigious national awards for their high- Mansfield Surgery Clinic Visits:...... 40 Jonathan I. Groner, MD are recognized for their expertise in clinical care, research quality research, bringing our total number of research Surgery/Burn Clinic Visits:...... 6,155 and education. One of the most important aspects of the Ihab Halaweish, MD awards to an unprecedented 35 in the past nine years. program is the opportunity to train the next generation Westerville Surgery Clinic Visits:...... 363 Brian D. Kenney, MD, MPH Faculty members in the department are highly prolific, of pediatric surgeons through our highly desirable Total Surgery Clinic Visits:...... 9,083 Marc P. Michalsky, MD, MBA publishing 150 to 200 papers a year. training programs in pediatric surgery, as well as several *Excludes observation and outpatient-in-a-bed patients. Peter C. Minneci, MD, MHSc additional specialty training programs. Several faculty Ihab Halaweish, MD, joined the department in 2019. members received awards this year for their excellent Benedict C. Nwomeh, MD, MPH He obtained his medical degree from Case Western clinical care and educational expertise, including the Art Reserve University, did his General Surgery and Trauma 2019 – 2020 NATIONWIDE CHILDREN’S Oluyinka O. Olutoye, MD, PhD of Medicine Award received by Jennifer H. Aldrink, MD; Translational and Clinical Research training at the FELLOWSHIP PROGRAM Surgeon-in-Chief the Physician of the Year Award received by Benedict C. University of Michigan, and did his Fellowship in Nwomeh, MD, MPH; the Golden Apple Teaching Award Pediatric Surgery at Texas Children’s Hospital. His clinical Rajan K. Thakkar, MD PEDIATRIC MINIMALLY INVASIVE received by Dr. Aldrink; and the Denis R. King Teacher interests focus on colorectal surgery and general pediatric Richard J. Wood, MD SURGERY of the Year Award received by Rajan K. Thakkar, MD. In surgery. addition, Gail E. Besner, MD, was inducted into the OSU Maria Carmen Mora, MD OSU-AFFILIATE FACULTY Mazzaferri-Ellison Society of Master Clinicians. Seven GRANTS AWARDED PEDIATRIC SURGERY Michael R. Go, MD faculty members were listed as Castle Connolly 2020 Top JULY 1, 2019 – JUNE 30, 2020 Dani Gonzalez, MD Afif Kulaylat, MD Mounir J. Haurani, MD Doctors. $3,294,715 SURGICAL CRITICAL CARE Bradley J. Needleman, MD Kate Savoie, MD

PLASTIC AND RECONSTRUCTIVE SURGERY SELECTED PUBLICATIONS 2019 – 2020 NATIONWIDE CHILDREN’S Crerand CE, Da Silveira AC, Kapa H, Litteral J, Markey MK, Mercado A, Scott M. FELLOWSHIP PROGRAM The Department of Plastic and Reconstructive Surgery at Nationwide Children’s Hospital provides Adherence to Orthodontic Treatment in Youth with Cleft Lip and/or Palate. The Cleft Palate- Craniofacial Journal. 2020 Feb;57(2):218-227. comprehensive, interdisciplinary management of cleft lip and palate, congenital and traumatic craniofacial Haenssler AE, Baylis A, Perry JL, Kollara L, Fang X, Kirschner R. Impact of Cranial Base PEDIATRIC PLASTIC AND CRANIOFACIAL SURGERY anomalies, 22q deletion syndrome, velopharyngeal dysfunction, hemangiomas and vascular anomalies, Abnormalities on Cerebellar Volume and the Velopharynx in 22q11. 2 Deletion Syndrome. Chinwe Kpaduwa, MD The Cleft Palate-Craniofacial Journal.2020; 57(4), 412-419. pigmented birthmarks, burn injuries, microtia and other ear anomalies, breast abnormalities, and congenital Madhoun LL, Crerand CE, Keim S, Baylis AL. Breast Milk Feeding Practices and Barriers CRANIOFACIAL SPEECH and traumatic hand and upper extremity anomalies and peripheral nerve disorders. and Supports Experienced by Mother–Infant Dyads with Cleft Lip and/or Palate. The Cleft Palate-Craniofacial Journal. 2020;57(4), 477-486. Brittany Bilitzo, MA, CCC-SLP

Perry JL, Kotlarek KJ, Spoloric K, Baylis A, Kollara L, Grischkan JM, Kirschner R, Bates FACULTY The Department of Plastic and Reconstructive Surgery DG, Smith M, Findlen U. Differences in the Tensor Veli Palatini Muscle and Hearing Status in Children with and without 22q11.2 Deletion Syndrome. The Cleft Palate-Craniofacial takes the leading role in several interdisciplinary teams Journal. 2020 Mar;57(3):302-309.

at Nationwide Children’s to provide comprehensive Rangwani S, Baylis A, Khansa I, Pearson G. Outcomes in Velopharyngeal Dysfunction care for the restoration of both form and function. The Treatment: Comparing Two Approaches for Pharyngeal Flaps. The Journal of Craniofacial department offers advanced fellowship training in both Surgery. 2020 Jun 26. pediatric plastic/craniofacial surgery and craniofacial speech science. Both the Cleft Lip and Palate Center and FAST FACTS the Center for Complex Craniofacial Disorders once again received national recognition as leading American July 2019 through June 2020 Cleft Palate-Craniofacial Association (ACPA)-approved programs. The 22q Center continued to fulfill its Inpatient Discharges:...... 59 Ortho Center Plastic Surgery Clinic Visits:...... 67 mission to provide comprehensive, coordinated services Observation and Outpatient-in-Bed Discharges:...... 239 Orthodontics Treatment Program Visits:...... 2,688 to patients and families from across the nation. Richard E. Kirschner, MD, FAAP, FACS Total Discharges:...... 317 Cleft Lip/Craniofacial Clinic Visits:...... 2,151 Chief In 2020, Lauren Madhoun, PhD, CCC-SLP, BCS-S, Average Length of Stay*:...... 4.3 Hilliard Plastic Surgery Clinic Visits:...... 284 was recruited to lead the Craniofacial Infant Feeding FULL-TIME NATIONWIDE CHILDREN’S FACULTY Average Daily Census*:...... 1.0 Plastic Surgery Clinic Visits:...... 3,764 Program and was appointed as assistant professor of Patient Days*:...... 371 Westerville Plastic Surgery Clinic Visits:...... 406 Adriane Baylis, PhD, CCC-SLP Plastic Surgery at The Ohio State University. This unique Total Surgical Procedures:...... 1,412 East Broad Plastic Surgery Clinic Visits:...... 66 Kim Bjorklund, MD program serves the Cleft Lip and Palate Center and the Center for Complex Craniofacial Disorders, providing Inpatient Consults:...... 53 Total Plastic Surgery Clinic Visits:...... 9,426 Ibrahim Khansa, MD feeding and dietary support to infants with cleft palate *Excludes observation and outpatient-in-a-bed patients. Lauren Madhoun, PhD and other craniofacial differences.

Ana Mercado, DMD, PhD Dr. Amy Moore, chief of the Department of Plastic Kara Morris, DDS, MS Surgery at The Ohio State University Wexner Medical Center, joined the Nationwide Children’s team in 2020. Gregory D. Pearson, MD An expert in pediatric peripheral nerve reconstruction, OSU-AFFILIATE FACULTY Dr. Moore has joined Dr. Kim Bjorklund to establish the Brachial Plexus and Peripheral Nerve Program at Albert Chao, MD Nationwide Children’s. In March, Dr. Moore and Dr. Matthew Chetta, MD Bjorklund performed the first lower extremity nerve Jeffrey E. Janis, MD transfer surgery for an acute flaccid myelitis patient at Nationwide Children’s, making the hospital one of the Clara N. Lee, MD only sites in the world performing this surgery. Amy Moore, MD In March of 2020, the Nationwide Children’s team Stephen J. Poteet, MD implemented one of the first and most comprehensive Ryan Schmucker, MD multidisciplinary cleft/craniofacial/22q telehealth team clinics in the nation, providing uninterrupted team care Steven Schulz, MD during the COVID-19 pandemic to patients with cleft Geoffrey Sisk, MD lip or palate and other craniofacial differences, as well Roman Skoracki, MD as those with 22q deletion syndrome, from across the United States.

TRANSPLANT The transplant programs at Nationwide Children’s Hospital provide comprehensive services to patients locally, nationally and internationally. Our programs are Abdominal Transplant (including Kidney and Liver Transplant), Blood and Marrow Transplant (BMT), Heart Transplant, and Lung and Heart-Lung Transplant.

PROGRAM LEADERSHIP

W. Kenneth Washburn, MD Alexander Weymann, MD Chief of Transplant Medical Director Director of Abdominal Transplant Liver Transplant

ABDOMINAL TRANSPLANT with malignant and nonmalignant disorders. Our team is The Abdominal Transplant Program at Nationwide dedicated to optimizing clinical applications of HCT by Children’s offers specialized and comprehensive care to reducing transplant-associated morbidity and mortality patients with end-stage liver disease due to congenital through novel care and innovative therapies, including immune-directed cellular therapies. The BMT Program Stephen E. Kirkby, MD and acquired hepatic and biliary disorders, and end-stage Rolla F. Abu-Arja, MD Jeffery J. Auletta, MD is supported by the Foundation for Accreditation of Medical Director renal disease due to kidney and urinary tract disorders. Clinical Director Medical Director Cellular Therapy (FACT)-accredited Apheresis Program Blood and Marrow Transplant Blood and Marrow Transplant Lung and Heart-Lung Transplant We perform both living- and deceased-donor kidney transplants and deceased-donor liver transplants for at Nationwide Children’s, which offers extracorporeal infants, children and adolescents. Both the Kidney and photopheresis for patients with graft-versus-host disease, Liver Transplant Programs are certified by the United and The James and W.W. Williams Company Cell Network for Organ Sharing (UNOS). The Kidney Therapy Laboratory at The James Cancer Hospital and Transplant Program is certified by the Centers for Solove Research Institute at The Ohio State University, Medicare and Medicaid Services (CMS) and is a member which offers unique forms of hematopoietic cell graft of the Improving Renal Outcomes Collaborative manipulation and processing. Our Cellular Therapy and (IROC). The Liver Transplant Program is accepted Cancer Immunotherapy Program (CTCIP) provides into the Ohio Solid Organ Transplant Consortium logistic support for cell therapy manufacturing and (OSOTC) and is an active member of the Society of protocol development for novel investigator-initiated Pediatric Liver Transplantation (SPLIT). In addition, cellular therapies. The BMT Program educates the next the programs partner with The Ohio State University generation of HCT and cell therapy physicians through Abdominal Organ Transplant Program to provide its fourth-year Pediatric BMT/Cell Therapy Fellowship Stephen E. Kirkby,Mark MD E. Galantowicz, MDMark E. Galantowicz, HirenMD P. Patel, MDHiren P. Patel, MD the full continuum of care to patients as they age and Program. Clinical Director Surgical Director Surgical Director Medical Director Medical Director transition to adult care. In the past year, the Nationwide The BMT Program is FACT-accredited and is affiliated Lung and Heart-LungLung Transplant and Heart-Lung TransplantLung and Heart-Lung TransplantKidney Transplant Kidney Transplant Children’s Kidney Transplant Program performed six with the National Marrow Donor Program (NMDP), the transplant surgeries, three of which were from a living Center for International Blood and Marrow Transplant donor. The Nationwide Children’s Liver Transplant Research (CIBMTR), the Children’s Oncology Group Program performed two liver transplants during the (COG), the Pediatric Transplant and Cell Therapy period, one of which was a combined liver-kidney Consortium (PTCTC), the Primary Immune Deficiency transplantation with the kidney transplant team, the Treatment Consortium (PIDTC), the Blood and Marrow first such combination transplant surgery at Nationwide Transplant Clinical Trials Network (BMT CTN), Children’s. the Sickle Transplant Alliance for Research (STAR) Consortium, and the New Approaches to Neuroblastoma BLOOD AND MARROW TRANSPLANT Therapy (NANT) Consortium. We actively collaborate The Blood and Marrow Transplant (BMT) Program in cutting-edge research and investigator-initiated clinical uses a family-centered, holistic care model in utilizing trials with The Ohio State University Comprehensive hematopoietic cell transplantation (HCT) as the definitive Cancer Center. Autologous and allogeneic hematopoietic Amer Rajab, MD, PhD Patrick McConnell, MD Robert J. Gajarski, MD, MHSA cure for pediatric and adolescent/young adult patients cell transplants are performed using all types of stem cell Surgical Director Surgical Director Medical Director Kidney Transplant Heart Transplant Heart Transplant

