Nationwide Children's 2020 Annual Report

N AT I O N W I D E C H I L D R E N ’ S H O S P I TA L A N N U A L R E P O R T

Decade Remarkable Transformation of

In the last decade, Nationwide Children’s Hospital has grown in all dimensions – in clinical care and outcomes, in research and innovation, and in our commitment to social justice and health equity. Join us as we share our achievements from the past year, highlight a decade of transformation and look toward our future.

This past year has been a year like none before it. From a global pandemic to continued efforts to end racism and support health equity, Nationwide Children’s has stood with our patients, families and staff as we face these challenges together. We’ve also grown our team, welcoming a nationally renowned expert in quality and safety as our new chief medical officer, among many other talented new faculty.

Decade Remarkable Transformation of

In the last decade, Nationwide Children’s Hospital has grown in all dimensions – in clinical care and outcomes, in research and innovation, and in our commitment to social justice and health equity. Join us as we share our achievements from the past year, highlight a decade of transformation and look toward our future.

This past year has been a year like none before it. From a global pandemic to continued efforts to end racism and support health equity, Nationwide Children’s has stood with our patients, families and staff as we face these challenges together. We’ve also grown 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:

MORE THAN

1.6 Million PATIENT VISITS

PER YEAR

* Based on CHA survey of utilization and financial indicators

Leaders for the New Decade

Rank sixth among NIH-funded freestanding pediatric research facilities in the U.S.

54.6 million

$

Direct NIH Awards

LEADING THE COUNTRY IN QUALITY AND SAFETY

83%

reduction in serious safety events

64%

reduction in actual harm (2009-2019)

38%

drop in hospital mortality* (2009-2019)

*Observed to Expected Mortality Ratio Based on Pediatric Health Information System® (PHIS) Data

(2009-2019)

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 pediatric surgery*

• Four-time American Nurses Credentialing Center Magnet® designation for nursing excellence

• Patients from all 50 states and 54 foreign countries travel to Nationwide Children’s for care

• Provide more than $194 million in charity care and community benefit services annually

• More than 104,400 donors contributed nearly $62 million to support the hospital’s mission

• Fully accredited by the Association for the Accreditation 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

HONORS AND ACHIEVEMENTS:

MORE THAN

1.6 Million PATIENT VISITS

PER YEAR

* Based on CHA survey of utilization and financial indicators

Leaders for the New Decade

Rank sixth among NIH-funded freestanding pediatric research facilities in the U.S.

54.6 million

$

Direct NIH Awards

LEADING THE COUNTRY IN QUALITY AND SAFETY

83%

reduction in serious safety events

64%

reduction in actual harm (2009-2019)

38%

drop in hospital mortality* (2009-2019)

*Observed to Expected Mortality Ratio Based on Pediatric Health Information System® (PHIS) Data

(2009-2019)

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 pediatric surgery*

• Four-time American Nurses Credentialing Center Magnet® designation for nursing excellence

• Patients from all 50 states and 54 foreign countries travel to Nationwide Children’s for care

• Provide more than $194 million in charity care and community benefit services annually

• More than 104,400 donors contributed nearly $62 million to support the hospital’s mission

• Fully accredited by the Association for the Accreditation 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 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 organizationwide strategic plan, Journey to Best Outcomes.

Architects of the Future

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 highlighted.

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.

We went from having a smattering of telehealth appointments in 2019 to 2,000 per day in April and May. Approximately half of those visits came in Behavioral Health, because our deep investments in those services over the last decade, highlighted by the new Pavilion opening this past February, allowed us to quickly pivot to the new technology. Even when the pandemic ends, it’s clear telehealth will benefit our patients far into the future.

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 chief medical officer, Richard Brilli, MD, pioneered the pediatric quality field at Nationwide Children’s; our new CMO, Rustin Morse, MD, is a nationally prominent safety leader poised to take us even further. Longtime Chief Nursing Officer Linda Stoverock, DNP, RN, also retired this year after guiding us to the prestigious American 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. Extensive research and lab capabilities allowed us to quickly develop in-house COVID-19 testing facilities and to begin studies to inform treatments for the coronavirus. Because our research programs continue to expand, 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

Pictured, left to right: John A. Barnard, MD, chief of Pediatrics and president of the Abigail Wexner Research Institute; 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 Ann Wallace, RN, MBA, NEA-BC, chief nursing officer

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 children in south central and southeastern Ohio, expanded in 2020 to the state’s west central region and an additional 94,000 children with the collaboration of Dayton Children’s Hospital. Healthy Neighborhoods Healthy Families, our nationally recognized community partnership to revitalize the South Side of Columbus, has moved into another neighborhood, Linden, to begin creating housing, educational opportunities and workforce development programs.

The events of 2020 have convinced us, however, that we must do even more to fight disparity and inequities. Our new hospital-wide initiative, Stand Against Racism. Stand For Health Equity, will help us improve the outcomes of children everywhere and guide our efforts to create a more equitable world for our staff, our community and the families we serve.

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 to seize opportunities to improve the lives of children through care, research and advocacy – and we are more optimistic than ever for the future.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 3

After a Decade of Achievement, Looking Forward Tim Robinson, CEO of Nationwide Children’s Hospital 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 organizationwide strategic plan, Journey to Best Outcomes.

Architects of the Future

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 highlighted.

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.

We went from having a smattering of telehealth appointments in 2019 to 2,000 per day in April and May. Approximately half of those visits came in Behavioral Health, because our deep investments in those services over the last decade, highlighted by the new Pavilion opening this past February, allowed us to quickly pivot to the new technology. Even when the pandemic ends, it’s clear telehealth will benefit our patients far into the future.

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 chief medical officer, Richard Brilli, MD, pioneered the pediatric quality field at Nationwide Children’s; our new CMO, Rustin Morse, MD, is a nationally prominent safety leader poised to take us even further. Longtime Chief Nursing Officer Linda Stoverock, DNP, RN, also retired this year after guiding us to the prestigious American 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. Extensive research and lab capabilities allowed us to quickly develop in-house COVID-19 testing facilities and to begin studies to inform treatments for the coronavirus. Because our research programs continue to expand, 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

Pictured, left to right: John A. Barnard, MD, chief of Pediatrics and president of the Abigail Wexner Research Institute; 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 Ann Wallace, RN, MBA, NEA-BC, chief nursing officer

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 children in south central and southeastern Ohio, expanded in 2020 to the state’s west central region and an additional 94,000 children with the collaboration of Dayton Children’s Hospital. Healthy Neighborhoods Healthy Families, our nationally recognized community partnership to revitalize the South Side of Columbus, has moved into another neighborhood, Linden, to begin creating housing, educational opportunities and workforce development programs.

The events of 2020 have convinced us, however, that we must do even more to fight disparity and inequities. Our new hospital-wide initiative, Stand Against Racism. Stand For Health Equity, will help us improve the outcomes of children everywhere and guide our efforts to create a more equitable world for our staff, our community and the families we serve.

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 to seize opportunities to improve the lives of children through care, research and advocacy – and we are more optimistic than ever for the future.

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

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

TABLE OF CONTENTS

2

After a Decade of Achievement, Looking Forward

8

Milestones of a Decade

13

Our Journey

26

Faculty Honors and Grants

28

New Appointments

68 Endocrinology

72

Gastroenterology, Hepatology and Nutrition

78

Genetic and Genomic Medicine

80

Hematology, Oncology & Blood and Marrow Transplant

136 RADIOLOGY

85

Hospital Pediatrics and Adult Hospital Medicine

139 The Heart Center/Cardiothoracic Surgery

140 Colorectal and Pelvic Reconstruction

88

Infectious Diseases

142 Dentistry

94 Neonatology

145 Neurosurgery

100 Nephrology and Hypertension

147 Ophthalmology

104 Neurology

150 Orthopaedics

110 Pediatric Psychology and Neuropsychology

154 Otolaryngology

156 Pediatric and Adolescent Gynecology

158 Pediatric Surgery

162 Plastic and Reconstructive Surgery

164 Transplant

168 Trauma

172 Urology

31

DEPARTMENT, SECTION & RESEARCH INSTITUTE REPORTS

33 PEDIATRICS

34

Residency Programs

36

Adolescent Medicine

38

Allergy and Immunology

40

Heart Center

47 Cardiology

50

Child and Family Advocacy

52

Clinical Informatics

54

Community Pediatrics

57

Complex Care

59

Critical Care Medicine

61 Dermatology

62

Developmental and Behavioral Pediatrics

64

Emergency Medicine

116 Pulmonary Medicine and Sleep Disorders Center

121 Rheumatology

123 Sports Medicine

125 Toxicology

126 ANESTHESIOLOGY AND PAIN MEDICINE

128 PATHOLOGY AND LABORATORY MEDICINE

132 PSYCHIATRY AND COMMUNITY

BEHAVIORAL HEALTH

112 Primary Care Pediatrics, and Healthy

Weight and Nutrition

130 PHYSICAL MEDICINE AND REHABILITATION

138 SURGICAL SERVICES

176 ABIGAIL WEXNER RESEARCH INSTITUTE

178 Battelle Center for Mathematical Medicine

179 Biopathology Center

181 Center for Biobehavioral Health

182 Center for Cardiovascular Research

183 Center for Childhood Cancer and Blood Diseases

184 Center for Clinical and Translational Research

185 Center for Gene Therapy

187 Center for Injury Research and Policy

188 Center for Innovation in Pediatric Practice

189 Center for Microbial Pathogenesis

191 Center for Perinatal Research

192 Center for Regenerative Medicine

193 Center for Vaccines and Immunity

194 STEVE AND CINDY RASMUSSEN INSTITUTE FOR GENOMIC MEDICINE

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

6 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 7

TABLE OF CONTENTS

2

After a Decade of Achievement, Looking Forward

8

Milestones of a Decade

13

Our Journey

26

Faculty Honors and Grants

28

New Appointments

68 Endocrinology

72

Gastroenterology, Hepatology and Nutrition

78

Genetic and Genomic Medicine

80

Hematology, Oncology & Blood and Marrow Transplant

136 RADIOLOGY

85

Hospital Pediatrics and Adult Hospital Medicine

139 The Heart Center/Cardiothoracic Surgery

140 Colorectal and Pelvic Reconstruction

88

Infectious Diseases

142 Dentistry

94 Neonatology

145 Neurosurgery

100 Nephrology and Hypertension

147 Ophthalmology

104 Neurology

150 Orthopaedics

110 Pediatric Psychology and Neuropsychology

154 Otolaryngology

156 Pediatric and Adolescent Gynecology

158 Pediatric Surgery

162 Plastic and Reconstructive Surgery

164 Transplant

168 Trauma

172 Urology

31

DEPARTMENT, SECTION & RESEARCH INSTITUTE REPORTS

33 PEDIATRICS

34

Residency Programs

36

Adolescent Medicine

38

Allergy and Immunology

40

Heart Center

47 Cardiology

50

Child and Family Advocacy

52

Clinical Informatics

54

Community Pediatrics

57

Complex Care

59

Critical Care Medicine

61 Dermatology

62

Developmental and Behavioral Pediatrics

64

Emergency Medicine

116 Pulmonary Medicine and Sleep Disorders Center

121 Rheumatology

123 Sports Medicine

125 Toxicology

126 ANESTHESIOLOGY AND PAIN MEDICINE

128 PATHOLOGY AND LABORATORY MEDICINE

132 PSYCHIATRY AND COMMUNITY

BEHAVIORAL HEALTH

112 Primary Care Pediatrics, and Healthy

Weight and Nutrition

130 PHYSICAL MEDICINE AND REHABILITATION

138 SURGICAL SERVICES

176 ABIGAIL WEXNER RESEARCH INSTITUTE

178 Battelle Center for Mathematical Medicine

179 Biopathology Center

181 Center for Biobehavioral Health

182 Center for Cardiovascular Research

183 Center for Childhood Cancer and Blood Diseases

184 Center for Clinical and Translational Research

185 Center for Gene Therapy

187 Center for Injury Research and Policy

188 Center for Innovation in Pediatric Practice

189 Center for Microbial Pathogenesis

191 Center for Perinatal Research

192 Center for Regenerative Medicine

193 Center for Vaccines and Immunity

194 STEVE AND CINDY RASMUSSEN INSTITUTE FOR GENOMIC MEDICINE

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

6 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 7

Milestones of a Decade

8 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 9 | 9 NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Milestones of a Decade

8 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 9 | 9 NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

ADVANCING BEST OUTCOMES FOR CHILDREN EVERYWHERE MASTER FACILITIES II

10.

eet Str

4

Livingston

Avenue

EXPANDING CARE:

RESEARCH:

2a. Livingston Ambulatory Center

6. Research Building IV

1. Hospital, building out levels two and seven

3

Livingston Avenue

7

5. Research Building III, building out levels two and three

2b. Parking Garage for Livingston Ambulatory Center 3. Childcare Center, renovation

INFRASTRUCTURE:

BEHAVIORAL HEALTH PAVILION:

7.

Faculty Office Building

11a. Behavioral Health Pavilion

8.

Near East Office Building and Garage

11b. Parking Garage for Behavioral Health

9.

Energy Plant

10.

Data Center

4. Livingston Park Enhancements

12.

11.

13.

1,000,000 PATIENT VISITS 14.

2012

The Center for Injury Research and Policy

15.

2014

16. Research Building III Opens, Increasing Research Space to More than 500,000 Square Feet

22.

29. Ground Breaks at The Residences at Career Gateway, a $12 Million Low-Income Housing Complex, Through Healthy Neighborhoods Healthy Families

29.

28.

2013

2015

Y • QUALITY

35.

36.

•

QUALITY & SAFETY

26.

Affiliate Company Dedicated to the Manufacture of Gene Therapy Products for Biotechnology and Pharmaceutical Industries, Formed

47. Recognized as BlackDoctor.

org 2019-2020 Top Hospital for Diversity

48.

47.

49.

48. Lee Ann Wallace, RN, MBA,

NEA-BC, Named Chief Nursing Officer

2018

2020

49. Big Lots Behavioral Health

Pavilion — America’s Largest Behavioral Health Facility on a Pediatric Medical Campus — Opens

50. Conference Center and

50.

State-of-the-Art Simulation Center Opens

51. COVID-19 Response

Includes Rapid Testing, Telehealth Ramp-up

41. First Central Ohio Hospital to Raise Its Minimum Wage to $15 per Hour 42. Research Institute Rededicated as Abigail Wexner Research Institute 43. FDA Approves First Ever Systemically Delivered Gene Therapy — Zolgensma — for the Treatment of Spinal Muscular Atrophy

•Q U

PQS ITY

FETY • H • SA EA

25.

31.

TY

PEDIATRIC

LT H

24.

2017

Y • H E A LT H

FET

E

46.

46. Andelyn Biosciences, an

40. Re-designated With American Nurses Credentialing Center Magnet Recognition® for Fourth Time

FET

SA

AF

33. NASCAR Driver Dale Earnhardt, Jr. and Nationwide Children’s Launch the Dale and Amy Earnhardt Fund

45.

38.

51.

39.

39. Tim Robinson Appointed Chief Executive Officer

32. New 7,500 Square Foot cGMP Facility increases Capacity for Viral Vector and Cell Therapy Manufacturing

A LT H • Q U • HE AL TY I

Stand for Health Equity Initiative Launched

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

SA

17.

18.

37. $20 Million Expansion of Healthy Neighborhoods Healthy Families Through the South Side Renaissance Fund

31. Nationwide Children’s Breaks Ground on Big Lots Behavioral Health Pavilion

•S

19.

26. Announcement of the Nation’s First PediatricFocused Quality and Safety Journal, Pediatric Quality & Safety

45. Stand Against Racism,

37.

25. Genomics Team Wins the International Clarity Challenge to Solve Undiagnosed Diseases

19. Center for Colorectal and Pelvic Reconstruction Established

HEALTHY FAMILIES

30.

24. Honored by the American Hospital AssociationMcKesson Quest for Quality Prize

18. Monarch 1 Takes Flight

Health Prize for Excellence in Population Health

36. Named One of the 20 Most Innovative Children’s Hospitals

by Parents Magazine

HEALTHY NEIGHBORHOODS

2016

30. Elaine Mardis, PhD, and Richard Wilson, PhD, Announced as Leaders of the Institute for Genomic Medicine

23.

9.

10 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

35. Named to Forbes’ 2018 America’s Best Employers List

•

9. The Center for Family Safety and Healing Established

28. Big Lots and the Big Lots Foundation Pledge $50 Million Gift for New Behavioral Health Pavilion

44. Awarded the 2020 Hearst

34. Named 2018 LGBTQ Healthcare Equality Leader

CHILDREN’S HOSPITAL*

AL

6.

7.

2011

23. Ground Breaks for the Faculty Office Building and Livingston Ambulatory Center

21.

15. Christopher Breuer, MD, and Toshiharu Shinoka, MD, PhD, Lead Tissue Engineering

16.

8.

22. New State-of-the-Art Facilities Open for Patients to Receive Meta-iodobenzylguanidine (MIBG) Therapy for Neuroblastoma

LARGEST

27. Named 2016 Leapfrog Top Hospital and America’s Largest Children’s Hospital

21. First-of-its-Kind in the Midwest Adult Fontan Clinic Opens

17. First-of-Its-Kind Phase I Trial of Systemic AAV9Delivered Gene Therapy for Spinal Muscular Atrophy Type 1 Begins

6. Surgeons Katherine Deans, MD, MHSc, and Peter Minneci, MD, MHSc, Join Nationwide Children’s to Co-direct New Center for Surgical Outcomes Research

8. Joins Neonatal Research Network

1

5

2b

5.

7. Ground Breaks for Second Sports Medicine and Orthopedic Center

th

14. CDC Renews Designation of the Center for Injury Research and Policy as the Only Pediatric Injury Control Research Center in the U.S.

18

2010

5. First “Off-Campus” NICU

uth So

13. First Honor Roll Designation as a Top 10 U.S. News & World Report Best Children’s Hospital

6

2a

12. Reaches 1,000,000 Patient Visits

3.

10

11b

11a

20. Nationwide Foundation Pediatric Innovation Fund at Nationwide Children’s Established With an Initial $10 Million Gift

ue Aven ons Pars

4.

3. The Columbus Fetal Medicine Collaborative Forms

11. Named Title Beneficiary of Columbus Marathon

/71 I-70

34.

AMERICA’S

9

ue t Aven Gran

2. LEED-Certified Central Energy Plant Completed

2.

44.

27.

I-70

I-70 E

10. 7-Year Campus Expansion Completed – The Largest Pediatric Expansion Project in U.S. History

1.

I-71 N

I-70 W

1. First Bloodless Heart Transplant Performed

4. Ohio Perinatal Research Network Formed Between Nationwide Children’s and The Ohio State University

20.

8

I-71 S

A Remarkable Decade 2010 - 2020

I-71

41.

32.

33.

The Dale and Amy Earnhardt Fund

2019

1

st

40.

43.

42.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 11

ADVANCING BEST OUTCOMES FOR CHILDREN EVERYWHERE MASTER FACILITIES II

10.

eet Str

4

Livingston

Avenue

EXPANDING CARE:

RESEARCH:

2a. Livingston Ambulatory Center

6. Research Building IV

1. Hospital, building out levels two and seven

3

Livingston Avenue

7

5. Research Building III, building out levels two and three

2b. Parking Garage for Livingston Ambulatory Center 3. Childcare Center, renovation

INFRASTRUCTURE:

BEHAVIORAL HEALTH PAVILION:

7.

Faculty Office Building

11a. Behavioral Health Pavilion

8.

Near East Office Building and Garage

11b. Parking Garage for Behavioral Health

9.

Energy Plant

10.

Data Center

4. Livingston Park Enhancements

12.

11.

13.

1,000,000 PATIENT VISITS 14.

2012

The Center for Injury Research and Policy

15.

2014

16. Research Building III Opens, Increasing Research Space to More than 500,000 Square Feet

22.

29. Ground Breaks at The Residences at Career Gateway, a $12 Million Low-Income Housing Complex, Through Healthy Neighborhoods Healthy Families

29.

28.

2013

2015

Y • QUALITY

35.

36.

•

QUALITY & SAFETY

26.

Affiliate Company Dedicated to the Manufacture of Gene Therapy Products for Biotechnology and Pharmaceutical Industries, Formed

47. Recognized as BlackDoctor.

org 2019-2020 Top Hospital for Diversity

48.

47.

49.

48. Lee Ann Wallace, RN, MBA,

NEA-BC, Named Chief Nursing Officer

2018

2020

49. Big Lots Behavioral Health

Pavilion — America’s Largest Behavioral Health Facility on a Pediatric Medical Campus — Opens

50. Conference Center and

50.

State-of-the-Art Simulation Center Opens

51. COVID-19 Response

Includes Rapid Testing, Telehealth Ramp-up

41. First Central Ohio Hospital to Raise Its Minimum Wage to $15 per Hour 42. Research Institute Rededicated as Abigail Wexner Research Institute 43. FDA Approves First Ever Systemically Delivered Gene Therapy — Zolgensma — for the Treatment of Spinal Muscular Atrophy

•Q U

PQS ITY

FETY • H • SA EA

25.

31.

TY

PEDIATRIC

LT H

24.

2017

Y • H E A LT H

FET

E

46.

46. Andelyn Biosciences, an

40. Re-designated With American Nurses Credentialing Center Magnet Recognition® for Fourth Time

FET

SA

AF

33. NASCAR Driver Dale Earnhardt, Jr. and Nationwide Children’s Launch the Dale and Amy Earnhardt Fund

45.

38.

51.

39.

39. Tim Robinson Appointed Chief Executive Officer

32. New 7,500 Square Foot cGMP Facility increases Capacity for Viral Vector and Cell Therapy Manufacturing

A LT H • Q U • HE AL TY I

Stand for Health Equity Initiative Launched

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

SA

17.

18.

37. $20 Million Expansion of Healthy Neighborhoods Healthy Families Through the South Side Renaissance Fund

31. Nationwide Children’s Breaks Ground on Big Lots Behavioral Health Pavilion

•S

19.

26. Announcement of the Nation’s First PediatricFocused Quality and Safety Journal, Pediatric Quality & Safety

45. Stand Against Racism,

37.

25. Genomics Team Wins the International Clarity Challenge to Solve Undiagnosed Diseases

19. Center for Colorectal and Pelvic Reconstruction Established

HEALTHY FAMILIES

30.

24. Honored by the American Hospital AssociationMcKesson Quest for Quality Prize

18. Monarch 1 Takes Flight

Health Prize for Excellence in Population Health

36. Named One of the 20 Most Innovative Children’s Hospitals

by Parents Magazine

HEALTHY NEIGHBORHOODS

2016

30. Elaine Mardis, PhD, and Richard Wilson, PhD, Announced as Leaders of the Institute for Genomic Medicine

23.

9.

10 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

35. Named to Forbes’ 2018 America’s Best Employers List

•

9. The Center for Family Safety and Healing Established

28. Big Lots and the Big Lots Foundation Pledge $50 Million Gift for New Behavioral Health Pavilion

44. Awarded the 2020 Hearst

34. Named 2018 LGBTQ Healthcare Equality Leader

CHILDREN’S HOSPITAL*

AL

6.

7.

2011

23. Ground Breaks for the Faculty Office Building and Livingston Ambulatory Center

21.

15. Christopher Breuer, MD, and Toshiharu Shinoka, MD, PhD, Lead Tissue Engineering

16.

8.

22. New State-of-the-Art Facilities Open for Patients to Receive Meta-iodobenzylguanidine (MIBG) Therapy for Neuroblastoma

LARGEST

27. Named 2016 Leapfrog Top Hospital and America’s Largest Children’s Hospital

21. First-of-its-Kind in the Midwest Adult Fontan Clinic Opens

17. First-of-Its-Kind Phase I Trial of Systemic AAV9Delivered Gene Therapy for Spinal Muscular Atrophy Type 1 Begins

6. Surgeons Katherine Deans, MD, MHSc, and Peter Minneci, MD, MHSc, Join Nationwide Children’s to Co-direct New Center for Surgical Outcomes Research

8. Joins Neonatal Research Network

1

5

2b

5.

7. Ground Breaks for Second Sports Medicine and Orthopedic Center

th

14. CDC Renews Designation of the Center for Injury Research and Policy as the Only Pediatric Injury Control Research Center in the U.S.

18

2010

5. First “Off-Campus” NICU

uth So

13. First Honor Roll Designation as a Top 10 U.S. News & World Report Best Children’s Hospital

6

2a

12. Reaches 1,000,000 Patient Visits

3.

10

11b

11a

20. Nationwide Foundation Pediatric Innovation Fund at Nationwide Children’s Established With an Initial $10 Million Gift

ue Aven ons Pars

4.

3. The Columbus Fetal Medicine Collaborative Forms

11. Named Title Beneficiary of Columbus Marathon

/71 I-70

34.

AMERICA’S

9

ue t Aven Gran

2. LEED-Certified Central Energy Plant Completed

2.

44.

27.

I-70

I-70 E

10. 7-Year Campus Expansion Completed – The Largest Pediatric Expansion Project in U.S. History

1.

I-71 N

I-70 W

1. First Bloodless Heart Transplant Performed

4. Ohio Perinatal Research Network Formed Between Nationwide Children’s and The Ohio State University

20.

8

I-71 S

A Remarkable Decade 2010 - 2020

I-71

41.

32.

33.

The Dale and Amy Earnhardt Fund

2019

1

st

40.

43.

42.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 11

Our

Journey 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

Our

Journey 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 Chief Diversity and Health Equity Officer

The graphic below represents the intentional actions of our Stand Against Racism, Stand For Health Equity. Each part is comprised of a working group led by our senior 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]

Racism and inequity have been part of the fabric of our society for far too long.

This year, we have experienced a Social Justice

collective call to the urgent need to come

Systemwide Education & Training

together to stand against racism and stand for health equity.

At Nationwide Children’s our commitment

Community Engagement & Partnerships

to diversity, inclusion and equity is now further strengthened by our commitment

Stand Against Racism.

Stand For Health Equity.

Faculty & Training Programs

Clinical & Health Equity Programs & Interventions

Just as we care for the whole child – physically, behaviorally, socially and economically – we are addressing racism and inequity holistically.

Research & Outcome Metrics Talent & 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

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 Chief Diversity and Health Equity Officer

The graphic below represents the intentional actions of our Stand Against Racism, Stand For Health Equity. Each part is comprised of a working group led by our senior 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]

Racism and inequity have been part of the fabric of our society for far too long.

This year, we have experienced a Social Justice

collective call to the urgent need to come

Systemwide Education & Training

together to stand against racism and stand for health equity.

At Nationwide Children’s our commitment

Community Engagement & Partnerships

to diversity, inclusion and equity is now further strengthened by our commitment

Stand Against Racism.

Stand For Health Equity.

Faculty & Training Programs

Clinical & Health Equity Programs & Interventions

Just as we care for the whole child – physically, behaviorally, socially and economically – we are addressing racism and inequity holistically.

Research & Outcome Metrics Talent & 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 director of the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital, was elected to the prestigious National Academy of Medicine (NAM). Election to NAM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.

One year later, Jerry R. Mendell, MD, principal investigator in the Center for Gene Therapy at the Abigail Wexner Research Institute at Nationwide Children’s Hospital, was also elected to NAM. New members are elected by current members through a process that recognizes individuals who have made major contributions to the advancement of the medical sciences, health care and public health. A diversity of talent among 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 example, from such fields as law, engineering, social sciences and the humanities.

“These newly elected members represent the most exceptional scholars and leaders whose remarkable work has advanced science, medicine and health in the U.S. and around the globe,” says 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 the benefit of us all. I am honored to welcome these esteemed individuals to the National Academy of Medicine.”

Dr. Mardis, who is also the Steve and Cindy Rasmussen Nationwide Foundation Endowed Chair in Genomic Medicine, and a professor of pediatrics at The Ohio State University College of Medicine, joined Nationwide Children’s in 2016.

She has authored more than 350 articles in prestigious peer-reviewed scientific and medical journals and has written book chapters for several medical textbooks.

Dr. Mardis has been a member of the American Association for Cancer Research (AACR) since 2007, was elected as a Fellow of the Academy of the AACR in 2019 and served AACR president in 2019.

A world-renowned researcher, Dr. Mendell has been a pioneer in the care of neuromuscular diseases for more than 40 years.

He was the first to standardize and publish on corticosteroid treatment of Duchenne muscular dystrophy (DMD) that preserved ambulation in affected boys. In 2007, he led the first-ever phase 1 clinical trial using AAV, a viral-based gene therapy approach in children with muscular dystrophy, paving a path for this promising approach. More recently, he demonstrated in the first exon-skipping clinical trial in North America, an alternative method to overcome the gene defect in a specific variant of DMD. A prolific author of nearly 400 publications, Dr. Mendell recently co-edited the book, Muscle Gene Therapy – Second Edition, published in 2019.

“These newly elected members represent the most exceptional scholars and leaders whose remarkable work has advanced science, medicine and health in the U.S. and around the globe.”

V­ ictor J. Dzau, President of NAM Dr. Mendell led the phase 1/2 clinical trial, which was the first effective gene therapy for SMA type 1, the most severe form of SMA that typically results in death by age 2. The study, published in the New England Journal of Medicine, was the People’s Choice for Science Magazine’s 2017 Breakthrough of the Year. In May 2019, the Food and Drug Administration (FDA) approved Zolgensma® for spinal muscular atrophy (SMA) for pediatric patients less than 2 years of age, including those who are pre-symptomatic, recognized by newborn screening. To date, Zolgensma has treated more 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

16 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Jerry R. Mendell, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 17

Two Nationwide Children’s Faculty Elected to the Prestigious National Academy of Medicine In October 2019, Elaine R. Mardis, PhD, co-executive director of the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital, was elected to the prestigious National Academy of Medicine (NAM). Election to NAM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.

One year later, Jerry R. Mendell, MD, principal investigator in the Center for Gene Therapy at the Abigail Wexner Research Institute at Nationwide Children’s Hospital, was also elected to NAM. New members are elected by current members through a process that recognizes individuals who have made major contributions to the advancement of the medical sciences, health care and public health. A diversity of talent among 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 example, from such fields as law, engineering, social sciences and the humanities.

“These newly elected members represent the most exceptional scholars and leaders whose remarkable work has advanced science, medicine and health in the U.S. and around the globe,” says 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 the benefit of us all. I am honored to welcome these esteemed individuals to the National Academy of Medicine.”

Dr. Mardis, who is also the Steve and Cindy Rasmussen Nationwide Foundation Endowed Chair in Genomic Medicine, and a professor of pediatrics at The Ohio State University College of Medicine, joined Nationwide Children’s in 2016.

She has authored more than 350 articles in prestigious peer-reviewed scientific and medical journals and has written book chapters for several medical textbooks.

Dr. Mardis has been a member of the American Association for Cancer Research (AACR) since 2007, was elected as a Fellow of the Academy of the AACR in 2019 and served AACR president in 2019.

A world-renowned researcher, Dr. Mendell has been a pioneer in the care of neuromuscular diseases for more than 40 years.

He was the first to standardize and publish on corticosteroid treatment of Duchenne muscular dystrophy (DMD) that preserved ambulation in affected boys. In 2007, he led the first-ever phase 1 clinical trial using AAV, a viral-based gene therapy approach in children with muscular dystrophy, paving a path for this promising approach. More recently, he demonstrated in the first exon-skipping clinical trial in North America, an alternative method to overcome the gene defect in a specific variant of DMD. A prolific author of nearly 400 publications, Dr. Mendell recently co-edited the book, Muscle Gene Therapy – Second Edition, published in 2019.

“These newly elected members represent the most exceptional scholars and leaders whose remarkable work has advanced science, medicine and health in the U.S. and around the globe.”

V­ ictor J. Dzau, President of NAM Dr. Mendell led the phase 1/2 clinical trial, which was the first effective gene therapy for SMA type 1, the most severe form of SMA that typically results in death by age 2. The study, published in the New England Journal of Medicine, was the People’s Choice for Science Magazine’s 2017 Breakthrough of the Year. In May 2019, the Food and Drug Administration (FDA) approved Zolgensma® for spinal muscular atrophy (SMA) for pediatric patients less than 2 years of age, including those who are pre-symptomatic, recognized by newborn screening. To date, Zolgensma has treated more 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

16 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Jerry R. Mendell, MD

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

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 540 fully loaded school buses.

EIGHTH FLOOR: • Inpatient Units

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

SEVENTH FLOOR: • Inpatient Units

THIRD FLOOR: • Youth Crisis Stabilization Unit (YCSU) • Behavioral Health Administrative Offices • Faculty Offices

The Big Lots Behavioral Health Pavilion has 610 workstations.

FIRST FLOOR: • Psychiatric Crisis Department with Extended Observation Suite • Critical Assessment and Treatment Clinic • Sanctuary 20 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SECOND FLOOR: • Mood and Anxiety Program • Family Based Intensive Therapy (FBIT) • Center for Suicide Prevention and Research • Outpatient Psychiatry Clinic

LOWER FLOOR: • Cafeteria • Gift Shop • Conference/Training Rooms

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 21

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 540 fully loaded school buses.

EIGHTH FLOOR: • Inpatient Units

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

SEVENTH FLOOR: • Inpatient Units

THIRD FLOOR: • Youth Crisis Stabilization Unit (YCSU) • Behavioral Health Administrative Offices • Faculty Offices

The Big Lots Behavioral Health Pavilion has 610 workstations.

FIRST FLOOR: • Psychiatric Crisis Department with Extended Observation Suite • Critical Assessment and Treatment Clinic • Sanctuary 20 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SECOND FLOOR: • Mood and Anxiety Program • Family Based Intensive Therapy (FBIT) • Center for Suicide Prevention and Research • Outpatient Psychiatry Clinic

LOWER FLOOR: • Cafeteria • Gift Shop • Conference/Training Rooms

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

29 37

$

million

25

licensing deals in 2019 (combined between startups and industry)

plus, in licensing revenue received in 2019 by the Office of Technology Commercialization

patents issued in 2019

3 101 88

3

clinical inventions developed from idea to commercially available

97

U.S. patent applications filed in 2019

disclosures submitted to our office from 31 different departments/ centers in 2019

230,000

$

startups launched in 2020 based on Nationwide Children’s inventions

foreign patent applications filed in 2019

awarded internally to inventors in 2019 to fund 4 projects on the commercialization path

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

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

29 37

$

million

25

licensing deals in 2019 (combined between startups and industry)

plus, in licensing revenue received in 2019 by the Office of Technology Commercialization

patents issued in 2019

3 101 88

3

clinical inventions developed from idea to commercially available

97

U.S. patent applications filed in 2019

disclosures submitted to our office from 31 different departments/ centers in 2019

230,000

$

startups launched in 2020 based on Nationwide Children’s inventions

foreign patent applications filed in 2019

awarded internally to inventors in 2019 to fund 4 projects on the commercialization path

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 Hearst Health and the Jefferson College of Population Health have announced 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.

HEALTHY NEIGHBORHOODS HEALTHY FAMILIES AFFORDABLE HOUSING

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:

Home, before

Healthy Home, after

370

More than 370 homes were impacted, including full-gut renovations, new builds, and grants to current residents through the Home Repair Program.

79

Early childhood programs have driven kindergarten readiness scores from 32% to 96% for participants, and graduation rates increased from 64% in 2013 to 79% in 2017.

%

Bathroom, before

Bathroom, after

Dining room, before

24 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Living room, after

58 H

The Residences at Career Gateway provides 58 units of apartments and townhomes along with on-site career development training.

Children who are Medicaid-eligible have experienced decreases in emergency department use and probability of inpatient admission.

50

%

Neighborhood vacancy rates fell from 25% to 6%, and owneroccupied home sale volumes increased by 50% in the Southern Orchards neighborhood.

In surveys, residents report feeling safer and a stronger sense of community.

“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.”

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 25

Nationwide Children’s Hospital Awarded Prestigious Hearst Health Prize Hearst Health and the Jefferson College of Population Health have announced 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.

HEALTHY NEIGHBORHOODS HEALTHY FAMILIES AFFORDABLE HOUSING

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:

Home, before

Healthy Home, after

370

More than 370 homes were impacted, including full-gut renovations, new builds, and grants to current residents through the Home Repair Program.

79

Early childhood programs have driven kindergarten readiness scores from 32% to 96% for participants, and graduation rates increased from 64% in 2013 to 79% in 2017.

%

Bathroom, before

Bathroom, after

Dining room, before

24 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Living room, after

58 H

The Residences at Career Gateway provides 58 units of apartments and townhomes along with on-site career development training.

Children who are Medicaid-eligible have experienced decreases in emergency department use and probability of inpatient admission.

50

%

Neighborhood vacancy rates fell from 25% to 6%, and owneroccupied home sale volumes increased by 50% in the Southern Orchards neighborhood.

In surveys, residents report feeling safer and a stronger sense of community.

“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.”

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 Cancer Moonshot Grant The National Cancer Institute at the National Institutes of Health announced it has 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. The multiyear Timothy Cripe, MD, PhD Elaine Mardis, PhD grant supports multiple ongoing projects led by the Pediatric Ohio-New 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 researchers at Nationwide Children’s.

Deena Chisolm, PhD, Receives Nationwide Foundation Endowed Chair of Health Equity Research

Deena Chisolm, PhD

Jeff Bridge, PhD, Receives Nationwide Foundation Endowed Chair of Innovation in Behavioral Health Research

$3 Million Grant Awarded to Children’s Hospitals in Ohio, Michigan to Establish Regional Disaster Center of Excellence The Assistant Secretary of Preparedness and Response of the U.S. Department of Health and Human Services recently awarded a $3 million grant that will establish The Eastern Great Lakes Pediatric 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 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 consortium team at Nationwide Children’s along with Ellen McManus, MD, attending Emergency Medicine physician.

Jeff Bridge, PhD

26 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

In 2020, the Nationwide Foundation Pediatric Innovation Fund supported the creation of the Nationwide Foundation Endowed Chair of Innovation in Behavioral Health Research. This chair 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 prevention at the Abigail Wexner Research Institute at Nationwide Children’s. His research focuses on the epidemiology of suicidal behavior in young people and on improving the quality of care for suicidal youth and adolescents who have attempted suicide.

National Pancreas Foundation Center of Excellence Designation

Nationwide Children’s Hospital Joins Four Other Top Research Institutions in Joint Initiative Focused on Single Ventricle Heart Defects The Abigail Wexner Research Institute (AWRI) at Nationwide Children’s Hospital is the recipient of a $1 million 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 highrisk, high-reward projects that are often challenging to fund through more traditional grant mechanisms.

In 2020, the Nationwide Foundation Pediatric Innovation Fund supported the creation and funding of the Nationwide Foundation Endowed Chair of Health Equity Research. This chair is awarded to Deena Chisolm, PhD, director of a Center of Emphasis dedicated to health equity research and vice president of Health Services Research at Nationwide Children’s Hospital.

Dr. Chisolm is an epidemiologist whose research is focused on measuring and improving the effectiveness, efficiency and equity of pediatric health care in at-risk communities.

Cheryl Gariepy, MD

Nationwide Children’s Hospital has been named a National Pancreas Foundation (NPF) Center 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.

Cheryl Gariepy, MD, is the director of the Pancreas Center at Nationwide Children’s.

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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 27

FACULTY HONORS AND GRANTS Childhood Cancer Research Team Awarded $10.2 Million Cancer Moonshot Grant The National Cancer Institute at the National Institutes of Health announced it has 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. The multiyear Timothy Cripe, MD, PhD Elaine Mardis, PhD grant supports multiple ongoing projects led by the Pediatric Ohio-New 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 researchers at Nationwide Children’s.

Deena Chisolm, PhD, Receives Nationwide Foundation Endowed Chair of Health Equity Research

Deena Chisolm, PhD

Jeff Bridge, PhD, Receives Nationwide Foundation Endowed Chair of Innovation in Behavioral Health Research

$3 Million Grant Awarded to Children’s Hospitals in Ohio, Michigan to Establish Regional Disaster Center of Excellence The Assistant Secretary of Preparedness and Response of the U.S. Department of Health and Human Services recently awarded a $3 million grant that will establish The Eastern Great Lakes Pediatric 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 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 consortium team at Nationwide Children’s along with Ellen McManus, MD, attending Emergency Medicine physician.

Jeff Bridge, PhD

26 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

In 2020, the Nationwide Foundation Pediatric Innovation Fund supported the creation of the Nationwide Foundation Endowed Chair of Innovation in Behavioral Health Research. This chair 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 prevention at the Abigail Wexner Research Institute at Nationwide Children’s. His research focuses on the epidemiology of suicidal behavior in young people and on improving the quality of care for suicidal youth and adolescents who have attempted suicide.

National Pancreas Foundation Center of Excellence Designation

Nationwide Children’s Hospital Joins Four Other Top Research Institutions in Joint Initiative Focused on Single Ventricle Heart Defects The Abigail Wexner Research Institute (AWRI) at Nationwide Children’s Hospital is the recipient of a $1 million 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 highrisk, high-reward projects that are often challenging to fund through more traditional grant mechanisms.

In 2020, the Nationwide Foundation Pediatric Innovation Fund supported the creation and funding of the Nationwide Foundation Endowed Chair of Health Equity Research. This chair is awarded to Deena Chisolm, PhD, director of a Center of Emphasis dedicated to health equity research and vice president of Health Services Research at Nationwide Children’s Hospital.

Dr. Chisolm is an epidemiologist whose research is focused on measuring and improving the effectiveness, efficiency and equity of pediatric health care in at-risk communities.

Cheryl Gariepy, MD

Nationwide Children’s Hospital has been named a National Pancreas Foundation (NPF) Center 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.

Cheryl Gariepy, MD, is the director of the Pancreas Center at Nationwide Children’s.

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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 27

NEW APPOINTMENTS

Rustin Morse, MD

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.

Dr. Morse is a nationally recognized leader in pediatric quality and safety and 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 sought-after thought leader on pediatric quality and safety and is regularly recognized by Becker’s Hospital Review as one of “50 Experts Leading the Field of Patient Safety.” A board-certified pediatric emergency room physician who has continued to practice emergency medicine throughout his career, Dr. Morse has a successful track record leading and advancing quality and safety programs in pediatric health care.

Maryam Fouladi, MD, MSc, FRCP, is a pediatric neuro-oncologist, co-executive director of the pediatric neuro-oncology program at Nationwide Children’s Hospital, and a professor of Pediatrics at The Ohio State University College of Medicine. Dr. Fouladi is an internationally recognized expert in pediatric brain tumors and is renowned for her work in phase I clinical trials. She is the founding director of CONNECT, an international consortium focused on developing and testing novel therapies in early phase clinical trials. In addition to her roles at Nationwide Children’s and The Ohio State University Wexner Medical Center, Dr. Fouladi serves as the chair of the Collaborative Network for Neuro-Oncology Clinical Trials and CNS Committee of the Children’s Oncology Group.

Dr. Morse received his medical degree from the State University of New York Health Science Center at Upstate Medical University. He then completed his pediatric residency at Children’s Hospital of Pittsburgh and his pediatric emergency medicine fellowship at Ann & Robert H. Lurie Children’s Hospital of Chicago. He obtained a master’s degree in Medical Management from the University of Southern California, Marshall School of Business.

Lee Ann Wallace, RN, MBD, NEA-BC, Chief Nursing Officer 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 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 experience as a clinical nurse manager, educator, service line leader and director of women’s and children’s services at four different health systems.

In 2012, Wallace joined the team at Nationwide Children’s as the Neonatology service line administrator, and in 2016 was promoted to vice president of Neonatology Services. She earned a bachelor of science in nursing from the University of Kentucky and obtained her master’s in business administration in health care administration from the University of Findlay. Wallace was instrumental in growing Nationwide Children’s Neonatal Network, now nationally recognized as the largest in the country.

Lee Ann Wallace, RN, MBD, NEA-BC

Katherine Deans, MD, MHSc, Chief Clinical Research Officer Katherine J. Deans, MD, MHSc, a pediatric surgeon and co-founder and former director of the Center for Surgical Outcomes Research at Nationwide Children’s Hospital, has been named the first chief clinical research officer at the Abigail Wexner Research Institute at Nationwide Children’s.

Katherine Deans, MD, MHSc

In her new role, she will focus on the development and oversight of clinical research operations across Nationwide Children’s, with an overall goal of facilitating impactful clinical research throughout the organization. Dr. Deans will oversee the full life cycle of the clinical research process, with an emphasis on increasing quality, compliance and efficiency along with promoting a culture of excellence among investigators and clinical research staff.

During her career, Dr. Deans has published more than 190 peer-reviewed papers, book chapters and abstracts and has received over $10 million in research funding. She received her medical degree from Dartmouth Medical School and her 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.

28 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Maryam Fouladi, MD, MSc, FRCP

Prior to coming to Nationwide Children’s, Dr. Fouladi served as medical director of the Brain Tumor Center at Cincinnati Children’s Hospital and was also a full professor and the Marjory J. Johnson Endowed Chair in Brain Tumor Translational Research at the University of Cincinnati. She received her medical degree from the University of Toronto and completed her 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 Pharmacology Department at St. Jude.

Shamlal Mangray, MB, BS, Chief of Pathology and Laboratory Medicine Shamlal Mangray, MB, BS, has been appointed chief of the Department of Pathology and Laboratory Medicine at Nationwide Children’s Hospital. Dr. Mangray, who is also a professor 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 the University of the West Indies and went on to complete residencies at St. Vincent’s Medical Center in Connecticut and at Rhode Island Hospital - Brown University. He completed a Surgical Pathology Fellowship at Vanderbilt University Medical Center and a Pediatric Pathology Fellowship Shamlal Mangray, MD, BS at Women & Infants Hospital of Rhode Island at Brown University. Dr. Mangray is board certified in Anatomic & Clinical Pathology and Pediatric Pathology.

Manmohan Kamboj, MD, Division Chief of Endocrinology Manmohan K. Kamboj, MD, has been named chief of the Division of Endocrinology at 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 of 10 sites in the National Type 1 Diabetes Exchange Quality Improvement Collaborative. She has various leadership roles in the Pediatric Endocrine Society (PES), including participation on multiple Education Committee initiatives and work as co-chair of the PES Drugs and Therapeutics Committee. Dr. Kamboj, who is also a professor of Pediatrics at The Ohio State University College Manmohan K. Kamboj, MD of Medicine, has authored more than 65 manuscripts, book chapters and peer-reviewed articles.

She has co-edited three books. She received her medical degree from Christian Medical College in India and completed her residency in pediatrics and fellowship in pediatric endocrinology at New York University Medical Center.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 29

NEW APPOINTMENTS

Rustin Morse, MD

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.

Dr. Morse is a nationally recognized leader in pediatric quality and safety and 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 sought-after thought leader on pediatric quality and safety and is regularly recognized by Becker’s Hospital Review as one of “50 Experts Leading the Field of Patient Safety.” A board-certified pediatric emergency room physician who has continued to practice emergency medicine throughout his career, Dr. Morse has a successful track record leading and advancing quality and safety programs in pediatric health care.

Maryam Fouladi, MD, MSc, FRCP, is a pediatric neuro-oncologist, co-executive director of the pediatric neuro-oncology program at Nationwide Children’s Hospital, and a professor of Pediatrics at The Ohio State University College of Medicine. Dr. Fouladi is an internationally recognized expert in pediatric brain tumors and is renowned for her work in phase I clinical trials. She is the founding director of CONNECT, an international consortium focused on developing and testing novel therapies in early phase clinical trials. In addition to her roles at Nationwide Children’s and The Ohio State University Wexner Medical Center, Dr. Fouladi serves as the chair of the Collaborative Network for Neuro-Oncology Clinical Trials and CNS Committee of the Children’s Oncology Group.

Dr. Morse received his medical degree from the State University of New York Health Science Center at Upstate Medical University. He then completed his pediatric residency at Children’s Hospital of Pittsburgh and his pediatric emergency medicine fellowship at Ann & Robert H. Lurie Children’s Hospital of Chicago. He obtained a master’s degree in Medical Management from the University of Southern California, Marshall School of Business.

Lee Ann Wallace, RN, MBD, NEA-BC, Chief Nursing Officer 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 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 experience as a clinical nurse manager, educator, service line leader and director of women’s and children’s services at four different health systems.

In 2012, Wallace joined the team at Nationwide Children’s as the Neonatology service line administrator, and in 2016 was promoted to vice president of Neonatology Services. She earned a bachelor of science in nursing from the University of Kentucky and obtained her master’s in business administration in health care administration from the University of Findlay. Wallace was instrumental in growing Nationwide Children’s Neonatal Network, now nationally recognized as the largest in the country.

Lee Ann Wallace, RN, MBD, NEA-BC

Katherine Deans, MD, MHSc, Chief Clinical Research Officer Katherine J. Deans, MD, MHSc, a pediatric surgeon and co-founder and former director of the Center for Surgical Outcomes Research at Nationwide Children’s Hospital, has been named the first chief clinical research officer at the Abigail Wexner Research Institute at Nationwide Children’s.

Katherine Deans, MD, MHSc

In her new role, she will focus on the development and oversight of clinical research operations across Nationwide Children’s, with an overall goal of facilitating impactful clinical research throughout the organization. Dr. Deans will oversee the full life cycle of the clinical research process, with an emphasis on increasing quality, compliance and efficiency along with promoting a culture of excellence among investigators and clinical research staff.

