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Creating the Patient-Centered Medical Neighborhood
 Creating the Patient-Centered Medical Neighborhood 1024 575 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD
Aerial view of a suburban neighborhood showing closely spaced single-family homes with light-colored roofs, small yards and intersecting streets arranged in a grid pattern.

How do we create a more integrated healthcare delivery system to improve outcomes in our community? The Agency for Healthcare Research and Quality (AHRQ) conceptualizes the medical neighborhood as a patient-centered medical home (PCMH) and the network of other clinicians providing health care services to patients within it, along with community and social service organizations, as well…

Using Social Media to Advance Care
 Using Social Media to Advance Care 150 150 Nationwide Children's
By: Nationwide Children's

As the use of social media has grown, so has the medical community’s understanding of how it can be harnessed for health care. From collaborating with peers and educating the public to building your career, physicians have a growing responsibility and growing presence in the social media arena. David R. Stukus, MD Section of Allergy…

Achieving CLARITY
 Achieving CLARITY 1024 575 Abbie Miller
By: Abbie Miller
conceptual art of DNA

Multidisciplinary team from Nationwide Children’s wins international genomics competition. Accurate, patient-centered, comprehensive. That’s how the judges and leaders of the CLARITY Undiagnosed Challenge described the work of a team from Nationwide Children’s Hospital. Those same words could be used to describe the highly motivated and diverse team who surprised themselves by winning the challenge. “When we entered the challenge, we knew we would…

Simulating Surgery With High-Performance Computing
 Simulating Surgery With High-Performance Computing 1024 575 Abbie Miller
By: Abbie Miller

By applying high-performance computing to the field of otolaryngology, a team of researchers is developing a simulation environment for teaching surgical techniques related to the temporal bone. The purpose of training — whether a fire drill or practicing a surgical technique — is to create successes and avoid failures. “The impact of training is safety…

The Smallest Victims of the Opioid Crisis
 The Smallest Victims of the Opioid Crisis 1024 575 Abbie Miller
By: Abbie Miller
Black and white photo of infant crying in hospital

Research, protocols and community connections lead to help infants with neonatal abstinence syndrome and their mothers. It’s a sound you’d never forget. The panicked, high-pitched cry of a newborn withdrawing from the drugs his mother took. All the sensations that drive an addict to use again and again just for the relief – shaking, vomiting,…

The Journey to a Program Project Grant
 The Journey to a Program Project Grant 1024 575 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD
Decorative project header.

Recommendations from a multi-institutional research team who persevered to obtain a P01 to develop a vaccine for RSV. In 2015, the National Institute of Allergy and Infectious Diseases (NIAID) awarded a $6.75 million program project grant to Mark Peeples, PhD, Octavio Ramilo, MD, and M. Asuncion Mejias, MD, PhD, all principal investigators in the Center for Vaccines and Immunity at The Research Institute at Nationwide Children’s…

The Collapse of Biofilms?
 The Collapse of Biofilms? 1024 575 Jeb Phillips
By: Jeb Phillips
Illustration showing the precise pattern of a biofilm - a perfect, 3D matrix

Scientists are working to eliminate the causes of countless chronic and recurrent human infections. Before the discoveries that could lead to biofilm eradication, before the idea that he was even working on treatments for the bacterial communities that are crucial to most human infections, Steven Goodman, PhD, had a mystery on his hands. For nearly 15 years. Dr. Goodman, then a biochemist…

Taking Aim at the Opioid Problem
 Taking Aim at the Opioid Problem 1024 683 Abbie Miller
By: Abbie Miller
open bottle of pills

Pediatric specialists offer practical advice for protecting vulnerable patients from a growing epidemic. The opioid epidemic in the United States is so widespread that even parents and teachers are now being issued opioid overdose kits complete with naloxone. It’s in rural communities, suburban neighborhoods and inner cities. It’s so far-reaching that physicians and non-experts alike are being called to work together…

Remote Control Treatment
 Remote Control Treatment 1024 575 Jeb Phillips
By: Jeb Phillips

Magnetic growing rods help patients who have early-onset scoliosis avoid repeated surgeries. A common surgical treatment for young children with severe early-onset scoliosis is the implantation of growing rods or expandable titanium ribs. The devices are lengthened as the child grows, helping to straighten the spine. Lengthening involves surgery under general anesthesia every six months. Magnetic Expansion Control (MAGEC)…

Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements
 Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements 150 150 Kevin Mayhood
By: Kevin Mayhood

Case study shows reduction in bipolar youth’s psychotic mania, depression and anxiety Medications unchanged, a severely bipolar girl’s depressive, manic and psychotic symptoms improved significantly during the two years her mother added omega-3 supplements to her daily diet. The case, reported by researchers at Nationwide Children’s Hospital and Ohio State University Wexner Medical Center, is…

Can You Ration Health Care in a Just Society?
 Can You Ration Health Care in a Just Society? 150 150 Pedro Weisleder, MD, PhD
By: Pedro Weisleder, MD, PhD

How the Clinical Effectiveness Model enables the provision of uncompromised, yet fiscally responsible, medical care Health care costs in the United States are an unsustainable expense. In 2014, the United States’ gross domestic product (GDP) was about $17 trillion, and of that, close to $2.7 trillion was spent on health care. Per capita, we spend…

Better Care and Better Business
 Better Care and Better Business 150 150 Dave Ghose
By: Dave Ghose

The changing economics of health care are forcing hospitals to find solutions that are good for patients and for the bottom line. A puzzled neonatologist approached Richard McClead, MD, after he spoke at a conference in Boston. It was 2010, and Dr. McClead just finished detailing a new initiative at Nationwide Children’s Hospital to reduce the…

InSight: Restoring Normal Habits
 InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD
Medical illustration showing the placement of a sacral nerve stimulation lead: a needle inserts a thin electrode through the bony opening of the sacrum toward the sacral nerves, which are depicted branching beneath the surface.

SACRAL NERVE STIMULATION (SNS) is a new treatment that helps control urinary incontinence and fecal soiling. For some children, the nerves that control urination and bowel movements do not work correctly. The SNS unit consists of a small, safe battery and wire under the skin and sends signals to the sacral nerve. The signals help restore…

The Transfusion Evolution
 The Transfusion Evolution 576 367 Abbie Miller
By: Abbie Miller
Illustration of a blood bag

The first successful open heart surgery with cardiopulmonary bypass was performed in 1953, but it wasn’t until the 1970s that these surgeries began to have high success rates — due in large part to the availability of fresh whole blood transfusions. However, fresh whole blood is difficult to attain. In response, blood component transfusions became…

A Practical Guide to Beginning Clinical Research
 A Practical Guide to Beginning Clinical Research 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

You wouldn’t travel to unknown destinations without a map or GPS, so why do clinical research without a plan? Here’s what you need to know to get started. Although the process for clinical research varies from institution to institution, the initial hurdles are often the same. From establishing clear protocols and outlining a detailed timeline…

Revealing the Secrets of Sepsis
 Revealing the Secrets of Sepsis 969 533 Abbie Miller
By: Abbie Miller
Illustration of NK Cells, T Cells, other immune cells floating across white background

Charting new territory in the understanding of how the immune system responds to sepsis. Two children are admitted to the hospital with sepsis. Both receive antibiotics and fluid resuscitation within the critical first hour. Why does one get better after the initial crisis while the other goes on to develop additional infections and multiple organ…

Planning, Teamwork and Technology Essential to Conjoined Twins’ Separation
 Planning, Teamwork and Technology Essential to Conjoined Twins’ Separation 150 150 Abbie Miller
By: Abbie Miller

In a meticulously planned 16-hour operation, a 30-person team from four specialties successfully separated 11-month-old twins conjoined at the buttocks and lower spine. Specialists from General Pediatric Surgery, Plastic and Reconstructive Surgery, Neurosurgery and Colorectal Surgery worked together to plan and execute a successful separation of conjoined twin girls, Acen and Apio, earlier this month. “In surgery,…

Treating Sickle Cell Disease in the United States
 Treating Sickle Cell Disease in the United States 1024 575 Abbie Miller
By: Abbie Miller
A close-up medical illustration of blood vessels showing normal round red blood cells flowing through the vessel, with a cluster of rigid, crescent-shaped sickle cells causing a blockage. White blood cells are also visible against the dark background.