164 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 165 sources (bone marrow, peripheral blood, and umbilical LUNG AND HEART-LUNG TRANSPLANT FAST FACTS 2019 – 2020 NATIONWIDE CHILDREN’S cord blood) from human leukocyte antigen (HLA)- The Lung and Heart-Lung Transplant Program is part of July 2019 through June 2020 FELLOWSHIP PROGRAM matched related, unrelated and haploidentical donors. an advanced lung disease center consisting of programs In the last year, patients have been treated with a wide for cystic fibrosis, congenital heart disease, pulmonary Blood and Marrow Transplants: ...... 53 PEDIATRIC BONE MARROW TRANSPLANT AND CELL THERAPY range of modified stem cell grafts and cellular therapies, vascular disorders, interstitial lung disease and neonatal Heart Transplants: ...... 5 Margaret Lamb, MD including Kymriah® CD19 CAR T-cell therapy. lung disease. Our transplant team also works in Lung Transplants: ...... 1 Hematopoietic stem cell transplants were given under conjunction with The Heart Center, offering combined PEDIATRIC RENAL TRANSPLANT Kidney Transplants: ...... early phase FDA-approved clinical trials, including αβ- heart-lung transplantation to patients with advanced 6 Jessica Greco, MD T-cell and CD19 B-cell depleted haploidentical stem cardiopulmonary disease. Liver Transplants: ...... 1 Reeti Kumar, MD cell grafts for patients with hematologic malignancies, Emily Stonebrook, MD and a novel approach to eliminating graft-versus-host We offer a full spectrum of lung assist devices and Jason Thomas, MD disease for patients with sickle cell disease. Virus-specific ambulatory extracorporeal membrane oxygenation T cells (VSTs) were isolated from healthy donors to treat (ECMO) to children with advanced lung disease, life-threatening viral infections, and natural killer (NK) including acute respiratory decompensation, and have cells were manufactured and delivered to patients with the capability of transporting patients to our center on high-risk acute myeloid leukemia (AML). The FDA lung assist devices and ECMO. approved five novel studies for NK cell therapy of brain tumors, relapsed/refractory neuroblastoma, sarcomas, and SELECTED PUBLICATIONS COVID-19. Bhunia N, Abu-Arja R, Bajwa RPS, Auletta JJ, Rangarajan HG. Successful Treatment with Eculizumab for Posterior Reversible Encephalopathy Syndrome Due to Transplant- Associated Thrombotic Microangiopathy in Patients Transplanted for Sickle Cell Disease. HEART TRANSPLANT Pediatric Blood & Cancer. 2019 Oct;66(10):e27912. Giafaglione J, Morrison A, Gowda C, Gajarski R, Nandi D, Giafaglione J. Pediatric The Heart Failure and Transplant Program aims to Donor Heart Allocation in the United States, 2006-2017: Current Patterns and Potential provide advanced cardiac support to any patient with for Improvement. Pediatric Transplantation. 2020 May 19. end-stage heart failure refractory to conventional Hayes D Jr, Feeney B, O'Connor DJ, Nicholson KL, Nance AE, Sakellaris KK, Dempster NR, Groh JD, Kirkby SE. Lung Transplant Index: A Quality Improvement therapies. This includes advanced mechanical circulatory Initiative. Pediatric Quality and Safety. 2019 Sep 19;4(5):e209.

support with state-of-the-art ventricular assist devices Jay CL, Washburn WK, Rogers J, Harriman D, Heimbach J, Stratta RJ. Difference in (VAD) used as a bridge to transplant in appropriate Survival in Early Kidney after Liver Transplantation Compared with Simultaneous Liver- Kidney Transplantation: Evaluating the Potential of the "Safety Net." The Journal of the patients nonresponsive to pharmacologic heart failure American College of Surgeons. 2020 Apr;230(4):463-473. therapies. The program is certified by UNOS, approved Ling S, Ye W, Leung D, Navarro O, Weymann A, Karnsakul W, Freeman A, Magee J, by the Ohio Department of Health and Human Services Narkewicz M. Liver Ultrasound Patterns in Children With Cystic Fibrosis Correlate With and remains a member in good standing within the Noninvasive Tests of Liver Disease. Journal of Pediatric Gastroenterology and Nutrition. 2019 Sep;69(3):351-357. Ohio Solid Organ Transplant Consortium. Lorts A, Smyth L, Gajarski RJ, VanderPluym CJ, Mehegan M, Villa CR, Murray JM, In the last year, the program experienced a nearly 75% Niebler RA, Almond CS, Thrush P, O'Connor MJ, Conway J, Sutcliffe DL, Lantz JE, increase in transplant referrals and completed six heart Zafar F, Morales DLS, Peng DM, Rosenthal DN, Lorts A. The Creation of a Pediatric Health Care Learning Network: The ACTION Quality Improvement Collaborative. The transplants. Six VADs were implanted as a bridge to ASAIO Journal. 2020 Apr;66(4):441-446. recovery or heart transplant, and a young infant was Nguyen MC, Avila CL, Brock GN, Benedict JA, James I, El-Hinnawi A, Rajab A, successfully supported for over five months prior to Elkhammas E, Pelletier RP, Henry M, Bumgardner GL. “Early” and “Late” Hospital transplant using the Berlin EXCOR VAD, the longest Readmissions in the First Year after Kidney Transplant at a Single Center. Clinical Transplantation. 2020 Mar;34(3):e13822. infant support to date at Nationwide Children’s. O'Connor MJ, Lorts A, Davies RR, Fynn-Thompson F, Joong A, Maeda K, Mascio There is expected to be continued growth in the VAD CE, McConnell PI, Mongé MC, Nandi D, Peng DM, Rosenthal DN, Si MS, Sutcliffe program as it strives to meet the needs of an increasing DL, VanderPluym CJ, Viegas M, Zafar F, Zinn M, Morales DLS, O'Connor MJ. Early Experience with the Heartmate 3 Continuous-Flow Ventricular Assist Device in Pediatric population of older pediatric and young adult patients Patients and Patients with Congenital Heart Disease: A Multicenter Registry Analysis. The with congenital heart disease. A novel cardio-oncology Journal of Heart and Lung Transplantation. 2020 Jun;39(6):573-579. program continues to grow in volume and provide Tullius BP, Setty BA, Lee DA. Natural Killer Cell Immunotherapy for Osteosarcoma. ongoing cardiac care to long-term survivors of childhood Advances in Experimental Medicine and Biology. 2020;1257:141-54. cancers at risk for or developing cardiomyopathy. Finally, Zimmerer JM, Basinger MW, Ringwald BA, Abdel-Rasoul M, Pelletier RP, Rajab A, El-Hinnawi A, Parekh H, Washburn K, Bumgardner GL. Inverse Association Between the program remains an active member of a recently the Quantity of Human Peripheral Blood CXCR5+IFN-γ+CD8+T cells with de novo formed multicenter international quality research DSA Production in the First Year after Kidney Transplant. Transplantation. 2020 Feb 6. consortium, the Advanced Cardiac Therapies Improving Outcomes Network (ACTION), and Nationwide Children’s transplant physicians remain in leadership roles within the VAD education, team communication and quality improvement modules.

TRAUMA PHYSICIAN TRAUMA/BURN LIAISONS • Sheila Giles, RN, BSN, was instrumental in Morgan Wurtz, MD (Emergency Medicine) acquiring the American Nursing Association’s Nationwide Children’s Hospital is one of the largest Level 1 pediatric trauma centers in the nation to be recognition of burn nursing as a specialty. Graciela Argote-Romero, MD (Anesthesia) verified by the American College of Surgeons. We are also one of the few free-standing pediatric burn • Lee Ann Wurster, MS, RN, CPNP, TCRN RN, centers in the United States to be verified by the American Burn Association. The trauma and burn Allan Beebe, MD (Orthopedics) MS, led the COVID-19 Pediatric Trauma Society programs provide clinical care for injured children, a robust quality improvement program to ensure that Greg Cambier, MD (Anesthesia) Nurse Leadership Group. the highest quality of care is provided, and research to improve outcomes through the Center for Pediatric Maria Estrada, DO (Critical Care) • Carrie Rhodes, CPST-I, BA, was appointed to Trauma Research at Nationwide Children’s. Our nationally recognized trauma and burn service provides Mark Hogan, MD (Radiology) the steering committee for the Pediatric Trauma care for injured children from infancy through adolescence. Pediatric trauma and burn experts are involved Society Injury Prevention Committee. Jeff Lutmer, MD (Critical Care) in all aspects of patient care, including pre-hospital, emergency department, critical care, inpatient, • Kathy Haley, MS, RN, was reappointed to the operative management and rehabilitation. Our multidisciplinary, collaborative approach allows us to David Martin, MD (Anesthesia) board of the Central Ohio Trauma System. provide patients with exceptional care. Our center serves as a resource for injury prevention and education Ellen McManus, MD (Emergency Medicine) The trauma team provides expertise and leadership for our primary service area and beyond. Eric Sribnik, MD (Neurosurgery) through the Central Ohio Trauma System, the state trauma system, and nationally through the Pediatric TRAUMA PROGRAM MANAGER Trauma Society, the Verification Review Committee of the FACULTY Kathy Haley, MS, RN American College of Surgeons, and other national trauma and burn organizations. Highlights from the past year: • Renata Fabia, MD, was nominated as president- elect for the North American Burn Society. • Rajan Thakkar, MD, provided leadership for the Pediatric Injury Quality Improvement Collaborative, a national burn injury quality collaborative. • The urnB Program launched its first full year of its Laser Therapy Program for burn scar reconstruction. Rajan Thakkar, MD Renata Fabia, MD Trauma Medical Director Co-Director Burn Program Co-Director Burn Program TRAUMA SURGEONS Jennifer H. Aldrink, MD CENTER FOR PEDIATRIC TRAUMA RESEARCH Gail E. Besner, MD RESEARCH CENTER FACULTY Christopher K. Breuer, MD Katherine J. Deans, MD Karen A. Diefenbach, MD Ihab Halaweish, MD Brian D. Kenney, MD, MPH Marc P. Michalsky, MD Jonathan I. Groner, MD Trauma Quality Medical Director Peter C. Minneci, MD Benedict C. Nwomeh, MD Julie Leonard, MD, MPH Oluyinka Olutoye, MD Henry Xiang, MD, MPH, PhD Jonathan I. Groner, MD Director Medical Director Associate Director Richard Wood, MD

168 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 169 FACULTY • Yuyang Zhang, graduate student of Bo Lu, Jennifer Cooper, PhD PhD, was the third-place winner of 2019 Renata Fabia, MD, PhD Ohio State University Center for Clinical and Brian Kenney, MD, MPH Translational Science Annual Scientific Meeting Jeffrey Leonard, MD poster competition in the graduate students Eric Sribnick, MD, PhD section. Rachel Stanley, MD Gerry Taylor, PhD GRANTS AWARDED Rajan Thakkar, MD JULY 1, 2019 – JUNE 30, 2020 Ginger Yang, PhD, MPH Trauma-related research funding spans multiple AFFILIATE FACULTY centers which include Emergency Medicine, Center for Biobehavioral Health, Pediatric Psychology and Allan C. Beebe, MD Neuropsychology, Center for Injury Research and Policy, Mark Hall, MD, FAAP, FCCM and Center for Innovation in Pediatric Practices. Bo Lu, PhD (The Ohio State University) Jennifer Lundine, PhD, CCC-SLP, BC-ANCDS $2,546,672 Keith Yeates, PhD SELECTED PUBLICATIONS NURSE RESEARCHERS Leonard JC, Browne LR, Ahmad FA, Schwartz H, Wallendorf M, Leonard JR, Lerner Kathy Haley, MS, RN EB, Kuppermann N. Cervical Spine Injury Risk Factors in Children with Blunt Trauma. Sheila Giles, BSN, RN Pediatrics. 2019 Jul. 144(1):e20183221. Dana Noffsinger, CPNP-AC Nattino G, Lu B, Shi J, Lemeshow S, Xiang H. Triplet Matching for Estimating Causal Effects with Three Treatment Arms: A Comparative Study of Mortality by Trauma Center LeeAnn Wurster, MS, RN, CPNP Level. The Journal of the American Statistical Association.2020 Apr 3. Published online.

Otto L, Wang A, Wheeler KK, Shi J, Groner J, Haley K, Nuss K, Xiang H. Comparison SENIOR RESEARCH ASSOCIATE of manual and machine assigned injury severity scores in US trauma registry data. Injury Megan Armstrong, MPH Prevention. 2020 Aug. 26(4):330-333. Petranovich DL, Smith-Payne J, Wade SL, Yeates KO, Taylor HG, Stancin T, Kurowski Center for Pediatric Trauma Research Achievements BG. From Early Childhood to Adolescence: Lessons About Traumatic Brain Injury (TBI) from the Ohio Head Injury Outcomes Study. The Journal of Head Trauma Rehabilitation. • Julie Leonard, MD, MPH, won the 2020;35(3):226-239. Outstanding Mentor Award from the Abigail Savioe K, Shi J, Wheeler K, Xiang H, Kenny B. Pediatric Blunt Cerebrovascular Injuries: A National Trauma Database Study. The Journal of Pediatric Surgery.2020;55(5):917-920. Wexner Research Institute. Schilling S, Mansour A, Sullivan L, Ding K, Pommering T, Yang JZ. Symptom Burden and • Ginger Yang, PhD, was featured by the U.S. Profiles in Concussed Children with and without Prolonged Recovery. The International Centers for Disease Control and Prevention Journal of Environmental Research and Public Health. 2020 Jan 4;17(1):351. in its Injury Control Research Centers success story about Ohio concussion laws. • Ginger Yang, PhD, received a multiyear NIH FAST FACTS grant to study the effectiveness of parent- July 2019 through June 2020 focused driving safety interventions on safe- driving practices among teen drivers who have Admissions:...... 1,575 committed a traffic violation. Average Length of Stay:...... 3.0 • Henry Xiang, MD, MPH, PhD, received a Blunt Injury Admissions:...... 1,192 research grant from the Ohio Department of Penetrating Injury Admissions:...... 142 Public Safety Emergency Medical Services to evaluate smart phone virtual reality for pediatric Burn Injury Admissions:...... 215 home burn-dressing pain management. Asphyxial Injury Admissions:...... 26 • Jennifer Lundine, PhD, received a multiyear Orthopedic Trauma Admissions:...... 499 CDC grant as the co-investigator to assess Neurosurgery Trauma Admissions:...... 187 return to school following pediatric traumatic Pediatric Surgery Trauma Admissions:...... 769 brain injury. Other Service Trauma Admissions:...... 120

170 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 171 Urology Using Biomarkers to Determine the Success of Ureteropelvic Junction Obstruction Surgery Biomarkers initially found to differ among patients with ureteropelvic junction obstruction and healthy controls may also objectively gauge post-surgical resolution of obstruction.