During her career, Dr. Deans has published more than 190 peer-reviewed papers, book chapters and abstracts and has received over $10 million in research funding. She received her medical degree from Dartmouth Medical School and her 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.

28 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Maryam Fouladi, MD, MSc, FRCP

Prior to coming to Nationwide Children’s, Dr. Fouladi served as medical director of the Brain Tumor Center at Cincinnati Children’s Hospital and was also a full professor and the Marjory J. Johnson Endowed Chair in Brain Tumor Translational Research at the University of Cincinnati. She received her medical degree from the University of Toronto and completed her 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 Pharmacology Department at St. Jude.

Shamlal Mangray, MB, BS, Chief of Pathology and Laboratory Medicine Shamlal Mangray, MB, BS, has been appointed chief of the Department of Pathology and Laboratory Medicine at Nationwide Children’s Hospital. Dr. Mangray, who is also a professor 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 the University of the West Indies and went on to complete residencies at St. Vincent’s Medical Center in Connecticut and at Rhode Island Hospital - Brown University. He completed a Surgical Pathology Fellowship at Vanderbilt University Medical Center and a Pediatric Pathology Fellowship Shamlal Mangray, MD, BS at Women & Infants Hospital of Rhode Island at Brown University. Dr. Mangray is board certified in Anatomic & Clinical Pathology and Pediatric Pathology.

Manmohan Kamboj, MD, Division Chief of Endocrinology Manmohan K. Kamboj, MD, has been named chief of the Division of Endocrinology at 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 of 10 sites in the National Type 1 Diabetes Exchange Quality Improvement Collaborative. She has various leadership roles in the Pediatric Endocrine Society (PES), including participation on multiple Education Committee initiatives and work as co-chair of the PES Drugs and Therapeutics Committee. Dr. Kamboj, who is also a professor of Pediatrics at The Ohio State University College Manmohan K. Kamboj, MD of Medicine, has authored more than 65 manuscripts, book chapters and peer-reviewed articles.

She has co-edited three books. She received her medical degree from Christian Medical College in India and completed her residency in pediatrics and fellowship in pediatric endocrinology at New York University Medical Center.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 29

Department, Section & Research Institute Reports

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

Department, Section & Research Institute Reports

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

DEPARTMENT OF PEDIATRICS

Carol Bradford, MD, Newly Appointed Dean of The Ohio State University College of Medicine In August, The Ohio State University announced that strong academic leader and well-known physician-scientist in the field of otolaryngology — head and neck surgery will lead its College of Medicine beginning in October.

Carol R. Bradford, MD, FACS, will be the 15th dean of the medical college and vice president for Health Sciences at The Ohio State University Wexner Medical Center, and will hold the Leslie H. and Abigail S. Wexner Dean’s Chair in Medicine.

Dr. Bradford comes to Ohio State from the University of Michigan, where she was the executive vice dean of academic affairs and the chief academic officer for Michigan Medicine.

She oversaw education, global initiatives, faculty 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 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.

DEPARTMENT OF PEDIATRICS The mission of the Department of Pediatrics at Nationwide Children’s Hospital and The Ohio State University is to achieve excellence in teaching, research, academics, advocacy and administrative service. With great energy and enthusiasm, we promote the well-being of children, discover new knowledge to bring to bear on optimal child health and provide evidence-based, efficient and compassionate medical care to our patients and their families.

The department comprises 27 clinical divisions, the Steve and Cindy Rasmussen Institute for Genomic Medicine and 13 research centers of emphasis in the Abigail Wexner Research Institute. Department of Pediatrics faculty members have formal appointments in The Ohio State University College of Medicine.

Our faculty has an unwavering commitment to excellence and aspires to the highest levels of professionalism, humanism, diagnostic acumen, clear communication and compassion. We educate and mentor more than 350 third- and fourth-year medical students from The Ohio State University and train approximately 300 residents and subspecialty fellows each year. Our Center for Faculty Development oversees a robust program that strives to engage, support and educate our more than 500 faculty. An important mission of our department and hospital is the discovery and dissemination of new knowledge related to child health and health care delivery. This discovery mission is supported by more than $105 million in research funding and we are ranked sixth among free-standing children’s hospitals in NIH funding.

Photo taken before COVD-19 pandemic.

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

DEPARTMENT OF PEDIATRICS

Carol Bradford, MD, Newly Appointed Dean of The Ohio State University College of Medicine In August, The Ohio State University announced that strong academic leader and well-known physician-scientist in the field of otolaryngology — head and neck surgery will lead its College of Medicine beginning in October.

Carol R. Bradford, MD, FACS, will be the 15th dean of the medical college and vice president for Health Sciences at The Ohio State University Wexner Medical Center, and will hold the Leslie H. and Abigail S. Wexner Dean’s Chair in Medicine.

Dr. Bradford comes to Ohio State from the University of Michigan, where she was the executive vice dean of academic affairs and the chief academic officer for Michigan Medicine.

She oversaw education, global initiatives, faculty 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 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.

DEPARTMENT OF PEDIATRICS The mission of the Department of Pediatrics at Nationwide Children’s Hospital and The Ohio State University is to achieve excellence in teaching, research, academics, advocacy and administrative service. With great energy and enthusiasm, we promote the well-being of children, discover new knowledge to bring to bear on optimal child health and provide evidence-based, efficient and compassionate medical care to our patients and their families.

The department comprises 27 clinical divisions, the Steve and Cindy Rasmussen Institute for Genomic Medicine and 13 research centers of emphasis in the Abigail Wexner Research Institute. Department of Pediatrics faculty members have formal appointments in The Ohio State University College of Medicine.

Our faculty has an unwavering commitment to excellence and aspires to the highest levels of professionalism, humanism, diagnostic acumen, clear communication and compassion. We educate and mentor more than 350 third- and fourth-year medical students from The Ohio State University and train approximately 300 residents and subspecialty fellows each year. Our Center for Faculty Development oversees a robust program that strives to engage, support and educate our more than 500 faculty. An important mission of our department and hospital is the discovery and dissemination of new knowledge related to child health and health care delivery. This discovery mission is supported by more than $105 million in research funding and we are ranked sixth among free-standing children’s hospitals in NIH funding.

Photo taken before COVD-19 pandemic.

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 NATIONWIDE CHILDREN’S HOSPITAL | THE OHIO STATE UNIVERSITY COLLEGE OF MEDICINE

Dear Colleagues: 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 diverse and preeminent educational experiences in pediatrics available in the United States. And our outstanding research programs are changing futures for children across the world.

PEDIATRICS RESIDENCY PROGRAM DIRECTOR

Dr. Kelsey M. Lecerf

Dr. Ashleigh J. Slemmer

Dr. Rachael E. Levine

Dr. Carly A. Stilphen

INTERNAL MEDICINEPEDIATRIC RESIDENTS

Rebecca G. Wallihan, MD

Dr. Celia E. Ligorski

Dr. Cristina Tomatis Souverbielle

CHIEF RESIDENTS

Dr. Nina J. Ma

Dr. Mark J. Wells

Dr. Matthew R. Emery

Dr. Kristin D. Maletsky

Dr. Bianca Zapanta

Dr. Mary J. Ryan

Dr. Aishwarya S. Navalpakam

PL-1

PGY-4

Dr. Haley B. Pearlstein

Dr. Nadine-Stella E. Achenjang

Dr. Katherine F. Ernst

Dr. Michael P. Perisa

Dr. Molly J. Austen

Dr. Matthew I. Lyons

Dr. Stephanie T. Quach

Dr. Nimisha Bajaj

Dr. Sarah M. MacDowell

Dr. James B. Reinecke

Dr. Megan N. Barcroft

Dr. Lucy E. Rosenbaum

Dr. Jessica H. Rutsky

Dr. Trevor R. Bushong

Dr. Brittany S. Shrefler

Dr. Jennifer B. Scheer

Dr. Kaitlyn D. Cassady

Dr. Corey A. Toocheck

Dr. Louisa Sethi

Dr. Michael T. Clark

Dr. Akshay B. Vijayaraman

Dr. Tara J. Shenoy

Dr. Nicole M. Davidson

Dr. Sneh A. Xavier

Claire A. Stewart, MD

Dr. Livpreet Singh

Dr. Samantha J. DeMarsh

Dr. Samantha K. Stough

Dr. Sabine J. Eid

PGY-3

INTERNAL MEDICINE/PEDIATRICS

Dr. Destiny D. Wilsonao

Dr. Maretta H. Fan

Dr. Philip Chang

Lucas McKnight, MD

Dr. Ryan M. Flaherty

Dr. Anyelika Delerme

Allison Rossetti, MD

PL-2

Dr. Gabriella T. Gonzales

Dr. Michelle Gillespie

Dr. Collin J. Abbott

Dr. Cory W. Gotowka

Dr. Robbi Gomez

Dr. Ruth D. Abrams

Dr. Emily M. Grad

Dr. Audrey Hiltunen

Dr. Keerthi Akubathini

Dr. Elizabeth M. Grogan

Dr. Austin Meyer

Dr. Abha H. Athale

Dr. Muhammed T. Gunduz

Dr. Michelle Moore Padilla

Dr. Erika L. Basil

Dr. Ezekiel D. Hartman

Dr. Nathaniel Sherrer

Dr. Brianna N. Brun

Dr. Ann M. Kebede

Dr. Amanda R. Campbell

Dr. Laura K. Lamberta

PGY-2

Dr. Sarah M. Chen

Dr. Kara D. Lawson

Dr. Nabeeha Ahmad

Dr. Christian M, Coletta

Dr. Rafael Lemus

Dr. Kristin Cooper

Dr. Zachary D. Daniels

Dr. Aaron Maki

Dr. Rachel D’Amico

Dr. Jonathan A. Digby

Dr. Corinne C. Mccabe

Dr. Michael Diesntbach

Dr. David W. Drees

Dr. Samir Mishra

Dr. Mary Hanks

Dr. Megan M. Fredwall

Dr. Jessica A. Nash

Dr. Rachael Mangaudis

Dr. Christopher Gable

Dr. Britney N. Onuma

Dr. Timothy Pian

Dr. John M. Grisham

Dr. Molly J. Osterhage

Dr. Daniel Schmitz

Dr. Rae Leonor Gumayan

Dr. Amudha Pazhanisamy

Dr. Savannah Smith

Dr. Monica L. Hoff

Dr. Heather Peterson-Schempp

Dr. Aisha J. White

Dr. Anneliese R. Huntzinger

Dr. Melonie A. Phillips

Dr. Kelly M. Irwin

Dr. Rachel E. Pratt

PGY-1

Dr. Megan A. King

Dr. Joshua J. Prudent

Dr. Cole Bredehoeft

Dr. Antonia T. Kopp

Dr. Stephanie L. Rinne

Dr. Duncan Campbell

Dr. Megan K. MacGregor

Dr. Alexandra E. Sankovic

Dr. Jennifer DeSalvo

Dr. Abigail J. McGinnis

Dr. Matthew T. Smith

Dr. Dominic Haertling

Dr. Claudia A. Mosquera Vasquez

Dr. Brandon S. Stone

Dr. Brandi Heinz

Dr. Rachel C. Nash

Dr. Kristin L. Sundy-Boyles

Dr. Michael Neiger

Dr. Jacqueline M. Nicodemo

Dr. Rachel L. Thompson

Dr. Anthony Sanchez

Dr. Kortney J. Pifher

Dr. Charles C. Treinen

Dr. Matthew Schreier

Dr. Aubrey K. Pizza

Dr. Jessica E. P. Williams

Dr. Shilpa Sridhar

Dr. Melanie C. Ribbeck

Dr. Mariah L. Wright

Dr. Christopher Woeste

Dr. Philip ‘Bucky’ Ribbeck

Dr. Jarrod J. Wurm

Dr. Hector A. Saucedo

Dr. Guillermo J. Yepes Junquera

As we work to advance optimal health in children, we do not insulate ourselves from real-world issues that confront modern society. In response to the spirit of the Black Lives Matter movement and Nationwide Children’s stand against racism, the Department of Pediatrics is aggressively confronting racism as a public health crisis.

INTERNAL MEDICINE/ PEDIATRICS RESIDENCY PROGRAM DIRECTOR

Along with many other initiatives at our hospital, we are working hard to increase year-over-year the number of underrepresented minority faculty and trainees in our Department. Through hard work by many people, we have made great progress in our residency program. Every Grand Rounds presentation must address some aspect of health equity and racism germane to the topic of the day. And we have a rich didactic curriculum and a variety of innovative experiential learning platforms that focus on diversity, equity and inclusion – all uniquely designed for our faculty.

ASSOCIATE PROGRAM DIRECTORS

I hope you enjoy the pages that follow and appreciate the depth of our commitment to achieve best outcomes for children everywhere.

Sincerely, John A. Barnard, MD Ann I. Wolfe Chair in Pediatric Research President, Abigail Wexner Research Institute at Nationwide Children’s Hospital Professor and Chair, Department of Pediatrics The Ohio State University College of Medicine

Margaret Chase, MD

PEDIATRICS Mary Kay Kuzma, MD Alexander T. Rakowsky, MD Suzanne M. Reed, MD

PEDIATRIC RESIDENTS CHIEF RESIDENTS Dr. Hannah J. Elkus Dr. Taylor H. Jersak Dr. Shauna M. Schord Dr. Megan E. Yanny Dr. Becky Zhao

DEPARTMENT OF PEDIATRICS VICE CHAIRS

PL-4 Dr. April N. Lehman PL-3 Dr. Karen M. Allen Dr. Zeenath S. Ameen Dr. Brett A. Ballard Dr. Angelique E. Boutzoukas Dr. Kyle B. Burghgraef

Kristina Reber, MD Vice Chair, Department of Pediatrics

Linda Cripe, MD Vice Chair, Academic Affairs

Rebecca Wallihan, MD Vice Chair, Education

Dennis Durbin, MD Vice Chair, Research

Dr. Lauren N. Carlozzi Dr. Aila L. Co Dr. Kaci L. Cunningham Dr. Laura M. DiScenna Dr. Maureen M. Faust Dr. Nathaniel H. Forman Dr. Noga Gal Dr. Sarah J. Gaubatz Dr. Jaclyn R. Giafaglione Dr. Lauren M. Gunderman Dr. Eric W. Jones Dr. Shelby C. Jordan Dr. Ajay S. Koti Dr. Jared A. Kusma

34 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Dr. Lauren E. Matera

Dr. Isma B. Shah

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 35

2019 – 2020 NATIONWIDE CHILDREN’S RESIDENCY PROGRAM NATIONWIDE CHILDREN’S HOSPITAL | THE OHIO STATE UNIVERSITY COLLEGE OF MEDICINE

Dear Colleagues: 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 diverse and preeminent educational experiences in pediatrics available in the United States. And our outstanding research programs are changing futures for children across the world.

PEDIATRICS RESIDENCY PROGRAM DIRECTOR

Dr. Kelsey M. Lecerf

Dr. Ashleigh J. Slemmer

Dr. Rachael E. Levine

Dr. Carly A. Stilphen

INTERNAL MEDICINEPEDIATRIC RESIDENTS

Rebecca G. Wallihan, MD

Dr. Celia E. Ligorski

Dr. Cristina Tomatis Souverbielle

CHIEF RESIDENTS

Dr. Nina J. Ma

Dr. Mark J. Wells

Dr. Matthew R. Emery

Dr. Kristin D. Maletsky

Dr. Bianca Zapanta

Dr. Mary J. Ryan

Dr. Aishwarya S. Navalpakam

PL-1

PGY-4

Dr. Haley B. Pearlstein

Dr. Nadine-Stella E. Achenjang

Dr. Katherine F. Ernst

Dr. Michael P. Perisa

Dr. Molly J. Austen

Dr. Matthew I. Lyons

Dr. Stephanie T. Quach

Dr. Nimisha Bajaj

Dr. Sarah M. MacDowell

Dr. James B. Reinecke

Dr. Megan N. Barcroft

Dr. Lucy E. Rosenbaum

Dr. Jessica H. Rutsky

Dr. Trevor R. Bushong

Dr. Brittany S. Shrefler

Dr. Jennifer B. Scheer

Dr. Kaitlyn D. Cassady

Dr. Corey A. Toocheck

Dr. Louisa Sethi

Dr. Michael T. Clark

Dr. Akshay B. Vijayaraman

Dr. Tara J. Shenoy

Dr. Nicole M. Davidson

Dr. Sneh A. Xavier

Claire A. Stewart, MD

Dr. Livpreet Singh

Dr. Samantha J. DeMarsh

Dr. Samantha K. Stough

Dr. Sabine J. Eid

PGY-3

INTERNAL MEDICINE/PEDIATRICS

Dr. Destiny D. Wilsonao

Dr. Maretta H. Fan

Dr. Philip Chang

Lucas McKnight, MD

Dr. Ryan M. Flaherty

Dr. Anyelika Delerme

Allison Rossetti, MD

PL-2

Dr. Gabriella T. Gonzales

Dr. Michelle Gillespie

Dr. Collin J. Abbott

Dr. Cory W. Gotowka

Dr. Robbi Gomez

Dr. Ruth D. Abrams

Dr. Emily M. Grad

Dr. Audrey Hiltunen

Dr. Keerthi Akubathini

Dr. Elizabeth M. Grogan

Dr. Austin Meyer

Dr. Abha H. Athale

Dr. Muhammed T. Gunduz

Dr. Michelle Moore Padilla

Dr. Erika L. Basil

Dr. Ezekiel D. Hartman

Dr. Nathaniel Sherrer

Dr. Brianna N. Brun

Dr. Ann M. Kebede

Dr. Amanda R. Campbell

Dr. Laura K. Lamberta

PGY-2

Dr. Sarah M. Chen

Dr. Kara D. Lawson

Dr. Nabeeha Ahmad

Dr. Christian M, Coletta

Dr. Rafael Lemus

Dr. Kristin Cooper

Dr. Zachary D. Daniels

Dr. Aaron Maki

Dr. Rachel D’Amico

Dr. Jonathan A. Digby

Dr. Corinne C. Mccabe

Dr. Michael Diesntbach

Dr. David W. Drees

Dr. Samir Mishra

Dr. Mary Hanks

Dr. Megan M. Fredwall

Dr. Jessica A. Nash

Dr. Rachael Mangaudis

Dr. Christopher Gable

Dr. Britney N. Onuma

Dr. Timothy Pian

Dr. John M. Grisham

Dr. Molly J. Osterhage

Dr. Daniel Schmitz

Dr. Rae Leonor Gumayan

Dr. Amudha Pazhanisamy

Dr. Savannah Smith

Dr. Monica L. Hoff

Dr. Heather Peterson-Schempp

Dr. Aisha J. White

Dr. Anneliese R. Huntzinger

Dr. Melonie A. Phillips

Dr. Kelly M. Irwin

Dr. Rachel E. Pratt

PGY-1

Dr. Megan A. King

Dr. Joshua J. Prudent

Dr. Cole Bredehoeft

Dr. Antonia T. Kopp

Dr. Stephanie L. Rinne

Dr. Duncan Campbell

Dr. Megan K. MacGregor

Dr. Alexandra E. Sankovic

Dr. Jennifer DeSalvo

Dr. Abigail J. McGinnis

Dr. Matthew T. Smith

Dr. Dominic Haertling

Dr. Claudia A. Mosquera Vasquez

Dr. Brandon S. Stone

Dr. Brandi Heinz

Dr. Rachel C. Nash

Dr. Kristin L. Sundy-Boyles

Dr. Michael Neiger

Dr. Jacqueline M. Nicodemo

Dr. Rachel L. Thompson

Dr. Anthony Sanchez

Dr. Kortney J. Pifher

Dr. Charles C. Treinen

Dr. Matthew Schreier

Dr. Aubrey K. Pizza

Dr. Jessica E. P. Williams

Dr. Shilpa Sridhar

Dr. Melanie C. Ribbeck

Dr. Mariah L. Wright

Dr. Christopher Woeste

Dr. Philip ‘Bucky’ Ribbeck

Dr. Jarrod J. Wurm

Dr. Hector A. Saucedo

Dr. Guillermo J. Yepes Junquera

As we work to advance optimal health in children, we do not insulate ourselves from real-world issues that confront modern society. In response to the spirit of the Black Lives Matter movement and Nationwide Children’s stand against racism, the Department of Pediatrics is aggressively confronting racism as a public health crisis.

INTERNAL MEDICINE/ PEDIATRICS RESIDENCY PROGRAM DIRECTOR

Along with many other initiatives at our hospital, we are working hard to increase year-over-year the number of underrepresented minority faculty and trainees in our Department. Through hard work by many people, we have made great progress in our residency program. Every Grand Rounds presentation must address some aspect of health equity and racism germane to the topic of the day. And we have a rich didactic curriculum and a variety of innovative experiential learning platforms that focus on diversity, equity and inclusion – all uniquely designed for our faculty.

ASSOCIATE PROGRAM DIRECTORS

I hope you enjoy the pages that follow and appreciate the depth of our commitment to achieve best outcomes for children everywhere.

Sincerely, John A. Barnard, MD Ann I. Wolfe Chair in Pediatric Research President, Abigail Wexner Research Institute at Nationwide Children’s Hospital Professor and Chair, Department of Pediatrics The Ohio State University College of Medicine

Margaret Chase, MD

PEDIATRICS Mary Kay Kuzma, MD Alexander T. Rakowsky, MD Suzanne M. Reed, MD

PEDIATRIC RESIDENTS CHIEF RESIDENTS Dr. Hannah J. Elkus Dr. Taylor H. Jersak Dr. Shauna M. Schord Dr. Megan E. Yanny Dr. Becky Zhao

DEPARTMENT OF PEDIATRICS VICE CHAIRS

PL-4 Dr. April N. Lehman PL-3 Dr. Karen M. Allen Dr. Zeenath S. Ameen Dr. Brett A. Ballard Dr. Angelique E. Boutzoukas Dr. Kyle B. Burghgraef

Kristina Reber, MD Vice Chair, Department of Pediatrics

Linda Cripe, MD Vice Chair, Academic Affairs

Rebecca Wallihan, MD Vice Chair, Education

Dennis Durbin, MD Vice Chair, Research

Dr. Lauren N. Carlozzi Dr. Aila L. Co Dr. Kaci L. Cunningham Dr. Laura M. DiScenna Dr. Maureen M. Faust Dr. Nathaniel H. Forman Dr. Noga Gal Dr. Sarah J. Gaubatz Dr. Jaclyn R. Giafaglione Dr. Lauren M. Gunderman Dr. Eric W. Jones Dr. Shelby C. Jordan Dr. Ajay S. Koti Dr. Jared A. Kusma

34 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Dr. Lauren E. Matera

Dr. Isma B. Shah

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 35

Department of Pediatrics

ADOLESCENT MEDICINE

FAST FACTS

The Section of Adolescent Medicine at Nationwide Children’s Hospital provides general and specialty care 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, health for incarcerated youth, and adolescents with complex health problems.

FACULTY

Andrea E. Bonny, MD Chief Elise D. Berlan, MD, MPH Gayathri Chelvakumar, MD, MPH Casey B. Cottrill, MD, MPH Fareeda W. Haamid, DO Cynthia M. Holland-Hall, MD, MPH Steven C. Matson, MD Erin R. McKnight, MD, MPH The Adolescent Medicine Clinic is located in the Livingston Ambulatory Center on our Columbus campus. Primary care is offered, as are consultative clinics for adolescents with reproductive health needs and those who need treatment for addiction.

The Medical Clinic at the Franklin County Juvenile Detention Facility provides health care for detained youth. The Eating Disorders Program is a multidisciplinary team involving Adolescent Medicine physicians, a psychiatrist, behavioral health therapists, nurses and dietitians. Three levels of care are available: partial hospitalization, intensive outpatient therapy and coordinated outpatient visits. The MedicationAssisted 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

known as BC4Teens, increases accessibility to longacting reversible contraception. The THRIVE Program provides comprehensive care to transgender and gendernonconforming youth. Physicians in the Section of Adolescent Medicine provide ongoing and consultative care for adolescents admitted to Nationwide Children’s with diverse medical problems, such as gynecological conditions and complications from eating disorders. An Accreditation Council for Graduate Medical Education Fellowship in Adolescent Medicine has been in place since 2010.

July 2019 through June 2020 Adolescent Medicine Clinic Visits:............................5,397

Linden Primary Care Adolescent Medicine Clinic Visits:.16

Adolescent Medicine Eating Disorders Visits:............2,921

Total Adolescent Medicine Clinic Visits:....................9,049

Dublin Adolescent Medicine Clinic Visits:.....................241

Inpatient Consults:........................................................39

East Broad Adolescent Medicine Clinic Visits:..............474

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM ADOLESCENT MEDICINE Maria D. Brown, MD Ashley M. Ebersole, MD Hunter Wernick, DO

Our faculty members actively participate in research and national leadership. Erin R. McKnight, MD, MPH, and Andrea E. Bonny, MD, are co-investigators on a National Institutes of Health grant, developing new statistical approaches for estimating county-level rates of opioid misuse to target areas of highest priority. The grant-funded research of Gayathri Chelvakumar, MD, MPH, explores the association between quality of life and menstrual suppression in gender minority youth.

Cynthia M. Holland-Hall, MD, MPH, was elected to the Executive Committee of the American Academy of Pediatrics Section of Adolescent Health, and Elise D. Berlan, MD, MPH, served on the board of directors for the North American Society for Pediatric and Adolescent Gynecology.

SELECTED PUBLICATIONS 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 Jul;65(1):32-38.

Stull SW, McKnight ER, Matson SC, Bonny AE. Immunity to Hepatitis B is Undetectable in the Majority of Adolescents and Young Adults Seeking Outpatient Medication Treatment for Opioid Use Disorder. The Journal of Addiction Medicine. 2020 Jun 12. [Epub ahead of print] Walker KS, Bonny AE, McKnight ER, Nahata MC. Impact of Office-Based Opioid Treatment on Emergency Visits and Hospitalization in Adolescents with Opioid Use Disorder. The Journal of Pediatrics. 2020 Apri;19:236-242.

Wilkinson TA, Kottke MJ, Berlan ED. Providing Contraception for Young People During a Pandemic is Essential Health Care. JAMA Pediatrics. 2020 May 7.

36 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 37

Department of Pediatrics

ADOLESCENT MEDICINE

FAST FACTS

The Section of Adolescent Medicine at Nationwide Children’s Hospital provides general and specialty care 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, health for incarcerated youth, and adolescents with complex health problems.

FACULTY

Andrea E. Bonny, MD Chief Elise D. Berlan, MD, MPH Gayathri Chelvakumar, MD, MPH Casey B. Cottrill, MD, MPH Fareeda W. Haamid, DO Cynthia M. Holland-Hall, MD, MPH Steven C. Matson, MD Erin R. McKnight, MD, MPH The Adolescent Medicine Clinic is located in the Livingston Ambulatory Center on our Columbus campus. Primary care is offered, as are consultative clinics for adolescents with reproductive health needs and those who need treatment for addiction.

The Medical Clinic at the Franklin County Juvenile Detention Facility provides health care for detained youth. The Eating Disorders Program is a multidisciplinary team involving Adolescent Medicine physicians, a psychiatrist, behavioral health therapists, nurses and dietitians. Three levels of care are available: partial hospitalization, intensive outpatient therapy and coordinated outpatient visits. The MedicationAssisted 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

known as BC4Teens, increases accessibility to longacting reversible contraception. The THRIVE Program provides comprehensive care to transgender and gendernonconforming youth. Physicians in the Section of Adolescent Medicine provide ongoing and consultative care for adolescents admitted to Nationwide Children’s with diverse medical problems, such as gynecological conditions and complications from eating disorders. An Accreditation Council for Graduate Medical Education Fellowship in Adolescent Medicine has been in place since 2010.

July 2019 through June 2020 Adolescent Medicine Clinic Visits:............................5,397

Linden Primary Care Adolescent Medicine Clinic Visits:.16

Adolescent Medicine Eating Disorders Visits:............2,921

Total Adolescent Medicine Clinic Visits:....................9,049

Dublin Adolescent Medicine Clinic Visits:.....................241

Inpatient Consults:........................................................39

East Broad Adolescent Medicine Clinic Visits:..............474

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM ADOLESCENT MEDICINE Maria D. Brown, MD Ashley M. Ebersole, MD Hunter Wernick, DO

Our faculty members actively participate in research and national leadership. Erin R. McKnight, MD, MPH, and Andrea E. Bonny, MD, are co-investigators on a National Institutes of Health grant, developing new statistical approaches for estimating county-level rates of opioid misuse to target areas of highest priority. The grant-funded research of Gayathri Chelvakumar, MD, MPH, explores the association between quality of life and menstrual suppression in gender minority youth.

Cynthia M. Holland-Hall, MD, MPH, was elected to the Executive Committee of the American Academy of Pediatrics Section of Adolescent Health, and Elise D. Berlan, MD, MPH, served on the board of directors for the North American Society for Pediatric and Adolescent Gynecology.

SELECTED PUBLICATIONS 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 Jul;65(1):32-38.

Stull SW, McKnight ER, Matson SC, Bonny AE. Immunity to Hepatitis B is Undetectable in the Majority of Adolescents and Young Adults Seeking Outpatient Medication Treatment for Opioid Use Disorder. The Journal of Addiction Medicine. 2020 Jun 12. [Epub ahead of print] Walker KS, Bonny AE, McKnight ER, Nahata MC. Impact of Office-Based Opioid Treatment on Emergency Visits and Hospitalization in Adolescents with Opioid Use Disorder. The Journal of Pediatrics. 2020 Apri;19:236-242.

Wilkinson TA, Kottke MJ, Berlan ED. Providing Contraception for Young People During a Pandemic is Essential Health Care. JAMA Pediatrics. 2020 May 7.

36 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 37

Department of Pediatrics

ALLERGY AND IMMUNOLOGY The Division of Allergy and Immunology at Nationwide Children’s Hospital provides comprehensive services for the diagnosis and treatment of patients with allergic and immunologic diseases from birth through age 21. Clinical activity includes an active outpatient clinic, several multispecialty clinics, an urgent referral clinic and inpatient consultation services. The division is also actively involved in both basic science and clinical research.

FACULTY

Mitchell H. Grayson, MD Division Chief

Rebecca Scherzer, MD Section Chief Elizabeth A. Erwin, MD Irene J. Mikhail, MD Peter J. Mustillo, MD Benjamin Prince, MD Margaret Redmond, MD Kasey Strothman, MD David R. Stukus, MD

This past year, the Division of Allergy and Immunology opened the Food Allergy Treatment Center. This center provides comprehensive evaluation, diagnosis and management of food allergies, and is the only center in central Ohio performing high-risk oral food challenges.

In addition to our food allergy focus, we remain a World Allergy Organization Center of Excellence, and continue to be a Jeffrey Modell Foundation for Primary Immunodeficiencies Diagnostic and Research Center of Excellence.

Our providers manage all allergic conditions, including asthma, allergic and nonallergic rhinitis, chronic sinusitis, hives, eczema, angioedema, drug and food allergies, latex allergy and stinging insect allergy. We 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 provide inpatient consultation and immediate assistance for health care providers through the physician consult transfer center.

allergy and immunology organizations and are invited speakers at local, regional, national and international conferences.

FAST FACTS July 2019 through June 2020

SELECTED PUBLICATIONS Erwin EA, Navalpakam A, Singla R, Bolender J, Workman LJ, Platts-Mills TAE. J 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.

Kraft MT, Prince BT. Atopic dermatitis is a barrier issue, not an allergy issue. Immunology and Allergy Clinics of North America. 2019 Nov;39(4):507-519.

Kraft MT, Scherzer R, Strothman K, Rogers G, Montgomery T, Grayson MH. Establishing standardized documentation for anaphylaxis treatment in a tertiary care pediatric allergy clinic. Pediatric Quality and Safety. 2020 Feb 15;5(2):e261.

Mikhail I, Prince BT, Stukus DR. Update on early introduction of peanut to prevent allergy development: Challenges with implementation. Current Allergy and Asthma Reports.

2019 Nov 9;19(11):51.

Takeda AJ, Maher TJ, Zhang Y, Lanahan SM, Bucklin ML, Compton SR, Tyler PM, Comrie WA, Matsuda M, Olivier KN, Pittaluga S, McElwee JJ, Long Priel DA, Kuhns 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 immunopathology. Nature Communications. 2019 Sep 25;10(1):4364.

Main Campus Allergy Clinic Visits:............................5,650 Immunology Clinic Visits:............................................379 Complex Asthma-Allergy Clinic Visits:.........................206 Hilliard Allergy Clinic Visits:.........................................609 Westerville Allergy Clinic Visits:...................................484 Early Peanut Introduction Clinic Visits:...........................44 Total Clinic Visits:.....................................................7,372 Inpatient Consults:........................................................76

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM ALLERGY & IMMUNOLOGY Basil Kahwash, MD Monica Kraft, MD Dylan Timberlake, MD Jennifer Yonkof, MD

A wide array of basic and clinical research is performed by division faculty, ranging from mechanisms driving development of asthma and allergies to clinical studies of eosinophilic esophagitis, food allergy, use of technology to improve patient outcomes, transition of care, primary immunodeficiency, asthma, and allergic and nonallergic rhinitis.

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

Department of Pediatrics

ALLERGY AND IMMUNOLOGY The Division of Allergy and Immunology at Nationwide Children’s Hospital provides comprehensive services for the diagnosis and treatment of patients with allergic and immunologic diseases from birth through age 21. Clinical activity includes an active outpatient clinic, several multispecialty clinics, an urgent referral clinic and inpatient consultation services. The division is also actively involved in both basic science and clinical research.

FACULTY

Mitchell H. Grayson, MD Division Chief

Rebecca Scherzer, MD Section Chief Elizabeth A. Erwin, MD Irene J. Mikhail, MD Peter J. Mustillo, MD Benjamin Prince, MD Margaret Redmond, MD Kasey Strothman, MD David R. Stukus, MD

This past year, the Division of Allergy and Immunology opened the Food Allergy Treatment Center. This center provides comprehensive evaluation, diagnosis and management of food allergies, and is the only center in central Ohio performing high-risk oral food challenges.

In addition to our food allergy focus, we remain a World Allergy Organization Center of Excellence, and continue to be a Jeffrey Modell Foundation for Primary Immunodeficiencies Diagnostic and Research Center of Excellence.

Our providers manage all allergic conditions, including asthma, allergic and nonallergic rhinitis, chronic sinusitis, hives, eczema, angioedema, drug and food allergies, latex allergy and stinging insect allergy. We 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 provide inpatient consultation and immediate assistance for health care providers through the physician consult transfer center.

allergy and immunology organizations and are invited speakers at local, regional, national and international conferences.

FAST FACTS July 2019 through June 2020

SELECTED PUBLICATIONS Erwin EA, Navalpakam A, Singla R, Bolender J, Workman LJ, Platts-Mills TAE. J 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.

Kraft MT, Prince BT. Atopic dermatitis is a barrier issue, not an allergy issue. Immunology and Allergy Clinics of North America. 2019 Nov;39(4):507-519.

Kraft MT, Scherzer R, Strothman K, Rogers G, Montgomery T, Grayson MH. Establishing standardized documentation for anaphylaxis treatment in a tertiary care pediatric allergy clinic. Pediatric Quality and Safety. 2020 Feb 15;5(2):e261.

Mikhail I, Prince BT, Stukus DR. Update on early introduction of peanut to prevent allergy development: Challenges with implementation. Current Allergy and Asthma Reports.

2019 Nov 9;19(11):51.

Takeda AJ, Maher TJ, Zhang Y, Lanahan SM, Bucklin ML, Compton SR, Tyler PM, Comrie WA, Matsuda M, Olivier KN, Pittaluga S, McElwee JJ, Long Priel DA, Kuhns 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 immunopathology. Nature Communications. 2019 Sep 25;10(1):4364.

Main Campus Allergy Clinic Visits:............................5,650 Immunology Clinic Visits:............................................379 Complex Asthma-Allergy Clinic Visits:.........................206 Hilliard Allergy Clinic Visits:.........................................609 Westerville Allergy Clinic Visits:...................................484 Early Peanut Introduction Clinic Visits:...........................44 Total Clinic Visits:.....................................................7,372 Inpatient Consults:........................................................76

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM ALLERGY & IMMUNOLOGY Basil Kahwash, MD Monica Kraft, MD Dylan Timberlake, MD Jennifer Yonkof, MD

A wide array of basic and clinical research is performed by division faculty, ranging from mechanisms driving development of asthma and allergies to clinical studies of eosinophilic esophagitis, food allergy, use of technology to improve patient outcomes, transition of care, primary immunodeficiency, asthma, and allergic and nonallergic rhinitis.

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.”

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

– May Ling Mah, MD

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 and boys with muscular dystrophy.

“What we learn in one of these patient populations can help the other,” she says. “With these moms 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]

40 40| NATIONWIDE CHILDREN’S HOSPITAL Annual Report | NATIONWIDE CHILDREN’S HOSPITAL| 2019-20 | 2019-20 Annual Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 41

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.”

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

– May Ling Mah, MD

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 and boys with muscular dystrophy.

“What we learn in one of these patient populations can help the other,” she says. “With these moms 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]

40 40| NATIONWIDE CHILDREN’S HOSPITAL Annual Report | NATIONWIDE CHILDREN’S HOSPITAL| 2019-20 | 2019-20 Annual Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 41

Department of Pediatrics

THE HEART CENTER

Kaitlin E. L’Italien, MD

The Heart Center at Nationwide Children’s Hospital combines all clinical and research disciplines under one umbrella in order to meet our mission: to improve outcomes by discovering the causes of heart disease and develop novel therapies for our patients, focusing on each as an individual and providing the state-ofthe-art care that all patients deserve, regardless of age. We support the mission of Nationwide Children’s to provide our services in a safe environment focused on family-centered care.

Eric A. Lloyd, MD

FACULTY

Aimee K. Armstrong, MD Carl H. Backes, MD Darren P. Berman, MD Brian A. Boe, MD Jessica L. Bowman, MD Elisa A. Bradley, MD Sergio A. Carrillo Melendez, MD Steven C. Cassidy, MD

Catherine D. Krawczeski, MD Co-Director Chief, Pediatric Cardiology

John P. Cheatham, MD Kristin M. Chenault, MD Marco Corridore, MD Linda H. Cripe, MD Clifford L. Cua, MD Curt J. Daniels, MD Stephen M. Druhan, MD Timothy F. Feltes, MD

Christopher T. McKee, DO Aymen N. Naguib, MD Deipanjan Nandi, MD Kathryn D. Nardell, MD Christina M. Phelps, MD Kerry L. Rosen, MD Daniel G. Rowland, MD Aarthi Sabanayagam, MD Toshiharu Shinoka, MD, PhD Janet M. Simsic, MD Corey A. Stiver, MD Karen M. Texter, MD Andrew Tran, MD Peter D. Winch, MD, MBA Andrew R. Yates, MD Cody M. Young, DO

Highlights •

Continued outstanding surgical outcomes, with overall surgical mortality 2% or less for last two years

•

Implemented new protocols, leading to significant decrease in blood stream infections associated with central intravenous lines in cardiac inpatients

•

Hosted the national 6th Summit on Transparency and Public Reporting of Pediatric and Congenital Heart Disease Outcomes

•

Successfully implemented telemedicine visits to support clinical services during the pandemic

•

Returned to full outpatient clinical volume in May 2020, maintaining infection control practices, with a record number of referrals in June 2020

Jennifer Gauntt, MD Stephen A. Hart, MD Kan N. Hor, MD Anna N. Kamp, MD, MPH Naomi J. Kertesz, MD Omar M. Khalid, MD Sarah Khan, MD John P. Kovalchin, MD

Vidu Garg, MD Director of Translational Research

Rajesh Krishnamurthy, MD Lauren Lastinger, MD Anthony Y. Lee, MD Simon Lee, MD

42 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Funded 10 intramural projects and obtained $2 million in extramural grant funding from National Institutes of Health and Foundation

•

One of five institutions in nation awarded Innovation Funds through Additional Ventures to study single ventricle heart disease

Our heart failure/transplant section, which has been renamed the Pediatric & Adult Advanced Cardiac Therapies (PAACT) program, saw a nearly 75% increase in transplant referrals in the last year and completed five heart transplants. We implanted six ventricular assist devices (VAD) as a bridge to recovery or heart transplant and successfully supported an infant over five months before transplant using the Berlin EXCOR VAD, our longest infant support to date. We anticipate continued VAD program growth, meeting the needs of an increasing population of older pediatric and young adult patients with congenital heart disease. We continue to grow a novel cardio-oncology program to provide ongoing cardiac care to long-term survivors of childhood cancers at risk for or developing cardiomyopathy.

Saurabh Rajpal, MD

Jill A. Fitch, MD

John Kelly, MD

•

The Heart Center continues to grow in both volume and capabilities with record numbers of outpatient visits and diagnostic studies in 2019.

Julie C. O’Donovan, MD

NATIONAL AND INTERNATIONAL REPUTATION

Don Hayes, MD, MS, MEd

Expanded regional outreach adult congenital clinics

Patrick I. McConnell, MD

Richard P. Fernandez, MD Robert J. Gajarski, MD, MHSA Mark E. Galantowicz, MD Co-Director Chief, Cardiothoracic Surgery

May Ling Mah, MD

•

Our cardiac catheterization and interventional therapies team participates in multiple device trials, including new self-expanding transcatheter pulmonary valves (Harmony and Alterra) to broaden nonsurgical valve replacement options for many patients. The team has organized the first multi-center, prospective, randomized trial for PDA device occlusion versus medical management in the premature neonate. Additionally, our catheterization team continues to participate in preclinical research, and has worked to refine the first fully bioabsorbable, tissue-engineered pulmonary valve in an animal fetus and implanted a fully absorbable ASD occluder in a sheep. Through a collaboration among cardiology, interventional radiology and hematology, the lymphatic disorder program is growing, performing diagnostic and interventional procedures for patients with lymphatic disorders. Lastly, the interventional team performed the first heart catheterization in the Midwest guided solely by magnetic resonance imaging (MRI).

As part of a busy clinical arrhythmia service, our electrophysiologist (EP) faculty staff a collaborative, inherited arrhythmia clinic, combining the expertise of specialists in cardiology, psychology and genetic counseling. They have developed appropriate use criteria

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 43

Department of Pediatrics

THE HEART CENTER

Kaitlin E. L’Italien, MD

The Heart Center at Nationwide Children’s Hospital combines all clinical and research disciplines under one umbrella in order to meet our mission: to improve outcomes by discovering the causes of heart disease and develop novel therapies for our patients, focusing on each as an individual and providing the state-ofthe-art care that all patients deserve, regardless of age. We support the mission of Nationwide Children’s to provide our services in a safe environment focused on family-centered care.

Eric A. Lloyd, MD

FACULTY

Aimee K. Armstrong, MD Carl H. Backes, MD Darren P. Berman, MD Brian A. Boe, MD Jessica L. Bowman, MD Elisa A. Bradley, MD Sergio A. Carrillo Melendez, MD Steven C. Cassidy, MD

Catherine D. Krawczeski, MD Co-Director Chief, Pediatric Cardiology

John P. Cheatham, MD Kristin M. Chenault, MD Marco Corridore, MD Linda H. Cripe, MD Clifford L. Cua, MD Curt J. Daniels, MD Stephen M. Druhan, MD Timothy F. Feltes, MD

Christopher T. McKee, DO Aymen N. Naguib, MD Deipanjan Nandi, MD Kathryn D. Nardell, MD Christina M. Phelps, MD Kerry L. Rosen, MD Daniel G. Rowland, MD Aarthi Sabanayagam, MD Toshiharu Shinoka, MD, PhD Janet M. Simsic, MD Corey A. Stiver, MD Karen M. Texter, MD Andrew Tran, MD Peter D. Winch, MD, MBA Andrew R. Yates, MD Cody M. Young, DO

Highlights •

Continued outstanding surgical outcomes, with overall surgical mortality 2% or less for last two years

•

Implemented new protocols, leading to significant decrease in blood stream infections associated with central intravenous lines in cardiac inpatients

•

Hosted the national 6th Summit on Transparency and Public Reporting of Pediatric and Congenital Heart Disease Outcomes

•

Successfully implemented telemedicine visits to support clinical services during the pandemic

•

Returned to full outpatient clinical volume in May 2020, maintaining infection control practices, with a record number of referrals in June 2020

Jennifer Gauntt, MD Stephen A. Hart, MD Kan N. Hor, MD Anna N. Kamp, MD, MPH Naomi J. Kertesz, MD Omar M. Khalid, MD Sarah Khan, MD John P. Kovalchin, MD

Vidu Garg, MD Director of Translational Research

Rajesh Krishnamurthy, MD Lauren Lastinger, MD Anthony Y. Lee, MD Simon Lee, MD

42 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Funded 10 intramural projects and obtained $2 million in extramural grant funding from National Institutes of Health and Foundation

•

One of five institutions in nation awarded Innovation Funds through Additional Ventures to study single ventricle heart disease

Our heart failure/transplant section, which has been renamed the Pediatric & Adult Advanced Cardiac Therapies (PAACT) program, saw a nearly 75% increase in transplant referrals in the last year and completed five heart transplants. We implanted six ventricular assist devices (VAD) as a bridge to recovery or heart transplant and successfully supported an infant over five months before transplant using the Berlin EXCOR VAD, our longest infant support to date. We anticipate continued VAD program growth, meeting the needs of an increasing population of older pediatric and young adult patients with congenital heart disease. We continue to grow a novel cardio-oncology program to provide ongoing cardiac care to long-term survivors of childhood cancers at risk for or developing cardiomyopathy.

Saurabh Rajpal, MD

Jill A. Fitch, MD

John Kelly, MD

•

The Heart Center continues to grow in both volume and capabilities with record numbers of outpatient visits and diagnostic studies in 2019.

Julie C. O’Donovan, MD

NATIONAL AND INTERNATIONAL REPUTATION

Don Hayes, MD, MS, MEd

Expanded regional outreach adult congenital clinics

Patrick I. McConnell, MD

Richard P. Fernandez, MD Robert J. Gajarski, MD, MHSA Mark E. Galantowicz, MD Co-Director Chief, Cardiothoracic Surgery

May Ling Mah, MD

•

Our cardiac catheterization and interventional therapies team participates in multiple device trials, including new self-expanding transcatheter pulmonary valves (Harmony and Alterra) to broaden nonsurgical valve replacement options for many patients. The team has organized the first multi-center, prospective, randomized trial for PDA device occlusion versus medical management in the premature neonate. Additionally, our catheterization team continues to participate in preclinical research, and has worked to refine the first fully bioabsorbable, tissue-engineered pulmonary valve in an animal fetus and implanted a fully absorbable ASD occluder in a sheep. Through a collaboration among cardiology, interventional radiology and hematology, the lymphatic disorder program is growing, performing diagnostic and interventional procedures for patients with lymphatic disorders. Lastly, the interventional team performed the first heart catheterization in the Midwest guided solely by magnetic resonance imaging (MRI).

As part of a busy clinical arrhythmia service, our electrophysiologist (EP) faculty staff a collaborative, inherited arrhythmia clinic, combining the expertise of specialists in cardiology, psychology and genetic counseling. They have developed appropriate use criteria

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 43

for implantable cardioverter defibrillators in patients with Duchenne muscular dystrophy and implanted the first leadless pacemaker in a child in the U.S. As part of Project Adam Ohio, which is housed at Nationwide Children’s, the EP staff have met with multiple school districts and have expanded to virtual teaching and remote drills to certify more schools in a larger radius, working with each school to guide the appropriate placement of and training in the use of automatic external defibrillators. Additionally, EP faculty are involved in several international multicenter research projects, are on national committees and continue research in the identification of arrhythmias in adults with congenital heart disease.

The Adult Congenital Heart Disease (ACHD) program remains one of the leading programs in the country.

Clinically, the group added a sixth ACHD cardiologist, surpassed 4,500 outpatient visits (largest in the country), expanded to Zanesville, Ohio, (our fifth ACHD outreach location) and maintained surgical and cardiac catheterization outcomes significantly better than published national benchmarks. Academically, the ACHD program published 28 articles this past year including studies in COVID-19 in ACHD patients. They are primary investigators on 14 grants including industry, intramural and NIH funded studies, and have developed national registries to study the impact of COVID-19 in ACHD patients, pulmonary hypertension and athletes. Finally, one of our ACHD faculty and ACHD fellows also developed a national teaching series to provide education for ACHD fellows nationally during the COVID -19 surge.

Cardiothoracic Intensive Care Unit (CTICU) physicians are principal or co-investigators on five extramurally funded grants and one intramural grant. In the last academic year, they authored 19 manuscripts published in peer-reviewed journals. Twelve of the coauthored manuscripts were part of national multicenter studies, including National Emergency Airway Registry for Children (NEAR4KIDS), Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA), Acute Rehabilitation for Kids in the PICU (PARK-PICU) and Collaborative Pediatric Critical Care Research Network (CPCCRN). Additionally, eight abstracts were presented at national and international scientific meetings.