While people with sickle cell disease have better outcomes in the United States and other Western countries, progress in treating the disease has been slow moving. Sickle cell disease is marked by painful sickle cell crises, in which sickle-shaped cells get distorted in the small vessels and cause problems including disrupting blood flow and a…

The Childhood Roots of Illness
 The Childhood Roots of Illness 1024 575 Dave Ghose
By: Dave Ghose
Photo of a toddler playing with toys

A growing body of scientific evidence reveals the dramatic impact of early-life adversity on lifelong health. Kelly Kelleher, MD, compares childhood health to a boulder sitting on the peak of a mountain. A slight push could send the boulder in many directions. And once it starts rolling, it’s hard to change its path. The same…

Technology Expands Access to Translational Medicine
 Technology Expands Access to Translational Medicine 150 150 Abbie Miller
By: Abbie Miller

When primary care physicians, specialists and all the lab work in their arsenal fail to provide a diagnosis for debilitating symptoms, patients earn the label of “undiagnosed.” These undiagnosed patients wait with unresolved symptoms for medical research to catch up with them. The Undiagnosed Diseases Program (UDP) at the National Institutes of Health sees 120-150 previously undefined…

Orphan Disease Seeks Parents, Funding
 Orphan Disease Seeks Parents, Funding 1024 575 Kevin Mayhood
By: Kevin Mayhood
Color photo, family portrait of Reagan, a young girl with an orphan disease, her parents, and their dog

Research on rare pediatric diseases often remains underfunded and obscure until motivated families give scientists — and their own children — a much-needed shot at potential therapies worthy of federal funding. Reagan McGee’s pediatrician couldn’t figure out why she had cold after cold. Her parents, Karin and Peter McGee, took her to an ear, nose and…

Fighting Fibrosis
 Fighting Fibrosis 1024 575 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
Colorful illustration showing how fibrosis, or a spiky lumpy mass of scar tissue, forms over healthy liver tissue when the liver attempts to repair and replace damaged cells

Fibrosis is an unmet medical challenge with no satisfactory test and insufficient therapy. Now, one naturally occurring cellular component could simultaneously diagnose and heal patients. It’s much more than a million-dollar idea. The person who invents a simple blood or urine test that can accurately measure the severity of scarring in internal organs will have…

Preserving Biopreservation
 Preserving Biopreservation 1024 575 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
"Large stainless steel cryogenic storage tanks arranged in a row inside a laboratory or biorepository facility. Each tank is labeled 'MEDICAL NITROGEN' near the top and fitted with metal handrails and wheeled bases for mobility.

Funding challenges, operational complexity and poor visibility threaten the field of human tissue biobanking. How sustainable are biorepositories? The Children’s Oncology Group (COG) boasts the collaboration of more than 9,000 pediatric cancer experts. They treat patients and research disease at more than 200 hospitals around the world. Nine out of every 10 U.S. children with cancer receive…

InSight: A Window to the Heart
 InSight: A Window to the Heart 720 530 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
A 3D cardiac MRI reconstruction showing the heart and major vessels of a 16‑year‑old patient with situs inversus with dextrocardia, tricuspid atresia, and L‑transposition of the great arteries after a Fontan procedure. The brightly colored, semi‑transparent rendering highlights the redirected venous pathways and associated vessels against a black background.

Cardiac MRI for Hypoplastic Left Heart Syndrome Hypoplastic left heart syndrome (HLHS) is a potentially fatal congenital heart defect affecting blood flow. It requires multiple palliative surgeries, starting within the first week of life. Nationwide Children’s employs a hybrid surgical approach. Hybrid Stage I (not shown) Bilateral branch pulmonary bands are placed to restrict blood flow.…

Beyond the Basics: Enrolling Children in Research
 Beyond the Basics: Enrolling Children in Research 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

The ethics of pediatric research include far more than the concepts of autonomy and assent. Consent and assent. Competence and autonomy. Physicians are familiar with the catchphrases of ethical research, but the deeper researchers dig, the more they find that the field’s current understanding of the dimensions involved in pediatric investigations is still shallow. Numerous…

Building the Modern-Day Vaccine
 Building the Modern-Day Vaccine 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Vaccine development used to be straightforward. Now, the challenges are many and the successes are few. What will it take to overcome the obstacles presented by both immunology and society? For 160 years, vaccine after vaccine succeeded at safely and effectively preventing its targeted illness using a set of standard strategies. Scientists knew they simply…