A follow-up study of a trial that initially identified four biomarkers that differ between healthy controls and pediatric patients about to undergo surgery for ureteropelvic junction obstruction (UPJO) has confirmed that two of these biomarkers may also be useful in determining whether the obstruction has successfully resolved post-surgery.

The study, published in the Journal of Pediatric Urology, found that levels of beta defensin 1 (BD-1) and hepatocarcinoma-intestine-pancreas/pancreatitis-associated protein (HIP/PAP) — both of which were significantly elevated pre-surgery compared to healthy control patients — significantly decreased after successful UPJO surgery, with BD-1 returning to normal, healthy control levels.

“Diagnosis of obstruction currently relies exclusively on the use of radiologic studies, which can take their toll on families because they’re often invasive and time-consuming, and they can be ambiguous in many cases of UPJO,” says Brian Becknell, MD, PhD, a pediatric nephrologist and principal investigator in the Center for Clinical and Translational Research at Nationwide Children’s Hospital. “It would be nice to have urine biomarkers we could serially monitor and measure noninvasively over time to determine which patients might need surgery and which can be monitored on a conservative, nonoperative basis.”

The clinician-scientists behind the research examined follow-up urine samples at least 6 months after surgery (to allow time for complete surgery-related healing) for 13 of the original study’s 30 patients. All had successful resolution of their obstruction after surgery, as demonstrated via improved radiologic imaging and symptom resolution.

Their work is the first to demonstrate that HIP/PAP and BD-1 may offer clinicians not only a noninvasive and non-imaging-based method of detecting ureteral obstruction but also of monitoring its resolution post-surgery.

“We now need to show how these biomarkers behave in a larger group of patients,” says Christina Ching, MD, senior author of the study, pediatric urologist and a physician-scientist at Nationwide Children’s. “In addition, while this study was the first step in demonstrating the potential of these markers in evaluating for resolution of obstruction, it was actually a drawback of this study that all patients had a successful outcome from surgery. We need to follow some patients who do not respond to surgery to determine if biomarkers follow a different trajectory in that situation.”

To learn more about a wide range of obstruction-related biomarkers, the team will use a recently awarded R01 grant (Brian Becknell, MD, PhD, lead investigator) to prospectively follow about 300 young children with UPJO, with the hope of correlating serial urine findings with radiologic imaging and kidney function testing as needed.

REFERENCES: “We now need to show how these biomarkers behave in a larger group of patients.” Gupta S, Jackson AR, DaJusta DG, McLeod DJ, Alpert SA, Jayanthi VR, McHugh K, Schwaderer AR, Becknell B, Ching CB. Urinary antimicrobial peptides: – Christina Ching, MD Potential novel biomarkers of obstructive uropathy. Journal of Pediatric Urology. 2018 Jun;14(3):238.e1-238.e6. Gupta S, Nicassio L, Junquera GY, Jackson AR, Fuchs M, McLeod D, Alpert S, Jayanthi VR, DaJusta D, McHugh KM, Becknell B, Ching CB. Impact of successful pediatric ureteropelvic junction obstruction surgery on urinary HIP/PAP and BD-1 levels. Journal of Pediatric Urology. 2020 Mar;S1477-5131(20)30059-0. [Epub ahead of print].

172 || NATIONWIDENATIONWIDE CHILDREN’SCHILDREN’S HOSPITALHOSPITAL || 2019-20 Annual Report || NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 173 Surgical Services

GRANTS AWARDED Fuchs ME, Halleran DR, Shin YJ, Sebastião Y, Weaver L, Ahmad H, Booth K, Ching UROLOGY JULY 1, 2019 – JUNE 30, 2020 CB, Levitt MA, Wood RJ, Dajusta DG. Anatomic Factors Predict Urinary Continence in Patient with Anorectal Malformation. The Journal of Pediatric Urology.2020 Jun The Department of Urology at Nationwide Children’s Hospital provides comprehensive diagnostic and $177,395 21;S1477-5131(20)30387-9. Gupta S, Junquera GY, Nicassio L, Becknell B, Ching CB. Trans IL-6 Signaling Does therapeutic services for a wide range of urological disorders in children of all ages, including teenagers and SELECTED PUBLICATIONS Not Appear to Play a Role in Renal Scarring After Urinary Tract Infection. The Journal of Pediatric Urology. 2020 May 29:S1477-5131(20)30178-9. young adults. Advanced services include reconstructive surgery of the urinary tract, genitalia and urinary Brown CT, Sebastião YV, Zann A, McLeod DJ, DaJusta D. Utilization of Robotics for Retroperitoneal Lymph-Node Dissection in Pediatric and Non-Pediatric Hospitals. The Sebastião YV, Cooper JN, Becknell B, Ching CB, McLeod DJ. Prediction of Kidney sphincter, as well as consultations for urinary tract abnormalities detected in utero. The department Journal of Robotic Surgery. 2020 Mar 21. Failure in Children with Chronic Kidney Disease and Obstructive Uropathy. Pediatric Nephrology. 2020 Jun 25. [Epub ahead of print.] participates in several multispecialty clinics, including THRIVE (a program specializing in care for Crerand CE, Kapa HM, Litteral JL, Nahata L, Combs B, Indyk JA, Jayanthi VR, Chan YM, Tishelman AC, Hansen-Moore J. Parent Perceptions of Psychosocial Care for differences of sexual development, complex urological problems and gender concerns), the Center for Children with Differences of Sex Development. The Journal of Pediatric Urology. 2019 Colorectal and Pelvic Reconstruction (CCPR), the Urology/Nephrology Combined Clinic, the Stone Clinic Oct;15(5):522.e1-522.e8. and the Myelomeningocele Program. FAST FACTS The mission of the department is to provide the highest quality pediatric urological care in the safest and July 2019 through June 2020 most child-friendly environment. The department includes members who are full-time pediatric urologists, hold faculty appointments in the Department of Urology at The Ohio State University College of Medicine Inpatient Discharges:...... 119 Dayton Children’s Clinic Visits:...... 623 and are committed to cutting-edge medical research and surgical education. Observation and Outpatient–in-a-Bed Discharges:...... 117 Dublin Urology Clinic Visits:...... 1,311 Total Discharges:...... 297 Lima Urology Clinic Visits:...... 172 FACULTY The academic productivity of the program has Average Length of Stay*:...... 2.9 Mansfield Urology Clinic Visits:...... 244 continued to increase. In the last year, the department Average Daily Census*:...... 1.3 Portsmouth Urology Clinic Visits:...... 288 had 30 publications, 63 presentations at national Patient Days*:...... 472 Urology (Main Campus) Clinic Visits:...... 7,242 and international meetings and nine book chapters published. Dr. Christina Ching is the first member of Total Surgical Procedures:...... 2,030 Urology/Nephrology (Main Campus) Clinic Visits:...... 194 the department to be a National Institutes of Health- Inpatient Consults:...... 111 Westerville Urology Clinic Visits:...... 1,364 funded researcher. Urodynamics:...... 828 Total Urology Clinic Visits:...... 11,650 The department continues to provide care to multiple Canal Winchester Urology Clinic Visits:...... 272 *Excludes observation and outpatient-in-a-bed patients. areas in the region, acknowledging that it is vital for a premier program to go to families as opposed to always 2019 – 2020 NATIONWIDE CHILDREN’S having them come to main campus. To that end we have FELLOWSHIP PROGRAM V. Rama Jayanthi, MD expanded long-distance Ohio outreach clinics in Lima, Chief Mansfield and Wheelersburg. In addition, the joint PEDIATRIC UROLOGY venture with Dayton Children’s Hospital continues to Kristin Ebert, MD FULL-TIME NATIONWIDE CHILDREN’S FACULTY serve southwest Ohio, with two Nationwide Children’s Michael Ernst, MD Seth A. Alpert, MD Urology faculty members offering full-time service to the Dayton metropolitan area. Christopher T. Brown, MD A Decade of Remarkable Transformation Christina B. Ching, MD The Robot-Assisted Laparoscopic Surgery Program is robust, performing a wide range of surgical UROLOGY Nationwide Children’s Urologists and Daniel G. DaJusta, MD Researchers Create the Urinary Tract procedures, from routine kidney level operations such Partnership with Dayton Children’s Infection Global Alliance (UTIGA) — A Rama Jayanthi, MD, Enhances Regional Pediatric Professional Society Focused on Solving Molly E. Fuchs, MD as pyeloplasties and nephrectomies, to more complex Appointed Chief of Urology Urology Care Challenges Related to UTI management Daryl J. McLeod, MD procedures such as bladder neck reconstructions and appendicovesicostomy. Only a handful of centers around Donald H. Nguyen, MD the country are performing the latter, but at Nationwide 2010 2012 2013 2016 2017 20202013 COMMUNITY-BASED FACULTY Children’s they have become commonplace. Our six robotically trained pediatric urologists are among the Nima Baradaran, MD Nephrology-Urology Center For Colorectal & Nationwide Children's Joins Four most active in the country with regard to surgical Research Affinity Group Pelvic Reconstruction is Other Premier Children’s Hospitals Roy R. Brown, Jr., MD volumes. (NURAG) Expands, Leading to World’s First to Formally to Form Pediatric Urology Midwest More Than 100 Collaborative Integrate Clinical and Alliance (PUMA) Publications Since Inception Surgical Specialties George T. Ho, MD Urology continues to place great importance on Adam C. Weiser, MD multispecialty collaborative clinics. These include the For the past decade, the Department of Urology has consistently led peers in collaborative innovation efforts such as THRIVE program for differences of sexual development, PUMA, UTIGA and NURAG. The team has also been part of surgical firsts, including the first team to integrate clinical the Center for Colorectal and Pelvic Reconstruction and surgical specialties for conditions requiring advanced colorectal and pelvic reconstruction interventions. (CCPR), and the Urology/Nephrology Combined Clinic.

174174 | |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL | |2019-20 2019-20 Annual Annual Report Report | |N ationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 175 Department, Section and Center Reports

INSTITUTE LEADERSHIP

Lauren O. Bakaletz, PhD Deena J. Chisolm, PhD Vice President, Vice President, Basic Sciences Research Health Services Research

John A. Barnard, MD Dennis R. Durbin, MD, MSCE President Chief Scientific Officer ABIGAIL WEXNER RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL HOSPITAL CHILDREN’S ABIGAIL WEXNER NATIONWIDE RESEARCH INSTITUTE AT

William E. Smoyer, MD Veronica J. Vieland, PhD ABIGAIL WEXNER RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL Vice President, Clinical Research Vice President, Computational Research As an international leader in pediatric research, science is thriving at Nationwide Children’s. The behavioral, basic and clinician scientists within the Abigail Wexner Research Institute (AWRI) at Nationwide Children’s are redefining pediatric health care with best outcomes for every child in mind. The AWRI occupies more than 500,000 square feet of dedicated INSTITUTES AND CENTERS OF EMPHASIS research space on the Nationwide Children’s campus. One of the largest pediatric research centers in the United States, the AWRI is ranked in the top six for National Institutes of Health funding among free-standing children’s hospitals. The centers of emphasis are structured to support multidisciplinary team science and discovery, enabled by outstanding shared resources. Each center is home to faculty members working in contiguous space and collaborating with talented staff, • Battelle Center for • Center for Clinical and • Center for Perinatal Research Mathematical Medicine Translational Research postdoctoral fellows, graduate students, residents and other students. • Center for Regenerative • Biopathology Center • Center for Gene Therapy Medicine • Center for • Center for Injury • Center for Vaccines Biobehavioral Health Research and Policy and Immunity • Center for • Center for Innovation • Steve and Cindy Rasmussen Cardiovascular Research in Pediatric Practice Institute for Genomic • Center for Childhood • Center for Microbial Medicine Cancer and Blood Diseases Pathogenesis