The Fetal Cardiology program continues to grow, with over 1200 visits in 2019 at four sites throughout the region.

Within the Ohio Fetal Medicine Collaborative, the team has developed standard-of-care protocols for fetuses with bradycardia and tachycardia and enhanced collaboration with the Perinatal Palliative Care team. They have been actively involved in the planning and development of a hospital-wide multidisciplinary Fetal Medicine Program.

The fetal cardiac intervention program through the

Congenital Heart Collaborative remains active and is one of only a few centers that has performed intervention in a fetus with pulmonary atresia with intact ventricular septum.

The Non-Invasive Imaging team initiated an AutoStrain program for detailed echocardiographic evaluation of ventricular function and a Point of Care Ultrasound Program (POCUS) in conjunction with emergency physicians. The team remains active in research with three funded investigators and a dedicated research imaging coordinator. New research programs are studying the cardiovascular effects of COVID-19 infection, including myocarditis and the multi-inflammatory syndrome in children (MIS-C), using imaging techniques. The team is also evaluating the appropriate use criteria in ordering echocardiograms.

Advanced Cardiac Imaging (MRI and CT) has shown steady growth in volume and continued innovation from a programmatic and research standpoint. The use of cardiac CT as a complement to echo in neonates and infants has seen remarkable growth with the ability to perform scans without sedation and with low radiation exposure. New programs introduced this year in cardiac MRI include 4D blood pool contrast imaging with ferumoxytol and use of machine learning approaches to rapid reconstruction of cine images. The myocardial stress perfusion MR imaging has seen rapid adoption and integration into the comprehensive MR-based pediatric myocardial characterization toolkit.

Novel research initiatives include creation of a patientspecific flow modeling group that incorporates 3D printing of physical models from advanced imaging and biomechanical flow modeling in the MR environment. The large animal cardiac imaging program continues to support the needs of tissue-engineered vascular graft development group at Nationwide Children’s.

The Heart Center is currently engaged in 20 active quality improvement projects including major projects to improve communication between the CTICU and the step-down unit at the time of transfer, improving 14day clinic access for patients and central line-associated blood stream infection (CLABSI) reduction. As a result of our communications projects, families have reported higher satisfaction during their stay, and the completeness of provider-to-provider handoff for transfer patients has improved. Optimization of the clinic scheduling process, despite challenges imposed by COVID-19, has resulted in a significant increase in timely clinic access for our patients. Finally, a multi-faceted approach, accentuated by physician engagement, to reduce CLABSIs in our patients has been very successful as we have gone >1 year and >250 days CLABSI free on our acute care cardiology ward and CTICU, respectively.

44 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Heart Center and Center for Cardiovascular Research continue to be involved in multiple NIH and industry-funded clinical trials. We participate in multiple interventional cardiology clinical trials and are currently conducting studies involving four types of transcatheter pulmonary valves. In addition, we actively collaborate with Dr. Breuer in the Center for Regenerative Medicine on the tissue-engineered vascular graft clinical trial for our patients with single ventricle heart disease. Lastly, we have several collaborations with scientists in the Abigail Wexner Research Institute studying the genetics of congenital heart disease, physical activity in congenital heart disease patients, and the extent of myocardial injury and complications in symptomatic and asymptomatic pediatric COVID-19 patients.

Center for Cardiovascular Research: See page 182 for information about this center in the Abigail Wexner Research Institute at Nationwide Children’s.

SELECTED PUBLICATIONS 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 Patient Age at Implant and Outcomes After Transcatheter Pulmonary Valve Replacement in the Multicenter Melody Valve Trials. Catheterization and Cardiovascular Interventions. 2019 Oct 1;94:607-617.

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, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Breuer J, Heuer 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 of Stenosis in Tissue-Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537).

Raman SV, Hor KN, Mazur W, Cardona A, He Z, Halnon N, Markham L, Soslow JH, Puchalski MD, Auerbach SR, Truong U, Smart S, McCarthy B, Saeed IM, Statland JM, Kissel 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).

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. Pediatric Quality & Safety. 2019 Nov 25;4(6):e237.

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, 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 Research Network. Survival and CPR Hemodynamics Following Cardiac Arrest in Children with Surgical Compared to Medical Heart Disease. Pediatric Critical Care Medicine. 2019 Dec;20(12):1126-1136.

GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971

FAST FACTS July 2019 through June 2020 Heart Center Inpatient/Observation Inpatient Discharges:..................................................... 702 Observation and Outpatient-in-a-Bed Discharges:........ 443 Total Discharges:........................................................ 1,129 Average Length of Stay*:.............................................. 11.2 Average Daily Census*:................................................ 21.1 Total Patient Days*:.................................................... 7,701 Cardiac ICU Inpatient Discharges:..................................................... 757 Average Length of Stay*:................................................ 4.7 Average Daily Census*:.................................................. 9.8 Total Patient Days*:.................................................... 3,569 Heart Center Clinics Athens Cardiology Clinic Visits:........................................ 69 Blanchard Cardiology (PAA) Clinic Visits:.......................... 35 Cardio Diagnostics (PAA) Clinic Visits:......................... 1,428 Cardiology Clinic Visits (Main Campus):.................... 10,600 Cardiothoracic Surgery Clinic Visits:.............................. 413

Chillicothe Cardiology Clinic Visits:................................ 313 Dayton Cardiology (PAA) Clinic Visits:............................. 176 Dublin Cardiology Clinic Visits:.................................... 1,026 Findlay Cardiology Clinic Visits:........................................ 62 Kawasaki Clinic Visits:..................................................... 59 Lewis Center Cardiology Clinic Visits:......................... 1,571 Lima Cardiology (PAA) Clinic Visits:................................ 365 Lima Memorial Cardiology (PAA) Clinic Visits:.................. 11 Mansfield ACHD Clinic Visits:........................................... 25 Mansfield Cardiology Clinic Visits:................................. 323 Marietta Cardiology Clinic Visits:.................................... 260 Marion Cardiology Clinic Visits:...................................... 138 OSU Cardiology (PAA) Clinic Visits:................................. 214 Portsmouth Cardiology Clinic Visits:............................... 225 Riverside Methodist Cardiology (PAA) Clinic Visits:......... 193 Westerville Cardiology Clinic Visits:................................ 270 Zanesville Cardiology Clinic Visits:................................. 278 *Excludes observation and outpatient-in-a-bed patients.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 45

for implantable cardioverter defibrillators in patients with Duchenne muscular dystrophy and implanted the first leadless pacemaker in a child in the U.S. As part of Project Adam Ohio, which is housed at Nationwide Children’s, the EP staff have met with multiple school districts and have expanded to virtual teaching and remote drills to certify more schools in a larger radius, working with each school to guide the appropriate placement of and training in the use of automatic external defibrillators. Additionally, EP faculty are involved in several international multicenter research projects, are on national committees and continue research in the identification of arrhythmias in adults with congenital heart disease.

The Adult Congenital Heart Disease (ACHD) program remains one of the leading programs in the country.

Clinically, the group added a sixth ACHD cardiologist, surpassed 4,500 outpatient visits (largest in the country), expanded to Zanesville, Ohio, (our fifth ACHD outreach location) and maintained surgical and cardiac catheterization outcomes significantly better than published national benchmarks. Academically, the ACHD program published 28 articles this past year including studies in COVID-19 in ACHD patients. They are primary investigators on 14 grants including industry, intramural and NIH funded studies, and have developed national registries to study the impact of COVID-19 in ACHD patients, pulmonary hypertension and athletes. Finally, one of our ACHD faculty and ACHD fellows also developed a national teaching series to provide education for ACHD fellows nationally during the COVID -19 surge.

Cardiothoracic Intensive Care Unit (CTICU) physicians are principal or co-investigators on five extramurally funded grants and one intramural grant. In the last academic year, they authored 19 manuscripts published in peer-reviewed journals. Twelve of the coauthored manuscripts were part of national multicenter studies, including National Emergency Airway Registry for Children (NEAR4KIDS), Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA), Acute Rehabilitation for Kids in the PICU (PARK-PICU) and Collaborative Pediatric Critical Care Research Network (CPCCRN). Additionally, eight abstracts were presented at national and international scientific meetings.

The Fetal Cardiology program continues to grow, with over 1200 visits in 2019 at four sites throughout the region.

Within the Ohio Fetal Medicine Collaborative, the team has developed standard-of-care protocols for fetuses with bradycardia and tachycardia and enhanced collaboration with the Perinatal Palliative Care team. They have been actively involved in the planning and development of a hospital-wide multidisciplinary Fetal Medicine Program.

The fetal cardiac intervention program through the

Congenital Heart Collaborative remains active and is one of only a few centers that has performed intervention in a fetus with pulmonary atresia with intact ventricular septum.

The Non-Invasive Imaging team initiated an AutoStrain program for detailed echocardiographic evaluation of ventricular function and a Point of Care Ultrasound Program (POCUS) in conjunction with emergency physicians. The team remains active in research with three funded investigators and a dedicated research imaging coordinator. New research programs are studying the cardiovascular effects of COVID-19 infection, including myocarditis and the multi-inflammatory syndrome in children (MIS-C), using imaging techniques. The team is also evaluating the appropriate use criteria in ordering echocardiograms.

Advanced Cardiac Imaging (MRI and CT) has shown steady growth in volume and continued innovation from a programmatic and research standpoint. The use of cardiac CT as a complement to echo in neonates and infants has seen remarkable growth with the ability to perform scans without sedation and with low radiation exposure. New programs introduced this year in cardiac MRI include 4D blood pool contrast imaging with ferumoxytol and use of machine learning approaches to rapid reconstruction of cine images. The myocardial stress perfusion MR imaging has seen rapid adoption and integration into the comprehensive MR-based pediatric myocardial characterization toolkit.

Novel research initiatives include creation of a patientspecific flow modeling group that incorporates 3D printing of physical models from advanced imaging and biomechanical flow modeling in the MR environment. The large animal cardiac imaging program continues to support the needs of tissue-engineered vascular graft development group at Nationwide Children’s.

The Heart Center is currently engaged in 20 active quality improvement projects including major projects to improve communication between the CTICU and the step-down unit at the time of transfer, improving 14day clinic access for patients and central line-associated blood stream infection (CLABSI) reduction. As a result of our communications projects, families have reported higher satisfaction during their stay, and the completeness of provider-to-provider handoff for transfer patients has improved. Optimization of the clinic scheduling process, despite challenges imposed by COVID-19, has resulted in a significant increase in timely clinic access for our patients. Finally, a multi-faceted approach, accentuated by physician engagement, to reduce CLABSIs in our patients has been very successful as we have gone >1 year and >250 days CLABSI free on our acute care cardiology ward and CTICU, respectively.

44 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Heart Center and Center for Cardiovascular Research continue to be involved in multiple NIH and industry-funded clinical trials. We participate in multiple interventional cardiology clinical trials and are currently conducting studies involving four types of transcatheter pulmonary valves. In addition, we actively collaborate with Dr. Breuer in the Center for Regenerative Medicine on the tissue-engineered vascular graft clinical trial for our patients with single ventricle heart disease. Lastly, we have several collaborations with scientists in the Abigail Wexner Research Institute studying the genetics of congenital heart disease, physical activity in congenital heart disease patients, and the extent of myocardial injury and complications in symptomatic and asymptomatic pediatric COVID-19 patients.

Center for Cardiovascular Research: See page 182 for information about this center in the Abigail Wexner Research Institute at Nationwide Children’s.

SELECTED PUBLICATIONS 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 Patient Age at Implant and Outcomes After Transcatheter Pulmonary Valve Replacement in the Multicenter Melody Valve Trials. Catheterization and Cardiovascular Interventions. 2019 Oct 1;94:607-617.

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, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Breuer J, Heuer 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 of Stenosis in Tissue-Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537).

Raman SV, Hor KN, Mazur W, Cardona A, He Z, Halnon N, Markham L, Soslow JH, Puchalski MD, Auerbach SR, Truong U, Smart S, McCarthy B, Saeed IM, Statland JM, Kissel 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).

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. Pediatric Quality & Safety. 2019 Nov 25;4(6):e237.

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, 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 Research Network. Survival and CPR Hemodynamics Following Cardiac Arrest in Children with Surgical Compared to Medical Heart Disease. Pediatric Critical Care Medicine. 2019 Dec;20(12):1126-1136.

GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971

FAST FACTS July 2019 through June 2020 Heart Center Inpatient/Observation Inpatient Discharges:..................................................... 702 Observation and Outpatient-in-a-Bed Discharges:........ 443 Total Discharges:........................................................ 1,129 Average Length of Stay*:.............................................. 11.2 Average Daily Census*:................................................ 21.1 Total Patient Days*:.................................................... 7,701 Cardiac ICU Inpatient Discharges:..................................................... 757 Average Length of Stay*:................................................ 4.7 Average Daily Census*:.................................................. 9.8 Total Patient Days*:.................................................... 3,569 Heart Center Clinics Athens Cardiology Clinic Visits:........................................ 69 Blanchard Cardiology (PAA) Clinic Visits:.......................... 35 Cardio Diagnostics (PAA) Clinic Visits:......................... 1,428 Cardiology Clinic Visits (Main Campus):.................... 10,600 Cardiothoracic Surgery Clinic Visits:.............................. 413

Chillicothe Cardiology Clinic Visits:................................ 313 Dayton Cardiology (PAA) Clinic Visits:............................. 176 Dublin Cardiology Clinic Visits:.................................... 1,026 Findlay Cardiology Clinic Visits:........................................ 62 Kawasaki Clinic Visits:..................................................... 59 Lewis Center Cardiology Clinic Visits:......................... 1,571 Lima Cardiology (PAA) Clinic Visits:................................ 365 Lima Memorial Cardiology (PAA) Clinic Visits:.................. 11 Mansfield ACHD Clinic Visits:........................................... 25 Mansfield Cardiology Clinic Visits:................................. 323 Marietta Cardiology Clinic Visits:.................................... 260 Marion Cardiology Clinic Visits:...................................... 138 OSU Cardiology (PAA) Clinic Visits:................................. 214 Portsmouth Cardiology Clinic Visits:............................... 225 Riverside Methodist Cardiology (PAA) Clinic Visits:......... 193 Westerville Cardiology Clinic Visits:................................ 270 Zanesville Cardiology Clinic Visits:................................. 278 *Excludes observation and outpatient-in-a-bed patients.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 45

Department of Pediatrics

CARDIOLOGY

A Decade of Remarkable Transformation

Cardiology is a Section of the Department of Pediatrics and an integral part of The Heart Center at Nationwide Children’s Hospital. See page 40 for complete details.

THE HEART CENTER World's First Hybrid Catheterization Suite and Operating Room

2010 Six-year-old Receives First Bloodless Heart Transplant

2010

Fetal Intervention Program Launches

Congenital Heart Collaborative Launches

2012

2013 2016

2014

Preeminent Tissue-Engineering Program First in the World to Tissue Engineer Blood Vessels and Implant Them in Human Infants for Repair of Congenital Heart Defects

FACULTY

2017 2020 2017 2018

Whole Exome Sequencing Used to Identify Causes of Congenital Heart Disease

The Heart Center at Nationwide Children’s is one of the nation’s top programs for diagnosis and treatment of congenital and acquired heart conditions in children. From fetal diagnosis and intervention, to long-term adult congenital care, our program has remained dedicated to providing the highest quality of comprehensive care.

Catherine D. Krawczeski, MD Division Chief, Cardiology

Robert J. Gajarski, MD, MHSA Section Chief, Cardiology Aimee K. Armstrong, MD Carl H. Backes, MD Darren P. Berman, MD Brian A. Boe, MD Jessica L. Bowman, MD Elisa A. Bradley, MD Steven C. Cassidy, MD John P. Cheatham, MD Linda H. Cripe, MD Clifford L. Cua, MD Curt J. Daniels, MD Timothy F. Feltes, MD Richard P. Fernandez, MD Jill A. Fitch, MD Vidu Garg, MD Jennifer Gauntt, MD Stephen A. Hart, MD

46 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Kan N. Hor, MD Anna N. Kamp, MD, MPH John Kelly, MD Naomi J. Kertesz, MD Omar M. Khalid, MD John P. Kovalchin, MD Lauren Lastinger, MD Anthony Y. Lee, MD Simon Lee, MD Kaitlin E. L’Italien, MD Eric A. Lloyd, MD May L. Mah, MD 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 Andrew Tran, MD Andrew R. Yates, MD GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971 SELECTED PUBLICATIONS 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 Patient Age at Implant and Outcomes After Transcatheter Pulmonary Valve Replacement in the Multicenter Melody Valve Trials. Catheterization and Cardiovascular Interventions. 2019 Oct 1;94:607-617.

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, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Breuer J, Heuer 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 of Stenosis in Tissue-Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537).

Raman SV, Hor KN, Mazur W, Cardona A, He Z, Halnon N, Markham L, Soslow JH, Puchalski MD, Auerbach SR, Truong U, Smart S, McCarthy B, Saeed IM, Statland JM, Kissel 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).

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 47

Department of Pediatrics

CARDIOLOGY

A Decade of Remarkable Transformation

Cardiology is a Section of the Department of Pediatrics and an integral part of The Heart Center at Nationwide Children’s Hospital. See page 40 for complete details.

THE HEART CENTER World's First Hybrid Catheterization Suite and Operating Room

2010 Six-year-old Receives First Bloodless Heart Transplant

2010

Fetal Intervention Program Launches

Congenital Heart Collaborative Launches

2012

2013 2016

2014

Preeminent Tissue-Engineering Program First in the World to Tissue Engineer Blood Vessels and Implant Them in Human Infants for Repair of Congenital Heart Defects

FACULTY

2017 2020 2017 2018

Whole Exome Sequencing Used to Identify Causes of Congenital Heart Disease

The Heart Center at Nationwide Children’s is one of the nation’s top programs for diagnosis and treatment of congenital and acquired heart conditions in children. From fetal diagnosis and intervention, to long-term adult congenital care, our program has remained dedicated to providing the highest quality of comprehensive care.

Catherine D. Krawczeski, MD Division Chief, Cardiology

Robert J. Gajarski, MD, MHSA Section Chief, Cardiology Aimee K. Armstrong, MD Carl H. Backes, MD Darren P. Berman, MD Brian A. Boe, MD Jessica L. Bowman, MD Elisa A. Bradley, MD Steven C. Cassidy, MD John P. Cheatham, MD Linda H. Cripe, MD Clifford L. Cua, MD Curt J. Daniels, MD Timothy F. Feltes, MD Richard P. Fernandez, MD Jill A. Fitch, MD Vidu Garg, MD Jennifer Gauntt, MD Stephen A. Hart, MD

46 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Kan N. Hor, MD Anna N. Kamp, MD, MPH John Kelly, MD Naomi J. Kertesz, MD Omar M. Khalid, MD John P. Kovalchin, MD Lauren Lastinger, MD Anthony Y. Lee, MD Simon Lee, MD Kaitlin E. L’Italien, MD Eric A. Lloyd, MD May L. Mah, MD 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 Andrew Tran, MD Andrew R. Yates, MD GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971 SELECTED PUBLICATIONS 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 Patient Age at Implant and Outcomes After Transcatheter Pulmonary Valve Replacement in the Multicenter Melody Valve Trials. Catheterization and Cardiovascular Interventions. 2019 Oct 1;94:607-617.

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, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Breuer J, Heuer 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 of Stenosis in Tissue-Engineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537).

Raman SV, Hor KN, Mazur W, Cardona A, He Z, Halnon N, Markham L, Soslow JH, Puchalski MD, Auerbach SR, Truong U, Smart S, McCarthy B, Saeed IM, Statland JM, Kissel 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).

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.

Pediatric Quality & Safety. 2019 Nov 25;4(6):e237.

2019 – 2020 NATIONWIDE CHILDREN’S 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, 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 Research Network. Survival and CPR Hemodynamics Following Cardiac Arrest in Children with Surgical Compared to Medical Heart Disease. Pediatric Critical Care Medicine. 2019 Dec;20(12):1126-1136.

ADULT CONGENITAL HEART DISEASE Anudeep Dodeja, MD Marc Lee, MD 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

48 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 49

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.

Pediatric Quality & Safety. 2019 Nov 25;4(6):e237.

2019 – 2020 NATIONWIDE CHILDREN’S 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, 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 Research Network. Survival and CPR Hemodynamics Following Cardiac Arrest in Children with Surgical Compared to Medical Heart Disease. Pediatric Critical Care Medicine. 2019 Dec;20(12):1126-1136.

ADULT CONGENITAL HEART DISEASE Anudeep Dodeja, MD Marc Lee, MD 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

48 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 49

Department of Pediatrics

CHILD AND FAMILY ADVOCACY

FAST FACTS

SELECTED PUBLICATIONS

The Section of Child and Family Advocacy housed within the Center for Family Safety and Healing at Nationwide Children’s Hospital is home to a team of board-certified child abuse pediatricians and advancedpractice nurse practitioners who are nationally recognized child maltreatment experts with an emphasis on physical abuse, sexual abuse and medical child abuse. The Center for Family Safety and Healing is a multidisciplinary organization that provides coordinated and comprehensive services in the prevention, diagnosis and treatment of family violence. As a national leader in this important work, a team of more than 120 professionals representing medicine, behavioral health, social services, law enforcement, prosecution and children services are co-located at the center to address the complex issues of family violence.

Bressler CJ, Letson MM, Kline D, McCarthy T, Davis J, Leonard JC. Characteristics 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

Hornor G, Sherfield J, Tscholl J. Teen Knowledge of Commercial Sexual Exploitation of Children. The Journal of Pediatric Health Care. 2020 May 1;34(3):239-245.

Clinic Visits:................................................................ 1,528

Letson MM, Davis C, Sherfield J, Beer OWJ, Phillips R, Wolf KG. Identifying Compassion Satisfaction, Burnout, & Traumatic Stress in Children’s Advocacy Centers.

Child Abuse & Neglect. 2019 Nov 8;104240.

Sharon Woods Foster Care Clinic Visits:......................... 316

Zins ZP, Wheeler KK, Brink F, Armstrong M, Shi J, Groner JI, Xiang H. Trends in US Physician Diagnosis of Child Physical Abuse and Neglect Injuries. 2006-2014. Child Abuse & Neglect. 2019 Dec; 98:104179.

Foster Care Clinic Visits:............................................. 1,448 Eastland Foster Care Clinic Visits:.................................. 220 Inpatient Consults (Child Abuse Team):.......................... 553 Non-Accidental TBI Clinic Visits:...................................... 48 Total Clinic Visits:........................................................ 3,560

FACULTY

Megan M. Letson, MD, MEd Chief Farah W. Brink, MD Kristin G. Crichton, DO, MPH Catherine M. Huber, MD Jennifer J. Tscholl, MD The Section of Child and Family Advocacy provides comprehensive evaluation and management of child maltreatment, offering inpatient and outpatient services.

Key services include the Child Assessment Center, Fostering Connections Program, Non-Accidental Traumatic Brain Injury Clinic and inpatient consultations.

The Child Assessment Center offers a coordinated response to family violence for families through partnerships with law enforcement, children services and a range of community resources. Through a collaborative effort with the Emergency Department, we provide suspected child abuse assessments after clinic hours by utilizing on-call forensic interviewers and pediatric sexual assault nurse examiners in the emergency department setting.

three different locations and serves as a medical home for children in out-of-home placement.

The section remains committed to providing quality educational experiences for trainees, including medical student and pediatric resident electives. Under the direction of Megan M. Letson, MD, MEd, the Child Abuse Pediatrics Fellowship is an Accreditation Council for Graduate Medical Education-accredited program and continues to attract excellent trainees. Additionally, in collaboration with Pediatric Emergency Medicine, we are one of a few programs nationally to offer a combined four-year Child Abuse Pediatrics and Pediatric Emergency Medicine Fellowship.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM CHILD ABUSE PEDIATRICS Nicole Barrett, MD Michelle Greene, DO (Combined Child Abuse Pediatrics and Pediatric Emergency Medicine Fellow)

Members of the section continue to be recognized nationally, including representation on the American Board of Pediatrics Sub-board on Child Abuse Pediatrics and on multiple Ray Helfer Society committees.

Additionally, faculty continue a tradition of national speaking engagements, including the Huntsville International Symposium on Child Abuse. During the past year, faculty work has been presented at the American Academy of Pediatrics National Conference and Exhibition, American Public Health Association, Society for Pediatric Radiology Annual Meeting, and the Ray Helfer Society Annual Meeting.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,585,946

As a clinical partnership with Franklin County Children Services, the Fostering Connections Program is offered at

50 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 51

Department of Pediatrics

CHILD AND FAMILY ADVOCACY

FAST FACTS

SELECTED PUBLICATIONS

The Section of Child and Family Advocacy housed within the Center for Family Safety and Healing at Nationwide Children’s Hospital is home to a team of board-certified child abuse pediatricians and advancedpractice nurse practitioners who are nationally recognized child maltreatment experts with an emphasis on physical abuse, sexual abuse and medical child abuse. The Center for Family Safety and Healing is a multidisciplinary organization that provides coordinated and comprehensive services in the prevention, diagnosis and treatment of family violence. As a national leader in this important work, a team of more than 120 professionals representing medicine, behavioral health, social services, law enforcement, prosecution and children services are co-located at the center to address the complex issues of family violence.

Bressler CJ, Letson MM, Kline D, McCarthy T, Davis J, Leonard JC. Characteristics 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

Hornor G, Sherfield J, Tscholl J. Teen Knowledge of Commercial Sexual Exploitation of Children. The Journal of Pediatric Health Care. 2020 May 1;34(3):239-245.

Clinic Visits:................................................................ 1,528

Letson MM, Davis C, Sherfield J, Beer OWJ, Phillips R, Wolf KG. Identifying Compassion Satisfaction, Burnout, & Traumatic Stress in Children’s Advocacy Centers.

Child Abuse & Neglect. 2019 Nov 8;104240.

Sharon Woods Foster Care Clinic Visits:......................... 316

Zins ZP, Wheeler KK, Brink F, Armstrong M, Shi J, Groner JI, Xiang H. Trends in US Physician Diagnosis of Child Physical Abuse and Neglect Injuries. 2006-2014. Child Abuse & Neglect. 2019 Dec; 98:104179.

Foster Care Clinic Visits:............................................. 1,448 Eastland Foster Care Clinic Visits:.................................. 220 Inpatient Consults (Child Abuse Team):.......................... 553 Non-Accidental TBI Clinic Visits:...................................... 48 Total Clinic Visits:........................................................ 3,560

FACULTY

Megan M. Letson, MD, MEd Chief Farah W. Brink, MD Kristin G. Crichton, DO, MPH Catherine M. Huber, MD Jennifer J. Tscholl, MD The Section of Child and Family Advocacy provides comprehensive evaluation and management of child maltreatment, offering inpatient and outpatient services.

Key services include the Child Assessment Center, Fostering Connections Program, Non-Accidental Traumatic Brain Injury Clinic and inpatient consultations.

The Child Assessment Center offers a coordinated response to family violence for families through partnerships with law enforcement, children services and a range of community resources. Through a collaborative effort with the Emergency Department, we provide suspected child abuse assessments after clinic hours by utilizing on-call forensic interviewers and pediatric sexual assault nurse examiners in the emergency department setting.

three different locations and serves as a medical home for children in out-of-home placement.

The section remains committed to providing quality educational experiences for trainees, including medical student and pediatric resident electives. Under the direction of Megan M. Letson, MD, MEd, the Child Abuse Pediatrics Fellowship is an Accreditation Council for Graduate Medical Education-accredited program and continues to attract excellent trainees. Additionally, in collaboration with Pediatric Emergency Medicine, we are one of a few programs nationally to offer a combined four-year Child Abuse Pediatrics and Pediatric Emergency Medicine Fellowship.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM CHILD ABUSE PEDIATRICS Nicole Barrett, MD Michelle Greene, DO (Combined Child Abuse Pediatrics and Pediatric Emergency Medicine Fellow)

Members of the section continue to be recognized nationally, including representation on the American Board of Pediatrics Sub-board on Child Abuse Pediatrics and on multiple Ray Helfer Society committees.

Additionally, faculty continue a tradition of national speaking engagements, including the Huntsville International Symposium on Child Abuse. During the past year, faculty work has been presented at the American Academy of Pediatrics National Conference and Exhibition, American Public Health Association, Society for Pediatric Radiology Annual Meeting, and the Ray Helfer Society Annual Meeting.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,585,946

As a clinical partnership with Franklin County Children Services, the Fostering Connections Program is offered at

50 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 51

Department of Pediatrics

CLINICAL INFORMATICS The Division of Clinical Informatics at Nationwide Children’s Hospital aims to transform health care through design, implementation and optimization of information and communication systems. Our goal is to enhance patient care activities with safe and reliable information systems, improve individual and population health outcomes through the use of technology and digital tools, enable innovation and research across the institution, and empower our patients and families with the tools they need to engage effectively with their health care team and our health care system.

FACULTY

Jeffrey M. Hoffman, MD Chief Aarti R. Chandawarkar, MD Juan D. Chaparro, MD, MS Jennifer A. Lee, MD Simon Lin, MD, MS, MBA Kathryn E. Nuss, MD Laura Rust, MD, MPH The faculty and fellows in the Division of Clinical Informatics work to enhance the effectiveness of our clinical information systems and to provide expert consultation to operational leaders, clinicians and investigators across the institution. We collaborate with other divisions and disciplines to improve tools for clinical documentation, patient management, population health, quality improvement and research.

No doubt 2020 will be a year to be remembered. In the face of a pandemic, our division worked tirelessly with our colleagues to provide the best patient care and the safest working environment possible. Within a few weeks, our division worked with clinical and IT teams to develop

new documentation and decision support tools for COVID-19. We collaborated on the deployment of the 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.

Sezgin E, Noritz G, Elek A, Conkol K, Rust S, Bailey M, Strouse R, Chandawarkar A, von Sadovszky V, Lin S, Huang Y. Capturing At-Home Health and Care Information for Children with Medical Complexity Using Voice Interactive Technologies: Multi-Stakeholder Viewpoint. The Journal of Medical Internet Research. 2020 Feb 13;22(2):e14202.

Stukus D, Patrick M, Nuss KE. Social Media for Medical Professionals – Strategies for Successfully Engaging in an Online World. 2019. Cham, Switzerland: Springer International Publishing AG; 2019.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM CLINICAL INFORMATICS Jennifer A. Lee, MD Samuel Yang, MD

At the same time, we provided the new Big Lots Behavioral Health Pavilion staff with technology and tools to address their unique patient needs. We continued to refine our pediatric sepsis detection model, which the software company Epic adopted as their standard predictive model, offered free of charge to other children’s hospitals across the country. We revamped our influenza vaccination decision support tools, which led to 5,000 more vaccinated children this season than last. Overall, despite these unprecedented times, we have many great accomplishments to celebrate this year, not the least of which is our most recent fellowship graduate, Dr. Jennifer Lee, who will be joining our division permanently.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $72,100 SELECTED PUBLICATIONS Chaparro JD, Hussain C, Lee JA, Hehmeyer J, Nguyen M, Hoffman J. Reducing Interruptive Alert Burden Using Quality Improvement Methodology. Applied Clinical 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. The Vitals Risk Index-Retrospective Performance Analysis of an Automated and Objective Pediatric Early Warning System. Pediatric Quality & Safety. 2020 Mar 20;5(2):e271.

Mezoff EA, Minneci PC, Hoyt RR, Hoffman JM. Toward an Electronic Health Record Leveraged to Learn from Every Complex Patient Encounter: Health Informatics Considerations with Pediatric Intestinal Rehabilitation as a Model. The Journal of Pediatrics. 2019 Dec;215:257-263.

52 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 53

Department of Pediatrics

CLINICAL INFORMATICS The Division of Clinical Informatics at Nationwide Children’s Hospital aims to transform health care through design, implementation and optimization of information and communication systems. Our goal is to enhance patient care activities with safe and reliable information systems, improve individual and population health outcomes through the use of technology and digital tools, enable innovation and research across the institution, and empower our patients and families with the tools they need to engage effectively with their health care team and our health care system.

FACULTY

Jeffrey M. Hoffman, MD Chief Aarti R. Chandawarkar, MD Juan D. Chaparro, MD, MS Jennifer A. Lee, MD Simon Lin, MD, MS, MBA Kathryn E. Nuss, MD Laura Rust, MD, MPH The faculty and fellows in the Division of Clinical Informatics work to enhance the effectiveness of our clinical information systems and to provide expert consultation to operational leaders, clinicians and investigators across the institution. We collaborate with other divisions and disciplines to improve tools for clinical documentation, patient management, population health, quality improvement and research.

No doubt 2020 will be a year to be remembered. In the face of a pandemic, our division worked tirelessly with our colleagues to provide the best patient care and the safest working environment possible. Within a few weeks, our division worked with clinical and IT teams to develop

new documentation and decision support tools for COVID-19. We collaborated on the deployment of the 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.

Sezgin E, Noritz G, Elek A, Conkol K, Rust S, Bailey M, Strouse R, Chandawarkar A, von Sadovszky V, Lin S, Huang Y. Capturing At-Home Health and Care Information for Children with Medical Complexity Using Voice Interactive Technologies: Multi-Stakeholder Viewpoint. The Journal of Medical Internet Research. 2020 Feb 13;22(2):e14202.

Stukus D, Patrick M, Nuss KE. Social Media for Medical Professionals – Strategies for Successfully Engaging in an Online World. 2019. Cham, Switzerland: Springer International Publishing AG; 2019.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM CLINICAL INFORMATICS Jennifer A. Lee, MD Samuel Yang, MD

At the same time, we provided the new Big Lots Behavioral Health Pavilion staff with technology and tools to address their unique patient needs. We continued to refine our pediatric sepsis detection model, which the software company Epic adopted as their standard predictive model, offered free of charge to other children’s hospitals across the country. We revamped our influenza vaccination decision support tools, which led to 5,000 more vaccinated children this season than last. Overall, despite these unprecedented times, we have many great accomplishments to celebrate this year, not the least of which is our most recent fellowship graduate, Dr. Jennifer Lee, who will be joining our division permanently.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $72,100 SELECTED PUBLICATIONS Chaparro JD, Hussain C, Lee JA, Hehmeyer J, Nguyen M, Hoffman J. Reducing Interruptive Alert Burden Using Quality Improvement Methodology. Applied Clinical 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. The Vitals Risk Index-Retrospective Performance Analysis of an Automated and Objective Pediatric Early Warning System. Pediatric Quality & Safety. 2020 Mar 20;5(2):e271.

Mezoff EA, Minneci PC, Hoyt RR, Hoffman JM. Toward an Electronic Health Record Leveraged to Learn from Every Complex Patient Encounter: Health Informatics Considerations with Pediatric Intestinal Rehabilitation as a Model. The Journal of Pediatrics. 2019 Dec;215:257-263.

52 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 53

Department of Pediatrics

COMMUNITY PEDIATRICS The Section of Community Pediatrics at Nationwide Children’s Hospital includes community physicians in pediatrics and internal medicine/pediatrics who are affiliated with Nationwide Children’s. Many of these physicians participate in the Pediatric Education in Community Sites (PECS) program. This provides residents with a very different kind of outpatient experience than that of a traditional hospitalbased practice. Beginning in their first or second year, each resident is assigned to an additional half-day continuity experience in a private practice. This offers thorough exposure to general pediatric practice and reinforces the relationship between Nationwide Children’s and the community physicians.

Robert W. Snyder, MD Chief Wahida B. Abaza, MD Nikola T. Al-ain, MD Ilona B. Albrecht, DO Benjamin P. Almasanu, DO Lacey J. Althausen, MD Mary S. Applegate, MD Nardia S. Ataman, MD Jennifer E. Bachman, MD Taylor A. Ballenger, MD Richard A. Baltisberger, MD Lauren C. Bar-Lev, MD Carrie J. Barnes-Mullett, MD Brent M. Barson, DO Ryan M. Barson, MD Courtney R. Bartsch, MD Steven M. Bass, DO Heather A. Battles, MD Stephen R. Bauer, DO Sarah A. Behrens, MD Anne M. Bever, MD Cynthia J. Black, MD Kathleen D. Blake, MD

Kimberly K. Blazer, MD Denise L. Blocker, MD Eileen C. Bolton, MD Wanda C. Boudinot, MD Sandra L. Boyle, MD Richard J. Breen, MD Steven Randall Brown, MD James A. Bryant, MD Michelle S. Buendia, MD Kyle Burghgraef, MD Jennifer L. Burkam, MD Shari L. Burns, MD Bethany J. Caldwell, MD Mitchell R. Camp, MD Jennifer H. Campbell, MD Patricia A. Cannon, MD Stephen M. Canowitz, MD Ali M. Carine, DO Jennifer B. Carlos, MD Mary B. Cass, MD Benjamin W. Cole, MD Kathleen A. Costlow, MD Sidney L. Couling, MD Jeffrey W. Crecelius, MD Elizabeth A. Crickard, DO Ann M. Croft, MD Camilla Curren, MD Omolara Y. Dairo, MD Virginia K. De Verteuil, MD Amy E. Deibel, MD Antonio J. DelRosario, MD Traci A. DeVoe, MD Praveena V. Dhawale, MD Michael T. DiBartola, MD

54 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Kevin M. Dickerson, MD Bradley E. Dickson, MD Dawn C. Dillinger, DO Kent W. Doherty, DO Lorna F. Donovan, MD Dennis M. Doody, MD James R. Dorado, MD Julie M. Dunlea, MD Kimberly A. Eilerman, DO Alicia D. Fenn, MD Emily T. Ferguson, MD Lenora A. Fitton, DO Patricia A. Francis, MD Michael R. Franks, MD Brad E. Fuller, MD Kathleen T. Fulop, MD Patricia T. Gabbe, MD Raju R. Gaglani, MD Barbara B. Galantowicz, MD Jessica M. Gefvert, MD Monica C. Gilbert, MD Kathryn L. Ginocchi, MD Jumana C. Giragos, MD Charles M. Goddard, MD Erin L. Goist, MD Michelle C. Golla, MD Anna C. Gray, MD Emily K. Gray, MD Patrick J. Gross, DO Dawn S. Hackshaw, MD Dana L. Hamilton, DO Daniel J. Heinmiller, MD John S. Heintz, MD Lawrence P. Heiny, MD

Megan E. Heitzman, MD David E. Henderson, MD Christopher B. Houts, MD Elizabeth M. Jacob, MD Julie R. Javorek, MD Ranee M. Jostpille, MD Enaas F. Kasheer, MD Stephen L. Kebe, MD Lisa A. Kelch, MD Andrew M. Keller, MD Sara M. Kelly, MD Richard A. Kern, MD Anja Kiel, MD Cheryl K. Kirkby, MD Adam M. Kirkland, MD Elizabeth L. Kirkland, MD William E.C. Knobeloch, MD Irene P. Koesters, MD Stephen C. Koesters, MD Maureen P. Kollar, DO Andrew S. Korcal, MD Katherine J. Krueck, MD Justin K. Krueger, MD Lisa A. Krumm, MD Celina M. LaBrec-Salmons, MD Robert C. LaMonte, MD Kristina M. Lehman, MD Michael J. Leymaster, MD Bradley A. Lisko, MD Elizabeth A. Little, MD Anne D. Littleton, MD Michael C. Loar, MD William W. Long, MD Tricia W. Lucin, MD Eileen M. Maher, MD Michele V. Mahoney, MD Jason W. Mailloux, MD Gwynette M. Marschall, MD Jennifer J. Mastruserio, MD Derek A. McClellan, MD Donna J. McDonald, MD Meera R. Mehta, MD George M. Messick, MD

Bruce P. Meyer, MD Leslie C. Meyers-Joseph, MD Cameron K. Miller, MD Bruce R. Mirvis, MD Stacy L. Morran, MD Matthew J. Morrison, MD Mark A. Muresan, MD Jill A. Neff, DO Mary-Lynn Niland, MD Autumn M. O’Brien, MD Adebomi A. Omikunle, MD Janet S. Orr, MD Lilliam I. Ortiz, MD Laura E. Osthaus, MD Jennifer Killion Overbey, MD Divya S. Parikh, MD Melissa M. Parsons, MD Jacqueline S. Pennywitt, MD Michael A. Perry, MD Richard A. Petrella, MD Brad T. Pfau, MD Laura D. Phillips-Chou, MD Domenico Pietropaolo, MD Phyllis Jo Polas, DO L. Robert Polster, MD Danielle S. Pottinger, MD M. Bonnie Pugh, MD Blake J. Randolph, MD Barbara B. Rayo, MD Teresa R. Recker Gross, DO Robert D. Reis, MD Darryl A. Robbins, DO Ann M. Rogers, MD J. Tyler Rogers, MD Patricia A. Ryan, MD Purbi S. Sahai, MD Timothy R. Savage, MD Erin K. Schaffner, MD Elizabeth A. Schloss, MD Dana J. Schultz, MD W. Andrew Searcy, MD Eileen H. Sheets, MD Larry M. Shepherd, MD

Phillip N. Simon, MD Rebecca M. Slaunwhite, MD Brandi F. Spitler, DO Donna L. Sterling, MD Nicholas S. Stevens, MD Wendy K. Stevens, MD Kathleen C. Stiles, MD Miller J. Sullivan, Jr., MD Nazhat Taj-Schaal, MD Ellen R. Tamburello, MD Katrina S. Tansky, MD Renee S. Taylor, MD Amy Rachelle A. TeleronKhorshad, MD Timothy A. Teller, MD Mark A. Thoma, MD Craig R. Thompson, MD Kristin E. Thompson, MD John D. Toth, MD Bonny M. Tsai, MD Ahmed J. Turjoman, MD H. Scott Tyson, MD Sean M. Vellucci, MD Victoria N. Vinsant, MD Diana T. Wagner, MD Laura E. Walawender, MD James D. Ward, MD Lawrence B. Watkins, MD Olivia N. Westhoven, MD Ray S. Wheasler, III, MD Elizabeth R. Whitaker, MD Jennifer R. White, MD Matthew M. White, MD Melissa D. Winterhalter, MD Kathleen M. Wodarcyk, MD Lindsay A. Wylie, MD Michelle E. Yaw, MD Becky Zhao, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 55

Department of Pediatrics

COMMUNITY PEDIATRICS The Section of Community Pediatrics at Nationwide Children’s Hospital includes community physicians in pediatrics and internal medicine/pediatrics who are affiliated with Nationwide Children’s. Many of these physicians participate in the Pediatric Education in Community Sites (PECS) program. This provides residents with a very different kind of outpatient experience than that of a traditional hospitalbased practice. Beginning in their first or second year, each resident is assigned to an additional half-day continuity experience in a private practice. This offers thorough exposure to general pediatric practice and reinforces the relationship between Nationwide Children’s and the community physicians.

Robert W. Snyder, MD Chief Wahida B. Abaza, MD Nikola T. Al-ain, MD Ilona B. Albrecht, DO Benjamin P. Almasanu, DO Lacey J. Althausen, MD Mary S. Applegate, MD Nardia S. Ataman, MD Jennifer E. Bachman, MD Taylor A. Ballenger, MD Richard A. Baltisberger, MD Lauren C. Bar-Lev, MD Carrie J. Barnes-Mullett, MD Brent M. Barson, DO Ryan M. Barson, MD Courtney R. Bartsch, MD Steven M. Bass, DO Heather A. Battles, MD Stephen R. Bauer, DO Sarah A. Behrens, MD Anne M. Bever, MD Cynthia J. Black, MD Kathleen D. Blake, MD

Kimberly K. Blazer, MD Denise L. Blocker, MD Eileen C. Bolton, MD Wanda C. Boudinot, MD Sandra L. Boyle, MD Richard J. Breen, MD Steven Randall Brown, MD James A. Bryant, MD Michelle S. Buendia, MD Kyle Burghgraef, MD Jennifer L. Burkam, MD Shari L. Burns, MD Bethany J. Caldwell, MD Mitchell R. Camp, MD Jennifer H. Campbell, MD Patricia A. Cannon, MD Stephen M. Canowitz, MD Ali M. Carine, DO Jennifer B. Carlos, MD Mary B. Cass, MD Benjamin W. Cole, MD Kathleen A. Costlow, MD Sidney L. Couling, MD Jeffrey W. Crecelius, MD Elizabeth A. Crickard, DO Ann M. Croft, MD Camilla Curren, MD Omolara Y. Dairo, MD Virginia K. De Verteuil, MD Amy E. Deibel, MD Antonio J. DelRosario, MD Traci A. DeVoe, MD Praveena V. Dhawale, MD Michael T. DiBartola, MD

54 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Kevin M. Dickerson, MD Bradley E. Dickson, MD Dawn C. Dillinger, DO Kent W. Doherty, DO Lorna F. Donovan, MD Dennis M. Doody, MD James R. Dorado, MD Julie M. Dunlea, MD Kimberly A. Eilerman, DO Alicia D. Fenn, MD Emily T. Ferguson, MD Lenora A. Fitton, DO Patricia A. Francis, MD Michael R. Franks, MD Brad E. Fuller, MD Kathleen T. Fulop, MD Patricia T. Gabbe, MD Raju R. Gaglani, MD Barbara B. Galantowicz, MD Jessica M. Gefvert, MD Monica C. Gilbert, MD Kathryn L. Ginocchi, MD Jumana C. Giragos, MD Charles M. Goddard, MD Erin L. Goist, MD Michelle C. Golla, MD Anna C. Gray, MD Emily K. Gray, MD Patrick J. Gross, DO Dawn S. Hackshaw, MD Dana L. Hamilton, DO Daniel J. Heinmiller, MD John S. Heintz, MD Lawrence P. Heiny, MD

Megan E. Heitzman, MD David E. Henderson, MD Christopher B. Houts, MD Elizabeth M. Jacob, MD Julie R. Javorek, MD Ranee M. Jostpille, MD Enaas F. Kasheer, MD Stephen L. Kebe, MD Lisa A. Kelch, MD Andrew M. Keller, MD Sara M. Kelly, MD Richard A. Kern, MD Anja Kiel, MD Cheryl K. Kirkby, MD Adam M. Kirkland, MD Elizabeth L. Kirkland, MD William E.C. Knobeloch, MD Irene P. Koesters, MD Stephen C. Koesters, MD Maureen P. Kollar, DO Andrew S. Korcal, MD Katherine J. Krueck, MD Justin K. Krueger, MD Lisa A. Krumm, MD Celina M. LaBrec-Salmons, MD Robert C. LaMonte, MD Kristina M. Lehman, MD Michael J. Leymaster, MD Bradley A. Lisko, MD Elizabeth A. Little, MD Anne D. Littleton, MD Michael C. Loar, MD William W. Long, MD Tricia W. Lucin, MD Eileen M. Maher, MD Michele V. Mahoney, MD Jason W. Mailloux, MD Gwynette M. Marschall, MD Jennifer J. Mastruserio, MD Derek A. McClellan, MD Donna J. McDonald, MD Meera R. Mehta, MD George M. Messick, MD

Bruce P. Meyer, MD Leslie C. Meyers-Joseph, MD Cameron K. Miller, MD Bruce R. Mirvis, MD Stacy L. Morran, MD Matthew J. Morrison, MD Mark A. Muresan, MD Jill A. Neff, DO Mary-Lynn Niland, MD Autumn M. O’Brien, MD Adebomi A. Omikunle, MD Janet S. Orr, MD Lilliam I. Ortiz, MD Laura E. Osthaus, MD Jennifer Killion Overbey, MD Divya S. Parikh, MD Melissa M. Parsons, MD Jacqueline S. Pennywitt, MD Michael A. Perry, MD Richard A. Petrella, MD Brad T. Pfau, MD Laura D. Phillips-Chou, MD Domenico Pietropaolo, MD Phyllis Jo Polas, DO L. Robert Polster, MD Danielle S. Pottinger, MD M. Bonnie Pugh, MD Blake J. Randolph, MD Barbara B. Rayo, MD Teresa R. Recker Gross, DO Robert D. Reis, MD Darryl A. Robbins, DO Ann M. Rogers, MD J. Tyler Rogers, MD Patricia A. Ryan, MD Purbi S. Sahai, MD Timothy R. Savage, MD Erin K. Schaffner, MD Elizabeth A. Schloss, MD Dana J. Schultz, MD W. Andrew Searcy, MD Eileen H. Sheets, MD Larry M. Shepherd, MD

Phillip N. Simon, MD Rebecca M. Slaunwhite, MD Brandi F. Spitler, DO Donna L. Sterling, MD Nicholas S. Stevens, MD Wendy K. Stevens, MD Kathleen C. Stiles, MD Miller J. Sullivan, Jr., MD Nazhat Taj-Schaal, MD Ellen R. Tamburello, MD Katrina S. Tansky, MD Renee S. Taylor, MD Amy Rachelle A. TeleronKhorshad, MD Timothy A. Teller, MD Mark A. Thoma, MD Craig R. Thompson, MD Kristin E. Thompson, MD John D. Toth, MD Bonny M. Tsai, MD Ahmed J. Turjoman, MD H. Scott Tyson, MD Sean M. Vellucci, MD Victoria N. Vinsant, MD Diana T. Wagner, MD Laura E. Walawender, MD James D. Ward, MD Lawrence B. Watkins, MD Olivia N. Westhoven, MD Ray S. Wheasler, III, MD Elizabeth R. Whitaker, MD Jennifer R. White, MD Matthew M. White, MD Melissa D. Winterhalter, MD Kathleen M. Wodarcyk, MD Lindsay A. Wylie, MD Michelle E. Yaw, MD Becky Zhao, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 55

Department of Pediatrics FAST FACTS July 2019 through June 2020 Inpatient Discharges:....................................................... 82

Average Daily Census*:.................................................. 1.2

Observation and Outpatient-in-a-Bed Discharges:........ 160

Patient Days*:................................................................ 456

Total Discharges:........................................................... 241

*Excludes observation and outpatient-in-a-bed patients.