InSight: Working Up the Nerve
 InSight: Working Up the Nerve 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Using regional anesthesia to numb nerves reduces pain and speeds recovery in pediatric orthopedic surgery. Ultrasound-guided regional anesthesia has been used in adult patients for more than a decade but is now being used more regularly in pediatric patients, especially for orthopedic procedures. Femoral nerve block, in which the femoral nerve is numbed, is among…

Body, Heal Thyself: Harnessing Our Innate Immunity
 Body, Heal Thyself: Harnessing Our Innate Immunity 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

What the urinary tract’s front-line defenses can teach us about our innate ability to self-heal …. and thwart antibiotic resistance. Antibiotic resistance is on the rise, health care-acquired infections are becoming harder to treat and even simple infectious illnesses account for billions of dollars per year in spending in the United States alone. As with…

Enteral Therapy on Trial
 Enteral Therapy on Trial 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Micah Cohen sat down at the dining room table in his family’s Columbus, Ohio, home and took the first sip of a new therapy he hoped would relieve the symptoms of his Crohn’s disease. The thick, sweet chocolate shake, rich with nutrients, felt heavy in the 14-year-old’s stomach. Can I really drink six of these a…

Thinking Outside the (Tool) Box: How Techniques From Alzheimer’s Research Illuminate the Pathophysiology of Preeclampsia
 Thinking Outside the (Tool) Box: How Techniques From Alzheimer’s Research Illuminate the Pathophysiology of Preeclampsia 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Irina Buhimschi, MD, has a habit of getting lost. In July 2007, that poor sense of direction proved to be a fortunate flaw. Having wandered into the wrong presentation at the Protein Society’s national conference, she hovered in the back to get her bearings. Up front, a speaker discussed how misfolded proteins accumulate in the…

Adult Congenital Heart Disease: Let’s Finish What We Started
 Adult Congenital Heart Disease: Let’s Finish What We Started 150 150 Curt Daniels, MD
By: Curt Daniels, MD

Congenital heart disease is the most common birth defect, diagnosed in nearly 1 percent of all births in the United States. Traditionally, life expectancy in many infants with severe CHD was limited to months. However, advances in medical and surgical care have led to remarkable improvements in survival: the median age of those living with severe…

Mentoring Junior Faculty: Fostering Tomorrow’s Leaders
 Mentoring Junior Faculty: Fostering Tomorrow’s Leaders 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Clinicians from institutions nationwide offer insight on how to piece together effective mentorship strategies in pediatrics. Mentoring may be a familiar concept to most pediatric professionals, but whether it occurs effectively in practice is less obvious. Research on the topic suggests a widespread lack of formal mentoring programs at academic medical institutions. Other studies point…

Gene Therapy’s Road to Redemption
 Gene Therapy’s Road to Redemption 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

Fifteen years ago, gene therapy suffered a highly visible fatality, leaving the field in shambles. Now, one team’s efforts at gene therapy for muscular dystrophy suggest the field may finally be on track to deliver on its initial promise. During the first few weeks of September in 1999, a 36-year-old air traffic controller from South…

Aiming for Zero
 Aiming for Zero 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

Efforts to eliminate preventable harm in pediatric care are making progress. But can we make it to zero? In October 2008, Richard Brilli, MD, stood in a silent conference room, waiting for his audience to digest the news he’d just delivered: hundreds of significant harm events are identified each year at Nationwide Children’s Hospital, and…

Evolution of an Atlas
 Evolution of an Atlas 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Adult brain atlases have existed for years. Why is it so crucial — and so difficult — to build one for preemies? Even experts need maps. They give perspective, scale and orientation. They can show both current location and the final destination. And in the world of premature brains, they can offer vital information about…

A Brave New World of Data
 A Brave New World of Data 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

According to William C. Ray, PhD, of the Battelle Center for Mathematical Medicine in The Research Institute at Nationwide Children’s Hospital, novel techniques prototyped for understanding protein data could soon enable the visualization of large sets of demographic data, displaying contingency tables and group relationships through visual representations of positive and negative correlation, covariance and…

Printed Motion: Holding Molecular Movement
 Printed Motion: Holding Molecular Movement 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

When student researcher Shareef Dabdoub discovered the appealing aesthetics of a transcriptional regulator from the Streptococcus family, he knew that cellular biology had handed him a work of art. And by using a computer program to predict the 3-D configuration of the molecule and its most probable pathway for rearranging from one state to another, he observed…