BATTELLE CENTER FOR MATHEMATICAL MEDICINE BIOPATHOLOGY CENTER Faculty from the Battelle Center for Mathematical Medicine in the Abigail Wexner Research Institute at The Biopathology Center provides a full range of services related to biospecimen procurement, banking, Nationwide Children’s Hospital apply state-of-the-art, quantitative methods to basic and clinical research processing, testing and distribution. The Biopathology Center is accredited by the College of American in order to better inform and ultimately improve clinical care in pediatrics. A primary goal of the center Pathologists Biorepository Accreditation Program (CAP BAP) and houses numerous National Cancer is to provide a unique environment in which specialists from a variety of mathematical, statistical and Institute (NCI) funded biospecimen collection efforts, including the biorepositories of the Children’s computational areas can share their professional “home” in order to facilitate creative, collaborative research Oncology Group (COG) and SWOG. Also part of the Biopathology Center are the NCI-funded Pediatric within the group. Division of the Cooperative Human Tissue Network and the Biospecimen Core Resource of the Center for Cancer Genomics (CCG BCR), as well as numerous biospecimen collections from other sponsors (e.g., Nationwide Children’s-funded investigators, the SARC Foundation). FACULTY GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,595,941 FACULTY We continuously pursue grant-supported, biorepository- SELECTED PUBLICATIONS based studies aimed to advance medical research. The Álvarez-Machancoses Ó, De Andrés-Galiana EJ, Fernández-Martínez JL, Kloczkowski Biopathology Center was awarded three NCI-sponsored A. Robust Prediction of Single and Multiple Point Protein Mutations Stability Changes. U24 grants for the period of 2020 to 2026: two for Biomolecules. 2019 Dec 31;10(1):67. supporting the ongoing biobanking efforts of COG and Bartlett CW, Klamer BG, Buyske S, Petrill SA, Ray WC. Forming Big Datasets through SWOG and a new one to support the Early-Phase and Latent Class Concatenation of Imperfectly Matched Databases Features. Genes (Basel). Experimental Clinical Trials (EET) Biobank. Also awarded 2019 Sep 19;10(9):727. was funding to support the NRG Oncology-Columbus Komarov M, Malerba P, Golden R, Nunez P, Halgren E, Bazhenov M. Selective biobank. The COG, SWOG and NRG Oncology- recruitment of cortical neurons by electrical stimulation. PLoS Computational Biology. Columbus biobanks are part of the NCI-sponsored Veronica J. Vieland, PhD 2019 Aug 26;15(8):e1007277. National Clinical Trials Network and support large phase 2 Director Pathak S, Stewart WCL, Burd CE, Hester ME, Greenberg DA. Brd2 haploinsufficiency extends lifespan and healthspan in C57B6/J mice. PLoS One. 2020 Jun and phase 3 clinical trials; the EET Biobank supports phase 19;15(6):e0234910. Christopher W. Bartlett, PhD Nilsa Del Carmen Ramirez-Milan, MD, FCAP 1 clinical trials. Wethington D, Harder O, Uppulury K, Stewart WCL, Chen P, King T, Reynolds SD, Medical Director and Principal Investigator Jayajit Das, PhD Perelson A, Peeples ME, Niewiesk S, Das J. Mathematical modelling identifies the role of The CCG BCR was awarded contracts to support adaptive immunity as a key controller of respiratory syncytial virus in cotton rats. Journal David A. Greenberg, PhD pathology review and nucleic acid isolation for the NCI of the Royal Society, Interface. 2019 Nov 29;16(160):20190389. Division of Cancer Epidemiology and Genetics (to Andrzej Kloczkowski, PhD study environmental causes of cancer), the Clinical Trial Paola Malerba, PhD Sequencing Project (to analyze cancer genomes from the ECOG-ACRIN 2805 renal cancer trial), Early Onset William C. Ray, PhD Malignancies Initiative (to investigate why certain racial and William Stewart, PhD ethnic populations are at increased risk of developing cancer at an early age) and the Human Cancer Model Initiative (an international consortium generating novel, next-generation, Battelle Center for Mathematical Medicine faculty tumor-derived culture models annotated with genomic and continued their tradition of active collaboration with clinical data). one another, with investigators across the Nationwide Jay Bowen, MS Children’s organization and with colleagues at The Ohio Principal Investigator Mr. Bowen replaced Dr. Gastier-Foster as PI of the State University and other institutions. This year saw the Biospecimen Core Resource of the Center for Cancer publication of 19 peer-reviewed research papers and the Genomics in October 2019. In June 2020 he and Dr. filing of one patent, the awarding of several new research Gastier-Foster were recipients of the American Association grants and the presentation of 16 invited research for Cancer Research (AACR) Team Science Award: The talks at high-profile national and international venues Cancer Genome Atlas. Dr. Nicol is contact-PI of the EET spanning seven countries. Our faculty also participated Biobank. Dr. Ramirez-Milan is contact-PI of the COG in organizing five national and international conferences and SWOG biobanks and PI of the NRG Oncology- on several topics in computational biology. Columbus and EET biobanks. Last September, she received a CAP Lifetime Achievement Award for her contributions to the field of pathology and her efforts to establish their Biorepository Accreditation Program. Kathleen Nicol, MD, FCAP Principal Investigator

GRANTS AWARDED CENTER FOR BIOBEHAVIORAL HEALTH JULY 1, 2019 – JUNE 30, 2020 The mission of the Center for Biobehavioral Health in the Abigail Wexner Research Institute at Nationwide $18,887,897 Children’s Hospital is to improve the health and health care of children and their families. This is achieved

SELECTED PUBLICATIONS through state-of-the-art research using a biopsychosocial approach. A special focus is placed on identification

Conley BA, Staudt L, Takebe N, Wheeler DA, Wang L, Cardenas MF, Zenklusen JC, of factors associated with developmental risk and resilience across the life span, design and evaluation of new McShane LM, Tricoli JV, Williams PM, Lubensky I, O’Sullivan-Coyne G, Kohn E, Little R, White J, Malik S, Harris LN, Mann B, Weil C, Tarnuzzer R, Karlovich C, Rodgers B, interventions, and dissemination and implementation of effective interventions into routine practice. Shankar L, Jacobs PM, Nolan T, Gastier-Foster J, Bowen J, Leraas K, Shen H, Laird PW, Esteller M, Miller V, Johnson A, Edmondson EF, Ivy SP. The Exceptional Responders Initiative: Feasibility of a National Cancer Institute Pilot Study. Journal of the National FACULTY the center is transforming the health care and well-being of Cancer Institute. 2020 Apr 27;djaa061. [Epub ahead of print] children and families in our community and worldwide.

Makhlouf H, Watson MA, Lankes HA, Weil C, Dickler M, Birrer M, Moskaluk C, Several new grants were awarded in the center. Kathryn Ramirez NC, Okby N, Alonsozana E, Barnes M, Goldman EB, Enos R, Lubensky I. Toward Improving Practices for Submission of Diagnostic Tissue Blocks for National Vannatta, PhD, received a four-year, $2.29 million grant from Cancer Institute Clinical Trials. American Journal of Clinical Pathology. 2020 Jan the National Heart, Lung and Blood Institute (NHLBI). The 2;153(2):149-155. study team will examine the developmental progression of

Ponnapalli SP, Bradley MW, Devine K, Bowen J, Coppens SE, Leraas KM, Milash BA, youth with critical congenital heart defects, particularly the Li F, Luo H, Qiu S, Wu K, Yang H, Wittwer CT, Palmer CA, Jensen RL, Gastier-Foster role of social cognition in peer relationships across elementary JM, Hanson HA, Barnholtz-Sloan JS, Alter O. Retrospective clinical trial experimentally validates glioblastoma genome-wide pattern of DNA copy-number alterations predictor of and middle school. The goal is to also identify family and survival. APL Bioengineering, 2020 Apr;4(2):026106. environmental factors that may protect against difficulties for these children. Rokita JL, Rathi KS, Cardenas MF, Upton KA, Jayaseelan J, Cross KL, Pfeil J, Egolf LE, Way GP, Farrel A, Kendsersky NM, Patel K, Gaonkar KS, Modi A, Berko ER, Lopez G, Jamie Jackson, PhD, was awarded a pilot grant from NHLBI Vaksman Z, Mayoh C, Nance J, Mccoy K, Haber M, Evans K, McCalmont H, Bendak Cynthia A. Gerhardt, PhD K, Böhm JW, Marshall GM, Tyrrell V, Kalletla K, Braun FK, Qi L, Du Y, Zhang H, Director to adapt a physical activity intervention for young adults with Lindsay HB, Zhao S, Shu J, Baxter P, Morton C, Kurmashev D, Zheng S, Chen Y, Bowen congenital heart disease (CHD). The goal is to improve health J, Bryan AC, Leraas KM, Coppens SE, Doddapaneni H, Momin Z, Zhang W, Sacks GI, FULL-TIME NATIONWIDE CHILDREN’S FACULTY Hart LS, Krytska K, Mosse YP, Gatto GJ, Sanchez Y, Greene CS, Diskin SJ, Vaske OM, outcomes among the growing population of CHD survivors as Haussler D, Gastier-Foster JM, Kolb EA, Gorlick R, Li X-N, Reynolds CP, Kurmasheva Canice E. Crerand, PhD these youth mature into adulthood. RT, Houghton PJ, Smith MA, Lock RB, Raman P, Wheeler DA. Genomic profiling of childhood tumor patient-derived xenograft models to enable rational clinical trial design. Kristen E. Hoskinson, PhD H. Gerry Taylor, PhD, became the founding director of the Cell Reports. 2019 Nov 5;29(6):1675-1689.e9. Jamie L. Jackson, PhD Neurodevelopmental Research Affinity Group (NRAG), Sarah A. Keim, PhD which now includes over 60 investigators across Nationwide Laura Mackner, PhD Children’s and OSU. The NRAG provides pilot funding and fosters collaboration on neurodevelopmental studies across the Leena Nahata, MD institutions. Eric E. Nelson, PhD Kristen Hoskinson, PhD, was named the 2019 Department Joseph R. Rausch, PhD of Pediatrics Outstanding Junior Faculty Investigator for her Jack H. Stevens, PhD research in the field of pediatric neuropsychology, particularly H. Gerry Taylor, PhD social outcomes in youth with traumatic brain injuries. Kathryn A. Vannatta, PhD Behavioral Health: See page 132 for information about Behavioral Health services at Nationwide Children’s Hospital. OSU-AFFILIATE FACULTY Christine A. Fortney, PhD, RN GRANTS AWARDED Tondi Harrison, PhD, RN JULY 1, 2019 – JUNE 30, 2020 $2,638,242 Kathy Lemanek, PhD Kelly McNally, PhD SELECTED PUBLICATIONS Crerand CE, Rumsey N, Kazak AE, Clark A, Rausch J, Sarwer DB. Sex differences in perceived stigmatization, Our vision is to achieve the best possible outcomes for children body image disturbance, and satisfaction with facial appearance and speech among adolescents with craniofacial and families by creating, disseminating and applying new conditions. Body Image. 2020 Mar;32:190-198. knowledge related to the reciprocal influences of behavior and Grupp-Phelan J, Stevens J, Boyd S, Cohen DM, Ammerman RT, Liddy-Hicks S, Heck K, Marcus SC, Stone L, Campo JV, Bridge JA. Effect of a motivational interviewing–based intervention on initiation of mental health health. We are also committed to training the next generation treatment and mental health after an emergency department visit among suicidal adolescents: A randomized of leaders in biobehavioral research. clinical trial. JAMA network open. 2019 Dec 2;2(12):e1917941-. Hoskinson KE, Bigler ED, Abildskov TJ, Dennis M, Taylor HG, Rubin K, Gerhardt CA, Vannatta K, Stancin Developmental, behavioral and social risk factors contribute to T, & Yeates KO. (2019). The mentalizing network and theory of mind mediate adjustment after childhood traumatic brain injury. Social Cognitive and Affective Neuroscience. 2019 Dec 14;(12):1285-1295. significant morbidity and mortality among youth. Childhood Nahata L, Chen D, Quinn GP, Travis M, Grannis C, Nelson E, Tishelman AC. Reproductive attitudes and health conditions affect not only the psychosocial well-being of behaviors among transgender/nonbinary adolescents. Journal of Adolescent Health. 2020 Mar 1;66(3):372-4.

youth but also that of families. Through our research, Zvara BJ, Keim SA, Boone KM, Anderson SE. Associations between parenting behavior and executive function among preschool-aged children born very preterm. Early Childhood Research Quarterly. 2019 Jul 1;48:317-24.