Average Length of Stay*:................................................ 5.6

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

COMPLEX CARE The Division of Complex Health Care at Nationwide Children’s Hospital provides comprehensive, coordinated and holistic care to children and adults with neurodevelopmental disabilities. For some patients 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 comprehensive Cerebral Palsy Program, and the comprehensive Feeding and Swallowing Program. Our 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 Heinzerling Foundation.

FACULTY

program. She is an internationally recognized expert in the medical care of children with cerebral palsy and other disabilities.

CLINICAL FELLOWSHIP IN QUALITY & SAFETY LEADERSHIP Tara Cosgrove, MD 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 cerebral palsy is a priority, we have improved the clinical 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.

Garey Noritz, MD Chief

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.

Our faculty continue to be a sought-after resource for mentoring and education, with invited lectures locally, nationally and internationally. Our non-physician staff are leaders in training their colleagues in nursing, nutrition, pharmacy, social work and allied therapies in the provision of family-centered care for children and adults with disabilities.

Laurie Glader, MD Section Chief Rukshana Ahmed, MD Wendy Burdo-Hartman, MD Derek Fletcher, MD Elizabeth Lucas, MD Katherine Steingass, MD Joy Walton, MD This year, we welcomed Laurie Glader, MD, as our section chief and medical director of the Cerebral Palsy

56 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Members of our faculty have leadership positions at leading national organizations, including the American Academy of Pediatrics, the Society for Developmental and Behavioral Pediatrics, the Pediatric Feeding Consortium and the American Academy for Cerebral Palsy and Developmental Medicine.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 57

Department of Pediatrics FAST FACTS July 2019 through June 2020 Inpatient Discharges:....................................................... 82

Average Daily Census*:.................................................. 1.2

Observation and Outpatient-in-a-Bed Discharges:........ 160

Patient Days*:................................................................ 456

Total Discharges:........................................................... 241

*Excludes observation and outpatient-in-a-bed patients.

Average Length of Stay*:................................................ 5.6

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

COMPLEX CARE The Division of Complex Health Care at Nationwide Children’s Hospital provides comprehensive, coordinated and holistic care to children and adults with neurodevelopmental disabilities. For some patients 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 comprehensive Cerebral Palsy Program, and the comprehensive Feeding and Swallowing Program. Our 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 Heinzerling Foundation.

FACULTY

program. She is an internationally recognized expert in the medical care of children with cerebral palsy and other disabilities.

CLINICAL FELLOWSHIP IN QUALITY & SAFETY LEADERSHIP Tara Cosgrove, MD 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 cerebral palsy is a priority, we have improved the clinical 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.

Garey Noritz, MD Chief

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.

Our faculty continue to be a sought-after resource for mentoring and education, with invited lectures locally, nationally and internationally. Our non-physician staff are leaders in training their colleagues in nursing, nutrition, pharmacy, social work and allied therapies in the provision of family-centered care for children and adults with disabilities.

Laurie Glader, MD Section Chief Rukshana Ahmed, MD Wendy Burdo-Hartman, MD Derek Fletcher, MD Elizabeth Lucas, MD Katherine Steingass, MD Joy Walton, MD This year, we welcomed Laurie Glader, MD, as our section chief and medical director of the Cerebral Palsy

56 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Members of our faculty have leadership positions at leading national organizations, including the American Academy of Pediatrics, the Society for Developmental and Behavioral Pediatrics, the Pediatric Feeding Consortium and the American Academy for Cerebral Palsy and Developmental Medicine.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 57

Department of Pediatrics

CRITICAL CARE MEDICINE

SELECTED PUBLICATIONS 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.

Hart LC, Crawford M, Crawford P, Noritz G. Practical Steps to Help Transition Pediatric Patients to Adult Care. The Journal of Pediatrics. 2019;144(6).

Lucas E. Medical Management of Neurogenic Bladder for Children and Adults: A Review. Topics in Spinal Cord Injury Rehabilitation. 2019;25(3):195-204.

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 Pediatric Infectious Disease Journal. 2019;38(8):786-90.

Statter MB, Noritz G, Committee On Bioethics Council on Children with Disabilities.

Children With Intellectual and Developmental Disabilities as Organ Transplantation Recipients. The Journal of Pediatrics. 2020;145(5).

FAST FACTS July 2019 through June 2020

The Section of Critical Care Medicine at Nationwide Children’s Hospital provides in-house faculty coverage of the Pediatric Intensive Care Units (PICUs) 24 hours a day and is dedicated to the care of children who have, or are at risk for, life-threatening illnesses across the spectrum of pediatric disease. This service also contributes actively to the vital missions of research and advanced training in the field of pediatric critical care medicine. This service cares for approximately 3,000 patients per year, covering up to 54 PICU beds at Nationwide Children’s and contributing to the coverage of the 20-bed cardiothoracic ICU. Therapies such as extracorporeal membrane oxygenation, high frequency oscillatory ventilation, and continuous renal replacement therapies are available at all times. We continue to boast one of the lowest rates of hospitalacquired 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.

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 Mark W. Hall, MD, FAAP, FCCM Division Chief

Marlina E. Lovett, MD Jeffrey E. Lutmer, MD 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 Section Chief Onsy S. Ayad, MD, FAAP Richard J. Brilli, MD, FAAP, MCCM Margaret A. Chase, MD Melissa G. Chung, MD Megan C. Daniel, MD Maria H. Estrada, DO, FAAP

58 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Andrew R. Yates, MD The section remains a leader in pediatric critical care research, with robust ongoing participation in single- and multi-center studies. In 2019, Nationwide Children’s Hospital continued its participation as one of only eight sites in the country in the National Institutes of Health-funded Collaborative Pediatric Critical Care Research Network. Division Chief Mark W. Hall, MD, is a national leader in the field of immunobiology research and led two multicenter

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 59

Department of Pediatrics

CRITICAL CARE MEDICINE

SELECTED PUBLICATIONS 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.

Hart LC, Crawford M, Crawford P, Noritz G. Practical Steps to Help Transition Pediatric Patients to Adult Care. The Journal of Pediatrics. 2019;144(6).

Lucas E. Medical Management of Neurogenic Bladder for Children and Adults: A Review. Topics in Spinal Cord Injury Rehabilitation. 2019;25(3):195-204.

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 Pediatric Infectious Disease Journal. 2019;38(8):786-90.

Statter MB, Noritz G, Committee On Bioethics Council on Children with Disabilities.

Children With Intellectual and Developmental Disabilities as Organ Transplantation Recipients. The Journal of Pediatrics. 2020;145(5).

FAST FACTS July 2019 through June 2020

The Section of Critical Care Medicine at Nationwide Children’s Hospital provides in-house faculty coverage of the Pediatric Intensive Care Units (PICUs) 24 hours a day and is dedicated to the care of children who have, or are at risk for, life-threatening illnesses across the spectrum of pediatric disease. This service also contributes actively to the vital missions of research and advanced training in the field of pediatric critical care medicine. This service cares for approximately 3,000 patients per year, covering up to 54 PICU beds at Nationwide Children’s and contributing to the coverage of the 20-bed cardiothoracic ICU. Therapies such as extracorporeal membrane oxygenation, high frequency oscillatory ventilation, and continuous renal replacement therapies are available at all times. We continue to boast one of the lowest rates of hospitalacquired 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.

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 Mark W. Hall, MD, FAAP, FCCM Division Chief

Marlina E. Lovett, MD Jeffrey E. Lutmer, MD 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 Section Chief Onsy S. Ayad, MD, FAAP Richard J. Brilli, MD, FAAP, MCCM Margaret A. Chase, MD Melissa G. Chung, MD Megan C. Daniel, MD Maria H. Estrada, DO, FAAP

58 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Andrew R. Yates, MD The section remains a leader in pediatric critical care research, with robust ongoing participation in single- and multi-center studies. In 2019, Nationwide Children’s Hospital continued its participation as one of only eight sites in the country in the National Institutes of Health-funded Collaborative Pediatric Critical Care Research Network. Division Chief Mark W. Hall, MD, is a national leader in the field of immunobiology research and led two multicenter

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 59

Department of Pediatrics clinical trials of immunostimulation in the setting of pediatric critical illness and injury in 2019. Examples of other areas of research focus for the pediatric critical care medicine faculty include Staphylococcus aureus microbiology (Montgomery), cerebral malaria and global health (O’Brien), transfusion science (Muszynski), respiratory infections (Karsies), anesthesiology (Tobias), resuscitation (Yates), and quality and safety (Brilli, Ayad). With this broad scientific portfolio, an in-situ research laboratory within the PICU, and four divisional research coordinators, the section remains at the forefront of innovation in the field.

Our Accreditation Council for Graduate Medical Education-approved Pediatric Critical Care Medicine Fellowship provides rigorous clinical and academic training for the next generation of ICU faculty, accepting four fellows per class in our three-year program. The Critical Care Medicine faculty participate in instruction for the pediatric and surgical residency programs, as well as multiple other fellowship programs.

A PICU elective is also provided for fourth-year medical students.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,128,271 SELECTED PUBLICATIONS Lovett ME, Maa T, Moore-Clingenpeel M, O’Brien NF. Transcranial Doppler Ultrasound Findings in Children with Moderate-to-Severe Traumatic Brain Injury Following Abusive Head Trauma. Child’s Nervous System. 2020 May;36(5):993-1000.

FAST FACTS July 2019 through June 2020 PICU Admissions:........................................................ 3,216

DERMATOLOGY The Section of Dermatology at Nationwide Children’s Hospital sees outpatients from birth through age 21 for both common and rare disorders of the hair, skin and nails.

Average Length of Stay*:................................................... 4 Average Daily Census*:................................................... 33

FACULTY

Other highlights of the 2019-2020 academic year include the acquisition of an excimer laser for our phototherapy program, providing another treatment option for families with vitiligo and psoriasis.

Total Patient Days*:.................................................. 12,167 Inpatient Discharges:.................................................. 3,267 Number of Beds:............................................................. 54

Additionally, the division began offering treatment with the CO2 laser, a useful treatment for scars and some birthmarks.

*Excludes observation and outpatient-in-a-bed patients.

SELECTED PUBLICATIONS

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC CRITICAL CARE MEDICINE Austin Biggs, MD Katherine Bline, MD Claire Christian, MD Loren Farley, MD Holly Gillis, MD Kelley Groves, MD Will Guider, MD Hunter Johnson, MD Takaharu Karube, MD Taylor Nickerson, MD Rachel Poeppelman, MD Sara Sanders, MD

Si Y, Zhao F, Beesetty P, Weiskopf D, Li Z, Tian Q, Alegre ML, Sette A, Chong AS, Montgomery CP. Inhibition of Protective Immunity Against Staphylococcus Aureus Infection

by Mhc-Restricted Immunodominance is Overcome by Vaccination. Scientific Advances.

2020 Apr 1;6(14):eaaw7713.

Sribnick EA, Weber MD, Hall MW. Innate Immune Suppression after Traumatic Brain Injury with Hemorrhagic Shock in a Juvenile Rat Model of Polytrauma. The Journal of Neuroimmunology. 2019 Dec 15;337:577073.

Ziemba KJ, Kumar R, Nuss K, Estrada M, Lin A, Ayad O. Clinical Decision Support Tools and a Standardized Order Set Enhances Early Enteral Nutrition in Critically Ill Children.

Nutrition in Clinical Practice. 2019 Dec;34(6):916-921.

Amigo M, Milani-Nejad N, Mosser-Goldfarb J. Periocular Tinea Faciei. The Journal of Pediatrics. 2020 Jun;221:255-256.

Bjorklund KA, Fernandez Faith E. Branching Hypopigmentation Following Intralesional Corticosteroid Injection: Case Report and Review of the Literature. Pediatric Dermatology.

2020 Jan; 37(1):235-236.

Patricia M. Witman, MD Chief Esteban Fernández Faith, MD

Milani-Nejad N, Mosser-Goldfarb J. Congenital Onychodysplasia of Index Fingers: IsoKikuchi Syndrome. The Journal of Pediatrics. 2020 Mar;218:254-254.e1

Katya Harfmann, MD

Reichert B, Fernandez Faith E, Harfmann K. Weight Counseling in Pediatric Hidradenitis Suppurativa Patients. Pediatric Dermatology. 2020 May;37(3):480-483.

Joy Lynn Mosser-Goldfarb, MD Although 2020 was the year we originally planned to launch telemedicine services in the section of Dermatology, the challenges brought by the COVID-19 pandemic accelerated that plan tremendously.

Fortunately, the visual nature of dermatology is especially well-suited for telemedicine, and we were able to rapidly implement video visits in April 2020, leading only to a temporary partial interruption in dermatology services when the pandemic hit Ohio. Now in the fine-tuning stages, we plan to continue telemedicine as a valuable addition to the in-person outpatient clinics that are now open again. In fact, families now enjoy the ability to choose either a telemedicine or in-person visit for most problems when making an appointment in Dermatology.

Ring N, Craiglow B, Panse G, Antaya R, Ashack K, Ashack R, Fernandez Faith E, Paller A, McNiff J, Chaote K, Ko C. Histopathologic Findings Characteristic of CARD14-Associated Papulosquamous Eruption. Journal of Cutaneous Pathology. 2020 May;47(5):425-430.

FAST FACTS July 2019 through June 2020 Canal Winchester Dermatology Clinic Visits: ................. 635 Dermatology Clinic Visits: .......................................... 7,140 Dublin Dermatology Clinic Visits: ............................... 2,513 Westerville Dermatology Clinic Visits: ........................... 689 Total Clinic Visits: ..................................................... 10,977 Inpatient Consults: ........................................................ 164

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 anxietyprovoking 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.

60 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 61

Department of Pediatrics clinical trials of immunostimulation in the setting of pediatric critical illness and injury in 2019. Examples of other areas of research focus for the pediatric critical care medicine faculty include Staphylococcus aureus microbiology (Montgomery), cerebral malaria and global health (O’Brien), transfusion science (Muszynski), respiratory infections (Karsies), anesthesiology (Tobias), resuscitation (Yates), and quality and safety (Brilli, Ayad). With this broad scientific portfolio, an in-situ research laboratory within the PICU, and four divisional research coordinators, the section remains at the forefront of innovation in the field.

Our Accreditation Council for Graduate Medical Education-approved Pediatric Critical Care Medicine Fellowship provides rigorous clinical and academic training for the next generation of ICU faculty, accepting four fellows per class in our three-year program. The Critical Care Medicine faculty participate in instruction for the pediatric and surgical residency programs, as well as multiple other fellowship programs.

A PICU elective is also provided for fourth-year medical students.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,128,271 SELECTED PUBLICATIONS Lovett ME, Maa T, Moore-Clingenpeel M, O’Brien NF. Transcranial Doppler Ultrasound Findings in Children with Moderate-to-Severe Traumatic Brain Injury Following Abusive Head Trauma. Child’s Nervous System. 2020 May;36(5):993-1000.

FAST FACTS July 2019 through June 2020 PICU Admissions:........................................................ 3,216

DERMATOLOGY The Section of Dermatology at Nationwide Children’s Hospital sees outpatients from birth through age 21 for both common and rare disorders of the hair, skin and nails.

Average Length of Stay*:................................................... 4 Average Daily Census*:................................................... 33

FACULTY

Other highlights of the 2019-2020 academic year include the acquisition of an excimer laser for our phototherapy program, providing another treatment option for families with vitiligo and psoriasis.

Total Patient Days*:.................................................. 12,167 Inpatient Discharges:.................................................. 3,267 Number of Beds:............................................................. 54

Additionally, the division began offering treatment with the CO2 laser, a useful treatment for scars and some birthmarks.

*Excludes observation and outpatient-in-a-bed patients.

SELECTED PUBLICATIONS

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC CRITICAL CARE MEDICINE Austin Biggs, MD Katherine Bline, MD Claire Christian, MD Loren Farley, MD Holly Gillis, MD Kelley Groves, MD Will Guider, MD Hunter Johnson, MD Takaharu Karube, MD Taylor Nickerson, MD Rachel Poeppelman, MD Sara Sanders, MD

Si Y, Zhao F, Beesetty P, Weiskopf D, Li Z, Tian Q, Alegre ML, Sette A, Chong AS, Montgomery CP. Inhibition of Protective Immunity Against Staphylococcus Aureus Infection

by Mhc-Restricted Immunodominance is Overcome by Vaccination. Scientific Advances.

2020 Apr 1;6(14):eaaw7713.

Sribnick EA, Weber MD, Hall MW. Innate Immune Suppression after Traumatic Brain Injury with Hemorrhagic Shock in a Juvenile Rat Model of Polytrauma. The Journal of Neuroimmunology. 2019 Dec 15;337:577073.

Ziemba KJ, Kumar R, Nuss K, Estrada M, Lin A, Ayad O. Clinical Decision Support Tools and a Standardized Order Set Enhances Early Enteral Nutrition in Critically Ill Children.

Nutrition in Clinical Practice. 2019 Dec;34(6):916-921.

Amigo M, Milani-Nejad N, Mosser-Goldfarb J. Periocular Tinea Faciei. The Journal of Pediatrics. 2020 Jun;221:255-256.

Bjorklund KA, Fernandez Faith E. Branching Hypopigmentation Following Intralesional Corticosteroid Injection: Case Report and Review of the Literature. Pediatric Dermatology.

2020 Jan; 37(1):235-236.

Patricia M. Witman, MD Chief Esteban Fernández Faith, MD

Milani-Nejad N, Mosser-Goldfarb J. Congenital Onychodysplasia of Index Fingers: IsoKikuchi Syndrome. The Journal of Pediatrics. 2020 Mar;218:254-254.e1

Katya Harfmann, MD

Reichert B, Fernandez Faith E, Harfmann K. Weight Counseling in Pediatric Hidradenitis Suppurativa Patients. Pediatric Dermatology. 2020 May;37(3):480-483.

Joy Lynn Mosser-Goldfarb, MD Although 2020 was the year we originally planned to launch telemedicine services in the section of Dermatology, the challenges brought by the COVID-19 pandemic accelerated that plan tremendously.

Fortunately, the visual nature of dermatology is especially well-suited for telemedicine, and we were able to rapidly implement video visits in April 2020, leading only to a temporary partial interruption in dermatology services when the pandemic hit Ohio. Now in the fine-tuning stages, we plan to continue telemedicine as a valuable addition to the in-person outpatient clinics that are now open again. In fact, families now enjoy the ability to choose either a telemedicine or in-person visit for most problems when making an appointment in Dermatology.

Ring N, Craiglow B, Panse G, Antaya R, Ashack K, Ashack R, Fernandez Faith E, Paller A, McNiff J, Chaote K, Ko C. Histopathologic Findings Characteristic of CARD14-Associated Papulosquamous Eruption. Journal of Cutaneous Pathology. 2020 May;47(5):425-430.

FAST FACTS July 2019 through June 2020 Canal Winchester Dermatology Clinic Visits: ................. 635 Dermatology Clinic Visits: .......................................... 7,140 Dublin Dermatology Clinic Visits: ............................... 2,513 Westerville Dermatology Clinic Visits: ........................... 689 Total Clinic Visits: ..................................................... 10,977 Inpatient Consults: ........................................................ 164

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 anxietyprovoking 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.

60 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 61

Department of Pediatrics

DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS The mission of the Division of Developmental and Behavioral Pediatrics at Nationwide Children’s Hospital is to achieve best outcomes for children with developmental and behavioral needs through evidence-based, family-centered, interprofessional practice. Outpatient services include comprehensive care delivered by developmental and behavioral pediatricians and advanced nurse practitioners in partnership with pediatric psychology and other health care professionals. Areas of expertise include the evaluation and management of complex ADHD, Autism Spectrum Disorders and developmental delay. Additional focus areas include myelomeningocele, neonatal follow-up, Down syndrome and Williams syndrome. The division often provides care in collaboration with programs through Nationwide Children’s Hospital’s Behavioral Health Services.

FACULTY

Amy Newmeyer, MD Interim Chief Lindsay Bartram, DO Daniel L. Coury, MD Anita R. Narayanan, MD Patricia L. Nash, MD Katherine Steingass, MD Jennifer Walton, MD, MPH

The Division of Developmental and Behavioral Pediatrics at Nationwide Children’s is led by Amy Newmeyer, MD. A visiting associate professor of pediatrics at The Ohio State University College of Medicine, Dr. Newmeyer serves on the American Board of Psychiatry and Neurology NDD Committee and as the Nationwide Children’s site medical co-director for the Autism Learning Health Network.

Faculty in the division contribute at the local and national levels to improve clinical outcomes and reduce avoidable harm. Daniel L. Coury, MD, holds multiple national administrative and research roles,

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

FAST FACTS July 2019 through June 2020 Child Development Center Visits:..............................2,041

DEVELOPMENTAL BEHAVIORAL PEDIATRICS

Developmental Disabilities Clinic Visits:.......................112

SECOND YEAR Juan Lozano, MD

Myelomeningocele Clinic Visits:..................................625 Developmental Behavioral Pediatrics Clinic Visits:....5,377

FIRST YEAR Elizabeth Barnhardt, DO Rohan Patel, MD

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.

Katherine Steingass, MD, serves as medical director of the Nationwide Children’s Myelomeningocele Clinic and as a PI on the National Spina Bifida Patient Registry.

Patricia L. Nash, MD, serves as medical director of the Nationwide Children’s Down Syndrome Program.

The division continues to support a robust fellowship program led by Dr. Katherine Steingass. The fellowship is integrated with The Ohio State University’s Leadership Education in Neurodevelopmental Disabilities program at the Nisonger Center, with Dr. Walton serving as the program’s associate director.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $279,778 SELECTED PUBLICATIONS 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.

Journal of Developmental and Behavioral Pediatrics. 2020 Feb/Mar;41(2):157-160.

Bartram LA, Lozano J, Coury DL. Aripiprazole for treating irritability associated with autism spectrum disorders. Expert Opinion on Pharmacotherapy. 2019 Aug;20(12):14211427.

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 Medicine. 2020 Apr;22(4):767-776.

62 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 63

Department of Pediatrics

DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS The mission of the Division of Developmental and Behavioral Pediatrics at Nationwide Children’s Hospital is to achieve best outcomes for children with developmental and behavioral needs through evidence-based, family-centered, interprofessional practice. Outpatient services include comprehensive care delivered by developmental and behavioral pediatricians and advanced nurse practitioners in partnership with pediatric psychology and other health care professionals. Areas of expertise include the evaluation and management of complex ADHD, Autism Spectrum Disorders and developmental delay. Additional focus areas include myelomeningocele, neonatal follow-up, Down syndrome and Williams syndrome. The division often provides care in collaboration with programs through Nationwide Children’s Hospital’s Behavioral Health Services.

FACULTY

Amy Newmeyer, MD Interim Chief Lindsay Bartram, DO Daniel L. Coury, MD Anita R. Narayanan, MD Patricia L. Nash, MD Katherine Steingass, MD Jennifer Walton, MD, MPH

The Division of Developmental and Behavioral Pediatrics at Nationwide Children’s is led by Amy Newmeyer, MD. A visiting associate professor of pediatrics at The Ohio State University College of Medicine, Dr. Newmeyer serves on the American Board of Psychiatry and Neurology NDD Committee and as the Nationwide Children’s site medical co-director for the Autism Learning Health Network.

Faculty in the division contribute at the local and national levels to improve clinical outcomes and reduce avoidable harm. Daniel L. Coury, MD, holds multiple national administrative and research roles,

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

FAST FACTS July 2019 through June 2020 Child Development Center Visits:..............................2,041

DEVELOPMENTAL BEHAVIORAL PEDIATRICS

Developmental Disabilities Clinic Visits:.......................112

SECOND YEAR Juan Lozano, MD

Myelomeningocele Clinic Visits:..................................625 Developmental Behavioral Pediatrics Clinic Visits:....5,377

FIRST YEAR Elizabeth Barnhardt, DO Rohan Patel, MD

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.

Katherine Steingass, MD, serves as medical director of the Nationwide Children’s Myelomeningocele Clinic and as a PI on the National Spina Bifida Patient Registry.

Patricia L. Nash, MD, serves as medical director of the Nationwide Children’s Down Syndrome Program.

The division continues to support a robust fellowship program led by Dr. Katherine Steingass. The fellowship is integrated with The Ohio State University’s Leadership Education in Neurodevelopmental Disabilities program at the Nisonger Center, with Dr. Walton serving as the program’s associate director.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $279,778 SELECTED PUBLICATIONS 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.

Journal of Developmental and Behavioral Pediatrics. 2020 Feb/Mar;41(2):157-160.

Bartram LA, Lozano J, Coury DL. Aripiprazole for treating irritability associated with autism spectrum disorders. Expert Opinion on Pharmacotherapy. 2019 Aug;20(12):14211427.

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 Medicine. 2020 Apr;22(4):767-776.

62 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 63

Department of Pediatrics

EMERGENCY MEDICINE

East Columbus, Hilliard, Marysville and Westerville.

The Emergency Department is a hub for medical education in the acute care of children, adolescents and selected adults. Medical students and more than 300 residents from Emergency Medicine, Family Practice, Internal Medicine/Pediatrics and Pediatrics programs are educated in all aspects of pediatric emergencies. In addition, Nationwide Children’s has a large, vibrant Pediatric Emergency Medicine Fellowship program.

Members of the Section of Emergency Medicine are active leaders and participants in the residency program at Nationwide Children’s and at The Ohio State University College of Medicine.

Manuel Lugo, MD

The Emergency Department at Nationwide Children’s Hospital is one of the nation’s highest-ranked and busiest pediatric emergency departments (based on Children’s Hospital Association benchmarking data and Parents magazine). Emergency Medicine features a Level I Pediatric Trauma Center and ED staffed by board-certified/eligible pediatric emergency medicine subspecialists 24 hours a day.

Timothy Mcclung, MD Ellen McManus, MD Jennifer Melvin, MD Leah Middelberg, MD Leslie Mihalov, MD

FACULTY

Brian Bowden, MD Mary Bowman, MD Beth Bubolz, MD Michael Chua, MD Cullen Clark, MD Beth Claxton, MD Daniel Cohen, MD Melanie Copenhaver, DO Carrie DeHoff, MD

Rachel M. Stanley, MD, MHSA Division Chief

Lori Deschene, MD Meghan Dishong, MD Michael Dunn, MD Meika Eby, MD Emile Elshammaa, MD Joelle Farlow, MD Rachel Feldkamp, MD Aarti Gaglani, MD Adam Garlock, MD Yaffa Gewirtz, MD Delia Gold, MD

Michael Stoner, MD Section Chief

Angela Harris, MD

Alana Albano, MD

Todd Holman, MD

Barbara Amakye, MD

Daniela Humphrey, MD

Adjoa Andoh, MD

Maya Iyer, MD

Srikanth Aravapalli, MD

Iram Jafri, MD

Brett Ballard, MD

Chris Jones, DO

Terry Barber, MD

Simmi Dogra Kulkarni, MD

Robert Baun, MD

Catherine Lambert, MD

Berkeley Bennett, MD

Marc Leder, MD

Luciana Berg, MD

Julie Leonard, MD

Deborah Blackwell, MD

Rachel Levine, MD

Alan Bleiberg, MD

Celia Ligorski, DO

Bema Bonsu, MD

Seth Linakis, MD

Traci Bouchard, MD

Julia Lloyd, MD

Karla Hauersperger, MD

64 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Jennifer Mitzman, MD Rustin Morse, MD Jennifer Mrozek, MD Kathy Nuss, MD Nkeiruka Orajiaka, MD

The Department of Emergency Medicine was integral in the successful opening of the Psychiatric Crisis Department at the Big Lots Behavioral Health Pavilion (BHP) in 2020. Concurrently with the BHP opening, Emergency Medicine successfully navigated the challenges presented by COVID-19 by playing a significant role in the implementation of a drive-up COVID-19 testing facility.

Jimisha Patel, MD Michael Patrick, MD Jan Perry, MD Jonathan Price, MD Sheela Rao, MD Maegan Reynolds, MD

In addition to providing clinical, operational and educational excellence, Emergency Medicine has a strong history of clinical research. We lead the federally funded Great Lakes node of the Pediatric Emergency Care Applied Research Network (PECARN), a large 18-hospital research network. We have developed research collaborations with the Columbus Division of Fire and other emergency medical service agencies regionally and nationally. The section is committed to the ongoing improvement of health care delivery in the Emergency Department and in clinical outcomes.

Laura Rust, MD Mary Ryan, MD Daniel Scherzer, MD Betsy Schmerler, MD Emily Sentman, MD Bashar Shihabuddin, MD John Sotos, MD Sandra Spencer, MD Gregory Stewart, MD Kristin Stukus, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Jerry Stultz, MD Kathleen Sugrue, MD

$1,806,663

Bethany Uhl, MD

SELECTED PUBLICATIONS

Rishi Verma, MD

Bressler CJ, Letson MM, Kline D, McCarthy T, Davis J, Leonard JC. Characteristics of Neighborhoods Where Emergency Medical Services Encounter Children at Risk for Maltreatment. Prehospital Emergency Care Journal. 2019;23(5):672-682.

Tracey Wagner, MD

Chamberlain JM, Kapur J, Shinnar S, Elm J, Holsti M, Babcock L, Rogers A, Barsan W, Cloyd J, Lowenstein D, Bleck TP, Conwit R, Meinzer C, Cock H, Fountain NB, Underwood E, Connor JT, Silbergleit R, Neurological Emergencies Treatment Trials; Pediatric Emergency Care Applied Research Network investigators. Efficacy of Levetiracetam, Fosphenytoin, and Valproate for Established Status Epilepticus by Age Group (ESETT): A Double-Blind, Responsive-Adaptive, Randomized Controlled Trial.

The Lancet. 2020 Apr 11;395(10231):1217-1224.

Jordee Wells, MD Jessica Wilson, MD Morgan Wurtz, MD Jennifer Wyse, MD Anita Yalamanchi, DO The Emergency Department provides expertise in pediatric advanced life support and resuscitation, as well as evaluation and treatment in every area for acute medical and surgical conditions. Off-site urgent care services are provided at Nationwide Children’s Close To HomeSM Centers in Canal Winchester, Dublin,

Kapur J, Elm J, Chamberlain JM, Barsan W, Cloyd J, Lowenstein D, Shinnar S, Conwit 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 Epilepticus. The New England Journal of Medicine. 2019 Nov 28;381(22):2103-2113.

Lo CB, Bridge JA, Shi J, Ludwig L, Stanley RM. Children's Mental Health Emergency Department Visits: 2007-2016. Pediatrics. 2020 Jun;145(6):e20191536.

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 Graduate Medical Education. 2020 Feb;12(1):51-57.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 65

Department of Pediatrics

EMERGENCY MEDICINE

East Columbus, Hilliard, Marysville and Westerville.

The Emergency Department is a hub for medical education in the acute care of children, adolescents and selected adults. Medical students and more than 300 residents from Emergency Medicine, Family Practice, Internal Medicine/Pediatrics and Pediatrics programs are educated in all aspects of pediatric emergencies. In addition, Nationwide Children’s has a large, vibrant Pediatric Emergency Medicine Fellowship program.

Members of the Section of Emergency Medicine are active leaders and participants in the residency program at Nationwide Children’s and at The Ohio State University College of Medicine.

Manuel Lugo, MD

The Emergency Department at Nationwide Children’s Hospital is one of the nation’s highest-ranked and busiest pediatric emergency departments (based on Children’s Hospital Association benchmarking data and Parents magazine). Emergency Medicine features a Level I Pediatric Trauma Center and ED staffed by board-certified/eligible pediatric emergency medicine subspecialists 24 hours a day.

Timothy Mcclung, MD Ellen McManus, MD Jennifer Melvin, MD Leah Middelberg, MD Leslie Mihalov, MD

FACULTY

Brian Bowden, MD Mary Bowman, MD Beth Bubolz, MD Michael Chua, MD Cullen Clark, MD Beth Claxton, MD Daniel Cohen, MD Melanie Copenhaver, DO Carrie DeHoff, MD

Rachel M. Stanley, MD, MHSA Division Chief

Lori Deschene, MD Meghan Dishong, MD Michael Dunn, MD Meika Eby, MD Emile Elshammaa, MD Joelle Farlow, MD Rachel Feldkamp, MD Aarti Gaglani, MD Adam Garlock, MD Yaffa Gewirtz, MD Delia Gold, MD

Michael Stoner, MD Section Chief

Angela Harris, MD

Alana Albano, MD

Todd Holman, MD

Barbara Amakye, MD

Daniela Humphrey, MD

Adjoa Andoh, MD

Maya Iyer, MD

Srikanth Aravapalli, MD

Iram Jafri, MD

Brett Ballard, MD

Chris Jones, DO

Terry Barber, MD

Simmi Dogra Kulkarni, MD

Robert Baun, MD

Catherine Lambert, MD

Berkeley Bennett, MD

Marc Leder, MD

Luciana Berg, MD

Julie Leonard, MD

Deborah Blackwell, MD

Rachel Levine, MD

Alan Bleiberg, MD

Celia Ligorski, DO

Bema Bonsu, MD

Seth Linakis, MD

Traci Bouchard, MD

Julia Lloyd, MD

Karla Hauersperger, MD

64 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Jennifer Mitzman, MD Rustin Morse, MD Jennifer Mrozek, MD Kathy Nuss, MD Nkeiruka Orajiaka, MD

The Department of Emergency Medicine was integral in the successful opening of the Psychiatric Crisis Department at the Big Lots Behavioral Health Pavilion (BHP) in 2020. Concurrently with the BHP opening, Emergency Medicine successfully navigated the challenges presented by COVID-19 by playing a significant role in the implementation of a drive-up COVID-19 testing facility.

Jimisha Patel, MD Michael Patrick, MD Jan Perry, MD Jonathan Price, MD Sheela Rao, MD Maegan Reynolds, MD

In addition to providing clinical, operational and educational excellence, Emergency Medicine has a strong history of clinical research. We lead the federally funded Great Lakes node of the Pediatric Emergency Care Applied Research Network (PECARN), a large 18-hospital research network. We have developed research collaborations with the Columbus Division of Fire and other emergency medical service agencies regionally and nationally. The section is committed to the ongoing improvement of health care delivery in the Emergency Department and in clinical outcomes.

Laura Rust, MD Mary Ryan, MD Daniel Scherzer, MD Betsy Schmerler, MD Emily Sentman, MD Bashar Shihabuddin, MD John Sotos, MD Sandra Spencer, MD Gregory Stewart, MD Kristin Stukus, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Jerry Stultz, MD Kathleen Sugrue, MD

$1,806,663

Bethany Uhl, MD

SELECTED PUBLICATIONS

Rishi Verma, MD

Bressler CJ, Letson MM, Kline D, McCarthy T, Davis J, Leonard JC. Characteristics of Neighborhoods Where Emergency Medical Services Encounter Children at Risk for Maltreatment. Prehospital Emergency Care Journal. 2019;23(5):672-682.

Tracey Wagner, MD

Chamberlain JM, Kapur J, Shinnar S, Elm J, Holsti M, Babcock L, Rogers A, Barsan W, Cloyd J, Lowenstein D, Bleck TP, Conwit R, Meinzer C, Cock H, Fountain NB, Underwood E, Connor JT, Silbergleit R, Neurological Emergencies Treatment Trials; Pediatric Emergency Care Applied Research Network investigators. Efficacy of Levetiracetam, Fosphenytoin, and Valproate for Established Status Epilepticus by Age Group (ESETT): A Double-Blind, Responsive-Adaptive, Randomized Controlled Trial.

The Lancet. 2020 Apr 11;395(10231):1217-1224.

Jordee Wells, MD Jessica Wilson, MD Morgan Wurtz, MD Jennifer Wyse, MD Anita Yalamanchi, DO The Emergency Department provides expertise in pediatric advanced life support and resuscitation, as well as evaluation and treatment in every area for acute medical and surgical conditions. Off-site urgent care services are provided at Nationwide Children’s Close To HomeSM Centers in Canal Winchester, Dublin,

Kapur J, Elm J, Chamberlain JM, Barsan W, Cloyd J, Lowenstein D, Shinnar S, Conwit 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 Epilepticus. The New England Journal of Medicine. 2019 Nov 28;381(22):2103-2113.

Lo CB, Bridge JA, Shi J, Ludwig L, Stanley RM. Children's Mental Health Emergency Department Visits: 2007-2016. Pediatrics. 2020 Jun;145(6):e20191536.

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 Graduate Medical Education. 2020 Feb;12(1):51-57.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 65

FAST FACTS

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

July 2019 through June 2020 ED Visits (Includes All Visits Regardless of Disposition): .84,852 Urgent Care Visits Main Campus Urgent Care: ..................................... 42,109 Canal Winchester Urgent Care: ................................ 13,649 Dublin Urgent Care: ................................................... 9,712 East Broad Urgent Care: .......................................... 20,377 Hilliard Urgent Care: ................................................ 15,113 Marysville Urgent Care: ............................................. 9,311 Westerville Urgent Care: .......................................... 24,598 Total Urgent Care Visits:.......................................... 134,869

PEDIATRIC EMERGENCY MEDICINE Bridget Bonaventura, MD Crista Cerrone, MD Courtney Coyle, MD Kristol Das, MD Nathaniel Forman, MD Michelle Greene, DO Nita Gupta, MD Lia Holzman, MD Yamin Jadcherla, MD Chelsea Kadish, MD Jennifer Nystrom, MD Alan Potts, MD 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

FAST FACTS

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

July 2019 through June 2020 ED Visits (Includes All Visits Regardless of Disposition): .84,852 Urgent Care Visits Main Campus Urgent Care: ..................................... 42,109 Canal Winchester Urgent Care: ................................ 13,649 Dublin Urgent Care: ................................................... 9,712 East Broad Urgent Care: .......................................... 20,377 Hilliard Urgent Care: ................................................ 15,113 Marysville Urgent Care: ............................................. 9,311 Westerville Urgent Care: .......................................... 24,598 Total Urgent Care Visits:.......................................... 134,869

PEDIATRIC EMERGENCY MEDICINE Bridget Bonaventura, MD Crista Cerrone, MD Courtney Coyle, MD Kristol Das, MD Nathaniel Forman, MD Michelle Greene, DO Nita Gupta, MD Lia Holzman, MD Yamin Jadcherla, MD Chelsea Kadish, MD Jennifer Nystrom, MD Alan Potts, MD 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 followup 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.

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

– Kathryn Obrynba, MD

These patients completed the screening at check-in, independent of a social worker. Several high-level changes were also implemented such as an electronic dashboard within each patient’s EMR to track delivery of care.

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.

68 68| NATIONWIDE | NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| 2019-20 | 2019-20 Annual Annual Report Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 69

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 followup 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.

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

– Kathryn Obrynba, MD

These patients completed the screening at check-in, independent of a social worker. Several high-level changes were also implemented such as an electronic dashboard within each patient’s EMR to track delivery of care.

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.

68 68| NATIONWIDE | NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| 2019-20 | 2019-20 Annual Annual Report Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 69

Department of Pediatrics

ENDOCRINOLOGY The Section of Endocrinology at Nationwide Children’s Hospital provides comprehensive primary and consultative services for the diagnosis and treatment of endocrine/hormone disorders and diabetes mellitus 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 and puberty, thyroid gland disorders, thyroid nodules and cancers, adrenal gland disorders, disorders of bone metabolism, genetic syndromes with hormone disturbances, diabetes insipidus, and differences of sexual development and gender identification.

FACULTY

Manmohan K. Kamboj, MD Division Chief Sasigarn A. Bowden, MD Monika Chaudhari, MD Kajal Gandhi, DO Rohan K. Henry, MD, MS Robert P. Hoffman, MD Justin A. Indyk, MD, PhD Leena Mamilly, MD Leena Nahata, MD

include Metabolic Bone Disease, Cystic Fibrosis-Related Diabetes, Prader-Willi Syndrome Clinic, Bone Marrow Transplant Long-term Follow-up Clinic, Muscular Dystrophy Clinic, Thyroid Nodule/Cancer, Type 2 Diabetes clinics, fertility consultations, Sickle Cell Clinic, Young Adult Diabetes Transition Clinic, and the THRIVE program (differences of sexual development).

The section maintains a robust quality improvement portfolio that includes over 15 active projects designed to achieve best outcomes for patients with diabetes mellitus and endocrine disorders. As a member of the National T1D Exchange Quality Improvement Collaborative, the section participates in initiatives to further expand the reach of quality improvement best practices nationally.

The Section of Endocrinology is a major referral center for children and adolescents in and beyond central Ohio and is a consultative resource for the Ohio Department of Health Newborn Screening Program for congenital hypothyroidism and congenital adrenal hyperplasia.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $344,567

Kathryn Obrynba, MD

SELECTED PUBLICATIONS

Juan F. Sotos, MD (Emeritus)

Bowden SA, Connolly AM, Kinnett K, Zeitler PS. Management of Adrenal Insufficiency Risk After Long-term Systemic Glucocorticoid Therapy in Duchenne Muscular Dystrophy: Clinical Practice Recommendations. Journal of Neuromuscular Diseases.

2019;6(1):31-41.

Aurelia C.H. Wood, MD The Section of Endocrinology currently has 11 active pediatric endocrinologists, five advanced practitioners and four pediatric endocrinology fellows. The section presently conducts 15,000 outpatient appointments per year. In 2019, there were over 330 patients diagnosed with new-onset diabetes, and over 2,000 patients with diabetes mellitus being followed at Nationwide Children’s on a regular basis.

Glick BA, Hong KMC, Buckingham D, Moore-Clingenpeel M, Salvator A, Kamboj MK. Validation of a Risk Screening Tool for Pediatric Type 1 Diabetes Patients: A Predictor of Increased Acute Health Care Utilization. Journal of Pediatric Endocrinology & Metabolism. 2019 Oct 25;32(10):1155-1162.

The section collaborates closely with other disciplines to offer endocrine expertise in the multidisciplinary clinic format to facilitate patient care. At present, these

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. Pediatr Diabetes. 2020;21(4):637-643.

Hoffman RP, Copenhaver MM, Zhou D, Yu CY. Increased Body Fat and Reduced Insulin Sensitivity are Associated with Impaired Endothelial Function and Subendocardial Viability in Healthy, Non-Hispanic White Adolescents. Pediatric Diabetes. 2019 Nov;20(7):842-848.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:..................................................... 370

Dublin Endocrinology Clinic Visits:.............................. 1,425

Observation and Outpatient-in-a-Bed Discharges:........ 231

East Broad Endocrinology Clinic Visits:.......................... 595

Total Discharges:........................................................... 595

Endocrinology Clinic Visits:......................................... 9,777

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

Inpatient Consults:......................................................... 449

*Excludes observation and outpatient-in-a-bed patients.

Canal Winchester Endocrinology Clinic Visits:................ 276

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC ENDOCRINOLOGY Cecilia Damilano, MD Alissa M. Guarneri, MD Nisha Patel, MD

A Decade of Remarkable Transformation ENDOCRINOLOGY

Juan Sotos, MD, Honored for Dedication and Vast Contributions to the Field of Pediatric Endocrinology

Developed Diabetes Calculator for Kids — First-of-Its-Kind Electronic Tool

2010

2013

2014 New THRIVE Program Specializes in Care for Differences of Sexual Development, Complex Urological Problems and Gender Concerns

2015

Manmohan Kamboj, MD, Named Division Chief

2013 2018

2017 2020 2019

Nationwide Children’s Joins T1D Exchange Quality Improvement Collaborative

Over the last 10 years, Endocrinology has expanded to provide comprehensive programs for pediatric and adolescent endocrine care including Prader Willi disease, fertility, gender diversity, and difference of sex development. The division has also become a national leader in diabetes quality improvement initiatives by joining the T1D Exchange Quality Improvement Collaborative.

Nahata L, Morgan TL, Lipak KG, Olshefski RS, Gerhardt CA, Lehmann V. Romantic Relationships and Physical Intimacy Among Survivors of Childhood Cancer. Journal of Adolescent and Young Adult Oncology. 2020 Jun;9(3):359-366.

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

Department of Pediatrics

ENDOCRINOLOGY The Section of Endocrinology at Nationwide Children’s Hospital provides comprehensive primary and consultative services for the diagnosis and treatment of endocrine/hormone disorders and diabetes mellitus 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 and puberty, thyroid gland disorders, thyroid nodules and cancers, adrenal gland disorders, disorders of bone metabolism, genetic syndromes with hormone disturbances, diabetes insipidus, and differences of sexual development and gender identification.

FACULTY

Manmohan K. Kamboj, MD Division Chief Sasigarn A. Bowden, MD Monika Chaudhari, MD Kajal Gandhi, DO Rohan K. Henry, MD, MS Robert P. Hoffman, MD Justin A. Indyk, MD, PhD Leena Mamilly, MD Leena Nahata, MD

include Metabolic Bone Disease, Cystic Fibrosis-Related Diabetes, Prader-Willi Syndrome Clinic, Bone Marrow Transplant Long-term Follow-up Clinic, Muscular Dystrophy Clinic, Thyroid Nodule/Cancer, Type 2 Diabetes clinics, fertility consultations, Sickle Cell Clinic, Young Adult Diabetes Transition Clinic, and the THRIVE program (differences of sexual development).

The section maintains a robust quality improvement portfolio that includes over 15 active projects designed to achieve best outcomes for patients with diabetes mellitus and endocrine disorders. As a member of the National T1D Exchange Quality Improvement Collaborative, the section participates in initiatives to further expand the reach of quality improvement best practices nationally.

The Section of Endocrinology is a major referral center for children and adolescents in and beyond central Ohio and is a consultative resource for the Ohio Department of Health Newborn Screening Program for congenital hypothyroidism and congenital adrenal hyperplasia.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $344,567

Kathryn Obrynba, MD

SELECTED PUBLICATIONS

Juan F. Sotos, MD (Emeritus)

Bowden SA, Connolly AM, Kinnett K, Zeitler PS. Management of Adrenal Insufficiency Risk After Long-term Systemic Glucocorticoid Therapy in Duchenne Muscular Dystrophy: Clinical Practice Recommendations. Journal of Neuromuscular Diseases.

2019;6(1):31-41.

Aurelia C.H. Wood, MD The Section of Endocrinology currently has 11 active pediatric endocrinologists, five advanced practitioners and four pediatric endocrinology fellows. The section presently conducts 15,000 outpatient appointments per year. In 2019, there were over 330 patients diagnosed with new-onset diabetes, and over 2,000 patients with diabetes mellitus being followed at Nationwide Children’s on a regular basis.

Glick BA, Hong KMC, Buckingham D, Moore-Clingenpeel M, Salvator A, Kamboj MK. Validation of a Risk Screening Tool for Pediatric Type 1 Diabetes Patients: A Predictor of Increased Acute Health Care Utilization. Journal of Pediatric Endocrinology & Metabolism. 2019 Oct 25;32(10):1155-1162.

The section collaborates closely with other disciplines to offer endocrine expertise in the multidisciplinary clinic format to facilitate patient care. At present, these

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. Pediatr Diabetes. 2020;21(4):637-643.

Hoffman RP, Copenhaver MM, Zhou D, Yu CY. Increased Body Fat and Reduced Insulin Sensitivity are Associated with Impaired Endothelial Function and Subendocardial Viability in Healthy, Non-Hispanic White Adolescents. Pediatric Diabetes. 2019 Nov;20(7):842-848.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:..................................................... 370

Dublin Endocrinology Clinic Visits:.............................. 1,425

Observation and Outpatient-in-a-Bed Discharges:........ 231

East Broad Endocrinology Clinic Visits:.......................... 595

Total Discharges:........................................................... 595

Endocrinology Clinic Visits:......................................... 9,777

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

Inpatient Consults:......................................................... 449

*Excludes observation and outpatient-in-a-bed patients.

Canal Winchester Endocrinology Clinic Visits:................ 276

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC ENDOCRINOLOGY Cecilia Damilano, MD Alissa M. Guarneri, MD Nisha Patel, MD

A Decade of Remarkable Transformation ENDOCRINOLOGY

Juan Sotos, MD, Honored for Dedication and Vast Contributions to the Field of Pediatric Endocrinology

Developed Diabetes Calculator for Kids — First-of-Its-Kind Electronic Tool

2010

2013

2014 New THRIVE Program Specializes in Care for Differences of Sexual Development, Complex Urological Problems and Gender Concerns

2015

Manmohan Kamboj, MD, Named Division Chief

2013 2018

2017 2020 2019

Nationwide Children’s Joins T1D Exchange Quality Improvement Collaborative

Over the last 10 years, Endocrinology has expanded to provide comprehensive programs for pediatric and adolescent endocrine care including Prader Willi disease, fertility, gender diversity, and difference of sex development. The division has also become a national leader in diabetes quality improvement initiatives by joining the T1D Exchange Quality Improvement Collaborative.