CENTER FOR CARDIOVASCULAR RESEARCH CENTER FOR CHILDHOOD CANCER AND BLOOD DISEASES The mission of the Center for Cardiovascular Research in the Abigail Wexner Research Institute The mission of the Center for Childhood Cancer and Blood Diseases in the Abigail Wexner Research at Nationwide Children’s Hospital is to conduct innovative, mechanism-based research leading to Institute at Nationwide Children’s Hospital is to transform the care of children, adolescents and young improved therapies and outcomes for pediatric cardiovascular diseases and to foster preventive strategies adults with cancer and blood diseases through research and clinical translation. Center investigators and promote cardiovascular health in adults. collaborate closely to study how cells grow, divide and function, how these basic processes are usurped to allow cancers to develop, how the body responds to developing cancers and how this knowledge can be used to better diagnose and treat these diseases. Investigators work closely with physicians at Nationwide FACULTY faculty members are investigating how the SARS-CoV-2 Children’s, as well as with national and international colleagues, to translate these findings to the patient. virus causes the heart damage observed in COVID-19 patients in collaboration with faculty in the Center for FACULTY the process of tumor development, and thereby support Vaccines and Immunity. Lastly, the center continues to the development of new treatments for cancer in children. support the cardiovascular research education of trainees at These new teams are integrated with a growing collaborative all levels. These efforts have been supported by an NIH- of pediatric sarcoma research programs in the center. This funded T32 postdoctoral training grant, along with an collaborative has been leveraged in the form of multiple American Heart Association training award that supports large, collaborative grants (U54 awards) from the National summer research fellowships for undergraduate students. Institutes of Health and the National Cancer Institute as The Heart Center:See page 40 for information about part of their Cancer Moonshot Initiative. One of these U54 Cardiology and page 139 for Cardiovascular Surgery awards is led by Stephen Lessnick, MD, PhD, and seeks services. to understand how the EWS/FLI mutant protein regulates genes that cause Ewing sarcoma. The second U54 award is Vidu Garg, MD GRANTS AWARDED TO HEART CENTER Director AND CARDIOVASCULAR RESEARCH FACULTY led by Timothy Cripe, MD, PhD, and studies various aspects JULY 1, 2019 – JUNE 30, 2020 Stephen L. Lessnick, MD, PhD of how the immune system can be manipulated to treat Madhumita Basu, PhD pediatric cancers, including sarcomas. $2,302,971 Director Brenda Lilly, PhD Kevin A. Cassady, MD Hematology/Oncology/BMT: See page 80 for information SELECTED PUBLICATIONS about the Division of Hematology, Oncology & Blood and Kim L. McBride, MD, MS Dawn S. Chandler, PhD Majumdar U, Yasuhara J, Garg V. In vivo and in vitro genetic models of congenital heart Marrow Transplant at Nationwide Children’s Hospital. disease. Cold Spring Harbor Perspectives in Biology. 2019 Dec 9;a036764. Long-Sheng Chang, PhD Patrick I. McConnell, MD Manivannan SN, Darouich S, Masmoudi A, Gordon D, Zender G, Han Z, Fitzgerald- GRANTS AWARDED TO CENTER AND McBride KL, Garg V. Timothy P. Cripe, MD, PhD Aaron J. Trask, PhD Butt S, White P, Kharrat M, Novel frameshift variant in myl2 DIVISION CLINICAL AND RESEARCH FACULTY reveals molecular differences between dominant and recessive forms of hypertrophic Genevieve C. Kendall, PhD JULY 1, 2019 – JUNE 30, 2020 cardiomyopathy. PLoS Genetics. 2020 May;16(5):e1008639. Mingtao Zhao, DVM, PhD McCallinhart PE, Biwer LA, Clark OE, Isakson BE, Lilly B, Trask AJ. Myoendothelial Dean A. Lee, MD, PhD $15,198,205 junctions of mature coronary vessels express notch signaling proteins. Frontiers in Jeffrey R. Leonard, MD Our cardiovascular research projects span the spectrum Physiology. 2020 Feb 4;11:29. SELECTED PUBLICATIONS from basic research, which occurs in the Center for McCallinhart PE, Cho Y, Sun Z, Ghadiali S, Meininger GA, Trask AJ. Reduced Ryan D. Roberts, MD, PhD Gryder BE, Khan J, Stanton BZ. Measurement of differential chromatin interactions with absolute quantification of architecture (AQuA-HiChIP). Nature Protocols. 2020 Cardiovascular Research, to translational and clinical stiffness and augmented traction force in type 2 diabetic coronary microvascular smooth Benjamin Z. Stanton, PhD muscle. American Journal of Physiology-Heart and Circulatory Physiology. 2020 Jun Mar;15(3):1209-1236. research that is performed in collaboration with clinicians 1;318(6):H1410-H1419. Emily R. Theisen, PhD Reinecke JB, Roberts RD. Targetable Intercellular Signaling Pathways Facilitate in The Heart Center at Nationwide Children’s. Areas Lung Colonization in Osteosarcoma. Advances in Experimental Medicine and Biology. Zhao MT, Shao NY, Garg V. Subtype-specific cardiomyocytes for precision medicine: Ruoning Wang, PhD of focus include investigation into the genes and gene- Where are we now? Stem Cells. 2020 Mar 30. [Epub ahead of print] 2020;1258:111-123. environment interactions that contribute to congenital Showpnil, IR, Miller, KR, Taslim, CR, Pishas, K, Lessnick SL, and Theisen, ER. Mapping Genevieve Kendall, PhD, and Emily Theisen, PhD, are new the structure-function relationships of disordered oncogenic transcription factors using heart defects, molecular and signaling pathways regulating investigators in the Center for Childhood Cancer and Blood transcriptomic analysis. Journal of Visualized Experiments. 2020 Jun 27;(160). normal heart and blood vessel development and how they Diseases. Dr. Kendall’s research focuses on how single gene Wang T, Gnanaprakasam JNR, Chen X, Kang S, Xu X, Sun H, Liu L, Rodgers H, Miller E, are disrupted during disease development and progression. mutations (called translocations, such as PAX3/FOXO) can Cassel TA, Sun Q, Vicente-Muñoz S, Warmoes MO, Lin P, Piedra-Quintero ZL, Guerau- de-Arellano M, Cassady KA, Zheng SG, Yang J, Lane AN, Song X, Fan TW, Wang R. The center faculty receive funding from the National cause sarcomas (such as alveolar rhabdomyosarcoma) in Inosine is an alternative carbon source for CD8+-T-cell function under glucose restriction. Institutes of Health (NIH) and the American Heart children. Dr. Kendall uses zebrafish as her primary model Nature Metabolism. 2020 Jul;2(7):635-647. [Epub 2020 Jun 15] Association (AHA) to support their cutting-edge research. system as this organism allows for direct observation of tumor Wedekind MF, Cripe TP. Oncolytic Viruses and Their Potential as a Therapeutic In the past year, Dr. Mingtao Zhao joined our center and Opportunity in Osteosarcoma. Advances in Experimental Medicine and Biology. development while also allowing for genetic manipulation to 2020;1258:77-89. brought expertise in stem cell biology to the center. Drs. better understand how different genes work together to cause Zhao, McBride and Garg along with other faculty in The cancer. Dr. Theisen also focuses on sarcoma development Heart Center were awarded funding from the Additional and her research examines the interplay between epigenetic Ventures Innovation Fund to study genetic and molecular regulators (such as lysine specific demethylase 1, or LSD1) aspects of single ventricle heart disease. Additionally, and cancer-causing translocations (such as EWS/FLI in Ewing sarcoma). Both of these laboratories are deeply interested in identifying therapeutic opportunities to disrupt

CENTER FOR CLINICAL AND TRANSLATIONAL RESEARCH CENTER FOR GENE THERAPY The Center for Clinical and Translational Research in the Abigail Wexner Research Institute at Nationwide The primary mission of the Center for Gene Therapy in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is committed to improving the diagnosis, treatment and outcomes of society’s most Children’s Hospital is to develop novel genetically based therapies for inherited diseases in order to ease important pediatric diseases by integrating high-caliber basic science research with innovative patient-based the burden of these diseases on children and their families. This mission is pursued by a dedicated team research. of laboratory scientists whose work is directed toward clinical applications, and by the efforts of clinician- scientists who are tasked with bringing these therapies into clinical trials. To do this, the center works closely FACULTY with the regulatory expert staff of Nationwide Children’s Drug and Device Development Services and of children. Our faculty are from three departments the Nationwide Children’s Good Manufacturing Practice Clinical Manufacturing Facility. This integrated and represent nine different subspecialties: Nephrology, Hematology/Oncology, Adolescent Medicine, Critical approach allows us to accelerate the transfer of promising therapies from the bench to the bedside. Care, Urology, Pediatric Surgery, Anesthesia, Allergy/ Immunology and Emergency Medicine. Our research FACULTY SUPPORT STAFF programs are very diverse and include innate immunity in urinary tract infections, immunoparalysis after sepsis or Kathleen Church, Project Manager trauma, pathophysiology of stored RBC-induced immune Tabatha Simmons, PhD, Project Manager/Director, Gene suppression, novel treatments for nephrotic syndrome, Therapy Clinical Research Unit pathophysiology of thrombosis, pathophysiology of bladder dysfunction in urinary tract obstruction, burn The Center for Gene Therapy again had a highly injury, abdominal sepsis, hepatic fibrosis, cancer genetics, William E. Smoyer, MD, FASN productive and collaborative year, facilitated by adolescent addiction, interventions for traumatic brain the NIH/NIAMS P50-funded Center of Research Director injury, spinal cord injuries, mechanisms behind viral Translation (CORT) in Muscular Dystrophy Therapeutic Shipra Agrawal, PhD infection and allergic disease, perioperative respiratory Development, which focuses on rapidly moving Carlos E. Alvarez, PhD complications, neonatal pain assessments and the role of innovative therapies toward the clinic. pain control in immune function. M. Brian Becknell, MD, PhD This year saw the widespread adoption by the Kevin M. Flanigan, MD Andrea E. Bonny, MD Our vision is to use the delivery of care to each pediatric neuromuscular community of the first adeno-associated patient as an opportunity to learn how to improve future Director David R. Brigstock, PhD viral (AAV) treatment for spinal muscular atrophy (SMA) care. We believe it is our responsibility to learn from every PRINCIPAL INVESTIGATORS — onasemnogene abeparvovec, which was developed at Christina B. Ching, MD patient so that subsequent children will be able to benefit Nationwide Children’s — as well as the first publication Mitchell H. Grayson, MD from evidence-based improved care. Allison Bradbury, PhD of highly promising data from the first-in-human trial Mark W. Hall, MD, FAAP, FCCM Scott Harper, PhD of AAV-delivered microdystrophin in patients with Clinical Research Services is a core service provided within Duchenne muscular dystrophy. In addition, the first Bryce A. Kerlin, MD the Center for Clinical and Translational Research and is Stephen Kaler, MD, MPH clinical trial of viral-mediated exon skipping was initiated designed to be a portal through which clinical investigators Kirk M. McHugh, PhD Linda Lowes, PhD with Nationwide Children’s as the sole site, using an can access streamlined coordination of services necessary Jennifer A. Muszynski, MD AAV-delivered U7 small nuclear RNA (U7snRNA) to initiate clinical research projects, regardless of the Paul Martin, PhD in patients with exon duplications, with a goal of Olubukola O. Nafiu, MD funding source. Clinical Research Services supports all Jerry R. Mendell, MD expressing full-length dystrophin. Other gene therapy Lance M. Relland, MD, PhD clinical research studies, providing staff and/or services to trials continued, including for two forms of limb girdle manage investigators’ studies according to good clinical Kathrin Meyer, PhD John David Spencer, MD muscular dystrophy, for mucopolysaccharidosis types 3A practice and federal, state and institutional regulations and Eric A. Sribnick, MD, PhD Zarife Sahenk, MD and 3B, and for CLN3- and CLN6-related Batten disease. guidelines. The operationalization of new trials was facilitated by Rachel M. Stanley, MD, MHSA Megan Waldrop, MD GRANTS AWARDED the establishment of the Gene Therapy Clinical Research Rajan K. Thakkar, MD JULY 1, 2019 – JUNE 30, 2020 Nicolas Wein, MD Unit, made available to all investigators. $7,156,998 The Center for Clinical and Translational Research strives ASSOCIATE FACULTY Two additional faculty joined the center. Dr. to create an environment in which patients, families, SELECTED PUBLICATIONS Kim McBride, MD Stephen Kaler relocated from the NICHD/NIH, researchers and clinicians all collaborate to integrate Derebail VK, Rheault MN, Kerlin BA. Role of direct oral anticoagulants in patients with kidney with a longstanding interest in disorders of inherited “evidence-based medicine” with “evidence-generating disease. Kidney International. 2020 Apr;97(4):664-675. Christopher Walker, PhD neurometabolic, motor neuron and copper transport Nafiu OO, Chimbira WT. Albuterol and Pediatric Perioperative Respiratory Complications. JAMA medicine” to ensure children benefit from the latest Pediatrics. 2019 Sep 16. [Epub ahead of print] 2019-2020 FELLOWS diseases, and ongoing translational programs that address advances in both medical knowledge and innovative Sribnick EA, Hensley J, Moore-Clingenpeel M, Muszynski JA, Thakkar RK, Hall MW. Nosocomial Menkes disease and choroid plexus–targeted gene therapy Infection Following Severe Traumatic Injury in Children. Pediatric Critical Care Medicine. 2020 Nicolas Abreu, MD (Gene Therapy Fellow) treatments to improve their health. May;21(5):443-450. for alpha-mannosidosis, among others. Dr. Allison Sribnick EA, Weber MD, Hall MW. Innate immune suppression after traumatic brain injury Renatta Knox, MD, PhD (Neuromuscular Fellow) Bradbury joined from the University of Pennsylvania, Our center has scientists investigating several diverse and hemorrhage in a juvenile rat model of polytrauma. Journal of Neuroimmunology. 2019 Dec to further develop her translational programs in the areas of research. The overarching theme of our research 15;337:577073. Thakkar RK, Weiss SL, Fitzgerald JC, et al. Risk Factors for Mortality in Pediatric Postsurgical versus leukodystrophies, including Krabbe disease. programs is to bring new knowledge from both bedside Medical Severe Sepsis. The Journal of Surgical Research. 2019 Oct;242:100-110. to bench and from bench to bedside to improve the lives

Other highlights included development of a novel CENTER FOR INJURY RESEARCH AND POLICY approach to visualizing the overexpression of DUX4, The Center for Injury Research and Policy, located in the Abigail Wexner Research Institute at Nationwide providing a novel tool for the study of the complex molecular mechanism responsible for facioscapulohumeral Children’s Hospital, works globally to reduce injury-related pediatric death and disability. Established in 1999, muscular dystrophy; a large animal study demonstrating the center serves as a pioneer by translating cutting-edge injury research into education, advocacy and advances the feasibility of systemic delivery of the GALGT2 gene as in clinical care. From design changes in consumer products to new public policy, the Center for Injury Research a surrogate gene therapy for DMD; and the validation of a and Policy’s influence is leading the way to a safer world. novel reachable workspace as a measure of motor function in SMA.

Neurology: See page 104 for related information about the FACULTY research to achieve the best outcomes for pediatric trauma Section of Neurology at Nationwide Children’s. patients. Focusing on pre-hospital emergency medical services, acute treatment and rehabilitation care, researchers GRANTS AWARDED TO CENTER FOR GENE THERAPY associated with the Center for Pediatric Trauma Research AND NEUROLOGY CLINICAL AND RESEARCH FACULTY help promote the Center for Injury Research and Policy’s JULY 1, 2019 – JUNE 30, 2020 mission. $17,070,837 The Make Safe Happen® app helps parents and caregivers SELECTED PUBLICATIONS overcome a perceived “overwhelming amount of advice” to make their homes safer for children. Developed by a team Alfano LN, Miller NF, Iammarino MA, Moore Clingenpeel M, Lowes SL, Dugan ME, Kissel JT, Al Zaidy S, Tsao CY, Lowes LP. ACTIVE (Ability Captured Through led by Lara McKenzie, PhD, MA, it addresses the difficulties Interactive Video Evaluation) workspace volume video game to quantify meaningful parents and caregivers face when trying to keep their homes change in spinal muscular atrophy. Developmental Medicine & Child Neurology. 2020 Mar;62(3):303-309. Gary A. Smith, MD, DrPH safe for their children. It provides parents and caregivers with room-by-room safety checklists, and links to purchase Amini Chermahini G, Rashnonejad A, Harper SQ. RNAscope in situ hybridization-based Director method for detecting DUX4 RNA expression in vitro. RNA. 2019 Sep;25(9):1211-1217. recommended safety products. Recognizing that not all Koboldt DC, Waldrop MA, Wilson RK, Flanigan KM. The Genotypic and Phenotypic Julie C. Leonard, MD, MPH homes are the same, the app offers different solutions for Spectrum of BICD2 Variants in Spinal Muscular Atrophy. Annals of Neurology. 2020 Apr;87(4):487-496. Lara B. McKenzie, PhD, MA different situations. Users can set reminders for activities, such as monthly smoke alarm testing or annual replacement Lowes LP, Alfano LN, Arnold WD, Shell R, Prior TW, McColly M, Lehman KJ, Church Henry Xiang, MD, MPH, PhD K, Sproule DM, Nagendran S, Menier M, Feltner DE, Wells C, Kissel JT, Al-Zaidy S, of smoke alarm batteries. In 2016, a Home Fire Drill feature Mendell JR. Impact of Age and Motor Function in a Phase 1/2A Study of Infants With Jinzghen (Ginger) Yang, PhD, MPH was added, so families can choose a safe meeting place and SMA Type 1 Receiving Single-Dose Gene Replacement Therapy. Pediatric Neurology. 2019 Sep;98:39-45. Motao Zhu, MD, MS, PhD practice getting out of the home in less than two minutes. Mendell JR, Sahenk Z, Lehman K, Nease C, Lowes LP, Miller NF, Iammarino MA, The Nationwide Make Safe Happen campaign for Home Alfano LN, Nicholl A, Al-Zaidy S, Lewis S, Church K, Shell R, Cripe LH, Potter RA, POSTDOCTORAL FELLOWS Fire Drill Day was the winner of the 2017 Halo Award in Griffin DA, Pozsgai E, Dugar A, Hogan M, Rodino-Klapac LR. Assessment of Systemic Delivery of rAAVrh74.MHCK7.micro-dystrophin in Children With Duchenne Muscular Marco Benedetti, PhD the category of Best Message-Focused Campaign. The free Dystrophy: A nonrandomized Controlled Trial. JAMA Neurology. 2020 Jun 15:e201484. app is available for iOS and Android systems and has been Lindsay Sullivan, PhD Zygmunt DA, Xu R, Jia Y, Ashbrook A, Menke C, Shao G, Yoon JH, Hamilton S, downloaded more than 67,000 times since early 2015. Pisharath H, Bolon B, Martin PT. rAAVrh74.MCK. GALGT2 Demonstrates Safety and Widespread Muscle Glycosylation after Intravenous Delivery in C57BL/6J Mice. The Center for Injury Research and Policy works from Molecular Therapy – Methods & Clinical Development. 2019 Oct 21;15:305-319. local to global levels to reduce death and disability due to GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 injuries through research, education, advocacy and advances in clinical care. The center aims to improve the scientific $4,972,023 understanding of the epidemiology, prevention, acute treatment, rehabilitation and biomechanics of injuries. It SELECTED PUBLICATIONS Coxe K, Sullivan L, Newton A, Yang JZ. Barriers to the implementation of State Concussion provides leadership in the development, implementation Laws within high schools. Journal of Adolescent Health. 2020 Feb;66(2):233-239. and scientific evaluation of public policy regarding control Li A, Shen S, Nwosu A, Ratnapradipa K, Cooper J, Zhu M. Investigating traffic fatality of injuries. trends and restraint use among rear-seat passengers in the United States, 2000-2016. Journal of Safety Research. 2020 Jun;73:9-16. The center has been awarded designation as an Injury Merten JW, Roberts KJ, King JL, McKenzie LB. Pinterest Homemade Sunscreens: A Recipe Control Research Center (ICRC) by the Centers for Disease for Sunburn. Health Communication. 2020 Aug;35(9):1123-1128.

Control and Prevention since 2008. This designation was Nattino G, Lu B, Shi J, Lemeshow S, Xiang H. Triplet Matching for Estimating Causal recently renewed through 2024. CIRP is one of only 9 Effects With Three Treatment Arms: A Comparative Study of Mortality by Trauma Center centers nationally with this designation, and it is the only Level. Journal of the American Statistical Association. 2020 Apr 3. [Epub ahead of print] ICRC focused on pediatric injury research and prevention. Smith GA, Chounthirath T, Splaingard M. Do Sleeping Children Respond Better to a Smoke Alarm That Uses Their Mother’s Voice? Academic Pediatrics. 2020 Apr;20(3):319-326. The multidisciplinary Center for Pediatric Trauma Research at Nationwide Children’s, led by Henry Xiang, MD, MPH, PhD, conducts evidence-based trauma care and policy

CENTER FOR INNOVATION IN PEDIATRIC PRACTICE CENTER FOR MICROBIAL PATHOGENESIS The mission of the Center for Innovation in Pediatric Practice in the Abigail Wexner Research Institute at The emphasis of the Center for Microbial Pathogenesis in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to advance child health and well-being through research in and across Nationwide Children’s Hospital is to develop a greater understanding of the molecular mechanisms by clinical care, health services, health policy and community initiatives. We aspire to lead the nation in which microorganisms cause disease, as well as how the host responds to these disease states. Faculty within groundbreaking research that produces reduced disparities, vibrant communities, flourishing families and the center identify virulence mechanisms and define host response patterns, with the overall objective of equitable and best outcomes for all children. Investigators at the center develop and test new health service elucidating a detailed description of the structure, function and control of biological systems in health and delivery and payment systems in partnership with pediatricians, payers and Nationwide Children’s to improve disease via use of molecular and cellular, as well as genomic, proteomic, transcriptomic and metabolomic quality and equity of care — especially for those patients most at risk. approaches. This information is then translated into novel diagnostics, improved therapeutics and more broadly effective vaccines. FACULTY African American girls. Notable publications explored novel approaches to adherence measurement for sickle cell disease, FACULTY launch of Clarametyx Biosciences Inc. to move forward community development as an intervention for health and the promising technology that disrupts diverse pathogenic health system’s role in advancing population health. biofilms. The laboratory of Jennifer Edwards, PhD, Center for Surgical Outcomes Research faculty published identified and patented two nontraditional antibiotics results from their groundbreaking research on non-operative that can be used to prevent and cure female cervical treatment of uncomplicated appendicitis along with infection by “untreatable” Neisseria gonorrhoeae. John research on disparities in pediatric tonsillectomy and opioid Gunn, PhD, was awarded two new National Institutes prescribing. The center welcomed Dr. Prasanth Pattisapu, of Health grants important to ongoing research into the ENT, as a new investigator. mechanisms of gallstone biofilm-related chronic carriage Center for Suicide Prevention and Research investigators of Salmonella. Sheryl Justice, PhD, demonstrated that Deena J. Chisolm, PhD explored early correlates of pediatric suicidality, trends in bacterial mutants enhance formation of intracellular youth suicidal behavior and intensive crisis intervention. The Director Lauren O. Bakaletz, PhD bacterial communities, providing more insight into center moved to its new space in the Big Lots Behavioral the nutritional requirements for intracellular growth. Susan E. Creary, MD, MSc Director Health Pavilion, supporting expanded integration of research, Samantha King, PhD, was awarded a new R21 grant Jennifer L. Dotson, MD, MPH treatment and prevention. Michael T. Bailey, PhD by the National Institute of Allergy and Infectious Laura C. Hart, MD Faculty member achievements include: Dr. Katherine Deans Jennifer L. Edwards, PhD Diseases to study the serine-rich repeat protein adhesin Kelly J. Kelleher, MD, MPH appointed as the Chief Clinical Science Officer in the Abigail of the infective endocarditis pathogen Streptococcus Steven D. Goodman, PhD Alex R. Kemper, MD Wexner Research Institute and Dr. Chisolm named as oralis. Ben Kopp, MD, was awarded his first R01 Amrik S. Khalsa, MD Nationwide Foundation Endowed Chair in Health Equity John S. Gunn, PhD National Institutes of Health/National Heart Lung Research and appointed to the state’s Minority Health Task Sarah H. O’Brien, MD, MSc Sheryl S. Justice, PhD and Blood Institute grant titled, “The role of CFTR Force for COVID-19, Dr. Jeffrey Bridge named as Nationwide during macrophage-mediated killing of bacteria.” The Jordee M. Wells, MD, MPH Foundation Endowed Chair in Innovation in Behavioral Samantha J. King, PhD laboratory of Ross Maltz, MD, launched a longitudinal CENTER FOR SURGICAL OUTCOMES RESEARCH Health Research and Dr. Arielle Sheftall received a Young Benjamin T. Kopp, MD clinical trial in pediatric Crohn’s disease and developed Investigator Award from the American Foundation for Suicide two murine models for use in his research. Kevin Jennifer N. Cooper, PhD Prevention. Ross M. Maltz, MD Katherine J. Deans, MD, MHSc, Co-Director Mason, PhD, developed a sequential model of otitis Kevin M. Mason, PhD media to investigate microevolution through genetic Daryl J. McLeod, MD GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 Christopher P. Montgomery, MD mutations that modulate disease severity. The laboratory Peter C. Minneci, MD, MHSc, Co-Director $2,955,692 of Christopher Montgomery, MD, demonstrated that Prasanth Pattisapu, MD, MPH Santiago Partida-Sanchez, PhD genetically determined immunodominance inhibits CENTER FOR SUICIDE PREVENTION AND RESEARCH SELECTED PUBLICATIONS Chack-Yung Yu, PhD “natural” protective immunity against Staphylococcus Chisolm DJ, Jones C, Root ED, Dolce M, Kelleher KJ. A Community Development Program and Reduction in aureus infection in mice, but vaccination overcomes this Jeffrey A. Bridge, PhD, Director High-Cost Health Care Use. Pediatrics. 2020 Aug;146(2):e20194053. Each faculty member within the center highlighted restriction. Santiago Partida-Sanchez, PhD, was awarded Creary S, Chisolm DJ, Stanek J, Neville K, Garg U, Hankins JS, O’Brien SH. Measuring hydroxyurea adherence Arielle H. Sheftall, PhD by pharmacy and laboratory data compared with video observation in children with sickle cell disease. Pediatric a noteworthy accomplishment for the 2019-2020 a grant by the Cystic Fibrosis Foundation and published Blood & Cancer. 2020 Aug;67(8):e28250. academic year. Michael Bailey, PhD, and his team six research articles. Chack-Yung Yu, PhD, obtained Ohio Department of Medicaid, Dr. Deena Chisolm was Kemper AR, Kelleher KJ, Allen S, Sander C, Brilli RJ. Improving the Health of All Children in Our Community: awarded a $14.9 million Integrated Care for Kids (InCK) The Nationwide Children’s Hospital and Franklin County, Ohio, Pediatric Vital Signs Project. The Journal of discovered that the production of reactive oxygen evidence for a role complement C4 and C3 phenotypic cooperative agreement from CMS to study innovative Pediatrics. 2020 Jul;222:227-230. [Epub May 13 2020] intermediates by intestinal epithelial cells, a primary and genotypic diversity as risk factors for cardiovascular Minneci PC, Hade EM, Lawrence AE, Sebastião YV, Saito JM, Mak GZ, Fox C, Hirschl RB, Gadepalli S, approaches to reducing out of home placement in rural, Helmrath MA, Kohler JE, Leys CM, Sato TT, Lal DR, Landman MP, Kabre R, Fallat ME, Cooper JN, Deans mechanism by which the host response to stressful diseases. Medicaid-enrolled youth. Dr. Jordee Wells was awarded an KJ; Midwest Pediatric Surgery Consortium. Association of Nonoperative Management Using Antibiotic Therapy stimuli, leads to changes in the gut microbiome. Lauren vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Infectious Diseases: See page 88 for information NICHD diversity supplement to study racial disparities in Appendicitis. JAMA. 2020 Jul 27;324(6):581-593. Bakaletz, PhD, and Steven Goodman, PhD, cite both about the Division of Infectious Diseases at pediatric head trauma follow-up care. Dr. Sarah O’Brien Sheftall, A. H., Bergdoll, E. E., James, M., Bauer, C., Spector, E., Vakil, F., Armstrong, E., Allen, J., & Bridge, J. their recent publication in Proceedings of the National A. Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Nationwide Children’s. was named co-investigator on a new R21 awarded to Texas Study. Child Psychiatry and Human Development. 2020 Jun 1. [Epub ahead of print] Academy of Sciences and the successful co-founding and Children’s Hospital, studying iron deficiency anemia in