Nahata L, Morgan TL, Lipak KG, Olshefski RS, Gerhardt CA, Lehmann V. Romantic Relationships and Physical Intimacy Among Survivors of Childhood Cancer. Journal of Adolescent and Young Adult Oncology. 2020 Jun;9(3):359-366.

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.”

– Peter Lu, MD, MS

| NATIONWIDE CHILDREN’S HOSPITAL| 2019-20 | 2019-20 Annual Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report 72 72| NATIONWIDE CHILDREN’S HOSPITAL Annual Report

“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 who deserve our attention and care.”

REFERENCE: 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.

Neurogastroenterology and Motility. 2020;e13809.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 73

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.”

– Peter Lu, MD, MS

| NATIONWIDE CHILDREN’S HOSPITAL| 2019-20 | 2019-20 Annual Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report 72 72| NATIONWIDE CHILDREN’S HOSPITAL Annual Report

“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 who deserve our attention and care.”

REFERENCE: 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.

Neurogastroenterology and Motility. 2020;e13809.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 73

Department of Pediatrics

GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION Consistently ranked as a top 10 digestive disorders program by U.S. News & World Report, the Division of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s Hospital provides comprehensive care for a broad range of gastrointestinal, liver, pancreatic and nutritional problems. The division strives for excellence in research, teaching and clinical care and maintains a team of physician-scientists committed to the creation of new knowledge in the discipline. Our physicians work with pediatric nurse practitioners to diagnose and treat gastrointestinal, pancreatic and liver disorders while collaborating with other specialists, such as dietitians, behavioral and developmental psychologists and surgeons to provide comprehensive, coordinated care for each child.

FACULTY

Monique Goldschmidt, MD Jennifer Lee, MD Peter Lu, MD Ross Maltz, MD Hilary Michel, MD Ethan Mezoff, MD Carol J. Potter, MD John M. Russo, MD

Carlo Di Lorenzo, MD Division Chief

Ala K. Shaikhkhalil, MD Karla K. Vaz, MD Rajitha Venkatesh, MD

MD, and Jennifer Dotson, MD, is a leader in providing standardized care for children with Crohn’s disease and ulcerative colitis and boasts one of the highest remission rates in the country. The Intestinal Rehabilitation Service, led by Molly Dienhart, MD, and Ethan Mezoff, MD, follows a large cohort of children with intestinal failure and has some of the best outcomes in the country in the care of children with short bowel syndrome. The Celiac Disease Center, led by Tracy Ediger, MD, and Section Chief Ivor Hill, MD, is a leader in providing more standardized care to improve long-term outcomes for children with celiac disease. In addition, Steven Erdman, MD, is a world leader in the care of children with polyposis syndromes. A comprehensive Liver Disease Center, including a liver transplant program, is led by Alex Weymann, MD, and includes hepatologists Monique Goldschmidt, MD, Carol Potter, MD, and Cheryl Gariepy, MD, and a highly skilled transplant surgeon, Ken Washburn, MD. The Pancreas Center is accredited by the National Pancreas Foundation and is directed by Cheryl Gariepy, MD. It provides state-ofthe-art multidisciplinary care for infants, children and teens suffering from diseases of the pancreas. The division also provides specialized care with dedicated clinics for children with esophageal eosinophilic disease, autism and gastrointestinal disorders, muscular dystrophy, congenital heart diseases, cystic fibrosis and aero-digestive disorders.

Alex Weymann, MD

Ivor D. Hill, MD Section Chief Neetu Bali, MD John A. Barnard, MD Brendan M. Boyle, MD, MPH Steve L. Ciciora, MD Molly C. Dienhart, MD Jennifer L. Dotson, MD, MPH Tracy R. Ediger, MD, PhD Steven H. Erdman, MD Cheryl E. Gariepy, MD Jonathan M. Gisser, MD

74 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SELECTED PUBLICATIONS Gupta SR, Crandall WV, Donegan A, Johnson M, Drobnic B, Oates M, Boyle B, Maltz RM, Dotson JL. A Quality Improvement Approach to External Infliximab Infusions in Pediatric Inflammatory Bowel Disease. Journal of Pediatric Gastroenterology and Nutrition.

2019 Nov;69(5):544-550.

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 Shortchain Fatty Acid Levels and Receptors. Journal of Pediatric Gastroenterology and Nutrition.

2019;68:533-540.

Mezoff EA, Minneci PC, Hoyt RR, Hoffman JM. Toward an Electronic Health Record Leveraged to Learn from Every Complex Patient Encounter: Health Informatics Considerations with Pediatric Intestinal Rehabilitation as a Model. The Journal of Pediatrics. 2019 Dec;215:257-263.

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 Journal of Pediatrics. 2020 Jan;216:32-36.e2.

Vriesman MH, Wang L, Park C, Diefenbach KA, Levitt MA, Wood RJ, Alpert SA, 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 functional constipation and fecal incontinence. Neurogastroenterology and Motility. 2020 Aug;32(8):e13809. [Epub ahead of print]

July 2019 through June 2020

Frederick W. Woodley, PhD

The Division of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s provides comprehensive care through multiple multidisciplinary clinics and services for children from all over the world.

It has consistently been ranked among the top 10 programs in the country for the past 10 years by U.S. News & World Report, and is nationally recognized for its expertise in a number of gastrointestinal disorders.

The Motility Center remains a national leader in caring for children with neuro-gastrointestinal and functional disorders. Motility Center leadership includes Carlo Di Lorenzo, MD, chief of Gastroenterology, and Desale Yacob, MD, the center’s medical director, as well as Karla Vaz, MD, Neetu Bali, MD, Peter Lu, MD, and Ashley Kroon Van Diest, PhD. In partnership with the Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s, the Motility Center provides an exceptionally high level of comprehensive medical and surgical services for children with complex motility disorders. The Inflammatory Bowel Disease Center at Nationwide Children’s, co-directed by Brendan Boyle,

$70,053

FAST FACTS

Kent C. Williams, MD Desale Yacob, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Inpatient Discharges:..................................................... 558

GI Allergy Clinic Visits:..................................................... 63

Observation and Outpatient-in-a-Bed Discharges:........ 330

Gastroenterology Clinic Visits:................................... 15,137

Total Discharges:........................................................... 883

Mansfield Gastroenterology Clinic Visits:....................... 296

Average Length of Stay*:................................................ 6.1

Schrock Road Gastroenterology Clinic Visits:................. 132

Average Daily Census*:.................................................. 9.3

Westerville Gastroenterology Clinic Visits:................... 1,276

Patient Days*:............................................................. 3,289

Lima Gastroenterology Clinic Visits:............................... 293

Total Surgical Procedures:.......................................... 2,780

Total GI Clinic Visits:.................................................. 18,459

Dublin Gastroenterology Clinic Visits:.......................... 1,262

*Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC GASTROENTEROLOGY Zeyad Abdulkader, MD Madelyn Cohen, MD Colleen Flahive, MD Shivani Gupta, MD Kathryn Hawa, MD Grant Morris, MD

Salman S. Salman, MD Raul Sanchez, MD Monica Shukla-Udawatta, MD GI MOTILITY Nancy Swiader, DO

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 75

Department of Pediatrics

GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION Consistently ranked as a top 10 digestive disorders program by U.S. News & World Report, the Division of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s Hospital provides comprehensive care for a broad range of gastrointestinal, liver, pancreatic and nutritional problems. The division strives for excellence in research, teaching and clinical care and maintains a team of physician-scientists committed to the creation of new knowledge in the discipline. Our physicians work with pediatric nurse practitioners to diagnose and treat gastrointestinal, pancreatic and liver disorders while collaborating with other specialists, such as dietitians, behavioral and developmental psychologists and surgeons to provide comprehensive, coordinated care for each child.

FACULTY

Monique Goldschmidt, MD Jennifer Lee, MD Peter Lu, MD Ross Maltz, MD Hilary Michel, MD Ethan Mezoff, MD Carol J. Potter, MD John M. Russo, MD

Carlo Di Lorenzo, MD Division Chief

Ala K. Shaikhkhalil, MD Karla K. Vaz, MD Rajitha Venkatesh, MD

MD, and Jennifer Dotson, MD, is a leader in providing standardized care for children with Crohn’s disease and ulcerative colitis and boasts one of the highest remission rates in the country. The Intestinal Rehabilitation Service, led by Molly Dienhart, MD, and Ethan Mezoff, MD, follows a large cohort of children with intestinal failure and has some of the best outcomes in the country in the care of children with short bowel syndrome. The Celiac Disease Center, led by Tracy Ediger, MD, and Section Chief Ivor Hill, MD, is a leader in providing more standardized care to improve long-term outcomes for children with celiac disease. In addition, Steven Erdman, MD, is a world leader in the care of children with polyposis syndromes. A comprehensive Liver Disease Center, including a liver transplant program, is led by Alex Weymann, MD, and includes hepatologists Monique Goldschmidt, MD, Carol Potter, MD, and Cheryl Gariepy, MD, and a highly skilled transplant surgeon, Ken Washburn, MD. The Pancreas Center is accredited by the National Pancreas Foundation and is directed by Cheryl Gariepy, MD. It provides state-ofthe-art multidisciplinary care for infants, children and teens suffering from diseases of the pancreas. The division also provides specialized care with dedicated clinics for children with esophageal eosinophilic disease, autism and gastrointestinal disorders, muscular dystrophy, congenital heart diseases, cystic fibrosis and aero-digestive disorders.

Alex Weymann, MD

Ivor D. Hill, MD Section Chief Neetu Bali, MD John A. Barnard, MD Brendan M. Boyle, MD, MPH Steve L. Ciciora, MD Molly C. Dienhart, MD Jennifer L. Dotson, MD, MPH Tracy R. Ediger, MD, PhD Steven H. Erdman, MD Cheryl E. Gariepy, MD Jonathan M. Gisser, MD

74 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SELECTED PUBLICATIONS Gupta SR, Crandall WV, Donegan A, Johnson M, Drobnic B, Oates M, Boyle B, Maltz RM, Dotson JL. A Quality Improvement Approach to External Infliximab Infusions in Pediatric Inflammatory Bowel Disease. Journal of Pediatric Gastroenterology and Nutrition.

2019 Nov;69(5):544-550.

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 Shortchain Fatty Acid Levels and Receptors. Journal of Pediatric Gastroenterology and Nutrition.

2019;68:533-540.

Mezoff EA, Minneci PC, Hoyt RR, Hoffman JM. Toward an Electronic Health Record Leveraged to Learn from Every Complex Patient Encounter: Health Informatics Considerations with Pediatric Intestinal Rehabilitation as a Model. The Journal of Pediatrics. 2019 Dec;215:257-263.

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 Journal of Pediatrics. 2020 Jan;216:32-36.e2.

Vriesman MH, Wang L, Park C, Diefenbach KA, Levitt MA, Wood RJ, Alpert SA, 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 functional constipation and fecal incontinence. Neurogastroenterology and Motility. 2020 Aug;32(8):e13809. [Epub ahead of print]

July 2019 through June 2020

Frederick W. Woodley, PhD

The Division of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s provides comprehensive care through multiple multidisciplinary clinics and services for children from all over the world.

It has consistently been ranked among the top 10 programs in the country for the past 10 years by U.S. News & World Report, and is nationally recognized for its expertise in a number of gastrointestinal disorders.

The Motility Center remains a national leader in caring for children with neuro-gastrointestinal and functional disorders. Motility Center leadership includes Carlo Di Lorenzo, MD, chief of Gastroenterology, and Desale Yacob, MD, the center’s medical director, as well as Karla Vaz, MD, Neetu Bali, MD, Peter Lu, MD, and Ashley Kroon Van Diest, PhD. In partnership with the Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s, the Motility Center provides an exceptionally high level of comprehensive medical and surgical services for children with complex motility disorders. The Inflammatory Bowel Disease Center at Nationwide Children’s, co-directed by Brendan Boyle,

$70,053

FAST FACTS

Kent C. Williams, MD Desale Yacob, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Inpatient Discharges:..................................................... 558

GI Allergy Clinic Visits:..................................................... 63

Observation and Outpatient-in-a-Bed Discharges:........ 330

Gastroenterology Clinic Visits:................................... 15,137

Total Discharges:........................................................... 883

Mansfield Gastroenterology Clinic Visits:....................... 296

Average Length of Stay*:................................................ 6.1

Schrock Road Gastroenterology Clinic Visits:................. 132

Average Daily Census*:.................................................. 9.3

Westerville Gastroenterology Clinic Visits:................... 1,276

Patient Days*:............................................................. 3,289

Lima Gastroenterology Clinic Visits:............................... 293

Total Surgical Procedures:.......................................... 2,780

Total GI Clinic Visits:.................................................. 18,459

Dublin Gastroenterology Clinic Visits:.......................... 1,262

*Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC GASTROENTEROLOGY Zeyad Abdulkader, MD Madelyn Cohen, MD Colleen Flahive, MD Shivani Gupta, MD Kathryn Hawa, MD Grant Morris, MD

Salman S. Salman, MD Raul Sanchez, MD Monica Shukla-Udawatta, MD GI MOTILITY Nancy Swiader, DO

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 75

A Decade of Remarkable Transformation GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION First Use of Wireless Motility Capsule in Pediatric Patient

2010

2011 First Rumination Syndrome Treatment Program in Pediatrics

Center For Colorectal & Pelvic Reconstruction is World’s First to Formally Integrate Clinical and Surgical Specialties

2012 2012 Carlo Di Lorenzo, MD, is NASPGHAN President-Elect

2013

NASPGHAN Honors John Barnard, MD, With Harry Shwachman Award for Lifelong Contributions

2017 2020 20132018 2017 Liver Transplant Center Launched

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.

76 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 77

A Decade of Remarkable Transformation GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION First Use of Wireless Motility Capsule in Pediatric Patient

2010

2011 First Rumination Syndrome Treatment Program in Pediatrics

Center For Colorectal & Pelvic Reconstruction is World’s First to Formally Integrate Clinical and Surgical Specialties

2012 2012 Carlo Di Lorenzo, MD, is NASPGHAN President-Elect

2013

NASPGHAN Honors John Barnard, MD, With Harry Shwachman Award for Lifelong Contributions

2017 2020 20132018 2017 Liver Transplant Center Launched

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.

76 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 77

Department of Pediatrics

GENETIC AND GENOMIC MEDICINE

SELECTED PUBLICATIONS

The mission of the Division of Genetic and Genomic Medicine at Nationwide Children’s Hospital is to deliver compassionate, family-centered care via genetic/genomic diagnostic and therapeutic services while providing counseling, education, research and advocacy to improve the lives of individuals with genetic conditions. We treat inborn errors of metabolism and genetic conditions across the ages from preconception and prenatal through childhood and well into adulthood. Clinical services are supported partly by the Ohio Department of Health as a Regional Genetics Center of the state of Ohio, Region IV. Research partners include the Steve and Cindy Rasmussen Institute for Genomic Medicine and Centers for Gene Therapy and Cardiovascular Research.

Meyer AP, Roggenbuck J, LoRusso S, Kissel J, Smith RM, Kline D, Arnold WD. Genotype-Phenotype Correlations and Characterization of Medication Use in Inherited Myotonic Disorders. Frontiers in Neurology. 2020 Jun 26;11:593.

Chaudhari BP, Manickam K, McBride KL. A Pediatric Perspective on Genomics and Prevention in the Twenty-First Century. Pediatric Research. 2020 Jan;87(2):338-344.

Koboldt DC, Hickey SE, Chaudhari BP, Mihalic Mosher T, Bedrosian T, Crist E, Kaler SG, McBride K, White P, Wilson RK. Early-onset Wilson Disease Caused by ATP7B Exon Skipping Associated with Intronic Variant. Cold Spring Harbor Molecular Case Studies. 2020 Jun 12;6(3):a005306.

Mihalic Mosher T, 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.

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 Guidelines Committee. Systematic Evidence-Based Review: Outcomes From Exome and Genome Sequencing for Pediatric Patients with Congenital Anomalies or Intellectual Disability. Genetics in Medicine. 2020 Jun;22(6):986-1004.

FAST FACTS FACULTY

Kim L. McBride, MD, MS Division Chief

Dennis W. Bartholomew, MD Section Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Bimal Chaudhari, MD, MPH Scott E. Hickey, MD Stephen G. Kaler, MD Kandamurugu (Murugu) Manickam, MD Mari Mori, MD Kristin Truxal, MD

Our division has had an excellent year and notable achievements in all our core mission areas. Services and counseling continue to grow. We welcomed two academic physicians to the division: Dr. Bimal Chaudhari (also in Neonatology and IGM) and Dr. Stephen Kaler (Gene Therapy). Our solid group of genetic counselors was recently rounded out to include 10 in genetics, one in cardiology, one in developmental pediatrics, two in neurology, one in neuromuscular, and two shared with the Steve and Cindy Rasmussen Institute for Genomic Medicine. We also launched a new clinic for Menkes disease by nationally known Dr. Kaler. Education continues for genetic counseling 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 a Medical Biochemical Genetics Fellowship to our program (directed by Dr. Bartholomew, Dr. Hickey and Dr. Mori). Our group continues to influence the field at the national level through the creation of practice guidelines on exome sequencing (Hickey), management 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 the Institute’s Rare Disease Program has had success in both describing new manifestations of genetic disorders and also describing novel mechanisms of disease, best exemplified by a publication on Wilson disease that brought together our newest faculty, existing geneticists and Institute faculty. Finally, we continue to advocate and lobby at the state and federal level for recognition of genetic counselors as Centers for Medicare & Medicaid Services providers.

July 2019 through June 2020 Inpatient Discharges:....................................................... 27 Observation and Outpatient-in-a-Bed Discharges:.......... 19 Total Nationwide Children’s Discharges:.......................... 46 Average Length of Stay*:................................................ 3.7 Average Daily Census*:.................................................. 0.3 Patient Days*:................................................................ 101 Inpatient Consults:......................................................... 230 *Excludes observation and outpatient-in-a-bed patients.

Outpatient Visits Athens Genetics Clinic Visits:........................................... 15 Cardiogenetics Clinic Visits:........................................... 200 Genetics (Main Campus) Clinic Visits:......................... 2,449 Dublin Genetics Clinic Visits:.......................................... 102 Lima Genetics Clinic Visits:.............................................. 53 Marietta Genetics Clinic Visits:......................................... 15 Westerville Genetics Clinic Visits:................................... 163 Zanesville Genetics Clinic Visits:...................................... 15

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM MEDICAL GENETICS April Lehman, MD Bianca Zapanata, MD

GRANTS AWARDED TO CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $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

Department of Pediatrics

GENETIC AND GENOMIC MEDICINE

SELECTED PUBLICATIONS

The mission of the Division of Genetic and Genomic Medicine at Nationwide Children’s Hospital is to deliver compassionate, family-centered care via genetic/genomic diagnostic and therapeutic services while providing counseling, education, research and advocacy to improve the lives of individuals with genetic conditions. We treat inborn errors of metabolism and genetic conditions across the ages from preconception and prenatal through childhood and well into adulthood. Clinical services are supported partly by the Ohio Department of Health as a Regional Genetics Center of the state of Ohio, Region IV. Research partners include the Steve and Cindy Rasmussen Institute for Genomic Medicine and Centers for Gene Therapy and Cardiovascular Research.

Meyer AP, Roggenbuck J, LoRusso S, Kissel J, Smith RM, Kline D, Arnold WD. Genotype-Phenotype Correlations and Characterization of Medication Use in Inherited Myotonic Disorders. Frontiers in Neurology. 2020 Jun 26;11:593.

Chaudhari BP, Manickam K, McBride KL. A Pediatric Perspective on Genomics and Prevention in the Twenty-First Century. Pediatric Research. 2020 Jan;87(2):338-344.

Koboldt DC, Hickey SE, Chaudhari BP, Mihalic Mosher T, Bedrosian T, Crist E, Kaler SG, McBride K, White P, Wilson RK. Early-onset Wilson Disease Caused by ATP7B Exon Skipping Associated with Intronic Variant. Cold Spring Harbor Molecular Case Studies. 2020 Jun 12;6(3):a005306.

Mihalic Mosher T, 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.

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 Guidelines Committee. Systematic Evidence-Based Review: Outcomes From Exome and Genome Sequencing for Pediatric Patients with Congenital Anomalies or Intellectual Disability. Genetics in Medicine. 2020 Jun;22(6):986-1004.

FAST FACTS FACULTY

Kim L. McBride, MD, MS Division Chief

Dennis W. Bartholomew, MD Section Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Bimal Chaudhari, MD, MPH Scott E. Hickey, MD Stephen G. Kaler, MD Kandamurugu (Murugu) Manickam, MD Mari Mori, MD Kristin Truxal, MD

Our division has had an excellent year and notable achievements in all our core mission areas. Services and counseling continue to grow. We welcomed two academic physicians to the division: Dr. Bimal Chaudhari (also in Neonatology and IGM) and Dr. Stephen Kaler (Gene Therapy). Our solid group of genetic counselors was recently rounded out to include 10 in genetics, one in cardiology, one in developmental pediatrics, two in neurology, one in neuromuscular, and two shared with the Steve and Cindy Rasmussen Institute for Genomic Medicine. We also launched a new clinic for Menkes disease by nationally known Dr. Kaler. Education continues for genetic counseling 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 a Medical Biochemical Genetics Fellowship to our program (directed by Dr. Bartholomew, Dr. Hickey and Dr. Mori). Our group continues to influence the field at the national level through the creation of practice guidelines on exome sequencing (Hickey), management 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 the Institute’s Rare Disease Program has had success in both describing new manifestations of genetic disorders and also describing novel mechanisms of disease, best exemplified by a publication on Wilson disease that brought together our newest faculty, existing geneticists and Institute faculty. Finally, we continue to advocate and lobby at the state and federal level for recognition of genetic counselors as Centers for Medicare & Medicaid Services providers.

July 2019 through June 2020 Inpatient Discharges:....................................................... 27 Observation and Outpatient-in-a-Bed Discharges:.......... 19 Total Nationwide Children’s Discharges:.......................... 46 Average Length of Stay*:................................................ 3.7 Average Daily Census*:.................................................. 0.3 Patient Days*:................................................................ 101 Inpatient Consults:......................................................... 230 *Excludes observation and outpatient-in-a-bed patients.

Outpatient Visits Athens Genetics Clinic Visits:........................................... 15 Cardiogenetics Clinic Visits:........................................... 200 Genetics (Main Campus) Clinic Visits:......................... 2,449 Dublin Genetics Clinic Visits:.......................................... 102 Lima Genetics Clinic Visits:.............................................. 53 Marietta Genetics Clinic Visits:......................................... 15 Westerville Genetics Clinic Visits:................................... 163 Zanesville Genetics Clinic Visits:...................................... 15

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM MEDICAL GENETICS April Lehman, MD Bianca Zapanata, MD

GRANTS AWARDED TO CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $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

80 80| NATIONWIDE | NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| 2019-20 | 2019-20 Annual Annual Report Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 81

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

80 80| NATIONWIDE | NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| 2019-20 | 2019-20 Annual Annual Report Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 81

Department of Pediatrics

HEMATOLOGY, ONCOLOGY & BLOOD AND MARROW TRANSPLANT The Division of Hematology, Oncology & Blood and Marrow Transplant at Nationwide Children’s Hospital treats patients with any one of a full array of blood diseases, cancers, immunodeficiency disorders, bone marrow failure syndromes and inherited metabolic storage diseases. Our clinical team oversees the comprehensive evaluation, multidisciplinary diagnosis, treatment and long-term management of children, adolescents and young adults with blood diseases and cancer, as well as other diseases treated by cellular therapies or apheresis. In addition to clinical care, through our integrated programs within the Abigail Wexner Research Institute’s Center for Childhood Cancer and Blood Diseases, the Steve and Cindy Rasmussen Institute for Genomic Medicine, and the Biopathology Center, we seek to transform the way patients with cancer and blood diseases are cared for by fully integrating research, cutting-edge therapies and multidisciplinary teams.

FACULTY

Jonathan L. Finlay, MB, ChB Molly Gardner, PhD Cynthia A. Gerhardt, PhD Terri L. Guinipero, MD Jennifer Hansen-Moore, PhD Amanda Jacobson-Kelly, MD Bryce A. Kerlin, MD Riten Kumar, MD Dean Lee, MD, PhD

Timothy P. Cripe, MD, PhD Division Chief

Kathleen L. Lemanek, PhD Steve Lessnick, MD, PhD Erin Meyer, DO, MPH Sarah H. O’Brien, MD, MS Diana S. Osorio, MD Veronika Polishchuk, MD Mark A. Ranalli, MD Hemalatha G. Rangarajan, MD Suzanne M. Reed, MD Ryan D. Roberts, MD, PhD

Randal S. Olshefski, MD Section Chief

Melissa J. Rose, DO

Mohamed AbdelBaki, MD

Amanda Sankar, MD

Rolla F. Abu-Arja, MD

Bhuvana A. Setty, MD

Anthony N. Audino, MD

Nilay D. Shah, MD

Jeffery J. Auletta, MD

Natalie Slone, DO

Rajinder P. Bajwa, MD, MBBS

Keri A. Streby, MD

Nabanita Bhunia, MD

Kathryn Vannatta, PhD

Susan E. Creary, MD

Elizabeth Varga, MS, LGC

Amy L. Dunn, MD

Susan I. Vear, MD

Claire Russell, PhD

82 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Our large young adult population within our Hemophilia Treatment Center, coupled with the hospital’s research infrastructure and experience administering gene therapy trials, made us an ideal site for these trials.

Anthony D. Villella, MD Andrea Wojtowicz, PhD Nicholas D. Yeager, MD Tammi K. Young-Saleme, PhD Kristin Zajo, MS, LGC

Regionally, we’ve fostered our collaboration with Dayton Children’s Hospital. Our cancer, blood diseases and bone marrow transplant collaborative enhances services and creates more research opportunities for both institutions. Further, it allows more patients from the Dayton region to stay closer to home during treatment, which is extremely important to patients and their families, who can endure medical treatment over several years.

FELLOWS First Year Eman Abdelghani, MD Nicole Kendel, MD Laura Tyrrell, MD Second Year Ashleigh Kussman, MD Lynda Villagomez, MD

In 2019, we realized almost two-fold growth in international referrals. We anticipate continued program growth, with Maryam Fouladi, MD, recently named the co-executive director of the Neuro-Oncology Program at Nationwide Children’s Hospital. Dr. Fouladi will continue her extensive work on diffuse intrinsic pontine gliomas (DIPGs) alongside Jeffrey Leonard, MD, co-executive director of the Neuro-Oncology Program and chief of the Department of Pediatric Neurosurgery at Nationwide Children’s. Dr. Fouladi is the founding director of the Collaborative Network for Neuro-Oncology Clinical Trials (CONNECT), an international consortium that works to develop and test novel therapies in early phase clinical trials.

Third Year Jennifer Belsky, DO Kyle Davis, MD Brian Tullius, MD Fourth Year (BMT) Margaret Lamb, MD Fourth Year (Hemostasis & Thrombosis) Penelope Sandiford, MD Fourth Year (Neuro-Oncology) Margaret Shatara, MD Fourth Year (Sarcoma) Ajay Gupta, MD Through research, patient care and psychosocial support, the Division of Hematology, Oncology & Blood and Marrow Transplant provides a strong foundation for our patients, families and care teams.

For seven straight years, we’ve ranked in the top 10 of U.S. News & World Report. Our discoveries, clinical trials and new treatments offer new hope for patients and families, not only at Nationwide Children’s but around the world.

We were honored to be selected as one of only a few dozen sites worldwide to host three new hemophilia gene therapy clinical trials for adults. Hemophilia is a congenital bleeding disorder caused by lack of a clotting protein. Patients with severe hemophilia require frequent, lifelong intravenous infusions of clotting factor concentrate to protect them from bleeding. The trials each seek to engineer the patient’s own liver to produce normal clotting factor so that patients no longer need regular medication infusions.

Dr. Fouladi is also the founding chair of the International Diffuse Intrinsic Pontine Glioma (DIPG) and Diffuse Midline Glioma (DMG) registries and has served as the chair of CONNECT and the CNS Committee of the Children’s Oncology Group.

Through our clinical and research work, driven by the best and brightest physicians and staff, we vow to remain on the cutting edge of solutions for our patients worldwide.

Center for Childhood Cancer: See page 183 for information about the Center for Childhood Cancer in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED TO CENTER AND DIVISION CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $15,198,205

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 83

Department of Pediatrics

HEMATOLOGY, ONCOLOGY & BLOOD AND MARROW TRANSPLANT The Division of Hematology, Oncology & Blood and Marrow Transplant at Nationwide Children’s Hospital treats patients with any one of a full array of blood diseases, cancers, immunodeficiency disorders, bone marrow failure syndromes and inherited metabolic storage diseases. Our clinical team oversees the comprehensive evaluation, multidisciplinary diagnosis, treatment and long-term management of children, adolescents and young adults with blood diseases and cancer, as well as other diseases treated by cellular therapies or apheresis. In addition to clinical care, through our integrated programs within the Abigail Wexner Research Institute’s Center for Childhood Cancer and Blood Diseases, the Steve and Cindy Rasmussen Institute for Genomic Medicine, and the Biopathology Center, we seek to transform the way patients with cancer and blood diseases are cared for by fully integrating research, cutting-edge therapies and multidisciplinary teams.

FACULTY

Jonathan L. Finlay, MB, ChB Molly Gardner, PhD Cynthia A. Gerhardt, PhD Terri L. Guinipero, MD Jennifer Hansen-Moore, PhD Amanda Jacobson-Kelly, MD Bryce A. Kerlin, MD Riten Kumar, MD Dean Lee, MD, PhD

Timothy P. Cripe, MD, PhD Division Chief

Kathleen L. Lemanek, PhD Steve Lessnick, MD, PhD Erin Meyer, DO, MPH Sarah H. O’Brien, MD, MS Diana S. Osorio, MD Veronika Polishchuk, MD Mark A. Ranalli, MD Hemalatha G. Rangarajan, MD Suzanne M. Reed, MD Ryan D. Roberts, MD, PhD

Randal S. Olshefski, MD Section Chief

Melissa J. Rose, DO

Mohamed AbdelBaki, MD

Amanda Sankar, MD

Rolla F. Abu-Arja, MD

Bhuvana A. Setty, MD

Anthony N. Audino, MD

Nilay D. Shah, MD

Jeffery J. Auletta, MD

Natalie Slone, DO

Rajinder P. Bajwa, MD, MBBS

Keri A. Streby, MD

Nabanita Bhunia, MD

Kathryn Vannatta, PhD

Susan E. Creary, MD

Elizabeth Varga, MS, LGC

Amy L. Dunn, MD

Susan I. Vear, MD

Claire Russell, PhD

82 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Our large young adult population within our Hemophilia Treatment Center, coupled with the hospital’s research infrastructure and experience administering gene therapy trials, made us an ideal site for these trials.

Anthony D. Villella, MD Andrea Wojtowicz, PhD Nicholas D. Yeager, MD Tammi K. Young-Saleme, PhD Kristin Zajo, MS, LGC

Regionally, we’ve fostered our collaboration with Dayton Children’s Hospital. Our cancer, blood diseases and bone marrow transplant collaborative enhances services and creates more research opportunities for both institutions. Further, it allows more patients from the Dayton region to stay closer to home during treatment, which is extremely important to patients and their families, who can endure medical treatment over several years.

FELLOWS First Year Eman Abdelghani, MD Nicole Kendel, MD Laura Tyrrell, MD Second Year Ashleigh Kussman, MD Lynda Villagomez, MD

In 2019, we realized almost two-fold growth in international referrals. We anticipate continued program growth, with Maryam Fouladi, MD, recently named the co-executive director of the Neuro-Oncology Program at Nationwide Children’s Hospital. Dr. Fouladi will continue her extensive work on diffuse intrinsic pontine gliomas (DIPGs) alongside Jeffrey Leonard, MD, co-executive director of the Neuro-Oncology Program and chief of the Department of Pediatric Neurosurgery at Nationwide Children’s. Dr. Fouladi is the founding director of the Collaborative Network for Neuro-Oncology Clinical Trials (CONNECT), an international consortium that works to develop and test novel therapies in early phase clinical trials.

Third Year Jennifer Belsky, DO Kyle Davis, MD Brian Tullius, MD Fourth Year (BMT) Margaret Lamb, MD Fourth Year (Hemostasis & Thrombosis) Penelope Sandiford, MD Fourth Year (Neuro-Oncology) Margaret Shatara, MD Fourth Year (Sarcoma) Ajay Gupta, MD Through research, patient care and psychosocial support, the Division of Hematology, Oncology & Blood and Marrow Transplant provides a strong foundation for our patients, families and care teams.

For seven straight years, we’ve ranked in the top 10 of U.S. News & World Report. Our discoveries, clinical trials and new treatments offer new hope for patients and families, not only at Nationwide Children’s but around the world.

We were honored to be selected as one of only a few dozen sites worldwide to host three new hemophilia gene therapy clinical trials for adults. Hemophilia is a congenital bleeding disorder caused by lack of a clotting protein. Patients with severe hemophilia require frequent, lifelong intravenous infusions of clotting factor concentrate to protect them from bleeding. The trials each seek to engineer the patient’s own liver to produce normal clotting factor so that patients no longer need regular medication infusions.

Dr. Fouladi is also the founding chair of the International Diffuse Intrinsic Pontine Glioma (DIPG) and Diffuse Midline Glioma (DMG) registries and has served as the chair of CONNECT and the CNS Committee of the Children’s Oncology Group.

Through our clinical and research work, driven by the best and brightest physicians and staff, we vow to remain on the cutting edge of solutions for our patients worldwide.

Center for Childhood Cancer: See page 183 for information about the Center for Childhood Cancer in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED TO CENTER AND DIVISION CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $15,198,205

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 83

Department of Pediatrics SELECTED PUBLICATIONS Brown P, Inaba H, Annesley C, Beck J, Colace S, Dallas M, DeSantes K, Kelly K, Kitko C, Lacayo N, Larrier N, Maese L, Mahadeo K, Nanda R, Nardi V, Rodriguez V, Rossoff J, Schuettpelz L, Silverman L, Sun J, Sun W, Teachey D, Wong V, Yanik G, Johnson-Chilla A, Ogba N. Pediatric Acute Lymphoblastic Leukemia, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. The Journal of National Comprehensive Cancer Network. 2020 Jan;18(1):81-112.

Creary S, Chisolm D, Stanek J, Hankins J, O'Brien SH. A Multidimensional Electronic Hydroxyurea Adherence Intervention for Children with Sickle Cell Disease: Single-Arm Before-After Study. JMIR Mhealth and Uhealth. 2019 Aug 8;7(8):e13542.

Dhall G, O’Neil SH, Ji L, Haley K, Whitaker AM, Nelson MD, Gilles F, Gardner SL, 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

Of Young Children With Nodular Desmoplastic Medulloblastoma Treated On "Head Start" III: A Multi-Institutional, Prospective Clinical Trial. Neuro-Oncology. 2020 Apr 18;noaa102.

Jaffray J, Witmer C, O'Brien SH, Diaz R, Ji L, Krava E, Young G. Peripherally Inserted Central Catheters Lead to a High Risk of Venous Thromboembolism in Children. Blood. 2020 Jan 16;135(3):220-226.

Roberts RD, Lizardo MM, Reed DR, Hingorani P, Glover J, Allen-Rhoades W, Fan T, Khanna C, Sweet-Cordero EA, Cash T, Bishop MW, Hegde M, Sertil AR, Koelsche C, Mirabello L, Malkin D, Sorensen PH, Meltzer PS, Janeway KA, Gorlick R, Crompton BD. Provocative Questions In Osteosarcoma Basic And Translational Biology: A Report from the Children's Oncology Group. Cancer. 2019 Oct 15;125(20):35143525.

FAST FACTS

Inpatient Discharges:.................................................. 1,419

BMT Long-term Follow-up Clinic Visits:........................... 67

Observation and Outpatient-in-a-Bed Discharges:........ 271

Anticoagulation Clinic Visits:.......................................... 219

Total Discharges:........................................................ 1,690

Dublin Hematology Clinic Visits:..................................... 121

Patient Days*:............................................................. 9,370

East Broad Sickle Cell Clinic Visits:................................ 122

Average Length of Stay*:................................................ 6.7

Mansfield Hematology/Oncology Clinic Visits:.................. 43

Average Daily Census*:................................................ 25.7

Chillicothe Hematology/Oncology Clinic Visits:................. 19

Inpatient Consults:......................................................... 485

Dayton Hematology/Oncology Clinic Visits:........................ 2

Total Surgical Procedures:............................................. 893

Zanesville Hematology/Oncology Clinic Visits:................. 49

BMT Transplants:............................................................. 82

Surgical Oncology Clinic Visits:...................................... 109

Apheresis and Photopheresis Procedures:..................... 832

Hematology/Oncology Clinic Visits:........................... 10,322

BMT Clinic Visits:........................................................ 3,486

Portsmouth Hematology/Oncology Clinic Visits:................. 8 *Excludes observation and outpatient-in-a-bed patients.

A Decade of Remarkable Transformation

HEMATOLOGY, ONCOLOGY & BLOOD AND MARROW TRANSPLANT

2010

2012

Established NEXT Consortium to Expand Expedited Advance Treatments for Hem/Onc/BMT Conditions

2013 Launched MIBG Therapy – Innovative Treatment for Patients with High-Risk Neuroblastoma

2015

Childhood Cancer Research Team Awarded $10.2 Million Moonshot Grant

2016 Established Cellular Therapy and Cancer Immunology Program

2013 2018

Neuro-Oncology Team Brings CONNECT Consortium and Clinical Trials in High-Risk Pediatric Brain Tumors to Nationwide Children’s

2017 2020 2017 2018 Certified Treatment Center for Novartis CAR-T Cell Therapy Kymriah™

Over the past decade, the Division of Hematology, Oncology and Blood & Marrow Transplant has received 2 NIH Cancer Moonshot grants totaling $16.4 million, created first-in-pediatric resources like the Good Manufacturing Practice Facility, and established itself as a consistent top 10 program ranked by U.S. News &World Report.

84 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Section of Hospital Pediatrics at Nationwide Children’s Hospital, which also includes newborn and adult hospital medicine, is home to a diverse group of physicians who specialize in the care of hospitalized newborns, children, adolescents and adults. The section supports Nationwide Children’s commitment to providing the highest-quality care to all children and their families regardless of ability to pay, and specifically aims to set the standard in the provision of high-value, quality inpatient care, the intentional and thoughtful education of future generations of doctors, and the production of useful and influential clinical, educational and quality-improvement research.

FACULTY

July 2019 through June 2020

Established Host Defense Program Specifically Designed to Address the Needs of Immunocompromised Patients

HOSPITAL PEDIATRICS AND ADULT HOSPITAL MEDICINE

Ryan S. Bode, MD Chief Seth Agyeman-Berko, PA Sean Ankrom, MD Joshua D. Black, MD Jessica Bockenstedt, MD Carrie Cacioppo, MD Sharon Clark, MD Vignesh Doraiswamy, MD Samuel W. Dudley, MD Christian Earl, MD Lauren Finnegan, NP Emily Graham, MD Kelly Grannan, MD Rakhi Gupta-Basuray, MD Cara Harasaki, MD Allison C. Heacock, MD Shawn Jacquemin, MD Rena Kasick, MD Jillian S. Kunar, DO Stephanie Kwon, DO Stephanie Lauden, MD Kristina Lehman, MD Kristen S. Lewis, MD

Nancy N. Liao, MD Beth W. Liston, MD, PhD Jamie R. Macklin, MD Kathleen Matic, MD Daniel J. McFarlane, MD Gerd B. McGwire, MD, PhD Lucas V. McKnight, MD Christy Mulligan, MD Mohammed Najjar, MD Sajithya Perera, MD Michael Perry, MD Laura Plachta, MD Charles R. Redman, MD Allison Rossetti, MD Christine A. Schmerge, MD Shauna Schord, MD Eric R. Schumacher, DO, MBA Claire Sevov, MD Catherine C. Sinclair, MD Melissa L. Skaug, MD Isaac Spears, MD Ansley Splinter, MD Anuja Sriparameswaran, MD Matthew Suer, MD Devon Swick, DO Kimberly M. Tartaglia, MD The Section of Hospital Pediatrics and Adult Hospital Medicine provides inpatient care across the continuum to patients and families at Nationwide Children’s. Newborn hospitalists manage fullterm and late preterm newborns and the associated common conditions, including hyperbilirubinemia, feeding and nutrition, infections, neonatal abstinence syndrome, and newborn screening and anticipatory guidance. Pediatric hospitalists provide inpatient care

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 85

Department of Pediatrics SELECTED PUBLICATIONS Brown P, Inaba H, Annesley C, Beck J, Colace S, Dallas M, DeSantes K, Kelly K, Kitko C, Lacayo N, Larrier N, Maese L, Mahadeo K, Nanda R, Nardi V, Rodriguez V, Rossoff J, Schuettpelz L, Silverman L, Sun J, Sun W, Teachey D, Wong V, Yanik G, Johnson-Chilla A, Ogba N. Pediatric Acute Lymphoblastic Leukemia, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. The Journal of National Comprehensive Cancer Network. 2020 Jan;18(1):81-112.

Creary S, Chisolm D, Stanek J, Hankins J, O'Brien SH. A Multidimensional Electronic Hydroxyurea Adherence Intervention for Children with Sickle Cell Disease: Single-Arm Before-After Study. JMIR Mhealth and Uhealth. 2019 Aug 8;7(8):e13542.

Dhall G, O’Neil SH, Ji L, Haley K, Whitaker AM, Nelson MD, Gilles F, Gardner SL, 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

Of Young Children With Nodular Desmoplastic Medulloblastoma Treated On "Head Start" III: A Multi-Institutional, Prospective Clinical Trial. Neuro-Oncology. 2020 Apr 18;noaa102.

Jaffray J, Witmer C, O'Brien SH, Diaz R, Ji L, Krava E, Young G. Peripherally Inserted Central Catheters Lead to a High Risk of Venous Thromboembolism in Children. Blood. 2020 Jan 16;135(3):220-226.

Roberts RD, Lizardo MM, Reed DR, Hingorani P, Glover J, Allen-Rhoades W, Fan T, Khanna C, Sweet-Cordero EA, Cash T, Bishop MW, Hegde M, Sertil AR, Koelsche C, Mirabello L, Malkin D, Sorensen PH, Meltzer PS, Janeway KA, Gorlick R, Crompton BD. Provocative Questions In Osteosarcoma Basic And Translational Biology: A Report from the Children's Oncology Group. Cancer. 2019 Oct 15;125(20):35143525.

FAST FACTS

Inpatient Discharges:.................................................. 1,419

BMT Long-term Follow-up Clinic Visits:........................... 67

Observation and Outpatient-in-a-Bed Discharges:........ 271

Anticoagulation Clinic Visits:.......................................... 219

Total Discharges:........................................................ 1,690

Dublin Hematology Clinic Visits:..................................... 121

Patient Days*:............................................................. 9,370

East Broad Sickle Cell Clinic Visits:................................ 122

Average Length of Stay*:................................................ 6.7

Mansfield Hematology/Oncology Clinic Visits:.................. 43

Average Daily Census*:................................................ 25.7

Chillicothe Hematology/Oncology Clinic Visits:................. 19

Inpatient Consults:......................................................... 485

Dayton Hematology/Oncology Clinic Visits:........................ 2

Total Surgical Procedures:............................................. 893

Zanesville Hematology/Oncology Clinic Visits:................. 49

BMT Transplants:............................................................. 82

Surgical Oncology Clinic Visits:...................................... 109

Apheresis and Photopheresis Procedures:..................... 832

Hematology/Oncology Clinic Visits:........................... 10,322

BMT Clinic Visits:........................................................ 3,486

Portsmouth Hematology/Oncology Clinic Visits:................. 8 *Excludes observation and outpatient-in-a-bed patients.

A Decade of Remarkable Transformation

HEMATOLOGY, ONCOLOGY & BLOOD AND MARROW TRANSPLANT

2010

2012

Established NEXT Consortium to Expand Expedited Advance Treatments for Hem/Onc/BMT Conditions

2013 Launched MIBG Therapy – Innovative Treatment for Patients with High-Risk Neuroblastoma

2015

Childhood Cancer Research Team Awarded $10.2 Million Moonshot Grant

2016 Established Cellular Therapy and Cancer Immunology Program

2013 2018

Neuro-Oncology Team Brings CONNECT Consortium and Clinical Trials in High-Risk Pediatric Brain Tumors to Nationwide Children’s

2017 2020 2017 2018 Certified Treatment Center for Novartis CAR-T Cell Therapy Kymriah™

Over the past decade, the Division of Hematology, Oncology and Blood & Marrow Transplant has received 2 NIH Cancer Moonshot grants totaling $16.4 million, created first-in-pediatric resources like the Good Manufacturing Practice Facility, and established itself as a consistent top 10 program ranked by U.S. News &World Report.

84 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Section of Hospital Pediatrics at Nationwide Children’s Hospital, which also includes newborn and adult hospital medicine, is home to a diverse group of physicians who specialize in the care of hospitalized newborns, children, adolescents and adults. The section supports Nationwide Children’s commitment to providing the highest-quality care to all children and their families regardless of ability to pay, and specifically aims to set the standard in the provision of high-value, quality inpatient care, the intentional and thoughtful education of future generations of doctors, and the production of useful and influential clinical, educational and quality-improvement research.

FACULTY

July 2019 through June 2020

Established Host Defense Program Specifically Designed to Address the Needs of Immunocompromised Patients

HOSPITAL PEDIATRICS AND ADULT HOSPITAL MEDICINE

Ryan S. Bode, MD Chief Seth Agyeman-Berko, PA Sean Ankrom, MD Joshua D. Black, MD Jessica Bockenstedt, MD Carrie Cacioppo, MD Sharon Clark, MD Vignesh Doraiswamy, MD Samuel W. Dudley, MD Christian Earl, MD Lauren Finnegan, NP Emily Graham, MD Kelly Grannan, MD Rakhi Gupta-Basuray, MD Cara Harasaki, MD Allison C. Heacock, MD Shawn Jacquemin, MD Rena Kasick, MD Jillian S. Kunar, DO Stephanie Kwon, DO Stephanie Lauden, MD Kristina Lehman, MD Kristen S. Lewis, MD

Nancy N. Liao, MD Beth W. Liston, MD, PhD Jamie R. Macklin, MD Kathleen Matic, MD Daniel J. McFarlane, MD Gerd B. McGwire, MD, PhD Lucas V. McKnight, MD Christy Mulligan, MD Mohammed Najjar, MD Sajithya Perera, MD Michael Perry, MD Laura Plachta, MD Charles R. Redman, MD Allison Rossetti, MD Christine A. Schmerge, MD Shauna Schord, MD Eric R. Schumacher, DO, MBA Claire Sevov, MD Catherine C. Sinclair, MD Melissa L. Skaug, MD Isaac Spears, MD Ansley Splinter, MD Anuja Sriparameswaran, MD Matthew Suer, MD Devon Swick, DO Kimberly M. Tartaglia, MD The Section of Hospital Pediatrics and Adult Hospital Medicine provides inpatient care across the continuum to patients and families at Nationwide Children’s. Newborn hospitalists manage fullterm and late preterm newborns and the associated common conditions, including hyperbilirubinemia, feeding and nutrition, infections, neonatal abstinence syndrome, and newborn screening and anticipatory guidance. Pediatric hospitalists provide inpatient care

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 85

for common pediatric illnesses such as bronchiolitis, asthma and failure to thrive, as well as undifferentiated and/or multisystem diseases, coordinating and facilitating care, and ensuring a safe transition back to primary care providers. In addition, in conjunction with the Section of Child Psychiatry, hospitalists work collaboratively to provide medical care for children and adolescents facing acute mental health crises including in the new Big Lots Behavioral Health Pavilion. Internal medicine-trained adult hospitalists serve as consultants for adult patients with congenital and childhood-onset chronic illnesses admitted to Nationwide Children’s.

The section experienced significant growth and program development in all facets — clinical, educational, safety, quality improvement and research. Clinical encounters and average daily census increased over the prior academic year by approximately 20%. We continued to recruit new and talented faculty. Publications have increased by 40% each of the past three years.

Pediatric Hospital Medicine has recently been recognized by the American Board of Pediatrics as a board-certified specialty. Our Pediatric Hospital Medicine Fellowship Program began in July 2018. This past year, we were successful in obtaining Accreditation Council for Graduate Medical Education (ACGME) program accreditation and graduated our first fellow.