GRANTS AWARDED CENTER FOR PERINATAL RESEARCH JULY 1, 2019 – JUNE 30, 2020 The Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s Hospital $4,028,402 has a unique, integrative approach to prematurity research that extends from before birth to long after. In close collaboration with the Section of Neonatology, the mission of faculty in the Center for Perinatal SELECTED PUBLICATIONS Research is to conduct innovative basic, translational and clinical research focused on prevention of preterm Devaraj A, Buzzo JR, Marshburn-Warren L, Novotny LA, Bakaletz LO, Goodman SD. The Extracellular DNA Lattice of Bacterial Biofilms is Structurally Related to Holliday birth and improvement of prematurity-related outcomes. Junction Recombination Intermediates. Proceedings of the National Academy of Sciences of the United States of America. Dec 2019;116(50):25068-25077. FACULTY research delves into prematurity prevention and maternal González JF, Kurtz J, Bauer DL, Hitt R, Fitch J, Wetzel A, La Perle K, White P, McLachlan J, Gunn JS. Establishment of Chronic Typhoid Infection in a Mouse Carriage health (Klebanoff), infant feeding disorders (Jadcherla), Model Involves a Type 2 Immune Shift and T and B Cell Recruitment to the Gallbladder. infectious diseases (Sanchez), comparative effectiveness mBio. Oct 2019;10(5):e02262-19. in pharmacoepidemiology (Slaughter), cardiopulmonary Harrison A, Hardison RL, Fullen AR, Wallace RM, Gordon DM, White P, Jennings RN, Justice SS, Mason KM. Continuous Microevolution Accelerates Disease Progression deficiencies (Backes, Pavlek) and development of novel During Sequential Episodes of Infection. Cell Reports. Mar 2020;30(9):2978-2988. treatments and approaches for improving outcomes in Poole J, Day CJ, Haselhorst T, Jen FE-C, Torres VJ, Edwards JL, Jennings MP. infants with neurological disorders or injuries (Maitre, Repurposed Drugs that Block the Gonococcal-Complement Receptor 3 Interaction Can Neel, Benninger). The center received more than $600,000 Prevent and Cure Gonococcal Infection of Primary Human Cervical Epithelial Cells. mBio. Mar 2020;11(2):e03046-19. in new prime NIH funding this year. Collectively, the

Si Y, Zhao F, Beesetty P, Weiskopf D, Li Z, Tian Q, Alegre ML, Sette A, Chong AS, Center for Perinatal Research brought in $4.1 million in Montgomery CP. Inhibition of Protective Immunity Against Staphylococcus aureus NIH funding and $1.2 million in foundation and industry Infection by MHC-Restricted Immunodominance is Overcome by Vaccination. Science grants for the purpose of research. The center also is home Advances. Apr 2020;6(14):eaaw7713. Lynette K. Rogers, PhD to one of the sites of the Neonatal Research Network, a Interim Director consortium of 17 institutions from across the United States Carl H. Backes, MD funded by the NIH to conduct randomized, controlled Kristen Benninger, MD trials of promising therapies and observational studies to Gail E. Besner, MD advance care of highest risk newborns. In addition, our Rodney Britt, PhD accomplished investigators have filed multiple patents for Bernadette Chen, MD devices to improve infant outcomes. Sudarshan R. Jadcherla, MD Neonatology: See page 94 for information about Mark A. Klebanoff, MD, MPH Neonatology, home to one of the largest networks of Yusen Liu, PhD clinical neonatal care in the United States. Nathalie Maitre, MD, PhD Mary Lauren Neel, MD GRANTS AWARDED TO NEONATOLOGY Leif D. Nelin, MD CLINICAL AND RESEARCH FACULTY Leeann R. Pavlek, MD, MPH JULY 1, 2019 – JUNE 30, 2020 Susan Reynolds, PhD $5,562,391 Pablo Sanchez, MD Jonathan L. Slaughter, MD, MPH SELECTED PUBLICATIONS Jennifer K. Trittmann, MD, MPH Benninger KL, Inder TE, Goodman AM, Cotten CM, Nordli DR, Shah TA, Slaughter JL, Maitre NL. Perspectives from the Society for Pediatric Research. Neonatal encephalopathy Complications from preterm birth are the leading cause clinical trials: developing the future. Pediatric Research. 2020 Mar 27. [Epub ahead of print] Galley JD, Besner GE. The Therapeutic Potential of Breast Milk-Derived Extracellular of infant mortality and morbidity. The investigators in Vesicles. Nutrients. 2020 Mar 11;12(3):745. the Center for Perinatal Research focus on prevention Jadcherla SR, Hasenstab KA, Wei L, Osborn EK, Viswanathan S, Gulati IK, Slaughter JL, of prematurity and understanding and treating the Di Lorenzo C. Role of feeding strategy bundle with acid-suppressive therapy in infants with esophageal acid reflux exposure: a randomized controlled trial. Pediatric Research. 2020 May 7. complications that occur in as a result of preterm birth. [Epub ahead of print] Our diverse team encompasses expertise in both basic Klebanoff MA, Wilkins DG, Keim SA. Marijuana Use during Pregnancy and Preterm Birth: science and clinical investigations. The basic science A Prospective Cohort Study. American Journal of Perinatology. 2020 Apr 1. [Epub ahead of print] group explores the mechanisms involved in development Pavlek LR, Vudatala S, Bartlett CW, Buhimschi IA, Buhimschi CS, Rogers LK. MiR-29b is of chronic lung disease such as bronchopulmonary associated with perinatal inflammation in extremely preterm infants. Pediatric Research. 2020 dysplasia (Rogers), pulmonary hypertension (Nelin, May 9. [Epub ahead of print] Chen, Trittmann) and asthma (Britt), infection and inflammation (Liu), use of stem cell therapy in diagnosing and treating cystic fibrosis (Reynolds) and GI disorders such as necrotizing enterocolitis (Besner). Our diverse clinical

CENTER FOR REGENERATIVE MEDICINE CENTER FOR VACCINES AND IMMUNITY The Center for Regenerative Medicine in the Abigail Wexner Research Institute at Nationwide Children’s The Center for Vaccines and Immunity in the Abigail Wexner Research Institute at Nationwide Children’s Hospital applies the principles of engineering, computer modeling and life sciences to develop biological Hospital has a single purpose: to improve the health of children through fundamental and applied research substitutes to restore or improve tissue function. Regenerative medicine is the process of creating living, leading to a new generation of safe, protective vaccines against infection, cancer and allergy. functional tissues to repair or replace tissue or organ functions, lost primarily due to congenital defects or disease. The center currently focuses on producing blood vessels, valvular patches and heart valves, offering FACULTY immune response to RSV. Center researchers also study a positive impact on children with congenital heart disease. Other areas of regenerative medicine research in hepatitis virus infections. The hepatitis C virus (HCV) progress include intestinal and tracheal replacement. causes a persistent lifelong infection. It is of particular concern as it is transmitted to children from mothers at birth and by injection drug use during adolescence. FACULTY solutions. Further, we believe it is our responsibility to Jonathan Honegger, MD, published a study in the learn from every patient so our care for the next child prestigious Journal of Clinical Investigation that linked will be improved. recovery of a key mediator of antiviral immunity, the This has been an exciting year for the center. Not only T helper cell, to unexpected control of chronic HCV have we made significant progress on our NIH-funded infection in women after childbirth. Understanding how research, we have fostered collaborations with outside immune reconstitution occurs in the unique setting of pregnancy is expected to have a much broader impact sponsors to help develop the next generation of tissue- Chris Walker, PhD on strategies to treat chronic infections and develop engineered blood vessels. We have also brought on Director board Oluyinka Olutoye, MD, the new Surgeon-in- effective vaccines. Finally, Amit Kapoor, PhD, provided Chief at Nationwide Children’s, whose research focus Zongdi Feng, PhD important new insight into how HCV-like viruses evade is regenerating intestinal tissue to assist with infants Jonathan Honegger, MD immunity to establish a persistent infection using a novel battling necrotizing enterocolitis. Excitingly, we have rodent infection model that he discovered. This model Christopher K. Breuer, MD Amit Kapoor, PhD Director also begun the second phase of our human Tissue- holds great promise to define mechanisms of protective Engineered Vascular Graft (TEVG) clinical trial for Asuncion Mejias, MD, PhD, MSCS immunity and to assess new vaccine concepts to protect against a virus that takes a great toll on public health in Tendy Chiang, MD patients undergoing a Fontan repair. This NIH funded Mark Peeples, PhD project’s goal is to further our work on using the the United States and globally. Oluyinka O. Olutoye, MD, PhD Octavio Ramilo, MD body’s innate repair mechanisms to assist patients with Infectious Diseases: See page 88 for information about the Toshiharu Shinoka, MD, PhD congenital heart defects. Masako Shimamura, MD Division of Infectious Diseases at Nationwide Children’s. Mitchel R Stacy, PhD Ultimately, this comprehensive approach means that the Zhaohui Xu, PhD GRANTS AWARDED Center for Regenerative Medicine has the ability to turn Medical advances have made it possible to save more JULY 1, 2019 – JUNE 30, 2020 promising laboratory discoveries into proven treatments Nine investigators in the Center for Vaccines patients from life-threatening injuries, diseases and and make them available to patients. and Immunity study viral diseases of childhood. $5,044,969 congenital conditions. However, after the onset of Respiratory syncytial virus (RSV) is the leading cause these conditions, the damage is occasionally lifelong. SELECTED PUBLICATIONS GRANTS AWARDED of hospitalization for young children. Over the past Often, symptoms can be treated with success, but the year, center investigators made notable advances in Coss SL, Torres-Cornejo A, Prasad MR, Moore-Clingenpeel M, Grakoui A, Lauer GM, underlying tissue or organ damage remains unhealed and JULY 1, 2019 – JUNE 30, 2020 Walker CM, Honegger JR. CD4+ T Cell Restoration and Control of Hepatitis C Virus RSV vaccine design and our understanding of factors Replication after Childbirth. The Journal of Clinical Investigation. 2020 Feb 3;130(2):748- $2,145,809 can cause further complications over time. To develop contributing to the severity of airway disease. A key 753. new clinical applications that address the unmet needs Hartlage AS, Walker CM, Kapoor A. Priming of Antiviral CD8 T Cells without Effector SELECTED PUBLICATIONS objective of RSV research is to identify predictive of these patients, the AWRI at Nationwide Children’s Function by a Persistently Replicating Hepatitis C-like Virus. The Journal of Virology.2020 Chou TH, Stacy MR. Clinical Applications for Radiotracer Imaging of Lower Extremity markers of mild and severe disease to facilitate May 4;94(10):e00035-20. established the Center for Regenerative Medicine in Peripheral Arterial Disease and Critical Limb Ischemia. Molecular Imaging and Biology. development of vaccines and therapeutics. A study Heinonen S, Velazquez VM, Ye F, Mertz S, Acero-Bedoya S, Smith B, Bunsow E, Garcia- 2020;22(2):245-255. 2017. from Asuncion Mejias, MD, Octavio Ramilo, MD, and Mauriño C, Oliva S, Cohen DM, Moore-Clingenpeel M, Peeples ME, Ramilo O, Mejias Fukunishi T, Ong CS, Yesantharao P, Breuer CK, et al. Different degradation rates of A. Immune Profiles Provide Insights into Respiratory Syncytial Virus Disease Severity in Center for Regenerative Medicine clinicians and nanofiber vascular grafts in small and large animal models. Journal of Tissue Engineering Mark Peeples, PhD, in the highly influential journal, Young Children. Science Translational Medicine. 2020 Apr 22;12(540):eaaw0268. and Regenerative Medicine. 2020;14(2):203-214. researchers, led by Christopher Breuer, MD, are creating Science Translational Medicine, described an immune Lu M, Zhang Z, Xue M, Zhao BS, Harder O, Li A, Liang X, Gao TZ, Xu Y, Zhou J, biological vessels, intestines and tracheas; identifying Liu L, Rodman C, Worobetz NE, Johnson J, Elmaraghy C, Chiang T. Topical profile that distinguishes mild from severe RSV disease. Feng Z, Niewiesk S, Peeples ME, He C, Li J. N6-methyladenosine Modification Enables tissue progenitor cells, and developing ways to enhance biomaterials to prevent post-tonsillectomy hemorrhage. Journal of Otolaryngology - Head Children with mild disease harbored more virus and Viral RNA to Escape Recognition by RNA Sensor RIG-I. Nature Microbiology. 2020 & Neck Surgery. 2019 Sep;48(1):45. Apr;5(4):584-598. tissue repair and growth. To further diversify the center’s produced more interferon, a key component of the Molina TL, Stoll B, Mohammad M, Olutoye O, et al. New generation lipid Ramilo O, Rodriguez-Fernandez R, Peeples ME, Mejias A. Advanced Live Attenuated research strengths, we are actively recruiting principal emulsions increase brain DHA and improve body composition, but not short-term early protective immune response. They also had lower Vaccines for the Prevention of Respiratory Syncytial Virus Infections in Young Children. investigators. neurodevelopment in parenterally fed preterm piglets. Brain, Behavior, and Immunity. levels of inflammation than children with severe disease. The Journal of Infectious Diseases. 2020 Jun 16;222(1):4-6. 2020;85:46-56. These findings provide valuable insights into the host Our vision is to pioneer new approaches in tissue Szafron JM, Ramachandra AB, Breuer CK, Marsden AL, Humphrey JD. Optimization regeneration and to develop next-generation reparative of Tissue-Engineered Vascular Graft Design Using Computational Modeling. Tissue Engineering Part C: Methods. 2019;25(10):561-570.

STEVE AND CINDY RASMUSSEN INSTITUTE FOR GENOMIC MEDICINE Danielle E. Mouhlas, MS, LGC based diagnosis for patients in our neonatal Ruthann B. Pfau, PhD, FACMG intensive care unit who exhibit signs of The Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital is focused genetically linked difficulties on improving outcomes for our patients through the use of molecular diagnostics. Since its inception in 2016, Prajwal Rajappa, MD, MS • An IRB-approved protocol to study families the mission of the institute is to build a seamless continuum between research, clinical testing and patient care. Shalini C. Reshmi, PhD, FACMG with diagnoses of autism or bipolar disease and suicidality/depression, who are being treated in The institute combines robust clinical diagnostics, leading-edge research and development, and high-performance Maggie E. Stein, MS, LGC the new Big Lots Behavioral Health Pavilion computing to enable precision genomic medicine. Another area of emphasis is providing educational opportunities CLINICAL FELLOWS for care providers and all levels of trainees, as a means by which genome-based results are made accessible and For children with rare or undiagnosed diseases, genomic Sara Akhavanfard, MD, PhD testing often can provide additional resolution of the meaningful to the patients and families we serve. genetic causes, information relevant to reproductive Eleni Marina Melas, MSc, PhD FACULTY decisions, and new treatment directions. Since early 2017, Kathleen M. Schieffer, PhD, MLS(ASCP) the institute has performed clinical exome sequencing to identify alterations in the protein-coding regions RESEARCH FELLOWS (“exons”) of all human genes. This testing has elucidated Stephanie D. LaHaye, PhD a genetic diagnosis for greater than one-third of families. Katherine E. Miller, PhD For patients in whom this test does not reveal a diagnostic answer, enrollment in the institute’s Rare Disease Blythe S. Moreland, PhD Genomics Study examines the genome more broadly for genetic clues underlying their disease. Clinical genetic In 2018, the Steve and Cindy Rasmussen Institute for testing was further expanded in 2019 to include Fragile Genomic Medicine launched a comprehensive protocol X testing of a genetic locus associated with intellectual studying the genomes of children with cancer and disability and developmental delays. Richard K. Wilson, PhD Vincent J. Magrini, PhD hematologic disease. With a focus on rare, relapsed Executive Director Senior Director or treatment-refractory cancers, we can identify new Advanced computational analysis is a critical component treatment options, potentially leading to improved of precision medicine, and we have significantly grown outcomes. All pertinent research results are confirmed our capacity to provide the accurate and timely analysis of under CAP/CLIA standards and communicated to our the complex genomic data required to move Nationwide oncology providers to inform patient management, Children’s into the era of precision medicine. Our team including prognostication, diagnosis and eligibility for has developed a state-of-the-art bioinformatics platform, targeted therapeutics and clinical trials. To date, we have built upon cloud-computing technology, that enables studied more than 250 pediatric cancer patients on this us to rapidly analyze the human genome, identifying protocol. In general, we returned at least one medically rare genetic variants that lead to disease, and to perform meaningful result for over 90% of patients studied to date. comprehensive molecular profiling of a patient’s tumor sample. Over this past year we have implemented a Similarly, when pediatric patients display treatment cutting-edge laboratory information management system Elaine R. Mardis, PhD Peter White, PhD refractory epilepsy, DNA from the affected brain tissue (LIMS) to improve laboratory processes and reduce Co-Executive Director Senior Director removed by surgery for curative intent can be evaluated by our reliance on paper charts. We have developed a highly sensitive exome sequencing, with the demonstrated comprehensive sequence management tool that automates ability to detect mosaic genetic variation associated with highly complex bioinformatics workflows and eliminates Bimal P. Chaudhari, MD, MPH, FAAP, FACMG disease. Importantly, these results have dual benefit: the chance for errors. We are advancing the understanding Samantha S. Choi, MS, LGC they better inform patients and parents about the root of genomic medicine through the development of Erin R. Crist, MMSc, LGC cause of the seizures, and they fuel additional research novel computational tools and the application of big into how these altered genes lead to epilepsy. This is just data technologies. By combining novel laboratory Sayaka Hashimoto, MS, LGC one example of the virtuous cycle of discovery leading methods, state-of-the-art bioinformatics solutions and Daniel C. Koboldt, MS to treatment leading to discovery that fuels advances in machine learning technologies, the institute is driven to create a future where no child with genetic disease goes Christian L. Lauber, PhD our understanding of genetic diseases and their optimal treatment. undiagnosed and every child with cancer receives optimal Catherine E. Cottrell, PhD, FACMG Kristy Lee, PhD, FACMG treatment based on their genomic profile. Senior Director Marco L. Leung, PhD, FACMG In 2019, the institute advanced additional programs in genomic medicine, including: GRANTS AWARDED Mariam T. Mathew, PhD, FACMG JULY 1, 2019 – JUNE 30, 2020 • An IRB-approved protocol to pilot a workflow Theodora Jacobson Mathews, MS, LGC for rapid turnaround, whole genome sequencing- $1,465,172 Theresa Mihalic Mosher, MS, LGC

194 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 195 SELECTED PUBLICATIONS Koboldt DC, Mosher TM, Wilson RK, White P, Hickey SE, McBride KL, Manickam M. Mutations in PLS1, Encoding Fimbrin, Cause Autosomal Dominant Nonsyndromic Hearing Loss. Human Mutation. 2019 Dec;40(12):2286-2295.

Koboldt DC, Waldrop M, Wilson RK, Flanigan K. The Genotypic and Phenotypic Spectrum of BICD2 Variants in Spinal Muscular Atrophy. Annals of Neurology. 2020 Apr;87(4):487-496.

Mosher TM, Zygmunt DA, Koboldt DC, Kelly BJ, Johnson LR, McKenna DS, Hood BC, Hickey SE, White P, Wilson RK, Martin PT, McBride KL. Expansion of B4GALT7 Linkeropathy Phenotype to Include Perinatal Lethal Skeletal Dysplasia. European Journal of Human Genetics. 2019 Oct;27(10):1569-1577.

Miller KE, Koboldt DC, Schieffer KM, Bedrosian T, Crist ER, Sheline A, Leraas KM, Magrini V, Zhong H, Brennan PJ, Bush J, Fitch J, Bir N, Miller AR, Cottrell CE, Leonard J, Pindrik JA, Rusin JA, Shah SH, White P, Wilson RK, Mardis ER, Pierson CR, Ostendorf A. Somatic SLC35A2 Mosaicism Correlates with Clinical Findings in Epilepsy Brain Tissue. Neurology. Genetics. 2020 Jun 17;6(4):e460.

Schieffer KM, Varga E, Miller KE, Agarwal V, Koboldt DC,Brennan P, Kelly B, Dave- Wala A, Pierson CR, Finlay JL, AbdelBaki MS, White P, Magrini V, Wilson RK, Mardis ER, Cottrell CE. Expanding the Clinical History Associated with Syndromic Klippel-Feil: A Unique Case of Comorbidity with Medulloblastoma. The European Journal of Medical Genetics. 2019 Aug;62(8):103701.

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LEADERSHIP EDITORIAL/WRITING Tim Robinson Brian Justus Chief Executive Officer, Senior Account Manager, Physician & Referral Source Marketing Nationwide Children’s Hospital Jeb Phillips John A. Barnard, MD Managing Editor, Executive Communication President, Abigail Wexner Research Institute at Nationwide Abbie Roth Children’s Hospital Managing Editor, Science Communication Chair, Department of Pediatrics, The Ohio State University College of Medicine GRAPHIC DESIGN Rustin Morse, MD Chris Garbrandt Chief Medical Officer, Nationwide Children’s Hospital Director, Creative Services Professor of Pediatrics, Department of Pediatrics, John Ordaz The Ohio State University College of Medicine Art Director Oluyinka Olutoye, MD, PhD Erin Nusbaum Surgeon-in-Chief, Nationwide Children’s Hospital Senior Creative Designer E. Thomas Boles Chair of Pediatric Surgery, Nikki Ginley The Ohio State University College of Medicine Marketing Traffic Manager EDITORIAL LEADERSHIP PHOTOGRAPHY Donna Teach Brad Smith Chief Marketing and Communication Officer Senior Photographer Alicia Shoemaker Dan Smith Senior Director, Integrated Marketing Senior Photographer Jan Arthur Senior Director, Communication and Content Strategy WEBSITE: NATIONWIDECHILDRENS.ORG/2020-REPORT Aaron Stenhoff Scott Milburn Senior Director, Digital Engagement Senior Director, Corporate Communications Roy Goudy Senior User Experience Engineer Mike Walsh Digital Project Specialist

WE ALSO THANK THE FOLLOWING INDIVIDUALS WHO ASSISTED IN THE PREPARATION OF THIS REPORT: Jane Abel Dawn Edwards Sarah Koster Linda Newport Sara Styer Melinda Akins Phynesia Edwards Marissa Larouere Brittany O’Brien Karen Sweitzer Hannah Baker Robin Egan Molly Lebel Donna O’Connor Ray Tam Jahaira Ballentine Jennifer English Lanelle Lines Tiffini Payten Laura Taylor Andrew Banks Diane Eplin Corinne Long Maria Penrose Jordanna Tomblin Daryl Barker Bob Feeney Emily Loughley Charlotte Prewitt Kristin Tomlinson Daniel Barr Tony Felty Angela Lyons Sandhya Ramachandran Cyndie Trapasso Gina Benedict Ann Fields Jamie Macklin Catherine Roebuck Stephanie Vyrostek Danielle Bishop Kelly Gibson Lindsay Maggs Cathleen Rooks Kerry Wardlow Jeffrey Burns Jamie Goodall Bethany Malloy Teaya Rough Travis Wells Tara Casper Kaitlin Hall Kelly McCallum Stephen Sales Gail White Elena Chiappinelli Hannah Hammeren Nicole McClendon Laurie Seipel Natalie Wilson Diana Crenshaw Ellen Hanna Susan Meyer Adrienne Sheline Julie Zaremski Robin Dalrymple Katie Johnson Vannessa Moses Rob Shepherd Rachel Zbiegien Beth Deley Laura Kelley Litsa Myers Kimberly Smitley Kim Dwyer Lisa Kluchurosky Jennifer Neelans Christina Stocker

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