The section is involved in a multitude of patient safety, quality improvement and research initiatives with demonstrated outcomes that include: •

•

Patient Centered Outcomes Research Institute (PCORI) funded grant investigating the safety and efficiency of hospital direct admissions versus Emergency Department admissions Agency for Healthcare Research and Quality (AHRQ) funded grant investigating the unnecessary utilization of pulse oximetry in hospitalized bronchiolitis patients

•

Clinical pathway development using evidencebased practice leading to improved patient outcomes

•

Identifying and eliminating diagnostic errors

•

Enhanced patient safety, including 24/7 inhouse attending coverage and the innovative “Safety Officer and Watchstander Program” leading to a decrease in unrecognized clinical deterioration on the floor, ICU transfers and patient mortality

We are dedicated and committed to the education of future pediatricians with an emphasis and excellence in the clinical teaching for both medical students and family practice and pediatric residents. Faculty serve as important mentors for these learners in their educational, clinical, research and professional development. Our faculty continue to get recognized on an annual basis with prestigious teaching awards, including being ranked as the No. 1 inpatient rotation this past academic year by the pediatric residents.

SELECTED PUBLICATIONS 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 Analysis of an Automated and Objective Pediatric Early Warning System. Pediatric Quality and Safety. 2020 Mar 20;5(2):e271.

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 Pediatric Abdominal Pain. Diagnosis. 2019 Nov 2. [Epub ahead of print] Mecham C, Mirea L, Bode R, McGreevy J. Trends in Adult Patients Presenting to Pediatric Emergency Departments. The American Journal of Emergency Medicine. 2020 Apr 8;38(9):1884-1889.

Perry MF, Macias C, Chaparro JD, Heacock AC, Jackson K, Bode RS. Improving Early Discharges with an Electronic Health Record Discharge Optimization Tool. Pediatric Quality and Safety. 2020 May 18;5(3):e301.

Webber S, Lauden SM, Fischer PR, Beyerlein L, Schubert C; Midwest Consortium of Global Child Health Educators S-PACK Workgroup. Predeparture Activities Curricular 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.

FAST FACTS July 2019 through June 2020 Inpatient Discharges: ................................................. 2,788 Observation Discharges: ............................................ 3,109 Total Discharges: ....................................................... 5,853 Average Length of Stay*: .................................................. 3 Average Daily Census*: .................................................. 23 Patient Days*: ............................................................ 8,317 Complex Health Care Clinic Visits: ............................. 3,407 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM HOSPITAL MEDICINE FELLOWSHIP Hilary Lin, MD Melanie Marsh, MD

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

for common pediatric illnesses such as bronchiolitis, asthma and failure to thrive, as well as undifferentiated and/or multisystem diseases, coordinating and facilitating care, and ensuring a safe transition back to primary care providers. In addition, in conjunction with the Section of Child Psychiatry, hospitalists work collaboratively to provide medical care for children and adolescents facing acute mental health crises including in the new Big Lots Behavioral Health Pavilion. Internal medicine-trained adult hospitalists serve as consultants for adult patients with congenital and childhood-onset chronic illnesses admitted to Nationwide Children’s.

The section experienced significant growth and program development in all facets — clinical, educational, safety, quality improvement and research. Clinical encounters and average daily census increased over the prior academic year by approximately 20%. We continued to recruit new and talented faculty. Publications have increased by 40% each of the past three years.

Pediatric Hospital Medicine has recently been recognized by the American Board of Pediatrics as a board-certified specialty. Our Pediatric Hospital Medicine Fellowship Program began in July 2018. This past year, we were successful in obtaining Accreditation Council for Graduate Medical Education (ACGME) program accreditation and graduated our first fellow.

The section is involved in a multitude of patient safety, quality improvement and research initiatives with demonstrated outcomes that include: •

•

Patient Centered Outcomes Research Institute (PCORI) funded grant investigating the safety and efficiency of hospital direct admissions versus Emergency Department admissions Agency for Healthcare Research and Quality (AHRQ) funded grant investigating the unnecessary utilization of pulse oximetry in hospitalized bronchiolitis patients

•

Clinical pathway development using evidencebased practice leading to improved patient outcomes

•

Identifying and eliminating diagnostic errors

•

Enhanced patient safety, including 24/7 inhouse attending coverage and the innovative “Safety Officer and Watchstander Program” leading to a decrease in unrecognized clinical deterioration on the floor, ICU transfers and patient mortality

We are dedicated and committed to the education of future pediatricians with an emphasis and excellence in the clinical teaching for both medical students and family practice and pediatric residents. Faculty serve as important mentors for these learners in their educational, clinical, research and professional development. Our faculty continue to get recognized on an annual basis with prestigious teaching awards, including being ranked as the No. 1 inpatient rotation this past academic year by the pediatric residents.

SELECTED PUBLICATIONS 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 Analysis of an Automated and Objective Pediatric Early Warning System. Pediatric Quality and Safety. 2020 Mar 20;5(2):e271.

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 Pediatric Abdominal Pain. Diagnosis. 2019 Nov 2. [Epub ahead of print] Mecham C, Mirea L, Bode R, McGreevy J. Trends in Adult Patients Presenting to Pediatric Emergency Departments. The American Journal of Emergency Medicine. 2020 Apr 8;38(9):1884-1889.

Perry MF, Macias C, Chaparro JD, Heacock AC, Jackson K, Bode RS. Improving Early Discharges with an Electronic Health Record Discharge Optimization Tool. Pediatric Quality and Safety. 2020 May 18;5(3):e301.

Webber S, Lauden SM, Fischer PR, Beyerlein L, Schubert C; Midwest Consortium of Global Child Health Educators S-PACK Workgroup. Predeparture Activities Curricular 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.

FAST FACTS July 2019 through June 2020 Inpatient Discharges: ................................................. 2,788 Observation Discharges: ............................................ 3,109 Total Discharges: ....................................................... 5,853 Average Length of Stay*: .................................................. 3 Average Daily Census*: .................................................. 23 Patient Days*: ............................................................ 8,317 Complex Health Care Clinic Visits: ............................. 3,407 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM HOSPITAL MEDICINE FELLOWSHIP Hilary Lin, MD Melanie Marsh, MD

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.

“We identified complex interactions among RSV viral loads, the innate immune response and patients’ age influencing disease severity.”

– Asuncion Mejias, MD, PhD

8888| |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| 2019-20 | 2019-20 Annual Annual Report Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

REFERENCE: 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, 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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 89

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.

“We identified complex interactions among RSV viral loads, the innate immune response and patients’ age influencing disease severity.”

– Asuncion Mejias, MD, PhD

8888| |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| 2019-20 | 2019-20 Annual Annual Report Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

REFERENCE: 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, 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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 89

Department of Pediatrics

INFECTIOUS DISEASES The specialists in the Division of Infectious Diseases at Nationwide Children’s Hospital provide expertise in the diagnosis and management of children with all types of acute and chronic infections in both immune-competent and immune-compromised children. Our physicians provide direct care for patients admitted to the Nationwide Children’s Infectious Diseases Unit and clinical consultation for patients with complicated infectious diseases throughout the hospital, in close partnership with their primary care teams.

We have developed close clinical and research collaborations with physicians in Hematology/Oncology & Bone Marrow Transplant, Pediatric Critical Care, Cardiology, Lung, Heart and Liver Transplantation, Neonatology and the various surgical departments in order to optimize the infectious diseases-related care of patients. Patients are also evaluated in the ambulatory setting following referral to the Infectious Diseases, Tuberculosis, Neonatal Infectious Disease, Host Defense, PANDAS, and the Family AIDS Clinic Education Services (FACES) Program Clinics located on the Nationwide Children’s main campus. Additionally, our division offers consultation to external providers and their patients through the Nationwide Children’s Hospital Physician Consult and Transfer Center. Research is conducted through the division and in collaboration with our colleagues from the Clinical Microbiology Laboratory, the Center for Microbial Pathogenesis, the Center for Vaccines and Immunity and other centers in the Abigail Wexner Research Institute at Nationwide Children’s, as well as national and international collaborators.

FACULTY

Megan Brundrett, MD Kevin Cassady, MD Juan Chaparro, MD Guliz Erdem, MD Charitha Gowda, MD, MPH Jonathan R. Honegger, MD W. Garrett Hunt, MD, MPH, DTM&H Su Jin Joo, MD

Octavio Ramilo, MD Division Chief

Maria Asuncion Mejias, MD, PhD, MSCS Christopher Ouellette, MD Pablo J. Sánchez, MD Masako Shimamura, MD Eunkyung Song, MD Rebecca Wallihan, MD Matthew Washam, MD, MPH Joshua Watson, MD CLINICAL MICROBIOLOGY

William J. Barson, MD Section Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Monica Ardura, DO, MSCS Jeffrey Auletta, MD

Amy Leber, PhD Director Sophonie Jean, PhD Assistant Director Huanyu Wang, PhD Assistant Director

90 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Division of Infectious Diseases continues to expand clinical activities to patients with complex infections in different settings across the hospital, including the specialized Infectious Diseases inpatient unit, the Infectious Diseases consult service, and in a number of specialized outpatient clinics (General ID, Host Defense, HIV, Neonatal Infectious Disease, Tuberculosis, Kawasaki and PANDAS). With plans to add an additional faculty member and a nurse practitioner, we continue to expand our team to optimize the preventive and therapeutic care of immunocompromised children through our Host Defense Program. Plans to open a Vaccine Clinic specifically designed for these patients were placed on hold because of the COVID-19 pandemic.

clinical trials aimed to optimize clinical outcomes in immunocompromised hosts (Monica Ardura, MD; Jeffrey Auletta, MD; Christopher Ouellette, MD; Masako Shimamura, MD; Eunkyung Song, MD).

Research: See page 189 for information about the Center for Microbial Pathogenesis, and page 193 for the Center for Vaccines and Immunity, in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED TO ALL INFECTIOUS DISEASES CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $3,631,180 SELECTED PUBLICATIONS

The COVID-19 pandemic brought challenges to the Section of Infectious Diseases in early 2020.

However, these challenges presented opportunities to improve patient care. Our five-bed Special Pathogens Unit was activated and has been caring for those patients admitted to Nationwide Children’s with confirmed SARS-CoV-2 infection. This unit offers an environment that affords the best possible care for these patients in the safest manner possible for their hospital caregivers. Seriously ill patients requiring ventilatory assistance are cared for in this protected environment by our Pediatric Intensive Care Unit (PICU) staff. We have also developed an outpatient COVID-19 clinic so that these patients can be followed in an outpatient setting that facilitates their participation in research. We continue to maintain our strong research collaborations with colleagues in the Center for Microbial Pathogenesis and the Center for Vaccines and Immunity in the Abigail Wexner Research Institute at Nationwide Children’s, as well as the Clinical Microbiology Laboratory. We maintain clinical translational research programs regarding a variety of conditions, including hepatitis (Jonathan Honegger, MD; Chris Walker, PhD; Charitha Gowda, MD), adenovirus (Amy Leber, PhD; Eunkyung Song, MD), cytomegalovirus (Pablo Sanchez, MD; Asuncion Mejias, MD; Masako Shimamura, MD), pneumococcus (William Barson, MD; Guliz Erdem, MD), tuberculosis and Global Health (W. Garrett Hunt, MD), RSV-vaccine development (Asuncion Mejias, MD; Octavio Ramilo, MD; Mark Peeples, PhD), pediatric pneumonia (Rebecca Wallihan, MD; Octavio Ramilo, MD), and translational and diagnostic/therapeutic

Auletta JJ, Sánchez PJ, Meyer EK, O'Donnell LC, Cassady KA, Ouellette CP, Hecht S, Diaz A, Pavlek LR, Salamon DP, Gallagher CL, Bradbury H, Welfley SL, Magers J, Armbruster DL, Lamb MG, Nakkula RJ, Bosse K, Lee DA. Adjuvant Haploidentical 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):594597.e4.

Coss SL, Torres-Cornejo A, Prasad MR, Moore-Clingenpeel M, Grakoui A, Lauer GM, Walker CM, Honegger JR. CD4+ T cell restoration and control of hepatitis C virus replication after childbirth. The Journal of Clinical Investigation. 2020 Feb 3;130(2):748753.

Hecht SM, Ardura MI, Yildiz VO, Ouellette CP. Central venous catheter management in high-risk children with bloodstream infections. The Pediatric Infectious Disease Journal.

2020 Jan;39(1):17-22.

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 expression profiles in infants with congenital cytomegalovirus infection. Nature Communications. 2020;11(1):3548.

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 enterovirus D68 among hospitalized pediatric patients in central Ohio: 2014 and 2018.

Emerging Infectious Diseases; 25 (11): 2019.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 91

Department of Pediatrics

INFECTIOUS DISEASES The specialists in the Division of Infectious Diseases at Nationwide Children’s Hospital provide expertise in the diagnosis and management of children with all types of acute and chronic infections in both immune-competent and immune-compromised children. Our physicians provide direct care for patients admitted to the Nationwide Children’s Infectious Diseases Unit and clinical consultation for patients with complicated infectious diseases throughout the hospital, in close partnership with their primary care teams.

We have developed close clinical and research collaborations with physicians in Hematology/Oncology & Bone Marrow Transplant, Pediatric Critical Care, Cardiology, Lung, Heart and Liver Transplantation, Neonatology and the various surgical departments in order to optimize the infectious diseases-related care of patients. Patients are also evaluated in the ambulatory setting following referral to the Infectious Diseases, Tuberculosis, Neonatal Infectious Disease, Host Defense, PANDAS, and the Family AIDS Clinic Education Services (FACES) Program Clinics located on the Nationwide Children’s main campus. Additionally, our division offers consultation to external providers and their patients through the Nationwide Children’s Hospital Physician Consult and Transfer Center. Research is conducted through the division and in collaboration with our colleagues from the Clinical Microbiology Laboratory, the Center for Microbial Pathogenesis, the Center for Vaccines and Immunity and other centers in the Abigail Wexner Research Institute at Nationwide Children’s, as well as national and international collaborators.

FACULTY

Megan Brundrett, MD Kevin Cassady, MD Juan Chaparro, MD Guliz Erdem, MD Charitha Gowda, MD, MPH Jonathan R. Honegger, MD W. Garrett Hunt, MD, MPH, DTM&H Su Jin Joo, MD

Octavio Ramilo, MD Division Chief

Maria Asuncion Mejias, MD, PhD, MSCS Christopher Ouellette, MD Pablo J. Sánchez, MD Masako Shimamura, MD Eunkyung Song, MD Rebecca Wallihan, MD Matthew Washam, MD, MPH Joshua Watson, MD CLINICAL MICROBIOLOGY

William J. Barson, MD Section Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Monica Ardura, DO, MSCS Jeffrey Auletta, MD

Amy Leber, PhD Director Sophonie Jean, PhD Assistant Director Huanyu Wang, PhD Assistant Director

90 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Division of Infectious Diseases continues to expand clinical activities to patients with complex infections in different settings across the hospital, including the specialized Infectious Diseases inpatient unit, the Infectious Diseases consult service, and in a number of specialized outpatient clinics (General ID, Host Defense, HIV, Neonatal Infectious Disease, Tuberculosis, Kawasaki and PANDAS). With plans to add an additional faculty member and a nurse practitioner, we continue to expand our team to optimize the preventive and therapeutic care of immunocompromised children through our Host Defense Program. Plans to open a Vaccine Clinic specifically designed for these patients were placed on hold because of the COVID-19 pandemic.

clinical trials aimed to optimize clinical outcomes in immunocompromised hosts (Monica Ardura, MD; Jeffrey Auletta, MD; Christopher Ouellette, MD; Masako Shimamura, MD; Eunkyung Song, MD).

Research: See page 189 for information about the Center for Microbial Pathogenesis, and page 193 for the Center for Vaccines and Immunity, in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED TO ALL INFECTIOUS DISEASES CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $3,631,180 SELECTED PUBLICATIONS

The COVID-19 pandemic brought challenges to the Section of Infectious Diseases in early 2020.

However, these challenges presented opportunities to improve patient care. Our five-bed Special Pathogens Unit was activated and has been caring for those patients admitted to Nationwide Children’s with confirmed SARS-CoV-2 infection. This unit offers an environment that affords the best possible care for these patients in the safest manner possible for their hospital caregivers. Seriously ill patients requiring ventilatory assistance are cared for in this protected environment by our Pediatric Intensive Care Unit (PICU) staff. We have also developed an outpatient COVID-19 clinic so that these patients can be followed in an outpatient setting that facilitates their participation in research. We continue to maintain our strong research collaborations with colleagues in the Center for Microbial Pathogenesis and the Center for Vaccines and Immunity in the Abigail Wexner Research Institute at Nationwide Children’s, as well as the Clinical Microbiology Laboratory. We maintain clinical translational research programs regarding a variety of conditions, including hepatitis (Jonathan Honegger, MD; Chris Walker, PhD; Charitha Gowda, MD), adenovirus (Amy Leber, PhD; Eunkyung Song, MD), cytomegalovirus (Pablo Sanchez, MD; Asuncion Mejias, MD; Masako Shimamura, MD), pneumococcus (William Barson, MD; Guliz Erdem, MD), tuberculosis and Global Health (W. Garrett Hunt, MD), RSV-vaccine development (Asuncion Mejias, MD; Octavio Ramilo, MD; Mark Peeples, PhD), pediatric pneumonia (Rebecca Wallihan, MD; Octavio Ramilo, MD), and translational and diagnostic/therapeutic

Auletta JJ, Sánchez PJ, Meyer EK, O'Donnell LC, Cassady KA, Ouellette CP, Hecht S, Diaz A, Pavlek LR, Salamon DP, Gallagher CL, Bradbury H, Welfley SL, Magers J, Armbruster DL, Lamb MG, Nakkula RJ, Bosse K, Lee DA. Adjuvant Haploidentical 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):594597.e4.

Coss SL, Torres-Cornejo A, Prasad MR, Moore-Clingenpeel M, Grakoui A, Lauer GM, Walker CM, Honegger JR. CD4+ T cell restoration and control of hepatitis C virus replication after childbirth. The Journal of Clinical Investigation. 2020 Feb 3;130(2):748753.

Hecht SM, Ardura MI, Yildiz VO, Ouellette CP. Central venous catheter management in high-risk children with bloodstream infections. The Pediatric Infectious Disease Journal.

2020 Jan;39(1):17-22.

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 expression profiles in infants with congenital cytomegalovirus infection. Nature Communications. 2020;11(1):3548.

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 enterovirus D68 among hospitalized pediatric patients in central Ohio: 2014 and 2018.

Emerging Infectious Diseases; 25 (11): 2019.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 91

FAST FACTS 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

NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| |2019-20 2019-20 Annual Annual Report Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report | 93

FAST FACTS 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

NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| |2019-20 2019-20 Annual Annual Report Report| |NationwideChildrens.org/2020-Report NationwideChildrens.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.

“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.”

– Nathalie Maitre, MD, PhD

9494| |NATIONWIDE CHILDREN’S HOSPITAL Annual Report NATIONWIDE CHILDREN’S HOSPITAL| |2019-20 2019-20 Annual Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

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.

REFERENCES: Byrne R, Noritz G, Maitre NL, Nationwide Children’s Hospital Early Developmental Group. Implementation of early diagnosis and intervention guidelines for 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 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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 95

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.

“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.”

– Nathalie Maitre, MD, PhD

9494| |NATIONWIDE CHILDREN’S HOSPITAL Annual Report NATIONWIDE CHILDREN’S HOSPITAL| |2019-20 2019-20 Annual Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

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.

REFERENCES: Byrne R, Noritz G, Maitre NL, Nationwide Children’s Hospital Early Developmental Group. Implementation of early diagnosis and intervention guidelines for 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 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.

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 United States. The Section of Neonatology at Nationwide Children’s is an integral component of the neonatal program, which includes a full range of family-centered newborn care and innovative clinical and translational research programs, conducted through the Division of Neonatology and in collaboration with the Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s.

Jennifer Haase, MD

Apurwa S. Naik, MD

Jason Jackson, DO

Mitali Pakvasa, MD

Jason Kovalcik, MD

Brooke Redmond, MD

J. Wells Logan, MD

Christopher Regan, DO

Nathalie Maitre, MD, PhD

John H. Seguin, MD

Daniel Malleske, MD

Teresa L. Seto, MD

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

FACULTY

Leif D. Nelin, MD Division Chief

Sudarshan Jadcherla, MD Associate Division Chief for Academics

Jonathan L. Slaughter, MD, MPH Michael R. Stenger, MD Christopher J. Timan, MD Jennifer K. Trittmann, MD, MPH

Lawrence Baylis, MHA Service Line Administrator

COMMUNITY-BASED FACULTY

Heather Larson Business Manager

Gary Bixler, MD Sarah J. Corriveau, MD

Edward G. Shepherd, MD Section Chief

Valencia P. Walker, MD, MPH Associate Division Chief for Health Equity and Inclusion

Ene Fairchild, MD Angela Firestine, MD Joshua H. Goldberg, MD

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

Barry Halpern, MD

Ehab I. Ahmed, MD

Nancy B. Hansen, MD

Carl H. Backes, MD

Juli Kern, MD

Molly K. Ball, MD

Jeffrey S. Keyes, MD

Roopali V. Bapat, MD

Michelle Lash, MD

Thomas Bartman, MD, PhD

Corin Cozzi Linsey, MD

Kristen L. Benninger, MD

Wendy A. Luce, MD

Elizabeth M. Bonachea, MD

Maclain Magee, MD

Erica Braswell, MD

Benjamin A. McDonald, MD

Bernadette Chen, MD

Randy R. Miller, MD

Jana Erner, MD

Avante Milton, MD

Omid Fathi, MD 96 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Marissa E. Larouere, MBA, BSN, RN Vice President Neonatal Services

Sheria D. Wilson, MD

Craig W. Anderson, MD

Kristina M. Reber, MD Associate Division Chief

NEONATOLOGY ADMINISTRATION

NEONATAL NETWORK DIRECTORS Renee Gardikes-Gingery, MSN, RN Melissa Hamms, MBA, BSN, RN Jennifer Thompson, MBA, BSN, RN DIRECTOR OF NEONATAL ADVANCED PRACTITIONERS Erin Keels, DNP, APRN, NNP-BC The Section of Neonatology is dedicated to providing integrated perinatal care and research throughout the patient life cycle to reduce infant mortality and morbidities so that children are able to reach their full potential. To achieve this, the section not only provides outstanding neonatal care, but has also implemented a variety of innovative, unique programs that bring together multidisciplinary groups to provide advanced clinical care and research targeting the most common and most debilitating causes of mortality and morbidity in these babies. These programs include the comprehensive Center for Bronchopulmonary Dysplasia, the Infant Feeding Disorders Program, the Small Baby Program, the Congenital Infections Program and the NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 97

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 United States. The Section of Neonatology at Nationwide Children’s is an integral component of the neonatal program, which includes a full range of family-centered newborn care and innovative clinical and translational research programs, conducted through the Division of Neonatology and in collaboration with the Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s.

Jennifer Haase, MD

Apurwa S. Naik, MD

Jason Jackson, DO

Mitali Pakvasa, MD

Jason Kovalcik, MD

Brooke Redmond, MD

J. Wells Logan, MD

Christopher Regan, DO

Nathalie Maitre, MD, PhD

John H. Seguin, MD

Daniel Malleske, MD

Teresa L. Seto, MD

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

FACULTY

Leif D. Nelin, MD Division Chief

Sudarshan Jadcherla, MD Associate Division Chief for Academics

Jonathan L. Slaughter, MD, MPH Michael R. Stenger, MD Christopher J. Timan, MD Jennifer K. Trittmann, MD, MPH

Lawrence Baylis, MHA Service Line Administrator

COMMUNITY-BASED FACULTY

Heather Larson Business Manager

Gary Bixler, MD Sarah J. Corriveau, MD

Edward G. Shepherd, MD Section Chief

Valencia P. Walker, MD, MPH Associate Division Chief for Health Equity and Inclusion

Ene Fairchild, MD Angela Firestine, MD Joshua H. Goldberg, MD

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

Barry Halpern, MD

Ehab I. Ahmed, MD

Nancy B. Hansen, MD

Carl H. Backes, MD

Juli Kern, MD

Molly K. Ball, MD

Jeffrey S. Keyes, MD

Roopali V. Bapat, MD

Michelle Lash, MD

Thomas Bartman, MD, PhD

Corin Cozzi Linsey, MD

Kristen L. Benninger, MD

Wendy A. Luce, MD

Elizabeth M. Bonachea, MD

Maclain Magee, MD

Erica Braswell, MD

Benjamin A. McDonald, MD

Bernadette Chen, MD

Randy R. Miller, MD

Jana Erner, MD

Avante Milton, MD

Omid Fathi, MD 96 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Marissa E. Larouere, MBA, BSN, RN Vice President Neonatal Services

Sheria D. Wilson, MD

Craig W. Anderson, MD

Kristina M. Reber, MD Associate Division Chief

NEONATOLOGY ADMINISTRATION

NEONATAL NETWORK DIRECTORS Renee Gardikes-Gingery, MSN, RN Melissa Hamms, MBA, BSN, RN Jennifer Thompson, MBA, BSN, RN DIRECTOR OF NEONATAL ADVANCED PRACTITIONERS Erin Keels, DNP, APRN, NNP-BC The Section of Neonatology is dedicated to providing integrated perinatal care and research throughout the patient life cycle to reduce infant mortality and morbidities so that children are able to reach their full potential. To achieve this, the section not only provides outstanding neonatal care, but has also implemented a variety of innovative, unique programs that bring together multidisciplinary groups to provide advanced clinical care and research targeting the most common and most debilitating causes of mortality and morbidity in these babies. These programs include the comprehensive Center for Bronchopulmonary Dysplasia, the Infant Feeding Disorders Program, the Small Baby Program, the Congenital Infections Program and the NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 97

Neurodevelopmental Follow-up Program. The Center for Bronchopulmonary Dysplasia has the only dedicated unit (C4A) for the care of infants with BPD in the country. The BPD unit draws patients from all over the United States including as far away as California, Oregon and Utah. The BPD unit has excellent outcomes including a very low mortality rate and tracheostomy rate. Furthermore, the neurodevelopmental outcomes of patients taken care of by the BPD unit were published and we found that 56% of patients have no evidence of neurodevelopmental impairment, despite the fact that 78% of the patients in this cohort had severe BPD. The Infant Feeding Disorders Program provides advanced care and treatment to optimize outcomes for infants with feeding disorders. The Infant Feeding Disorders Program published outcomes of their ongoing QI initiative — the feeding enhancement program — and demonstrated significant and sustained shortened length of time for preterm infants to achieve full oral feeds, which resulted in a significant shorter length of stay. The Small Baby Program continues to positively impact the outcomes of extremely preterm infants (those born at <27 weeks gestation). This year the small baby program found that using a novel algorithm with data available at the time of admission that survival in this high-risk population could be predicted. The Congenital Infections Program, a multidisciplinary program targeting babies born with congenital viral infections, has implemented universal screening for congenital cytomegaloviral infections in the Nationwide Children’s Neonatal Network. Finally, for our patients to reach their full potential requires longer term outpatient neurodevelopmental care available through our Neonatal Follow-up Program, which this year published results that demonstrate that their novel, multi-component, upper-extremity intervention improved motor function in patients with cerebral palsy.

Perinatal Research: See page 191 for information about the Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s.

Lewandowski DJ, Byrne R. Network Implementation of Guideline for Early Detection Decreases Age at Cerebral Palsy Diagnosis. Pediatrics. 2020 May;145(5):e20192126.

Ronchi A, Zeray F, Lee LE, Owen KE, Shoup AG, Garcia F, Vazquez LN, Cantey JB, Varghese S, Pugni L, Mosca F, Sánchez PJ. Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection. Journal of Perinatology. 2020 Jan;40(1):89-96.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM NEONATAL-PERINATAL MEDICINE Amy Brown, MD Julie A. Dillard, MD Lindsey Korbel, MD Alexandra Medoro, MD Avante D. Milton, MD Clifford Mueller, MD Leeann R. Pavlek, MD Zubin Shah, MD George Ziegler, MD

CLINICAL FAST FACTS July 2019 through June 2020 Main Campus Inpatient Discharges:.................................................. 1,092

July 2019 through June 2020 Newborn Intensive Care Unit at Grant Medical Center Total Discharges:........................................................... 255 Average Length of Stay*:.............................................. 19.2 Average Daily Census*:................................................ 13.4 Patient Days*:............................................................. 4,888 Newborn Intensive Care Unit at Doctor’s Hospital West Inpatient Discharges:..................................................... 125 Observation and Outpatient-in-a-Bed Discharges:............ 2 Total Discharges:........................................................... 127

Average Length of Stay*:................................................. 10 Average Daily Census*:.................................................. 4.1 Patient Days*:............................................................. 1,496 Newborn Intensive Care Unit at St. Ann’s Hospital Total Discharges:........................................................... 326 Average Length of Stay*:.............................................. 17.9 Average Daily Census*:................................................ 15.9 Patient Days*:............................................................. 5,811

Average Length of Stay*:.............................................. 13.7

Newborn Intensive Care Unit at The Ohio State University Wexner Medical Center

Average Daily Census*:.................................................. 4.7

Inpatient Discharges:..................................................... 651

Patient Days*:............................................................. 1,717

Total Discharges:........................................................... 655

Newborn Special Care Nursery at Dublin Methodist Hospital Inpatient Discharges:..................................................... 150

Observation and Outpatient-in-a-Bed Discharges:............ 4

Observation and Outpatient-in-a-Bed Discharges:............ 4 Total Discharges:........................................................... 154

Average Length of Stay*:.............................................. 17.6 Average Daily Census*:................................................ 31.4 Patient Days*:........................................................... 11,479 *Excludes observation and outpatient-in-a-bed patients.

Observation and Outpatient-in-a-Bed Discharges:............ 1 Total Discharges:........................................................ 1,093 Average Length of Stay*:.............................................. 38.1 Average Daily Census*:.............................................. 113.1

A Decade of Remarkable Transformation

NEONATOLOGY

Patient Days*:........................................................... 41,278

Guidelines Developed for Extremely Premature Infants Proven to be Life-Changing

Fetal Medicine Collaborative Clinic Visits:...................... 201 Neonatology Clinic Visits:............................................ 3,163 Neonatology BPD Clinic Visits:....................................... 965 Neonatal Abstinence Syndrome Clinic Visits:................. 117 Newborn Intensive Care Unit at Riverside Methodist Hospital Inpatient Discharges:..................................................... 483

GRANTS AWARDED TO NEONATOLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020

Observation and Outpatient-in-a-Bed Discharges:............ 3

$5,562,391

Total Discharges:........................................................... 486

SELECTED PUBLICATIONS

Average Length of Stay*:.............................................. 27.3

Bapat R, Gulati IK, Jadcherla S. Impact of SIMPLE Feeding Quality Improvement Strategies on Aerodigestive Milestones and Feeding Outcomes in BPD Infants. Hospital Pediatrics. 2019 Nov;9(11):859-866.

CLINICAL FAST FACTS (CONTINUED)

Pishevar N, Fathi O, Backes CH, Shepherd EG, Nelin LD. Predicting survival in infants born at <27 weeks gestation admitted to an all referral neonatal intensive care unit: a pilot study. Journal of Perinatology. 2020 May;40(5):750-757.

Average Daily Census*:................................................ 36.1 Patient Days*:........................................................... 13,164

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

2010 Comprehensive BPD Center Established Using Innovative Multidisciplinary Approach With Demonstrated Improvements in Survival and Outcomes

2012

Prediction of Short-Term Neonatal Complications In Preterm Infants Using ExomeWide Genetic Variation

Positive touch in the NICU: Study Led by Nathalie Maitre, MD, PhD, Reinforces Touch Helps Shape Preterm Babies’ Brains

2014 Neonatal Aerodigestive Program Launched

2016

2013 2017

2017 2017 2020 2019

Congenital Infections Program Established Combining High Quality Clinical Care With Cutting Edge Research

Throughout the past decade, we have made great strides in clinical care and research for neonates. Advancing strong collaborations, digging deeper into the treatment and prevention of prematurity, and leading in research and innovation, has enabled the size and strength of our program to be unmatched. Caring for more than 3,000 babies each year, we are the nation’s largest neonatal center.

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

Neurodevelopmental Follow-up Program. The Center for Bronchopulmonary Dysplasia has the only dedicated unit (C4A) for the care of infants with BPD in the country. The BPD unit draws patients from all over the United States including as far away as California, Oregon and Utah. The BPD unit has excellent outcomes including a very low mortality rate and tracheostomy rate. Furthermore, the neurodevelopmental outcomes of patients taken care of by the BPD unit were published and we found that 56% of patients have no evidence of neurodevelopmental impairment, despite the fact that 78% of the patients in this cohort had severe BPD. The Infant Feeding Disorders Program provides advanced care and treatment to optimize outcomes for infants with feeding disorders. The Infant Feeding Disorders Program published outcomes of their ongoing QI initiative — the feeding enhancement program — and demonstrated significant and sustained shortened length of time for preterm infants to achieve full oral feeds, which resulted in a significant shorter length of stay. The Small Baby Program continues to positively impact the outcomes of extremely preterm infants (those born at <27 weeks gestation). This year the small baby program found that using a novel algorithm with data available at the time of admission that survival in this high-risk population could be predicted. The Congenital Infections Program, a multidisciplinary program targeting babies born with congenital viral infections, has implemented universal screening for congenital cytomegaloviral infections in the Nationwide Children’s Neonatal Network. Finally, for our patients to reach their full potential requires longer term outpatient neurodevelopmental care available through our Neonatal Follow-up Program, which this year published results that demonstrate that their novel, multi-component, upper-extremity intervention improved motor function in patients with cerebral palsy.

Perinatal Research: See page 191 for information about the Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s.

Lewandowski DJ, Byrne R. Network Implementation of Guideline for Early Detection Decreases Age at Cerebral Palsy Diagnosis. Pediatrics. 2020 May;145(5):e20192126.

Ronchi A, Zeray F, Lee LE, Owen KE, Shoup AG, Garcia F, Vazquez LN, Cantey JB, Varghese S, Pugni L, Mosca F, Sánchez PJ. Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection. Journal of Perinatology. 2020 Jan;40(1):89-96.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM NEONATAL-PERINATAL MEDICINE Amy Brown, MD Julie A. Dillard, MD Lindsey Korbel, MD Alexandra Medoro, MD Avante D. Milton, MD Clifford Mueller, MD Leeann R. Pavlek, MD Zubin Shah, MD George Ziegler, MD

CLINICAL FAST FACTS July 2019 through June 2020 Main Campus Inpatient Discharges:.................................................. 1,092

July 2019 through June 2020 Newborn Intensive Care Unit at Grant Medical Center Total Discharges:........................................................... 255 Average Length of Stay*:.............................................. 19.2 Average Daily Census*:................................................ 13.4 Patient Days*:............................................................. 4,888 Newborn Intensive Care Unit at Doctor’s Hospital West Inpatient Discharges:..................................................... 125 Observation and Outpatient-in-a-Bed Discharges:............ 2 Total Discharges:........................................................... 127

Average Length of Stay*:................................................. 10 Average Daily Census*:.................................................. 4.1 Patient Days*:............................................................. 1,496 Newborn Intensive Care Unit at St. Ann’s Hospital Total Discharges:........................................................... 326 Average Length of Stay*:.............................................. 17.9 Average Daily Census*:................................................ 15.9 Patient Days*:............................................................. 5,811

Average Length of Stay*:.............................................. 13.7

Newborn Intensive Care Unit at The Ohio State University Wexner Medical Center

Average Daily Census*:.................................................. 4.7

Inpatient Discharges:..................................................... 651

Patient Days*:............................................................. 1,717

Total Discharges:........................................................... 655

Newborn Special Care Nursery at Dublin Methodist Hospital Inpatient Discharges:..................................................... 150

Observation and Outpatient-in-a-Bed Discharges:............ 4

Observation and Outpatient-in-a-Bed Discharges:............ 4 Total Discharges:........................................................... 154

Average Length of Stay*:.............................................. 17.6 Average Daily Census*:................................................ 31.4 Patient Days*:........................................................... 11,479 *Excludes observation and outpatient-in-a-bed patients.

Observation and Outpatient-in-a-Bed Discharges:............ 1 Total Discharges:........................................................ 1,093 Average Length of Stay*:.............................................. 38.1 Average Daily Census*:.............................................. 113.1

A Decade of Remarkable Transformation

NEONATOLOGY

Patient Days*:........................................................... 41,278

Guidelines Developed for Extremely Premature Infants Proven to be Life-Changing

Fetal Medicine Collaborative Clinic Visits:...................... 201 Neonatology Clinic Visits:............................................ 3,163 Neonatology BPD Clinic Visits:....................................... 965 Neonatal Abstinence Syndrome Clinic Visits:................. 117 Newborn Intensive Care Unit at Riverside Methodist Hospital Inpatient Discharges:..................................................... 483

GRANTS AWARDED TO NEONATOLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020

Observation and Outpatient-in-a-Bed Discharges:............ 3

$5,562,391

Total Discharges:........................................................... 486

SELECTED PUBLICATIONS

Average Length of Stay*:.............................................. 27.3

Bapat R, Gulati IK, Jadcherla S. Impact of SIMPLE Feeding Quality Improvement Strategies on Aerodigestive Milestones and Feeding Outcomes in BPD Infants. Hospital Pediatrics. 2019 Nov;9(11):859-866.

CLINICAL FAST FACTS (CONTINUED)

Pishevar N, Fathi O, Backes CH, Shepherd EG, Nelin LD. Predicting survival in infants born at <27 weeks gestation admitted to an all referral neonatal intensive care unit: a pilot study. Journal of Perinatology. 2020 May;40(5):750-757.

Average Daily Census*:................................................ 36.1 Patient Days*:........................................................... 13,164

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

2010 Comprehensive BPD Center Established Using Innovative Multidisciplinary Approach With Demonstrated Improvements in Survival and Outcomes

2012

Prediction of Short-Term Neonatal Complications In Preterm Infants Using ExomeWide Genetic Variation

Positive touch in the NICU: Study Led by Nathalie Maitre, MD, PhD, Reinforces Touch Helps Shape Preterm Babies’ Brains

2014 Neonatal Aerodigestive Program Launched

2016

2013 2017

2017 2017 2020 2019

Congenital Infections Program Established Combining High Quality Clinical Care With Cutting Edge Research

Throughout the past decade, we have made great strides in clinical care and research for neonates. Advancing strong collaborations, digging deeper into the treatment and prevention of prematurity, and leading in research and innovation, has enabled the size and strength of our program to be unmatched. Caring for more than 3,000 babies each year, we are the nation’s largest neonatal center.

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 of the antimicrobial peptide RNase 7 compared to healthy controls.”

– John David Spencer, MD

100 CHILDREN’S HOSPITAL Annual Report 100| |NATIONWIDE NATIONWIDE CHILDREN’S HOSPITAL| |2019-20 2019-20 Annual Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

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 3;128(12):5634-5646.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 101

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 of the antimicrobial peptide RNase 7 compared to healthy controls.”

– John David Spencer, MD

100 CHILDREN’S HOSPITAL Annual Report 100| |NATIONWIDE NATIONWIDE CHILDREN’S HOSPITAL| |2019-20 2019-20 Annual Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

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 3;128(12):5634-5646.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 101

Department of Pediatrics

NEPHROLOGY AND HYPERTENSION The Division of Nephrology and Hypertension at Nationwide Children’s Hospital provides specialized primary and consultative care for children with kidney and urinary tract problems through age 21. Disorders treated include acute kidney injury, chronic kidney disease, congenital anomalies of the kidneys and urinary tract, glomerular disorders, tubular disorders, urinary tract infection, kidney stones, electrolyte disorders, hypertension and metabolic bone disease. A full range of renal replacement therapy services are available, including hemodialysis, peritoneal dialysis, continuous renal replacement therapy, aquapheresis and kidney transplantation.

FACULTY

John David Spencer, MD Division Chief

Hiren P. Patel, MD Section Chief Brian Becknell, MD, PhD Ray Bignall II, MD Mahmoud Kallash, MD John D. Mahan, MD Tahagod Mohamed, MD William E. Smoyer, MD Beth A. Vogt, MD Amy Wright, NP Diana Zepeda-Orozco, MD, MS

In the 2019-2020 academic year, the division welcomed two new nephrologists: Tahagod Mohamed, MD, and Diana Zepeda-Orozco, MD, MS. Dr. Mohamed is a junior nephrologist who completed her Nephrology Fellowship at the University of Virginia. Dr. Mohamed is developing a national reputation in neonatal nephrology and acute kidney injury. Dr. Zepeda-Orozco joined our team after serving as the director of the kidney transplantation program at the University of Iowa for nearly 10 years. Dr. Zepeda-Orozco is a National Institutes of Health (NIH)funded physician scientist who is investigating mechanisms of acute kidney injury. Dr. Zepeda-Orozco will serve as the director of the acute kidney injury program at Nationwide Children’s. The division continues to work closely and in collaboration with multiple clinical and surgical divisions.

Clinical operations in the Urology/Nephrology Combined Clinic have nearly doubled. While doing so, we have standardized clinical care for children with urinary tract obstruction and integrated preclinical and translational 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 Rheumatology.

The Division of Nephrology and Hypertension maintains an active and highly funded research program in the Abigail Wexner Research Institute at Nationwide Children’s Hospital. Four of our physician-scientists maintain actively funded NIH research programs. This past winter, Brian Becknell, MD, PhD, was awarded his first R01 application from the NIH to study mechanisms of obstructive kidney disease. Additionally, our division participates in over 50 Institutional Review Board-approved clinical and translational studies that are supported by five clinical research coordinators. These studies investigate mechanisms and outcomes of urinary tract infection, obstructive uropathy, chronic kidney disease, bacterial peritonitis, renal transplantation, glomerular diseases, metabolic bone disorders and medical education. Many of these studies are performed in conjunction with the Pediatric Nephrology Research Consortium (PNRC). John D. Mahan, MD, 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

multicenter study funded by the NIH to identify markers of glomerular disease and evaluate how new therapies impact disease progression.

Research done by the clinical and research faculty was presented at several national academic meetings, including the American Society of Nephrology Kidney Week, the Pediatric Academic Societies meeting and multiple specialized international research symposia. Nephrology faculty had over 40 unique, peer-reviewed publications, some of which are highlighted here.

Research: See page 184 for information about the Center for Clinical and Translational Research in the Abigail Wexner Research Institute at Nationwide Children’s.

SELECTED PUBLICATIONS Ching C, Schwartz L, Spencer JD, Becknell B. Innate Immunity and Urinary Tract Infection. Pediatric Nephrology. 2020 Jul;35(7):1183-1192.

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. (2019).

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.

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] Kallash M, Smoyer WE, Mahan JD. Rituximab Use in the Management of Childhood Nephrotic Syndrome. Frontiers Pediatrics. 2019 May 10;7:178.

McLeod DJ, Sebastião YV, Ching CB, Greenberg JH, Furth SL, Becknell B. Longitudinal Kidney Injury Biomarker Trajectories in Children with Obstructive Uropathy. Pediatric Nephrology. 2020 May 22.

FAST FACTS

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

July 2019 through June 2020

$4,400,892

Inpatient Discharges:..................................................... 171

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

Observation and Outpatient-in-a-Bed Discharges:........ 106 Total Discharges:........................................................... 274 Average Length of Stay*:................................................ 4.0

PEDIATRIC NEPHROLOGY Jessamyn Carter, MD (Medicine/Pediatrics) Jessica M. Greco, MD (Medicine/Pediatrics) Emily Stonebrook, MD (Pediatrics) Jason P. Thomas, MD (Pediatrics)

Average Daily Census*:.................................................. 1.8 Patient Days*:................................................................ 669 Nephrology Clinic Visits:............................................. 4,211 Dublin Nephrology Clinic Visits:..................................... 230 Kidney Transplants:........................................................... 6 *Excludes observation and outpatient-in-a-bed patients.

A Decade of Remarkable Transformation

NEPHROLOGY AND HYPERTENSION Nephrologists Invest in Patient Advocacy by Becoming John E. Lewy (JELF) Scholars through American Society of Pediatric Nephrology

2010

2012

Division Rebranded to Division of Nephrology and Hypertension

New Multidisciplinary Lupus Clinic Starts in Collaboration with Rheumatology

2013 New Multidisciplinary Nephro-Urology and Kidney Stone Clinic Starts in Collaboration with Urology

2017

2013 2019

2017 2020

First Simultaneous Liver-Kidney Transplant at Nationwide Children’s

In the past decade, the Division of Nephrology and Hypertension has received national recognition and awards for clinical research. The Nephrology and Urology Research Affinity Group (NURAG) at Nationwide Children’s has received over $18.7 million in extramural funding between 2015-2020.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 103

Department of Pediatrics

NEPHROLOGY AND HYPERTENSION The Division of Nephrology and Hypertension at Nationwide Children’s Hospital provides specialized primary and consultative care for children with kidney and urinary tract problems through age 21. Disorders treated include acute kidney injury, chronic kidney disease, congenital anomalies of the kidneys and urinary tract, glomerular disorders, tubular disorders, urinary tract infection, kidney stones, electrolyte disorders, hypertension and metabolic bone disease. A full range of renal replacement therapy services are available, including hemodialysis, peritoneal dialysis, continuous renal replacement therapy, aquapheresis and kidney transplantation.

FACULTY

John David Spencer, MD Division Chief

Hiren P. Patel, MD Section Chief Brian Becknell, MD, PhD Ray Bignall II, MD Mahmoud Kallash, MD John D. Mahan, MD Tahagod Mohamed, MD William E. Smoyer, MD Beth A. Vogt, MD Amy Wright, NP Diana Zepeda-Orozco, MD, MS

In the 2019-2020 academic year, the division welcomed two new nephrologists: Tahagod Mohamed, MD, and Diana Zepeda-Orozco, MD, MS. Dr. Mohamed is a junior nephrologist who completed her Nephrology Fellowship at the University of Virginia. Dr. Mohamed is developing a national reputation in neonatal nephrology and acute kidney injury. Dr. Zepeda-Orozco joined our team after serving as the director of the kidney transplantation program at the University of Iowa for nearly 10 years. Dr. Zepeda-Orozco is a National Institutes of Health (NIH)funded physician scientist who is investigating mechanisms of acute kidney injury. Dr. Zepeda-Orozco will serve as the director of the acute kidney injury program at Nationwide Children’s. The division continues to work closely and in collaboration with multiple clinical and surgical divisions.

Clinical operations in the Urology/Nephrology Combined Clinic have nearly doubled. While doing so, we have standardized clinical care for children with urinary tract obstruction and integrated preclinical and translational 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 Rheumatology.

The Division of Nephrology and Hypertension maintains an active and highly funded research program in the Abigail Wexner Research Institute at Nationwide Children’s Hospital. Four of our physician-scientists maintain actively funded NIH research programs. This past winter, Brian Becknell, MD, PhD, was awarded his first R01 application from the NIH to study mechanisms of obstructive kidney disease. Additionally, our division participates in over 50 Institutional Review Board-approved clinical and translational studies that are supported by five clinical research coordinators. These studies investigate mechanisms and outcomes of urinary tract infection, obstructive uropathy, chronic kidney disease, bacterial peritonitis, renal transplantation, glomerular diseases, metabolic bone disorders and medical education. Many of these studies are performed in conjunction with the Pediatric Nephrology Research Consortium (PNRC). John D. Mahan, MD, 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

multicenter study funded by the NIH to identify markers of glomerular disease and evaluate how new therapies impact disease progression.

Research done by the clinical and research faculty was presented at several national academic meetings, including the American Society of Nephrology Kidney Week, the Pediatric Academic Societies meeting and multiple specialized international research symposia. Nephrology faculty had over 40 unique, peer-reviewed publications, some of which are highlighted here.

Research: See page 184 for information about the Center for Clinical and Translational Research in the Abigail Wexner Research Institute at Nationwide Children’s.

SELECTED PUBLICATIONS Ching C, Schwartz L, Spencer JD, Becknell B. Innate Immunity and Urinary Tract Infection. Pediatric Nephrology. 2020 Jul;35(7):1183-1192.

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. (2019).

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.

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] Kallash M, Smoyer WE, Mahan JD. Rituximab Use in the Management of Childhood Nephrotic Syndrome. Frontiers Pediatrics. 2019 May 10;7:178.

McLeod DJ, Sebastião YV, Ching CB, Greenberg JH, Furth SL, Becknell B. Longitudinal Kidney Injury Biomarker Trajectories in Children with Obstructive Uropathy. Pediatric Nephrology. 2020 May 22.

FAST FACTS

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

July 2019 through June 2020

$4,400,892

Inpatient Discharges:..................................................... 171

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

Observation and Outpatient-in-a-Bed Discharges:........ 106 Total Discharges:........................................................... 274 Average Length of Stay*:................................................ 4.0

PEDIATRIC NEPHROLOGY Jessamyn Carter, MD (Medicine/Pediatrics) Jessica M. Greco, MD (Medicine/Pediatrics) Emily Stonebrook, MD (Pediatrics) Jason P. Thomas, MD (Pediatrics)

Average Daily Census*:.................................................. 1.8 Patient Days*:................................................................ 669 Nephrology Clinic Visits:............................................. 4,211 Dublin Nephrology Clinic Visits:..................................... 230 Kidney Transplants:........................................................... 6 *Excludes observation and outpatient-in-a-bed patients.

A Decade of Remarkable Transformation

NEPHROLOGY AND HYPERTENSION Nephrologists Invest in Patient Advocacy by Becoming John E. Lewy (JELF) Scholars through American Society of Pediatric Nephrology

2010

2012

Division Rebranded to Division of Nephrology and Hypertension

New Multidisciplinary Lupus Clinic Starts in Collaboration with Rheumatology

2013 New Multidisciplinary Nephro-Urology and Kidney Stone Clinic Starts in Collaboration with Urology

2017

2013 2019

2017 2020

First Simultaneous Liver-Kidney Transplant at Nationwide Children’s

In the past decade, the Division of Nephrology and Hypertension has received national recognition and awards for clinical research. The Nephrology and Urology Research Affinity Group (NURAG) at Nationwide Children’s has received over $18.7 million in extramural funding between 2015-2020.

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.microdystrophin 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.”

“Duchenne muscular dystrophy is difficult to treat, and gene therapy offers a needed option having the potential to alter the course of the disease.”

– Jerry Mendell, MD

104 CHILDREN’S HOSPITAL Annual Report 104| |NATIONWIDE NATIONWIDE CHILDREN’S HOSPITAL| |2019-20 2019-20 Annual Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

Sarepta has exclusive rights to the gene therapy program initially developed at AWRI at Nationwide Children’s.

CITATION: 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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 105

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.microdystrophin 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.”

“Duchenne muscular dystrophy is difficult to treat, and gene therapy offers a needed option having the potential to alter the course of the disease.”

– Jerry Mendell, MD

104 CHILDREN’S HOSPITAL Annual Report 104| |NATIONWIDE NATIONWIDE CHILDREN’S HOSPITAL| |2019-20 2019-20 Annual Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

Sarepta has exclusive rights to the gene therapy program initially developed at AWRI at Nationwide Children’s.

CITATION: 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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 105

Department of Pediatrics

NEUROLOGY The Division of Neurology providers at Nationwide Children’s Hospital deliver comprehensive care for children with a wide variety of disorders. These include simple and complex epilepsy, primary and secondary headache and migraine, tics and movement disorders, neuroinflammatory conditions, muscular dystrophy, spinal muscular atrophy and neuropathy (acquired and genetic). In order to correctly identify and safely treat these children, state-of-the-art neurophysiological diagnostic testing and intraoperative monitoring is used. Our mission is to achieve the best outcomes for all children and adolescents with neurological illness.

FACULTY

Monica P. Islam, MD Latif Khuhro, MD Neil Kulkarni, MD Warren D. Lo, MD Jennifer McKinney, MD Jerry Mendell, MD John Mytinger, MD Adam Ostendorf, MD

Anne M. Connolly, MD Division Chief

Ann Pakalnis, MD Margie Ream, MD, PhD Sean Rose, MD Zarife Sahenk, MD, PhD Laurel Slaughter, MD Chang-Yong Tsao, MD

The Neurology division includes 31 physicians and 12 advanced health care providers who oversee comprehensive programs for children with epilepsy, headache, movement disorders, neurodegenerative disorders and neuromuscular diseases. For children with complex disorders, we use a multidisciplinary clinical approach. In 2019, we added two additional multidisciplinary clinics: the Neuroimmunology clinic (led by Dr. Melissa Hutchinson) and the center of excellence for Charcot Marie Tooth (CMT) (led by Dr. Zarife Sahenk). Additional ongoing multidisciplinary programs include the Batten Disease Center of Excellence, Pediatric Intracranial Hypertension (pseudotumor cerebri) Clinic, Muscular Dystrophy Clinic, Brain Tumor Program, Cerebrovascular Disease Clinic, Concussion Clinic, Epilepsy Clinic, Epilepsy Surgery Program, Muscular Dystrophy Clinic, Spinal Muscular Atrophy Clinic, Stroke Clinic and Tuberous Sclerosis Clinic.

The section offers outstanding residency and fellowship programs. The Child Neurology Residency program (certified by Accreditation Council for Graduate Medical Education) includes five residents per year with options for clinical- or research-focused educational tracks.

Neurology also offers pediatric fellowship training in clinical and surgical neurophysiology, gene therapy, headache, neuromuscular disease, neuromuscular pathology and stroke. Faculty members conducted both basic and clinical research and published numerous journal articles and book chapters in 2019.

Jaime-Dawn Twanow, MD

Research: See page 185 for information about the Center for Gene Therapy in the Abigail Wexner Research Institute at Nationwide Children’s.

Neurosurgery: See page 145 to learn about the Department of Neurosurgery at Nationwide Children’s.

GRANTS AWARDED TO CENTER FOR GENE THERAPY AND NEUROLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $17,070,837 SELECTED PUBLICATIONS Albert DVF, Moreland JJ, Salvator A, Moore-Clingenpeel M, Haridas B, Cole JW, Glynn P, Fults M, Dawson MZ, Moreland P, Patel AD. Seizure Action Plans for Pediatric Patients with Epilepsy: A Randomized Controlled Trial. Journal of Child Neurology. 2019 Oct;34(11):666-673 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 LR, 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 Neurology. 2020 Jun 15 [Epub ahead of print] Miller KE, Koboldt DC, Schieffer KM, Bedrosian TA, Crist E, Sheline A, Leraas K, Magrini V, Zhong H, Brennan P, 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 AP. Somatic SLC35A2 mosaicism correlates with clinical findings in epilepsy brain tissue. Neurology Genetics. 2020 Jun 17;6(4):e460.

Mytinger JR, Albert DVF, Twanow JD, Vidaurre J, Tan Y, Grock GN, Ostendorf, AP. Compliance with Standard Therapies and Remission Rates after Implementation of an Infantile Spasms Management Guideline. Pediatric Neurology. 2020 Mar;104:23-29.

Nizon M, Laugel V, Flanigan KM, Pastore M, Waldrop MA, Rosenfeld JA, Marom R, Xiao R, Gerard A, Pichon O, Caignec CL, Gerard M, Dieterich K, Cho MT, McWalter K, Hiatt S, Thompson ML, Bezieau S, Wadley A, Wierenga KJ, Egly JM, Isidor B. Variants in MED12L, encoding a subunit of the mediator kinase module, are responsible for intellectual disability associated with transcriptional defect. Genetics in Medicine. 2019 Dec;21(12):2713-2722.

Jorge Vidaurre, MD Megan Waldrop, MD Pedro Weisleder, MD, PhD Anup D. Patel, MD Section Chief Dara Albert, DO Sylvia Awadalla, MD William D. Arnold, MD Kristen Arredondo, MD Shawn Aylward, MD Melissa Chung, MD Emily De Los Reyes, MD John L. Eickholt III, MD Kevin Flanigan, MD Mariam L. Freimer, MD Darrah Haffner, MD

In 2020, the neurology section welcomed two new faculty members and one new advanced practitioner. Dr. Sylvia Awadalla joined in early January and brings deep expertise in headache and movement disorders. Dr. Darrah Haffner joined in August after completing fellowship training in neonatal neurology and neurodevelopment. Ms. Alison Remy joined our APP group in August and will be focusing on childhood epilepsy.

After the U.S. Food and Drug Administration approval (February 2019) of gene transfer for infants with spinal muscular atrophy (SMA), we have delivered gene transfers for more than 20 children. Ongoing research continues to develop gene therapy for older children with SMA, muscular dystrophy (Duchenne and limb girdle) and CMT. Additional work has led to improvements in the care and understanding of children with infantile spasms, status epilepticus and complex epilepsy.

CLINICAL FAST FACTS July 2019 through June 2020 Neurology Inpatient Discharges:..................................................... 200

Findlay Neurology Clinic Visits:........................................ 43

Observation and Outpatient-in-a-Bed Discharges:........ 507

Neurology Clinic Visits:............................................. 11,151

Total Discharges:........................................................... 704

Mansfield Neurology Clinic Visits:.................................... 53

Average Length of Stay*:................................................ 3.0

Westerville Neurology Clinic Visits:............................. 1,241

Average Daily Census*:.................................................. 1.6

Total Neurology Clinic Visits:..................................... 16,460

Patient Days*:................................................................ 595 Inpatient Consults:...................................................... 1,163 Blanchard Neurology (PAA) Visits:...................................... 8 Complex Concussion Clinic Visits:................................. 308 Stroke Clinic Visits:........................................................ 209 Dublin Neurology Clinic Visits:.................................... 2,740 East Broad Neurology Clinic Visits:................................ 679

Heinzerling Neurology Clinic Visits:.................................. 28

Neuromuscular Disorders MDA Clinic Visits:........................................................... 645 Westerville Neuromuscular Clinic Visits:.......................... 19 Neuromuscular Disorders Clinic Visits:.......................... 885 Spinal Muscular Atrophy Clinic Visits:............................ 273 Total Neuromuscular Clinic Visits:............................... 1,822 *Excludes observation and outpatient-in-a-bed patients.

Melissa Hutchinson, MD 106 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 107

Department of Pediatrics

NEUROLOGY The Division of Neurology providers at Nationwide Children’s Hospital deliver comprehensive care for children with a wide variety of disorders. These include simple and complex epilepsy, primary and secondary headache and migraine, tics and movement disorders, neuroinflammatory conditions, muscular dystrophy, spinal muscular atrophy and neuropathy (acquired and genetic). In order to correctly identify and safely treat these children, state-of-the-art neurophysiological diagnostic testing and intraoperative monitoring is used. Our mission is to achieve the best outcomes for all children and adolescents with neurological illness.

FACULTY

Monica P. Islam, MD Latif Khuhro, MD Neil Kulkarni, MD Warren D. Lo, MD Jennifer McKinney, MD Jerry Mendell, MD John Mytinger, MD Adam Ostendorf, MD

Anne M. Connolly, MD Division Chief

Ann Pakalnis, MD Margie Ream, MD, PhD Sean Rose, MD Zarife Sahenk, MD, PhD Laurel Slaughter, MD Chang-Yong Tsao, MD

The Neurology division includes 31 physicians and 12 advanced health care providers who oversee comprehensive programs for children with epilepsy, headache, movement disorders, neurodegenerative disorders and neuromuscular diseases. For children with complex disorders, we use a multidisciplinary clinical approach. In 2019, we added two additional multidisciplinary clinics: the Neuroimmunology clinic (led by Dr. Melissa Hutchinson) and the center of excellence for Charcot Marie Tooth (CMT) (led by Dr. Zarife Sahenk). Additional ongoing multidisciplinary programs include the Batten Disease Center of Excellence, Pediatric Intracranial Hypertension (pseudotumor cerebri) Clinic, Muscular Dystrophy Clinic, Brain Tumor Program, Cerebrovascular Disease Clinic, Concussion Clinic, Epilepsy Clinic, Epilepsy Surgery Program, Muscular Dystrophy Clinic, Spinal Muscular Atrophy Clinic, Stroke Clinic and Tuberous Sclerosis Clinic.

The section offers outstanding residency and fellowship programs. The Child Neurology Residency program (certified by Accreditation Council for Graduate Medical Education) includes five residents per year with options for clinical- or research-focused educational tracks.

Neurology also offers pediatric fellowship training in clinical and surgical neurophysiology, gene therapy, headache, neuromuscular disease, neuromuscular pathology and stroke. Faculty members conducted both basic and clinical research and published numerous journal articles and book chapters in 2019.

Jaime-Dawn Twanow, MD

Research: See page 185 for information about the Center for Gene Therapy in the Abigail Wexner Research Institute at Nationwide Children’s.

Neurosurgery: See page 145 to learn about the Department of Neurosurgery at Nationwide Children’s.

GRANTS AWARDED TO CENTER FOR GENE THERAPY AND NEUROLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $17,070,837 SELECTED PUBLICATIONS Albert DVF, Moreland JJ, Salvator A, Moore-Clingenpeel M, Haridas B, Cole JW, Glynn P, Fults M, Dawson MZ, Moreland P, Patel AD. Seizure Action Plans for Pediatric Patients with Epilepsy: A Randomized Controlled Trial. Journal of Child Neurology. 2019 Oct;34(11):666-673 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 LR, 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 Neurology. 2020 Jun 15 [Epub ahead of print] Miller KE, Koboldt DC, Schieffer KM, Bedrosian TA, Crist E, Sheline A, Leraas K, Magrini V, Zhong H, Brennan P, 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 AP. Somatic SLC35A2 mosaicism correlates with clinical findings in epilepsy brain tissue. Neurology Genetics. 2020 Jun 17;6(4):e460.

Mytinger JR, Albert DVF, Twanow JD, Vidaurre J, Tan Y, Grock GN, Ostendorf, AP. Compliance with Standard Therapies and Remission Rates after Implementation of an Infantile Spasms Management Guideline. Pediatric Neurology. 2020 Mar;104:23-29.

Nizon M, Laugel V, Flanigan KM, Pastore M, Waldrop MA, Rosenfeld JA, Marom R, Xiao R, Gerard A, Pichon O, Caignec CL, Gerard M, Dieterich K, Cho MT, McWalter K, Hiatt S, Thompson ML, Bezieau S, Wadley A, Wierenga KJ, Egly JM, Isidor B. Variants in MED12L, encoding a subunit of the mediator kinase module, are responsible for intellectual disability associated with transcriptional defect. Genetics in Medicine. 2019 Dec;21(12):2713-2722.

Jorge Vidaurre, MD Megan Waldrop, MD Pedro Weisleder, MD, PhD Anup D. Patel, MD Section Chief Dara Albert, DO Sylvia Awadalla, MD William D. Arnold, MD Kristen Arredondo, MD Shawn Aylward, MD Melissa Chung, MD Emily De Los Reyes, MD John L. Eickholt III, MD Kevin Flanigan, MD Mariam L. Freimer, MD Darrah Haffner, MD

In 2020, the neurology section welcomed two new faculty members and one new advanced practitioner. Dr. Sylvia Awadalla joined in early January and brings deep expertise in headache and movement disorders. Dr. Darrah Haffner joined in August after completing fellowship training in neonatal neurology and neurodevelopment. Ms. Alison Remy joined our APP group in August and will be focusing on childhood epilepsy.

After the U.S. Food and Drug Administration approval (February 2019) of gene transfer for infants with spinal muscular atrophy (SMA), we have delivered gene transfers for more than 20 children. Ongoing research continues to develop gene therapy for older children with SMA, muscular dystrophy (Duchenne and limb girdle) and CMT. Additional work has led to improvements in the care and understanding of children with infantile spasms, status epilepticus and complex epilepsy.

CLINICAL FAST FACTS July 2019 through June 2020 Neurology Inpatient Discharges:..................................................... 200

Findlay Neurology Clinic Visits:........................................ 43

Observation and Outpatient-in-a-Bed Discharges:........ 507

Neurology Clinic Visits:............................................. 11,151

Total Discharges:........................................................... 704

Mansfield Neurology Clinic Visits:.................................... 53

Average Length of Stay*:................................................ 3.0

Westerville Neurology Clinic Visits:............................. 1,241

Average Daily Census*:.................................................. 1.6

Total Neurology Clinic Visits:..................................... 16,460

Patient Days*:................................................................ 595 Inpatient Consults:...................................................... 1,163 Blanchard Neurology (PAA) Visits:...................................... 8 Complex Concussion Clinic Visits:................................. 308 Stroke Clinic Visits:........................................................ 209 Dublin Neurology Clinic Visits:.................................... 2,740 East Broad Neurology Clinic Visits:................................ 679

Heinzerling Neurology Clinic Visits:.................................. 28

Neuromuscular Disorders MDA Clinic Visits:........................................................... 645 Westerville Neuromuscular Clinic Visits:.......................... 19 Neuromuscular Disorders Clinic Visits:.......................... 885 Spinal Muscular Atrophy Clinic Visits:............................ 273 Total Neuromuscular Clinic Visits:............................... 1,822 *Excludes observation and outpatient-in-a-bed patients.

Melissa Hutchinson, MD 106 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 107

2019 – 2020 NATIONWIDE CHILDREN’S RESIDENCY AND FELLOWSHIP PROGRAM

RESIDENCY PROGRAMS

FELLOWSHIP PROGRAMS

CHILD NEUROLOGY Daniel Clark, MD Alexandra B. Kornbluh, MD Matthew Martin, MD Thomas Murray, DO Lisa Pabst, MD Melissa D. Squires, MD Whitney Woodhull, MD

GENE TRANSFER FELLOWSHIP Nicolas Abreu, MD

CLINICAL NEUROPHYSIOLOGY Stephanie Ahrens, DO Daniel Freedman, DO

NEUROMUSCULAR GENETIC THERAPEUTICS Renatta Knox, MD, PhD

A Decade of Remarkable Transformation NEUROLOGY Named Batten Disease Center of Excellence by BDSRA

2010

First Dedicated Program for Infantile Spasms

2010 First Intracranial Hypertension Program for Pediatric Patients

2012

Results of First Successful Gene Therapy for DMD Led

by Dr. Mendell and Team Published in JAMA Neurology

Dr. Jerry Mendell and Team Publish SMA-1 Gene Therapy Results in NEJM; Paves Way for FDA’s 2019 Approval

2014

2017

Columbus and Nationwide Children's Host Child Neurology Society Annual Meeting

2019

2020

2017 2020

Named CMT Center of Excellence by Charcot-MarieTooth 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.

108 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 109

2019 – 2020 NATIONWIDE CHILDREN’S RESIDENCY AND FELLOWSHIP PROGRAM

RESIDENCY PROGRAMS

FELLOWSHIP PROGRAMS

CHILD NEUROLOGY Daniel Clark, MD Alexandra B. Kornbluh, MD Matthew Martin, MD Thomas Murray, DO Lisa Pabst, MD Melissa D. Squires, MD Whitney Woodhull, MD

GENE TRANSFER FELLOWSHIP Nicolas Abreu, MD

CLINICAL NEUROPHYSIOLOGY Stephanie Ahrens, DO Daniel Freedman, DO

NEUROMUSCULAR GENETIC THERAPEUTICS Renatta Knox, MD, PhD

A Decade of Remarkable Transformation NEUROLOGY Named Batten Disease Center of Excellence by BDSRA

2010

First Dedicated Program for Infantile Spasms

2010 First Intracranial Hypertension Program for Pediatric Patients

2012

Results of First Successful Gene Therapy for DMD Led

by Dr. Mendell and Team Published in JAMA Neurology

Dr. Jerry Mendell and Team Publish SMA-1 Gene Therapy Results in NEJM; Paves Way for FDA’s 2019 Approval

2014

2017

Columbus and Nationwide Children's Host Child Neurology Society Annual Meeting

2019

2020

2017 2020

Named CMT Center of Excellence by Charcot-MarieTooth 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.

108 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 109

Department of Pediatrics

PEDIATRIC PSYCHOLOGY AND NEUROPSYCHOLOGY Pediatric Psychology and Neuropsychology is a Section of the Department of Pediatrics at Nationwide Children’s Hospital that concentrates clinical services in three primary areas: Pediatric Psychology provides specialized assessment and intervention services that focus on the relationship between cognitive, social and emotional functioning and physical health, typically for children with co-occurring medical conditions (e.g., cancer, diabetes, sickle cell disease); Pediatric Neuropsychology performs specialized evaluations for children and adolescents with a range of medical and neurological disorders that impact thinking or behavior (e.g., brain tumors, epilepsy, seizure disorders, traumatic brain injury); Pediatric Psychiatric Acute Care Psychology provides services to support the acute care continuum in the Big Lots Behavioral Health Pavilion; and Intellectual and Developmental Disability/Autism Spectrum Disorder Psychology provides specialized assessment and intervention services for children and adolescents impacted by various genetic and neurodevelopmental disabilities, including autism spectrum disorders. See page 132 for details and for information about all Behavioral Health services.

FACULTY

Jackie Doxie-King, PhD Christine Eichelberger, PhD Anya Froelich, PsyD Lauren Garbacz, PhD Molly Gardner, PhD Cynthia A. Gerhardt, PhD Shannon Gilespie, PhD Alana Goldstein-Leever, PhD Amy Hahn, PhD

Eric M. Butter, PhD Chief

Jane Hamel-Lambert, PhD

Charles Albright, PhD

Sharnita Harris, PhD

Jessica Bailey, PhD Amy E. Baughcum, PhD Doug Bodin, PhD Shalonda Brooks, PhD Catherine Butz, PhD Jennifer E. Cass, PhD Eileen Chaves, PhD Sarah Connolly, PhD Andrea Coppens, PhD Canice Crerand, PhD Anne Dawson, PhD Ashley Debeljak, PhD Nicole Dempster, PhD Robert M. Dempster, PhD

Jennifer Hansen, PhD Rebecca Hellenthal, PhD Jessica Hoehn, PhD Ariana Hoet, PhD Kristen E. Hoskinson, PhD Cody Hostutler, PhD Parker Huston, PhD Cara Inglis, PsyD Jamie Jackson, PhD Katie Johanning Gray, PhD Oula Khoury, PhD Chrissie Koterba, PhD Ashley Kroon Van Diest, PhD Elizabeth Kryszak, PhD

110 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Kathleen L. Lemanek, PhD

Andrea Wojtowicz, PhD

Ann Levine, PhD

Jacqueline Wynn, PhD

Barbara Mackinaw-Koons, PhD

Heather L. Yardley, PhD

Laura M. Mackner, PhD

Tammi K. Young-Saleme, PhD

Marilee Martens, PhD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $524,626

Hannah McKillop, PhD Kelly A. McNally, PhD Margaret Mehling, PhD

SELECTED PUBLICATIONS

David Michalec, PhD

Butz C, Castillo A, Gallup J, Valleru J, Butter E. Timely Access to Mental Health Services for Patients with Pain. Pediatric Quality & Safety. 2019 Dec 6;4(6):e240.

Alana Moses, PhD James A. Mulick, PhD Caroline Murphy, PhD Emily Newton, PhD Megan Norris, PhD Jessica Palila, PhD

Johnson B, Leibowitz S, Chavez A, Herbert SE. Risk Versus Resiliency: Addressing Depression in Lesbian, Gay, Bisexual, and Transgender Youth. Child & Adolescent Psychiatric Clinics of North America. 2019 Jul;28(3):509-521.

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.

2020 Jul;50(7):2307-2319.

Ramtekkar U, Bridge J, Thomas G, Butter E, Reese J, Logan E, Lin S, Axelson D. Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19.

JMIR Mental Health. 2020; 10:10.

Ari Rabkin, PhD Natalie Raff, PhD Whitney Raglin-Bignall, PhD Courtney Rice, PsyD

FAST FACTS July 2019 through June 2020

Claire Russell, PhD

Inpatient Consultations: ..........................................4,164

Jessica Scherr, PhD

Psychology Clinic Visits:.........................................14,241

Rose Schroedl, PhD

Psychology Medical Clinic Visits/Outpatient Consultation Visits:......................15,149

Ashley Showalter, PhD Micheline Silva, PhD Tyanna Snider, PsyD Janet Souder, PsyD Jack H. Stevens, PhD Karen Tabern, PhD H. Gerry Taylor, PhD Kristen Trott, PhD Natalie Truba, PhD Kathryn A. Vannatta, PhD Lindsey Vater, PhD Sarah N. VerLee, PhD Bethany Walker, PhD Jonathan Wilkins, PhD Camille Wilson, PhD Mary Wojnaroski, PhD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 111

Department of Pediatrics

PEDIATRIC PSYCHOLOGY AND NEUROPSYCHOLOGY Pediatric Psychology and Neuropsychology is a Section of the Department of Pediatrics at Nationwide Children’s Hospital that concentrates clinical services in three primary areas: Pediatric Psychology provides specialized assessment and intervention services that focus on the relationship between cognitive, social and emotional functioning and physical health, typically for children with co-occurring medical conditions (e.g., cancer, diabetes, sickle cell disease); Pediatric Neuropsychology performs specialized evaluations for children and adolescents with a range of medical and neurological disorders that impact thinking or behavior (e.g., brain tumors, epilepsy, seizure disorders, traumatic brain injury); Pediatric Psychiatric Acute Care Psychology provides services to support the acute care continuum in the Big Lots Behavioral Health Pavilion; and Intellectual and Developmental Disability/Autism Spectrum Disorder Psychology provides specialized assessment and intervention services for children and adolescents impacted by various genetic and neurodevelopmental disabilities, including autism spectrum disorders. See page 132 for details and for information about all Behavioral Health services.

FACULTY

Jackie Doxie-King, PhD Christine Eichelberger, PhD Anya Froelich, PsyD Lauren Garbacz, PhD Molly Gardner, PhD Cynthia A. Gerhardt, PhD Shannon Gilespie, PhD Alana Goldstein-Leever, PhD Amy Hahn, PhD

Eric M. Butter, PhD Chief

Jane Hamel-Lambert, PhD

Charles Albright, PhD

Sharnita Harris, PhD

Jessica Bailey, PhD Amy E. Baughcum, PhD Doug Bodin, PhD Shalonda Brooks, PhD Catherine Butz, PhD Jennifer E. Cass, PhD Eileen Chaves, PhD Sarah Connolly, PhD Andrea Coppens, PhD Canice Crerand, PhD Anne Dawson, PhD Ashley Debeljak, PhD Nicole Dempster, PhD Robert M. Dempster, PhD

Jennifer Hansen, PhD Rebecca Hellenthal, PhD Jessica Hoehn, PhD Ariana Hoet, PhD Kristen E. Hoskinson, PhD Cody Hostutler, PhD Parker Huston, PhD Cara Inglis, PsyD Jamie Jackson, PhD Katie Johanning Gray, PhD Oula Khoury, PhD Chrissie Koterba, PhD Ashley Kroon Van Diest, PhD Elizabeth Kryszak, PhD

110 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Kathleen L. Lemanek, PhD

Andrea Wojtowicz, PhD

Ann Levine, PhD

Jacqueline Wynn, PhD

Barbara Mackinaw-Koons, PhD

Heather L. Yardley, PhD

Laura M. Mackner, PhD

Tammi K. Young-Saleme, PhD

Marilee Martens, PhD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $524,626

Hannah McKillop, PhD Kelly A. McNally, PhD Margaret Mehling, PhD

SELECTED PUBLICATIONS

David Michalec, PhD

Butz C, Castillo A, Gallup J, Valleru J, Butter E. Timely Access to Mental Health Services for Patients with Pain. Pediatric Quality & Safety. 2019 Dec 6;4(6):e240.

Alana Moses, PhD James A. Mulick, PhD Caroline Murphy, PhD Emily Newton, PhD Megan Norris, PhD Jessica Palila, PhD

Johnson B, Leibowitz S, Chavez A, Herbert SE. Risk Versus Resiliency: Addressing Depression in Lesbian, Gay, Bisexual, and Transgender Youth. Child & Adolescent Psychiatric Clinics of North America. 2019 Jul;28(3):509-521.

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.

2020 Jul;50(7):2307-2319.

Ramtekkar U, Bridge J, Thomas G, Butter E, Reese J, Logan E, Lin S, Axelson D. Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19.

JMIR Mental Health. 2020; 10:10.

Ari Rabkin, PhD Natalie Raff, PhD Whitney Raglin-Bignall, PhD Courtney Rice, PsyD

FAST FACTS July 2019 through June 2020

Claire Russell, PhD

Inpatient Consultations: ..........................................4,164

Jessica Scherr, PhD

Psychology Clinic Visits:.........................................14,241

Rose Schroedl, PhD

Psychology Medical Clinic Visits/Outpatient Consultation Visits:......................15,149

Ashley Showalter, PhD Micheline Silva, PhD Tyanna Snider, PsyD Janet Souder, PsyD Jack H. Stevens, PhD Karen Tabern, PhD H. Gerry Taylor, PhD Kristen Trott, PhD Natalie Truba, PhD Kathryn A. Vannatta, PhD Lindsey Vater, PhD Sarah N. VerLee, PhD Bethany Walker, PhD Jonathan Wilkins, PhD Camille Wilson, PhD Mary Wojnaroski, PhD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 111

Department of Pediatrics

PRIMARY CARE PEDIATRICS Pediatricians in the Division of Primary Care Pediatrics at Nationwide Children’s Hospital staff the 12 Nationwide Children’s Hospital Primary Care Centers located throughout the Columbus area. A multidisciplinary staff provides comprehensive primary care services for a diverse and underserved population of patients.

FACULTY

Alex R. Kemper, MD, MPH, MS Division Chief

Dane A. Snyder, MD Section Chief Mary Ann Abrams, MD Oghenevwiroro Akpovwa, MD Razan Alkhoury, MD Zeenath Ameen, MD Akua A. Amponsah, MD Kristen Beck, MD Stefanie R. Bester, MD Sara Bode, MD Courtney Brown, MD Megan Brundrett, MD Nicole V. Caldwell, MD Milagro P. Castaneda-Viduarre, MD Aarti Chandawarkar, MD Linda E. Chun, MD

Katharine Coffman, MD Frances Comer, DO Duane R. Copenheaver, DO Kimberly Dean, MD Emily A. Decker, MD Tanya Dedyo, MD Robyn Dennis, MD Sarah Denny, MD Ihuoma U. Eneli, MD Maureen Faust, DO Ashley Fernandes, MD Susan Friedman, MD Sean P. Gleeson, MD Judith A. Groner, MD Uma Gupta, MD Malika Haque, MD Laura Hart, MD Stephen J. Hersey, MD Lisa Humphrey, MD Aurelia J. Jackson, MD Sinimol James, MD Angela V. Jones, MD Tabitha Jones-McKnight, DO Shelby Jordan, MD Tatyana Karakay, MD Amrik Singh Khalsa, MD Lindsay Kneen, MD Jack A. Kopechek, MD Ajay Koti, MD Alicia Kuper, DO Mary Kay Kuzma, MD Gilbert Liu, MD Benjamin Levinson, MD Jonathan T. Lucas, MD Shengyi Mao, MD Laura Martin, MD Lucas McKnight, MD

112 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Douglas J. McLaughlin, MD Melissa A. Meyer, MD Belinda M. Mills, MD Alana Milton, MD Asma Mobin-Uddin, MD Mary A. Nelin, MD Barbara Oettgen, MD Michele Oyortey, MD Cheryl B. Pippin, MD Quiana Pollock, MD Stephanie Quach, MD Alexander T. Rakowsky, MD Jessica Retzke, MD Jennifer Ricciardo, MD Nathan Richards, MD Richard E. Rodenberg Jr., MD Allison Rossetti, MD Andrea Sattler, MD Sara Schroder, MD Amina Smajlovic, MD Kimberly Stettler, MD Lisa Stone, DO Melissa Swanson, MD Patricia Temple Gabbe, MD Olivia W. Thomas, MD Gina R. Thompson, DO Jagadisharaje K. Urs, MD Jose Vargas, MD Shravani Vundavalli, MD Caroline Weingart, MD Mark Winerman, MD

array of conditions, including anemia, asthma, attention deficit-hyperactivity disorder, depression and obesity. The division also focuses on ensuring all children and adolescents receive timely preventive services, including well-child visits and immunizations.

The division also houses the Center for Healthy Weight and Nutrition, a national model for multidisciplinary comprehensive care for children and adolescents with obesity. In 2019, the division expanded its focus on adolescent preventive services, including screening for depression and suicide risk. To address the needs of patients and families during the COVID-19 pandemic, the division expanded access through telemedicine in addition to regular, in-person visits.

Rachael Zanotti-Morocco, DO

Walley SC, Wilson KM, Winickoff JP, Groner J. A public health crisis: electronic cigarettes, vape, and JUUL. Pediatrics. 2019;143(6): e20182741.

The Division of Primary Care Pediatrics provides training and education for The Ohio State University College of Medicine students, as well as residents in Pediatrics, Family Medicine and combined Internal Medicine-Pediatrics. Research focuses on a broad range of preventive services, smoking cessation, obesity prevention and treatment, health literacy, and transition from pediatric to adult health care services.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,972,014 SELECTED PUBLICATIONS Ghastine L, Kerlek AJ, Kopechek JA. Childhood sexual abuse: a call to action in pediatric primary care. Pediatrics. 2020;4:e20193327.

Hart LC, Crawford M, Crawford P, Noritz G. Practical steps to help transition pediatric patients to adult care. Pediatrics. 2019;144(6):e20190373.

Kemper AR, Kelleher KJ, Allen S, Sander C, Brilli RJ. Improving the health of all children in our community: The Nationwide Children’s Hospital and Franklin County Ohio, Pediatric Vital Signs Project. Journal of Pediatrics. 2020;222:227-230.

Khalsa AS, Copeland KA, Misik L, Brown CL, Kharofa RY, Olderbing NJ. Maternal body dissatisfaction and accuracy of infant weight perception in families from low-income backgrounds. Academic Pediatrics. 2020;20(6):793-800.

The Primary Care centers provide comprehensive care primarily for children from birth to 21 years of age. Available services include preventive care, chronic disease management and acute care, with both scheduled and same-day, walk-in access. In addition to pediatricians and pediatric nurse practitioners, the clinics include a wide array of other individuals to support the needs of patients and their families, including health coaches, pharmacists, psychologists and social workers. Combined adult and pediatric adult health services are available at one clinic site.

FAST FACTS July 2019 through June 2020 Primary Care Network Visits:.................................. 188,273 Unique Patients Treated in Entire Primary Care Network:............................... 84,594

The division’s quality improvement initiatives continue to focus on improving care for patients with a broad

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 113

Department of Pediatrics

PRIMARY CARE PEDIATRICS Pediatricians in the Division of Primary Care Pediatrics at Nationwide Children’s Hospital staff the 12 Nationwide Children’s Hospital Primary Care Centers located throughout the Columbus area. A multidisciplinary staff provides comprehensive primary care services for a diverse and underserved population of patients.

FACULTY

Alex R. Kemper, MD, MPH, MS Division Chief

Dane A. Snyder, MD Section Chief Mary Ann Abrams, MD Oghenevwiroro Akpovwa, MD Razan Alkhoury, MD Zeenath Ameen, MD Akua A. Amponsah, MD Kristen Beck, MD Stefanie R. Bester, MD Sara Bode, MD Courtney Brown, MD Megan Brundrett, MD Nicole V. Caldwell, MD Milagro P. Castaneda-Viduarre, MD Aarti Chandawarkar, MD Linda E. Chun, MD

Katharine Coffman, MD Frances Comer, DO Duane R. Copenheaver, DO Kimberly Dean, MD Emily A. Decker, MD Tanya Dedyo, MD Robyn Dennis, MD Sarah Denny, MD Ihuoma U. Eneli, MD Maureen Faust, DO Ashley Fernandes, MD Susan Friedman, MD Sean P. Gleeson, MD Judith A. Groner, MD Uma Gupta, MD Malika Haque, MD Laura Hart, MD Stephen J. Hersey, MD Lisa Humphrey, MD Aurelia J. Jackson, MD Sinimol James, MD Angela V. Jones, MD Tabitha Jones-McKnight, DO Shelby Jordan, MD Tatyana Karakay, MD Amrik Singh Khalsa, MD Lindsay Kneen, MD Jack A. Kopechek, MD Ajay Koti, MD Alicia Kuper, DO Mary Kay Kuzma, MD Gilbert Liu, MD Benjamin Levinson, MD Jonathan T. Lucas, MD Shengyi Mao, MD Laura Martin, MD Lucas McKnight, MD

112 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Douglas J. McLaughlin, MD Melissa A. Meyer, MD Belinda M. Mills, MD Alana Milton, MD Asma Mobin-Uddin, MD Mary A. Nelin, MD Barbara Oettgen, MD Michele Oyortey, MD Cheryl B. Pippin, MD Quiana Pollock, MD Stephanie Quach, MD Alexander T. Rakowsky, MD Jessica Retzke, MD Jennifer Ricciardo, MD Nathan Richards, MD Richard E. Rodenberg Jr., MD Allison Rossetti, MD Andrea Sattler, MD Sara Schroder, MD Amina Smajlovic, MD Kimberly Stettler, MD Lisa Stone, DO Melissa Swanson, MD Patricia Temple Gabbe, MD Olivia W. Thomas, MD Gina R. Thompson, DO Jagadisharaje K. Urs, MD Jose Vargas, MD Shravani Vundavalli, MD Caroline Weingart, MD Mark Winerman, MD

array of conditions, including anemia, asthma, attention deficit-hyperactivity disorder, depression and obesity. The division also focuses on ensuring all children and adolescents receive timely preventive services, including well-child visits and immunizations.

The division also houses the Center for Healthy Weight and Nutrition, a national model for multidisciplinary comprehensive care for children and adolescents with obesity. In 2019, the division expanded its focus on adolescent preventive services, including screening for depression and suicide risk. To address the needs of patients and families during the COVID-19 pandemic, the division expanded access through telemedicine in addition to regular, in-person visits.

Rachael Zanotti-Morocco, DO

Walley SC, Wilson KM, Winickoff JP, Groner J. A public health crisis: electronic cigarettes, vape, and JUUL. Pediatrics. 2019;143(6): e20182741.

The Division of Primary Care Pediatrics provides training and education for The Ohio State University College of Medicine students, as well as residents in Pediatrics, Family Medicine and combined Internal Medicine-Pediatrics. Research focuses on a broad range of preventive services, smoking cessation, obesity prevention and treatment, health literacy, and transition from pediatric to adult health care services.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,972,014 SELECTED PUBLICATIONS Ghastine L, Kerlek AJ, Kopechek JA. Childhood sexual abuse: a call to action in pediatric primary care. Pediatrics. 2020;4:e20193327.

Hart LC, Crawford M, Crawford P, Noritz G. Practical steps to help transition pediatric patients to adult care. Pediatrics. 2019;144(6):e20190373.

Kemper AR, Kelleher KJ, Allen S, Sander C, Brilli RJ. Improving the health of all children in our community: The Nationwide Children’s Hospital and Franklin County Ohio, Pediatric Vital Signs Project. Journal of Pediatrics. 2020;222:227-230.

Khalsa AS, Copeland KA, Misik L, Brown CL, Kharofa RY, Olderbing NJ. Maternal body dissatisfaction and accuracy of infant weight perception in families from low-income backgrounds. Academic Pediatrics. 2020;20(6):793-800.

The Primary Care centers provide comprehensive care primarily for children from birth to 21 years of age. Available services include preventive care, chronic disease management and acute care, with both scheduled and same-day, walk-in access. In addition to pediatricians and pediatric nurse practitioners, the clinics include a wide array of other individuals to support the needs of patients and their families, including health coaches, pharmacists, psychologists and social workers. Combined adult and pediatric adult health services are available at one clinic site.

FAST FACTS July 2019 through June 2020 Primary Care Network Visits:.................................. 188,273 Unique Patients Treated in Entire Primary Care Network:............................... 84,594

The division’s quality improvement initiatives continue to focus on improving care for patients with a broad

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 113

HEALTHY WEIGHT AND NUTRITION weight management. In addition, the center offers adolescent bariatric surgery and is accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. The center leads the Primary Care Obesity Network (PCON), a program that supports primary care practices with training and resources.

Ihuoma U. Eneli, MD, MS, FAAP Director

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 addition to serving as an expert to obesity programs 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.

Dominique Williams, MD, MPH, FAAP, Dipl ABOM

Through leadership roles at the National Academy of Medicine (NAM) Roundtable on Obesity Solutions, American Society for Metabolic and Bariatric Surgery (ASMBS) and American Academy of Pediatrics (AAP) Institute for Healthy Childhood Weight (IHCW), our work led to the first AAP policy on bariatric surgery and the NAM obesity public workshops.

Jinyu Xu RD, MPH, PhD Research Scientist

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Keigo Yada, MD, PhD, FACS Childhood Obesity and Adolescent Bariatric Surgery Fellow

$285,835

The Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital offers a comprehensive approach to weight management with programs for the prevention and treatment of children and young adults, ages 2 to 21 years, with obesity. The center’s mission is to empower children and families to establish a foundation for healthy lifestyles through clinical care, education, research, community engagement and advocacy.

Bolling CF, Armstrong SC, Reichard KW, Michalsky MP, Section on Obesity, Section on Surgery. Metabolic and Bariatric Surgery for Pediatric Patients with Severe Obesity. The Journal of Pediatrics. Dec 2019;144(6):e20193224.

Marc P. Michalsky, MD, FACS, FAAP Surgical Director Eileen Chaves, PhD Jane Hamel-Lambert, PhD

The Center for Healthy Weight and Nutrition offers assessment clinics for evaluation of children and young adults with obesity and a variety of multidisciplinary programs with a physician, psychologist, dietitian, physical therapist and athletic trainer for intensive

FAST FACTS July 2019 through June 2020 Bariatric Clinic Visits:..................................................576 Healthy Weight and Nutrition Clinic Visits:.................2,219 Hilliard Healthy Weight Clinic Visits:.............................399 Westerville Healthy Weight Clinic Visits:.......................928

SELECTED PUBLICATIONS

Eneli I, Xu J, Tindall A, Watowicz R, Worthington J, Tanner K, Pratt K, Walston M. Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents with Severe Obesity: A Pilot Study. The International Journal of Environmental Research and Public Health. 2019 Aug 23;16(17):3061.

Williams D, Chaves E, McKnight E, Eneli I. Diagnostic and Treatment Challenges of Eating Disorders After Adolescent Bariatric Surgery: A Case Report. Clinical Obesity.

2020;10(4):e12367.

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, Rofey DL. Suicidal Thoughts and Behaviors in Adolescents who Underwent Bariatric Surgery. Surgery for Obesity and Related Disease. 2020 Apr;16(4):568-580.

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

HEALTHY WEIGHT AND NUTRITION weight management. In addition, the center offers adolescent bariatric surgery and is accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. The center leads the Primary Care Obesity Network (PCON), a program that supports primary care practices with training and resources.

Ihuoma U. Eneli, MD, MS, FAAP Director

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 addition to serving as an expert to obesity programs 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.

Dominique Williams, MD, MPH, FAAP, Dipl ABOM

Through leadership roles at the National Academy of Medicine (NAM) Roundtable on Obesity Solutions, American Society for Metabolic and Bariatric Surgery (ASMBS) and American Academy of Pediatrics (AAP) Institute for Healthy Childhood Weight (IHCW), our work led to the first AAP policy on bariatric surgery and the NAM obesity public workshops.

Jinyu Xu RD, MPH, PhD Research Scientist

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Keigo Yada, MD, PhD, FACS Childhood Obesity and Adolescent Bariatric Surgery Fellow

$285,835

The Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital offers a comprehensive approach to weight management with programs for the prevention and treatment of children and young adults, ages 2 to 21 years, with obesity. The center’s mission is to empower children and families to establish a foundation for healthy lifestyles through clinical care, education, research, community engagement and advocacy.

Bolling CF, Armstrong SC, Reichard KW, Michalsky MP, Section on Obesity, Section on Surgery. Metabolic and Bariatric Surgery for Pediatric Patients with Severe Obesity. The Journal of Pediatrics. Dec 2019;144(6):e20193224.

Marc P. Michalsky, MD, FACS, FAAP Surgical Director Eileen Chaves, PhD Jane Hamel-Lambert, PhD

The Center for Healthy Weight and Nutrition offers assessment clinics for evaluation of children and young adults with obesity and a variety of multidisciplinary programs with a physician, psychologist, dietitian, physical therapist and athletic trainer for intensive

FAST FACTS July 2019 through June 2020 Bariatric Clinic Visits:..................................................576 Healthy Weight and Nutrition Clinic Visits:.................2,219 Hilliard Healthy Weight Clinic Visits:.............................399 Westerville Healthy Weight Clinic Visits:.......................928

SELECTED PUBLICATIONS

Eneli I, Xu J, Tindall A, Watowicz R, Worthington J, Tanner K, Pratt K, Walston M. Using a Revised Protein-Sparing Modified Fast (rPSMF) for Children and Adolescents with Severe Obesity: A Pilot Study. The International Journal of Environmental Research and Public Health. 2019 Aug 23;16(17):3061.

Williams D, Chaves E, McKnight E, Eneli I. Diagnostic and Treatment Challenges of Eating Disorders After Adolescent Bariatric Surgery: A Case Report. Clinical Obesity.

2020;10(4):e12367.

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, Rofey DL. Suicidal Thoughts and Behaviors in Adolescents who Underwent Bariatric Surgery. Surgery for Obesity and Related Disease. 2020 Apr;16(4):568-580.

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 effect of this medicine is so huge that it took only small groups to be able to say we have extraordinarily significant results.”

– Karen McCoy, MD

116 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

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 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 the F508del mutation: a double-blind, randomized, phase 3 trial. Lancet. 2019 Oct 31;394(10212):1940-1948.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 117

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 effect of this medicine is so huge that it took only small groups to be able to say we have extraordinarily significant results.”

– Karen McCoy, MD

116 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

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 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 the F508del mutation: a double-blind, randomized, phase 3 trial. Lancet. 2019 Oct 31;394(10212):1940-1948.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 117

Department of Pediatrics

PULMONARY MEDICINE The mission of the Division of Pulmonary Medicine at Nationwide Children’s Hospital is to provide outstanding clinical care for children and adults with congenital and acquired respiratory disorders, including asthma, cystic fibrosis (CF), sleep-related breathing disorders, lung transplant, advanced lung disease care and management of chronic mechanical ventilation, environmental exposures and vapingrelated injuries. The care model is multidisciplinary. Our mission also includes education of medical and allied health professional trainees and involvement in cutting-edge clinical, basic and translational research.

FACULTY Mark L. Splaingard, MD Rohan A. Thompson, MD Lisa Ulrich, MD

Karen S. McCoy, MD Division Chief

Richard D. Shell, MD Section Chief Elizabeth D. Allen, MD John Heintz, MD Melissa Holtzlander, MD Stephen E. Kirkby, MD Benjamin T. Kopp, MD Kavitha Kotha, MD Katelyn Krivchenia, MD Anne E. May, MD Sabrina Palacios, MD Alpa V. Patel, MD Grace R. Paul, MD Swaroop Pinto, MD Shahid I. Sheikh, MD

Pulmonary Medicine clinicians provide care at the Nationwide Children’s main campus in Columbus and at regional Ohio locations in Westerville, Dublin and Lima Close To HomeSM Centers. Our 19 physicians collaborate to complete over 10,000 outpatient visits at these four locations. Ranked sixth in the U.S. News & World Report, the program excels in patient care, training programs and research.

The cornerstone of the Division of Pulmonary Medicine is our nationally recognized Cystic Fibrosis Care Center, which is a designated Therapeutic Development Center site. The center collaborates with our colleagues in Endocrinology, Gastroenterology, Hepatology, Otolaryngology, Psychology and Psychiatry to provide the best clinical outcomes for our pediatric and adult CF patients. A strong collaboration, Cure CF Columbus (C3), has also formed with clinicians and basic researchers at The Ohio State University and the Abigail Wexner Research Institute. This collaboration is funded as a Research and Development Program through the Cystic Fibrosis Foundation. This work is focused on immune dysfunction and infection in CF. Huge advances have been made with our most unstable patients with asthma. In our Complex Asthma Clinic, we collaborate with our school-based asthma therapy (SBAT) program to provide quality medical care and consistent treatment therapies. A reduction in urgent care and emergency department visits by these medically fragile patients is a noticeable benefit of these two programs.

Our department has a collaborative relationship with specialists caring for children with bronchopulmonary dysplasia (BPD), sickle cell and aerodigestive disorders.

We also have a reputation as a center of care focused on the respiratory health of patients with all forms of neuromuscular disorder.

118 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Our nationally accredited Cardiopulmonary Rehabilitation Program is led by our team of physicians, dietitians, social workers, nurses and respiratory, massage and exercise therapists to provide our patients with the tools necessary to resume normal living after a serious cardiopulmonary event or if they become deconditioned.

As evidence of our center having helped hundreds of patients regain their independence, we received reaccreditation in 2016 by the American Association of Cardiovascular and Pulmonary Rehabilitation.

The division also has a robust quality improvement portfolio, conducts clinical and translational research with a broad group of basic-science collaborators and exhibits steadily climbing research productivity with numerous faculty publications.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $979,443 SELECTED PUBLICATIONS Al-Zaidy S, Pickard AS, Kotha K, Alfano LN, Lowes L, Paul G, Church K, Lehman K, Sproule DM, Dabbous O, Maru B, Berry K, Arnold WD, Kissel JT, Mendell JR, Shell R. Health outcomes in spinal muscular atrophy type 1 following AVXS-101 gene replacement therapy. Pediatric Pulmonology. 2019 Feb;54(2):179-185.

Heijerman HGM, McKone EF, Downey DG, Van Braeckel E, Rowe SM, Tullis E, Mall MA, Welter JJ, Ramsey BW, McKee CM, Marigowda G, Moskowitz SM, Waltz 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 plus ivacaftor combination regimen in people with cystic fibrosis homozygous for the F508del mutation: a double-blind, randomised, phase 3 trial. The Lancet. 2019 Nov 23;394(10212):1940-1948.

Kopp BT, Thompson R, Kim J, Konstan R, Diaz A, Smith B, Shrestha C, Rogers LK, Hayes D Jr, Tumin D, Woodley FW, Ramilo O, Sanders DB, Groner JA, Mejias A. Secondhand smoke alters arachidonic acid metabolism and inflammation in infants and children with cystic fibrosis. Thorax. 2019 Mar;74(3):237-246.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:..................................................... 891 Observation and Outpatient-in-a-Bed Discharges*:.... 1,972 Total Discharges:........................................................ 2,850 Average Length of Stay†:................................................ 5.5 Average Daily Census†:................................................. 13.2 Patient Days†:............................................................. 4,822 Inpatient Consults:......................................................... 315 Cystic Fibrosis Patients:................................................. 540 Dublin Pulmonary Clinic Visits:...................................... 542 Lima Memorial Pulmonary Clinic Visits:........................... 32 Lima Pulmonary Clinic Visits:......................................... 149

Lung Transplant Clinic Visits:........................................... 71 Pulmonary Clinic Visits:.............................................. 7,631 Pulmonary Rehab Clinic Visits:...................................... 375 Total Pulmonary Clinic Visits:.................................... 11,492 Westerville Pulmonary Clinic Visits:............................ 2,152 Dublin Pulmonary Diagnostics Clinic Visits:....................... 7 Pulmonary Diagnostics Clinic Visits:.............................. 238 Westerville Pulmonary Diagnostics Clinic Visits:.............. 18 Total Pulmonary Diagnostics Clinic Visits:...................... 263 *Excludes sleep studies.

Excludes observation and outpatient-in-a-bed patients.

†

A Decade of Remarkable Transformation PULMONARY MEDICINE

2010 Keep Me Well Asthma Quality Improvement Initiative Launched

2012

$2 Million Grant Continues Development of Cure CF Columbus (C3) Research and Development Program

Doctors Develop AsthmaCare App Designed for Children and Teens

Multiple Regional Outreach Clinics for Pulmonary and Sleep Medicine

2013 Team Performs First Successful Cross-Country Transfer for Pediatric Lung Transplant

2016

2013 2018 Cure CF Columbus (C3) Collaboration with Clinicians and Researchers at The Ohio State University Launched

2017 2020 2017 2019 Ranked #6 by U.S. News & World Report — Ninth Consecutive Year in Top 10

In the past decade, Pulmonary Medicine has been at the forefront of groundbreaking research and scientific discoveries in cystic fibrosis. Nationwide Children’s serves as a translational research center for the Therapeutics Development Network (TDN) of the Cystic Fibro­sis Foundation. As a translational research center for TDN, our patients have access to some of the latest advances in cystic fibrosis treatment.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 119

Department of Pediatrics

PULMONARY MEDICINE The mission of the Division of Pulmonary Medicine at Nationwide Children’s Hospital is to provide outstanding clinical care for children and adults with congenital and acquired respiratory disorders, including asthma, cystic fibrosis (CF), sleep-related breathing disorders, lung transplant, advanced lung disease care and management of chronic mechanical ventilation, environmental exposures and vapingrelated injuries. The care model is multidisciplinary. Our mission also includes education of medical and allied health professional trainees and involvement in cutting-edge clinical, basic and translational research.

FACULTY Mark L. Splaingard, MD Rohan A. Thompson, MD Lisa Ulrich, MD

Karen S. McCoy, MD Division Chief

Richard D. Shell, MD Section Chief Elizabeth D. Allen, MD John Heintz, MD Melissa Holtzlander, MD Stephen E. Kirkby, MD Benjamin T. Kopp, MD Kavitha Kotha, MD Katelyn Krivchenia, MD Anne E. May, MD Sabrina Palacios, MD Alpa V. Patel, MD Grace R. Paul, MD Swaroop Pinto, MD Shahid I. Sheikh, MD

Pulmonary Medicine clinicians provide care at the Nationwide Children’s main campus in Columbus and at regional Ohio locations in Westerville, Dublin and Lima Close To HomeSM Centers. Our 19 physicians collaborate to complete over 10,000 outpatient visits at these four locations. Ranked sixth in the U.S. News & World Report, the program excels in patient care, training programs and research.

The cornerstone of the Division of Pulmonary Medicine is our nationally recognized Cystic Fibrosis Care Center, which is a designated Therapeutic Development Center site. The center collaborates with our colleagues in Endocrinology, Gastroenterology, Hepatology, Otolaryngology, Psychology and Psychiatry to provide the best clinical outcomes for our pediatric and adult CF patients. A strong collaboration, Cure CF Columbus (C3), has also formed with clinicians and basic researchers at The Ohio State University and the Abigail Wexner Research Institute. This collaboration is funded as a Research and Development Program through the Cystic Fibrosis Foundation. This work is focused on immune dysfunction and infection in CF. Huge advances have been made with our most unstable patients with asthma. In our Complex Asthma Clinic, we collaborate with our school-based asthma therapy (SBAT) program to provide quality medical care and consistent treatment therapies. A reduction in urgent care and emergency department visits by these medically fragile patients is a noticeable benefit of these two programs.

Our department has a collaborative relationship with specialists caring for children with bronchopulmonary dysplasia (BPD), sickle cell and aerodigestive disorders.

We also have a reputation as a center of care focused on the respiratory health of patients with all forms of neuromuscular disorder.

118 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Our nationally accredited Cardiopulmonary Rehabilitation Program is led by our team of physicians, dietitians, social workers, nurses and respiratory, massage and exercise therapists to provide our patients with the tools necessary to resume normal living after a serious cardiopulmonary event or if they become deconditioned.

As evidence of our center having helped hundreds of patients regain their independence, we received reaccreditation in 2016 by the American Association of Cardiovascular and Pulmonary Rehabilitation.

The division also has a robust quality improvement portfolio, conducts clinical and translational research with a broad group of basic-science collaborators and exhibits steadily climbing research productivity with numerous faculty publications.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $979,443 SELECTED PUBLICATIONS Al-Zaidy S, Pickard AS, Kotha K, Alfano LN, Lowes L, Paul G, Church K, Lehman K, Sproule DM, Dabbous O, Maru B, Berry K, Arnold WD, Kissel JT, Mendell JR, Shell R. Health outcomes in spinal muscular atrophy type 1 following AVXS-101 gene replacement therapy. Pediatric Pulmonology. 2019 Feb;54(2):179-185.

Heijerman HGM, McKone EF, Downey DG, Van Braeckel E, Rowe SM, Tullis E, Mall MA, Welter JJ, Ramsey BW, McKee CM, Marigowda G, Moskowitz SM, Waltz 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 plus ivacaftor combination regimen in people with cystic fibrosis homozygous for the F508del mutation: a double-blind, randomised, phase 3 trial. The Lancet. 2019 Nov 23;394(10212):1940-1948.

Kopp BT, Thompson R, Kim J, Konstan R, Diaz A, Smith B, Shrestha C, Rogers LK, Hayes D Jr, Tumin D, Woodley FW, Ramilo O, Sanders DB, Groner JA, Mejias A. Secondhand smoke alters arachidonic acid metabolism and inflammation in infants and children with cystic fibrosis. Thorax. 2019 Mar;74(3):237-246.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:..................................................... 891 Observation and Outpatient-in-a-Bed Discharges*:.... 1,972 Total Discharges:........................................................ 2,850 Average Length of Stay†:................................................ 5.5 Average Daily Census†:................................................. 13.2 Patient Days†:............................................................. 4,822 Inpatient Consults:......................................................... 315 Cystic Fibrosis Patients:................................................. 540 Dublin Pulmonary Clinic Visits:...................................... 542 Lima Memorial Pulmonary Clinic Visits:........................... 32 Lima Pulmonary Clinic Visits:......................................... 149

Lung Transplant Clinic Visits:........................................... 71 Pulmonary Clinic Visits:.............................................. 7,631 Pulmonary Rehab Clinic Visits:...................................... 375 Total Pulmonary Clinic Visits:.................................... 11,492 Westerville Pulmonary Clinic Visits:............................ 2,152 Dublin Pulmonary Diagnostics Clinic Visits:....................... 7 Pulmonary Diagnostics Clinic Visits:.............................. 238 Westerville Pulmonary Diagnostics Clinic Visits:.............. 18 Total Pulmonary Diagnostics Clinic Visits:...................... 263 *Excludes sleep studies.

Excludes observation and outpatient-in-a-bed patients.

†

A Decade of Remarkable Transformation PULMONARY MEDICINE

2010 Keep Me Well Asthma Quality Improvement Initiative Launched

2012

$2 Million Grant Continues Development of Cure CF Columbus (C3) Research and Development Program

Doctors Develop AsthmaCare App Designed for Children and Teens

Multiple Regional Outreach Clinics for Pulmonary and Sleep Medicine

2013 Team Performs First Successful Cross-Country Transfer for Pediatric Lung Transplant

2016

2013 2018 Cure CF Columbus (C3) Collaboration with Clinicians and Researchers at The Ohio State University Launched

2017 2020 2017 2019 Ranked #6 by U.S. News & World Report — Ninth Consecutive Year in Top 10

In the past decade, Pulmonary Medicine has been at the forefront of groundbreaking research and scientific discoveries in cystic fibrosis. Nationwide Children’s serves as a translational research center for the Therapeutics Development Network (TDN) of the Cystic Fibro­sis Foundation. As a translational research center for TDN, our patients have access to some of the latest advances in cystic fibrosis treatment.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 119

Department of Pediatrics SLEEP DISORDERS CENTER

Mark L. Splaingard, MD Medical Director A. Latif Khuhro, MD Robert Kowatch, MD, PhD Lenora M. Lehwald, MD Anne E. May, MD Grace R. Paul, MD Swaroop Pinto, MD Jack Stevens, PhD Rohan Thompson, MD Accredited by the American Association of Sleep Medicine, the Sleep Disorders Center at Nationwide Children’s Hospital provides inpatient and outpatient consultations and treatment for children with a wide variety of sleep-related problems. Most referrals are for evaluation of abnormal breathing during sleep. Other symptoms may include insomnia, unusual movements at night and excessive daytime sleepiness. As part of the Sleep Medicine Fellowship Program at The Ohio State University College of Medicine, the center provides two months of clinical training to sleep medicine fellows each year, which includes didactic lectures, supervised clinical experience and interpretation of infant and child polysomnographic studies.

The Sleep Disorders Center participates in the training of medical students; residents in Pediatrics, Neurology, Otolaryngology, Physical Medicine and Rehabilitation and Radiology; as well as pediatricians, psychiatrists and graduate students at The Ohio State University. Over the past 13 years, more than 50 sleep medicine and pediatric subspecialty fellows have completed required rotations in pediatric sleep medicine at the center. Center physicians lecture widely throughout The Ohio State University on a variety of topics, including sleep and performance. In 2019, the center performed over 2,250 polysomnographic studies and evaluated over 1,350 children in outpatient sleep clinics. The center has 23 registered polysomnographic technicians and two full-time pediatric nurse practitioners. At Nationwide

Children’s, pediatric subspecialists in pulmonology, neurology and psychiatry, who are also board-certified in sleep medicine, review all polysomnographic studies to determine both diagnosis and potential therapies that would benefit each child. Further evaluation and treatment is available through the outpatient Sleep Disorders Clinic.

Staff of the Sleep Disorders Center have collaborated on research projects with Nationwide Children’s investigators from Anesthesiology, Critical Care, Gastroenterology, Endocrinology, Neonatology, Neurology, Otolaryngology, Pediatric Surgery, Psychiatry, Psychology, Pulmonary, Plastic Surgery, the Center for Injury Research and Policy at Nationwide Children’s and the Department of Mathematics at The Ohio State University. Recently completed studies include CDC-funded research of effectiveness of different alarm signals in awakening children and adults during sleep, using OSA screening questionnaires to predict postoperative outcomes and examining the utility of sleep studies shorter than four hours in infants and sleep disturbances in pediatric intracranial hypertension.

RHEUMATOLOGY Our mission is to improve the lives of children with rheumatic disease through high-quality and innovative care, education and research. Rheumatology at Nationwide Children’s Hospital provides comprehensive, compassionate, evidence-based clinical care to children with musculoskeletal and rheumatic diseases, conducts research on these diseases and educates students, residents, fellows and pediatricians. The division is involved in several quality improvement projects to improve outcomes for children with rheumatic disease and partners with patients and families in these efforts.

FACULTY

rheumatology at The Ohio State University and with multiple pediatric subspecialists at Nationwide Children’s promote collaborative clinical care and research.

Rheumatology is engaged in clinical and basic science research projects and participates in several national and international collaborative studies of childhood rheumatic diseases. Basic scientist Chack-Yung Yu, DPhil, has an appointment in Rheumatology focusing on the relationship between complement genetics and rheumatic diseases. Rheumatology participates in the Childhood Arthritis and Rheumatology Research Alliance and Pediatric Rheumatology Collaborative Study Group clinical research networks. We also participate in the quality improvement initiative, Pediatric Rheumatology Care and Outcomes Improvement Network.

SELECTED PUBLICATIONS Kornbluh AB, Thompson K, Mcmahen G, Aylward S, Lehwald L. Sleep Disturbance in Pediatric Intracranial Hypertension. J Clin Sleep Med. 2020;jc-19-00636. [Epub ahead of print] Raman V, Geyer E, Miller R, Tumin D, Splaingard M, Jatana K, Tobias J. Pediatric OSA screening questionaire and post- operative outcomes: a prospective observational study. Int J Pediatr Otorhinolaryngol. 2019;127:109661.

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. 2020;10. [Epub ahead of print] Smith GA, Chounthirath T, Splaingard M. Do Sleeping Children Respond Better to a Smoke Alarm That Uses Their Mother’s Voice?. Acad Pediatr. 2020;20(3):319-326.

FAST FACTS July 2019 through June 2020 Main Campus Sleep Clinic Visits:................................... 424 Dublin Sleep Clinic Visits:.............................................. 505 Westerville Sleep Clinic Visits:....................................... 471 Total Sleep Clinic Visits:.............................................. 1,400

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC PULMONOLOGY Anas Al-Turki, MD Ashish George, MD Courtney A. Gushue, DO Daniel Malleske, MD Eric Mull, MD Robin Ortenberg, MD Ben Wisniewski, MD

120 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Stacy Payne Ardoin, MD, MS Chief Shoghik Akoghlanian, MD Fatima Barbar-Smiley, MD Kyla Driest, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Gloria C. Higgins, MD (Emeritus)

$176,632

Edward Oberle, MD

SELECTED PUBLICATIONS

Vidya Sivaraman, MD

Amarilyo G, Rothman D, Manthiram K, Edwards KM, Li SC, Marshall GS, YildirimToruner C, Haines K, Ferguson PJ, Lionetti G, Cherian J, Zhao Y, DeLaMora P, Syverson G, Nativ S, Twilt M, Michelow IC, Stepanovskiy Y, Thatayatikom A, Harel L, Akoghlanian S, Tucker L, Marques MC, Srinivasalu H, Propst EJ, Licameli GR, Dedeoglu F, Lapidus S; CARRA PFAPA Consensus Treatment Plan Workgroup. Consensus Treatment Plans for Periodic Fever, Aphthous Stomatitis, Pharyngitis and Adenitis Syndrome (PFAPA): A Framework to Evaluate Treatment Responses from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) PFAPA Work Group. Pediatric Rheumatology Online Journal.

2020 Apr 15;18(1):31.

The Rheumatology Clinic at Nationwide Children’s serves children with diseases, including juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, spondyloarthropathy, vasculitis, scleroderma, autoinflammatory conditions and painful musculoskeletal problems. The clinic conducts more than 6,000 outpatient visits annually. Our fellowship includes three categorical pediatric fellows and one internal medicine-pediatrics fellow. This year, with our neurology colleagues, we established a NeuroImmunology Clinic with collaborators from psychiatry, psychology and neuropsychology. We continue to have very busy multidisciplinary Lupus and Hypermobility Clinics. Edward Oberle, MD, leads our Musculoskeletal Ultrasound Clinic. Laura Ballenger, MD, who has expertise in musculoskeletal ultrasound, joined our faculty in August 2020. Our close collaborations with adult

de Jesus AA, Hou Y, Brooks S, Malle L, Biancotto A, Huang Y, Calvo KR, Marrero B, Moir S, Oler AJ, Deng Z, Montealegre Sanchez GA, Ahmed A, Allenspach E, Arabshahi B, Behrens E, Benseler S, Bezrodnik L, Bout-Tabaku S, Brescia AC, Brown D, Burnham JM, Caldirola MS, Carrasco R, Chan AY, Cimaz R, Dancey P, Dare J, DeGuzman M, Dimitriades V, Ferguson I, Ferguson P, Finn L, Gattorno M, Grom AA, Hanson EP, Hashkes PJ, Hedrich CM, Herzog R, Horneff G, Jerath R, Kessler E, Kim H, Kingsbury DJ, Laxer RM, Lee PY, Lee-Kirsch MA, Lewandowski L, Li S, Lilleby V, Mammadova V, Moorthy LN, Nasrullayeva G, O'Neil KM, Onel K, Ozen S, Pan N, Pillet P, Piotto DG, Punaro MG, Reiff A, Reinhardt A, Rider LG, Rivas- Chacon R, Ronis T, Rösen-Wolff A, Roth J, Ruth NM, Rygg M, Schmeling H, Schulert G, Scott C, Seminario G, Shulman A, Sivaraman V, Son MB, Stepanovskiy Y, Stringer E, Taber S, Terreri MT, Tifft C, Torgerson T, Tosi L, Van Royen-Kerkhof A, Wampler Muskardin T, Canna SW, Goldbach-Mansky R. Distinct Interferon Signatures and Cytokine Patterns Define Additional Systemic Autoinflammatory Diseases. Journal of Clinical Investigation. 2020 Apr 1;130(4):1669-1682.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 121

Department of Pediatrics SLEEP DISORDERS CENTER

Mark L. Splaingard, MD Medical Director A. Latif Khuhro, MD Robert Kowatch, MD, PhD Lenora M. Lehwald, MD Anne E. May, MD Grace R. Paul, MD Swaroop Pinto, MD Jack Stevens, PhD Rohan Thompson, MD Accredited by the American Association of Sleep Medicine, the Sleep Disorders Center at Nationwide Children’s Hospital provides inpatient and outpatient consultations and treatment for children with a wide variety of sleep-related problems. Most referrals are for evaluation of abnormal breathing during sleep. Other symptoms may include insomnia, unusual movements at night and excessive daytime sleepiness. As part of the Sleep Medicine Fellowship Program at The Ohio State University College of Medicine, the center provides two months of clinical training to sleep medicine fellows each year, which includes didactic lectures, supervised clinical experience and interpretation of infant and child polysomnographic studies.

The Sleep Disorders Center participates in the training of medical students; residents in Pediatrics, Neurology, Otolaryngology, Physical Medicine and Rehabilitation and Radiology; as well as pediatricians, psychiatrists and graduate students at The Ohio State University. Over the past 13 years, more than 50 sleep medicine and pediatric subspecialty fellows have completed required rotations in pediatric sleep medicine at the center. Center physicians lecture widely throughout The Ohio State University on a variety of topics, including sleep and performance. In 2019, the center performed over 2,250 polysomnographic studies and evaluated over 1,350 children in outpatient sleep clinics. The center has 23 registered polysomnographic technicians and two full-time pediatric nurse practitioners. At Nationwide

Children’s, pediatric subspecialists in pulmonology, neurology and psychiatry, who are also board-certified in sleep medicine, review all polysomnographic studies to determine both diagnosis and potential therapies that would benefit each child. Further evaluation and treatment is available through the outpatient Sleep Disorders Clinic.

Staff of the Sleep Disorders Center have collaborated on research projects with Nationwide Children’s investigators from Anesthesiology, Critical Care, Gastroenterology, Endocrinology, Neonatology, Neurology, Otolaryngology, Pediatric Surgery, Psychiatry, Psychology, Pulmonary, Plastic Surgery, the Center for Injury Research and Policy at Nationwide Children’s and the Department of Mathematics at The Ohio State University. Recently completed studies include CDC-funded research of effectiveness of different alarm signals in awakening children and adults during sleep, using OSA screening questionnaires to predict postoperative outcomes and examining the utility of sleep studies shorter than four hours in infants and sleep disturbances in pediatric intracranial hypertension.

RHEUMATOLOGY Our mission is to improve the lives of children with rheumatic disease through high-quality and innovative care, education and research. Rheumatology at Nationwide Children’s Hospital provides comprehensive, compassionate, evidence-based clinical care to children with musculoskeletal and rheumatic diseases, conducts research on these diseases and educates students, residents, fellows and pediatricians. The division is involved in several quality improvement projects to improve outcomes for children with rheumatic disease and partners with patients and families in these efforts.

FACULTY

rheumatology at The Ohio State University and with multiple pediatric subspecialists at Nationwide Children’s promote collaborative clinical care and research.

Rheumatology is engaged in clinical and basic science research projects and participates in several national and international collaborative studies of childhood rheumatic diseases. Basic scientist Chack-Yung Yu, DPhil, has an appointment in Rheumatology focusing on the relationship between complement genetics and rheumatic diseases. Rheumatology participates in the Childhood Arthritis and Rheumatology Research Alliance and Pediatric Rheumatology Collaborative Study Group clinical research networks. We also participate in the quality improvement initiative, Pediatric Rheumatology Care and Outcomes Improvement Network.

SELECTED PUBLICATIONS Kornbluh AB, Thompson K, Mcmahen G, Aylward S, Lehwald L. Sleep Disturbance in Pediatric Intracranial Hypertension. J Clin Sleep Med. 2020;jc-19-00636. [Epub ahead of print] Raman V, Geyer E, Miller R, Tumin D, Splaingard M, Jatana K, Tobias J. Pediatric OSA screening questionaire and post- operative outcomes: a prospective observational study. Int J Pediatr Otorhinolaryngol. 2019;127:109661.

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. 2020;10. [Epub ahead of print] Smith GA, Chounthirath T, Splaingard M. Do Sleeping Children Respond Better to a Smoke Alarm That Uses Their Mother’s Voice?. Acad Pediatr. 2020;20(3):319-326.

FAST FACTS July 2019 through June 2020 Main Campus Sleep Clinic Visits:................................... 424 Dublin Sleep Clinic Visits:.............................................. 505 Westerville Sleep Clinic Visits:....................................... 471 Total Sleep Clinic Visits:.............................................. 1,400

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC PULMONOLOGY Anas Al-Turki, MD Ashish George, MD Courtney A. Gushue, DO Daniel Malleske, MD Eric Mull, MD Robin Ortenberg, MD Ben Wisniewski, MD

120 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Stacy Payne Ardoin, MD, MS Chief Shoghik Akoghlanian, MD Fatima Barbar-Smiley, MD Kyla Driest, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Gloria C. Higgins, MD (Emeritus)

$176,632

Edward Oberle, MD

SELECTED PUBLICATIONS

Vidya Sivaraman, MD

Amarilyo G, Rothman D, Manthiram K, Edwards KM, Li SC, Marshall GS, YildirimToruner C, Haines K, Ferguson PJ, Lionetti G, Cherian J, Zhao Y, DeLaMora P, Syverson G, Nativ S, Twilt M, Michelow IC, Stepanovskiy Y, Thatayatikom A, Harel L, Akoghlanian S, Tucker L, Marques MC, Srinivasalu H, Propst EJ, Licameli GR, Dedeoglu F, Lapidus S; CARRA PFAPA Consensus Treatment Plan Workgroup. Consensus Treatment Plans for Periodic Fever, Aphthous Stomatitis, Pharyngitis and Adenitis Syndrome (PFAPA): A Framework to Evaluate Treatment Responses from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) PFAPA Work Group. Pediatric Rheumatology Online Journal.

2020 Apr 15;18(1):31.

The Rheumatology Clinic at Nationwide Children’s serves children with diseases, including juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, spondyloarthropathy, vasculitis, scleroderma, autoinflammatory conditions and painful musculoskeletal problems. The clinic conducts more than 6,000 outpatient visits annually. Our fellowship includes three categorical pediatric fellows and one internal medicine-pediatrics fellow. This year, with our neurology colleagues, we established a NeuroImmunology Clinic with collaborators from psychiatry, psychology and neuropsychology. We continue to have very busy multidisciplinary Lupus and Hypermobility Clinics. Edward Oberle, MD, leads our Musculoskeletal Ultrasound Clinic. Laura Ballenger, MD, who has expertise in musculoskeletal ultrasound, joined our faculty in August 2020. Our close collaborations with adult

de Jesus AA, Hou Y, Brooks S, Malle L, Biancotto A, Huang Y, Calvo KR, Marrero B, Moir S, Oler AJ, Deng Z, Montealegre Sanchez GA, Ahmed A, Allenspach E, Arabshahi B, Behrens E, Benseler S, Bezrodnik L, Bout-Tabaku S, Brescia AC, Brown D, Burnham JM, Caldirola MS, Carrasco R, Chan AY, Cimaz R, Dancey P, Dare J, DeGuzman M, Dimitriades V, Ferguson I, Ferguson P, Finn L, Gattorno M, Grom AA, Hanson EP, Hashkes PJ, Hedrich CM, Herzog R, Horneff G, Jerath R, Kessler E, Kim H, Kingsbury DJ, Laxer RM, Lee PY, Lee-Kirsch MA, Lewandowski L, Li S, Lilleby V, Mammadova V, Moorthy LN, Nasrullayeva G, O'Neil KM, Onel K, Ozen S, Pan N, Pillet P, Piotto DG, Punaro MG, Reiff A, Reinhardt A, Rider LG, Rivas- Chacon R, Ronis T, Rösen-Wolff A, Roth J, Ruth NM, Rygg M, Schmeling H, Schulert G, Scott C, Seminario G, Shulman A, Sivaraman V, Son MB, Stepanovskiy Y, Stringer E, Taber S, Terreri MT, Tifft C, Torgerson T, Tosi L, Van Royen-Kerkhof A, Wampler Muskardin T, Canna SW, Goldbach-Mansky R. Distinct Interferon Signatures and Cytokine Patterns Define Additional Systemic Autoinflammatory Diseases. Journal of Clinical Investigation. 2020 Apr 1;130(4):1669-1682.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 121

Department of Pediatrics

Peters E, Tompkins MK, Knoll MAZ, Ardoin SP, Shoots-Reinhard B, Meara AS. Despite High Objective Numeracy, Lower Numeric Confidence Relates to Worse Financial and Medical Outcomes. Proceedings of the National Academy of Sciences of the United States of America. 2019 Sep 24;116(39):19386-19391.

Sivaraman V, Wise KA, Cotton W, Barbar-Smiley F, AlAhmed O, MacDonald D, Lemle S, Yildirim-Toruner C, Ardoin SP, Ardura MI. Previsit Planning Improves Pneumococcal Vaccination Rates in Childhood-Onset SLE. Pediatrics. 2020 Jan;145(1).

Ting TV, Vega-Fernandez P, Oberle EJ, De Ranieri D, Bukulmez H, Lin C, Moser D, Barrowman NJ, Zhao Y, Benham HM, Tasan L, Thatayatikom A, Roth J; Childhood Arthritis and Rheumatology Research Alliance Juvenile Idiopathic Arthritis Ultrasound Workgroup.

Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee.

Arthritis Care & Research (Hoboken). 2019 Jul;71(7):977-985.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC RHEUMATOLOGY Ohoud Al-Ahmed, MD Christine Bacha, MD Laura R. Ballenger, MD Veronica Mruk, MD

SPORTS MEDICINE Sports Medicine at Nationwide Children’s Hospital includes a team of experts who specialize in the treatment and prevention of sports-related injuries in the pediatric and adolescent athlete. The focus of the department is prevention, diagnosis and treatment of youth and adolescent sports injuries, including concussions.

FACULTY Highlights:

FAST FACTS July 2019 through June 2020 Inpatient Discharges:....................................................... 48

Inpatient Consults:......................................................... 132

Observation and Outpatient-in-a-Bed Discharges:.......... 84

Main Campus Rheumatology Clinic Visits:.................. 4,840

Total Discharges:........................................................... 129

Dublin Rheumatology Clinic Visits:................................. 849

Average Length of Stay*:................................................ 5.3

Total Rheumatology Clinic Visits:................................ 5,689

Average Daily Census*:.................................................. 0.7

*Excludes observation and outpatient-in-a-bed patients.

Patient Days*:................................................................ 243

Thomas L. Pommering, DO Chief Steven C. Cuff, MD

•

Provided care for just under 17,000 patients at our eight locations

•

Provided medical services at more than 2,100 events, affecting more than 200,000 athletes

•

Developed an Adaptive Sports Medicine Program for athletes with special physical needs

•

Served as team physicians for Ohio Dominican University and several central Ohio high schools and middle schools

•

Faculty named over 50 times in publications, abstracts and national podium and poster presentations

Drew Duerson, MD

Services available at Nationwide Children’s Sports Medicine include:

Anastasia N. Fischer, MD James P. MacDonald, MD

•

Diagnosis and treatment of all sports-related 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

•

Point of service musculoskeletal ultrasound for diagnostic and therapeutic treatment

•

Injury rehabilitation

•

Specialized rehabilitation and injury prevention programs for swimmers, throwers, dancers, runners and athletes in other sports

•

Sports Nutrition Counseling

•

Sports Performance Training

•

Play Strong (supervised exercise program for children with medical conditions)

•

Sports Medicine Fellowship Training Program

•

Central Ohio EMS Community Outreach and Education for Care of Athletes Injured on the Field of Play

•

Partnerships with schools, and youth and club sport organizations

Jonathan Napolitano, MD

We provide team-centered sports medicine care.

Our clinical staff works with the athlete’s team, which includes the patient, family, athletic trainer, school nurse, coach and primary care physician, to assist in the recovery of the injury, development of a treatment plan and recommendations for successful participation in future sports activities.

Our department also helps patients navigate their care through our partners in other departments within Nationwide Children’s including Radiology, Orthopaedics, Physical Therapy, Cardiology, Healthy Weight and Nutrition, Pulmonary Medicine, Neuropsychology/Psychology, Emergency Medicine, Primary Care, Sports Nutrition, Education and any other necessary outside services.

122 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 123

Department of Pediatrics

Peters E, Tompkins MK, Knoll MAZ, Ardoin SP, Shoots-Reinhard B, Meara AS. Despite High Objective Numeracy, Lower Numeric Confidence Relates to Worse Financial and Medical Outcomes. Proceedings of the National Academy of Sciences of the United States of America. 2019 Sep 24;116(39):19386-19391.

Sivaraman V, Wise KA, Cotton W, Barbar-Smiley F, AlAhmed O, MacDonald D, Lemle S, Yildirim-Toruner C, Ardoin SP, Ardura MI. Previsit Planning Improves Pneumococcal Vaccination Rates in Childhood-Onset SLE. Pediatrics. 2020 Jan;145(1).

Ting TV, Vega-Fernandez P, Oberle EJ, De Ranieri D, Bukulmez H, Lin C, Moser D, Barrowman NJ, Zhao Y, Benham HM, Tasan L, Thatayatikom A, Roth J; Childhood Arthritis and Rheumatology Research Alliance Juvenile Idiopathic Arthritis Ultrasound Workgroup.

Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Knee.

Arthritis Care & Research (Hoboken). 2019 Jul;71(7):977-985.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC RHEUMATOLOGY Ohoud Al-Ahmed, MD Christine Bacha, MD Laura R. Ballenger, MD Veronica Mruk, MD

SPORTS MEDICINE Sports Medicine at Nationwide Children’s Hospital includes a team of experts who specialize in the treatment and prevention of sports-related injuries in the pediatric and adolescent athlete. The focus of the department is prevention, diagnosis and treatment of youth and adolescent sports injuries, including concussions.

FACULTY Highlights:

FAST FACTS July 2019 through June 2020 Inpatient Discharges:....................................................... 48

Inpatient Consults:......................................................... 132

Observation and Outpatient-in-a-Bed Discharges:.......... 84

Main Campus Rheumatology Clinic Visits:.................. 4,840

Total Discharges:........................................................... 129

Dublin Rheumatology Clinic Visits:................................. 849

Average Length of Stay*:................................................ 5.3

Total Rheumatology Clinic Visits:................................ 5,689

Average Daily Census*:.................................................. 0.7

*Excludes observation and outpatient-in-a-bed patients.

Patient Days*:................................................................ 243

Thomas L. Pommering, DO Chief Steven C. Cuff, MD

•

Provided care for just under 17,000 patients at our eight locations

•

Provided medical services at more than 2,100 events, affecting more than 200,000 athletes

•

Developed an Adaptive Sports Medicine Program for athletes with special physical needs

•

Served as team physicians for Ohio Dominican University and several central Ohio high schools and middle schools

•

Faculty named over 50 times in publications, abstracts and national podium and poster presentations

Drew Duerson, MD

Services available at Nationwide Children’s Sports Medicine include:

Anastasia N. Fischer, MD James P. MacDonald, MD

•

Diagnosis and treatment of all sports-related 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

•

Point of service musculoskeletal ultrasound for diagnostic and therapeutic treatment

•

Injury rehabilitation

•

Specialized rehabilitation and injury prevention programs for swimmers, throwers, dancers, runners and athletes in other sports

•

Sports Nutrition Counseling

•

Sports Performance Training

•

Play Strong (supervised exercise program for children with medical conditions)

•

Sports Medicine Fellowship Training Program

•

Central Ohio EMS Community Outreach and Education for Care of Athletes Injured on the Field of Play

•

Partnerships with schools, and youth and club sport organizations

Jonathan Napolitano, MD

We provide team-centered sports medicine care.

Our clinical staff works with the athlete’s team, which includes the patient, family, athletic trainer, school nurse, coach and primary care physician, to assist in the recovery of the injury, development of a treatment plan and recommendations for successful participation in future sports activities.

Our department also helps patients navigate their care through our partners in other departments within Nationwide Children’s including Radiology, Orthopaedics, Physical Therapy, Cardiology, Healthy Weight and Nutrition, Pulmonary Medicine, Neuropsychology/Psychology, Emergency Medicine, Primary Care, Sports Nutrition, Education and any other necessary outside services.

122 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 123

Department of Pediatrics •

Coordination of care with patient’s primary care physician and other Nationwide Children’s services; educational resources and training to physicians, athletic trainers, school nurses, patients/families and coaches

SELECTED PUBLICATIONS Coven SL, Bibart M, Frost R, Gallagher T, Guinipero T, Valasek AE, Olshefski R. A Quality Improvement Approach to Increase Exercise Assessment in Survivors of Childhood Leukemia. 2019. Pediatric Quality and Safety. Jul 29 4(4) e198 1-7.

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 of Environmental Research and Public Health. 2020 Jan;17:351.

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 Child Neurology. 2020 Feb;35(2):95-101.

Suryavanshi JR, Goto R, Jivanelli B, Aberdeen J, Duer T, Lam KC, Franklin CC, MacDonald J, Shea KG, Fabricant PD. Age-Appropriate Pediatric Sports Patient-Reported Outcome Measures and Their Psychometric Properties: A Systematic Review. American journal of sports medicine. 2019 Nov;47(13): 3270-3276.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC SPORTS MEDICINE Francis Comer, DO Kayla Daniel, MD

TOXICOLOGY The Section of Toxicology at Nationwide Children’s Hospital provides teaching, patient care and research to improve the outcome for poisoned patients. We provide medical supervision for the Central Ohio Poison 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 and population-based poison control. We provide important consultation resources to hospital-based and community physicians across Ohio, supporting them as they continue to treat poisoned patients in their own communities.

FACULTY

Selhorst M, Fischer A, MacDonald J. Prevalence of Spondylolysis in Symptomatic Adolescent Athletes: An Assessment of Sport Risk in Nonelite Athletes. Clinical Journal of Sport Medicine. 2019 Sep;29(5):421-425.

FAST FACTS July 2019 through June 2020 Main Campus Sports Medicine Clinic Visits:............... 1,522 Canal Winchester Sports Medicine Clinic Visits:.......... 1,394 Dublin Sports Medicine Clinic Visits:........................... 3,301 East Broad Sports Medicine Clinic Visits:....................... 827 Hilliard Sports Medicine Clinic Visits:.......................... 1,213 Marysville Sports Medicine Clinic Visits:........................ 489 New Albany Sports Medicine Clinic Visits:.................. 1,171 Westerville Sports Medicine Clinic Visits:.................... 3,850

Top 10 Principal Final Diagnoses at the Sports Medicine Clinics: Knee Pain/Injury:........................................................ 1,520 Concussion:................................................................ 1,260 Ankle Sprain:................................................................. 836 Low Back:..................................................................... 718 Foot Pain:...................................................................... 359 Patellofemoral Pain:....................................................... 345 Tendonitis:..................................................................... 318 Strain:............................................................................ 308 Shoulder Pain/Injury:..................................................... 301 Apophysitis:................................................................... 297 Spondylolysis/Spondylolisthesis:................................... 275 Salter Harris Fracture:................................................... 255 Dislocation/Subluxation:................................................ 249

124 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Marcel J. Casavant, MD, FACEP, FACMT, FAACT Chief Alexandra R. Funk, PharmD, DABAT Hannah L. Hays, MD, FACEP Michael T. Kelley, MD, MPH, FACMT Jason Russell, DO Henry Spiller, MS, DABAT Medical and pharmacy students, and physicians from emergency medicine, pediatrics, internal medicine, pediatric emergency medicine and child abuse training programs, benefit from rotations — now all remote in the era of COVID-19 — with the Section of Toxicology and the COPC. We teach the public through frequent media interviews and programs.

We also help local, county and state governments and agencies prepare to respond effectively to masscasualty events and to terrorism involving biological, chemical and radiological hazards, and have been a critical partner to the public health response to COVID-19. The section is an important resource for Ohio’s childhood lead poisoning prevention program.

The COPC serves the citizens of 64 Ohio counties.

The 19 specially trained, nationally certified nurses and pharmacists handle poison-exposure cases from the public, health care professionals, health departments and emergency medical services. Certified by the American Association of Poison Control Centers, the COPC has been improving the care of poisoned patients for 62 years.

With our nationally recognized Be Poison Smart!® public education program, the COPC works to reduce 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 toxicosurveillance, communications and emergency professional education in preparation for and during a community disaster. Research to describe important poisoning hazards and to reduce the incidence of poisoning is conducted with the Center for Injury Research and Policy in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $488,138 SELECTED PUBLICATIONS Chang A, Schnall AH, Law R, Bronstein AC, Marraffa JM, Spiller HA, Hays HL, Funk AR, MercurioZappala M, Calello DP, Aleguas A, Borys DJ, Boehmer T, Svendsen E. Cleaning and disinfectant chemical exposures and temporal associations with COVID-19. National Poison Data System, United States, January 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 product-related ocular exposures reported to the United States poison control centers. The Royal College of Ophthalmologists. 2019 Dec 9;34(9):1631-1639.

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.

2019 Nov 25;1-8.

Spiller HA, Ackerman JP, Smith GA, Kistamgari S, Funk AR, McDermott MR, Casavant MJ. Suicide attempts by self-poisoning in the United States among 10-25 year olds from 2000 to 2018: substances used, temporal changes and demographics. Clinical Toxicology. 2019 Oct 6;58(7):676-687.

Townsend JA, Spiller H, Hammersmith K, Casamassimo PS. Dental local anesthesia-related pediatric cases reported to U.S. poison control centers. Pediatric Dentistry. 2020 Mar 15;42(2):116-122.

FAST FACTS July 2019 through June 2020 Inpatient Toxicology Consults:........................................ 392 Toxicology Clinic Visits:...................................................... 4 Peer Consults:............................................................ 2,395 Toxicology Poison Center Consults:............................ 4,261 Poison Control Exposure Cases:............................... 38,197

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 125

Department of Pediatrics •

Coordination of care with patient’s primary care physician and other Nationwide Children’s services; educational resources and training to physicians, athletic trainers, school nurses, patients/families and coaches

SELECTED PUBLICATIONS Coven SL, Bibart M, Frost R, Gallagher T, Guinipero T, Valasek AE, Olshefski R. A Quality Improvement Approach to Increase Exercise Assessment in Survivors of Childhood Leukemia. 2019. Pediatric Quality and Safety. Jul 29 4(4) e198 1-7.

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 of Environmental Research and Public Health. 2020 Jan;17:351.

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 Child Neurology. 2020 Feb;35(2):95-101.

Suryavanshi JR, Goto R, Jivanelli B, Aberdeen J, Duer T, Lam KC, Franklin CC, MacDonald J, Shea KG, Fabricant PD. Age-Appropriate Pediatric Sports Patient-Reported Outcome Measures and Their Psychometric Properties: A Systematic Review. American journal of sports medicine. 2019 Nov;47(13): 3270-3276.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC SPORTS MEDICINE Francis Comer, DO Kayla Daniel, MD

TOXICOLOGY The Section of Toxicology at Nationwide Children’s Hospital provides teaching, patient care and research to improve the outcome for poisoned patients. We provide medical supervision for the Central Ohio Poison 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 and population-based poison control. We provide important consultation resources to hospital-based and community physicians across Ohio, supporting them as they continue to treat poisoned patients in their own communities.

FACULTY

Selhorst M, Fischer A, MacDonald J. Prevalence of Spondylolysis in Symptomatic Adolescent Athletes: An Assessment of Sport Risk in Nonelite Athletes. Clinical Journal of Sport Medicine. 2019 Sep;29(5):421-425.

FAST FACTS July 2019 through June 2020 Main Campus Sports Medicine Clinic Visits:............... 1,522 Canal Winchester Sports Medicine Clinic Visits:.......... 1,394 Dublin Sports Medicine Clinic Visits:........................... 3,301 East Broad Sports Medicine Clinic Visits:....................... 827 Hilliard Sports Medicine Clinic Visits:.......................... 1,213 Marysville Sports Medicine Clinic Visits:........................ 489 New Albany Sports Medicine Clinic Visits:.................. 1,171 Westerville Sports Medicine Clinic Visits:.................... 3,850

Top 10 Principal Final Diagnoses at the Sports Medicine Clinics: Knee Pain/Injury:........................................................ 1,520 Concussion:................................................................ 1,260 Ankle Sprain:................................................................. 836 Low Back:..................................................................... 718 Foot Pain:...................................................................... 359 Patellofemoral Pain:....................................................... 345 Tendonitis:..................................................................... 318 Strain:............................................................................ 308 Shoulder Pain/Injury:..................................................... 301 Apophysitis:................................................................... 297 Spondylolysis/Spondylolisthesis:................................... 275 Salter Harris Fracture:................................................... 255 Dislocation/Subluxation:................................................ 249

124 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Marcel J. Casavant, MD, FACEP, FACMT, FAACT Chief Alexandra R. Funk, PharmD, DABAT Hannah L. Hays, MD, FACEP Michael T. Kelley, MD, MPH, FACMT Jason Russell, DO Henry Spiller, MS, DABAT Medical and pharmacy students, and physicians from emergency medicine, pediatrics, internal medicine, pediatric emergency medicine and child abuse training programs, benefit from rotations — now all remote in the era of COVID-19 — with the Section of Toxicology and the COPC. We teach the public through frequent media interviews and programs.

We also help local, county and state governments and agencies prepare to respond effectively to masscasualty events and to terrorism involving biological, chemical and radiological hazards, and have been a critical partner to the public health response to COVID-19. The section is an important resource for Ohio’s childhood lead poisoning prevention program.

The COPC serves the citizens of 64 Ohio counties.

The 19 specially trained, nationally certified nurses and pharmacists handle poison-exposure cases from the public, health care professionals, health departments and emergency medical services. Certified by the American Association of Poison Control Centers, the COPC has been improving the care of poisoned patients for 62 years.

With our nationally recognized Be Poison Smart!® public education program, the COPC works to reduce 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 toxicosurveillance, communications and emergency professional education in preparation for and during a community disaster. Research to describe important poisoning hazards and to reduce the incidence of poisoning is conducted with the Center for Injury Research and Policy in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $488,138 SELECTED PUBLICATIONS Chang A, Schnall AH, Law R, Bronstein AC, Marraffa JM, Spiller HA, Hays HL, Funk AR, MercurioZappala M, Calello DP, Aleguas A, Borys DJ, Boehmer T, Svendsen E. Cleaning and disinfectant chemical exposures and temporal associations with COVID-19. National Poison Data System, United States, January 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 product-related ocular exposures reported to the United States poison control centers. The Royal College of Ophthalmologists. 2019 Dec 9;34(9):1631-1639.

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.

2019 Nov 25;1-8.

Spiller HA, Ackerman JP, Smith GA, Kistamgari S, Funk AR, McDermott MR, Casavant MJ. Suicide attempts by self-poisoning in the United States among 10-25 year olds from 2000 to 2018: substances used, temporal changes and demographics. Clinical Toxicology. 2019 Oct 6;58(7):676-687.

Townsend JA, Spiller H, Hammersmith K, Casamassimo PS. Dental local anesthesia-related pediatric cases reported to U.S. poison control centers. Pediatric Dentistry. 2020 Mar 15;42(2):116-122.

FAST FACTS July 2019 through June 2020 Inpatient Toxicology Consults:........................................ 392 Toxicology Clinic Visits:...................................................... 4 Peer Consults:............................................................ 2,395 Toxicology Poison Center Consults:............................ 4,261 Poison Control Exposure Cases:............................... 38,197

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 125

ANESTHESIOLOGY AND PAIN MEDICINE

Department Report

ANESTHESIOLOGY AND PAIN MEDICINE The Department of Anesthesiology and Pain Medicine at Nationwide Children’s Hospital consists of fellowship-trained, board-certified pediatric anesthesiologists. The department provides anesthesiology and pain-management services for pediatric patients of all ages, from neonates through adolescents, requiring all types of surgical procedures, procedural sedation outside the operating room, acute and chronic pain management, and palliative care.

FACULTY

Senthil G. Krishna, MD David Martin, MD Gregory Maves, MD Christopher McKee, DO Renata Miketic, MD Alok Moharir, MD Olubukola Nafiu, MD Aymen Naguib, MD

Joseph D. Tobias, MD Chief Emmanuel Alalade, MD Graciela Argote-Romero, MD Rita Banoub, MD Ralph Beltran, MD Jason Bryant, MD Candice Burrier, MD Gregory Cambier, MD Richard Cartabuke, MD Kristin Chenault, MD Marco Corridore, MD Olamide Dairo, MD Ajay D’Mello, MD Sujana Dontukurthy, MD Nicole Elsey, MD Seth Hayes, MD Renee Heng, MD Grant Heydinger, MD Lisa Humphrey, MD Natalie Jacobowski, MD Sarah Khan, MD

Vanessa Ng, MD Priyal Patel, DO Vidya Raman, MD Leila Reduque, MD Lance Relland, MD Devin Sanders, MD Brian Schloss, MD Erica Sivak, MD Ashley Smith, MD Steven Smith, MD Timothy Smith, MD Ahsan Syed, MD Arlyne Thung, MD Joshua Uffman, MD

in anesthesiology and pediatric anesthesiology by the American Board of Anesthesiology. Additional board certification is held in pediatric critical care medicine (two faculty), pain medicine (eight faculty) and general pediatrics (four faculty). An attending pediatric anesthesiologist is present in the hospital at all times for emergency cases. There is a division of cardiac anesthesia that includes six physicians dedicated to the care of patients with acquired and congenital heart disease.

We also have an active acute pain service that provides pain management services, including patient-controlled analgesia and regional anesthesia. The department also provides palliative care and hospice services with four full-time palliative care physicians.

The fellowship program provides subspecialty training in pediatric anesthesiology for fellows in both an ACGMEaccredited program and international fellows from all over the world. Advanced subspecialty training is offered in pediatric cardiac anesthesia, pediatric regional anesthesia, quality improvement and safety, acute pain management, chronic pain management and palliative care.

Departmental research initiatives are led by a Vice-Chair for Academic Affairs and supported by two postdoctoral research scientists, two full-time clinical research nurses, a data analyst and two research associates.

The department participates in an active clinical research program with numerous ongoing prospective investigations in various areas of pediatric anesthesiology, including novel approaches to airway management, techniques of regional anesthesia, perioperative implications of comorbid conditions, including obstructive sleep apnea and COVID-19, the use of novel pharmacologic agents in the pediatric population, outcomes research and quality improvement initiatives.

The department published more than 50 manuscripts in peer-reviewed journals and presented more than 50 abstracts at national meetings last year.

In response to the COVID-19 crisis, the perioperative team has put into place measures to effectively allow the safe continuation of all operating room and pain management activities. We anticipate that our surgical cases will see continued growth into the fall and winter months. An additional operating room site will be opened in the spring of 2021 to allow for expansion of our surgical volumes to meet the demands of newly hired surgical colleagues. We anticipate increases in the solid organ transplantation program and the development of a fetal surgery program. There will be continued growth of chronic pain initiatives, including expansion of palliative care services, the inpatient rehabilitation program for patients with complex pain issues and the chronic pain clinic.

SELECTED PUBLICATIONS Cartabuke RS, Anderson BJ, Elmaraghy C, Rice J, Tumin D, Tobias JD. Hemodynamic and pharmacokinetic analysis of oxymetazoline use during nasal surgery in children. The Laryngoscope. 2019 Dec;129(12):2775-2781.

Hodge AB, Thornton BA, Gajarski R, Hersey D, Cannon M, Naguib AN, Joy BF, McConnell PI. Quality improvement project in congenital cardiothoracic surgery patients: reducing surgical site infections. Pediatric Quality & Safety. 2019 Jul 22;4(4):e188.

Miller R, Tumin D, Hayes D Jr, Uffman JC, Raman VT, Tobias JD. Unmet need for care coordination among children with special health care needs. Population Health Management. 2019 Jun;22:255-261.

Nafiu OO, Mpody C, Kim SS, Uffman JC, Tobias JD. Race, postoperative complications and death in apparently healthy children. Pediatrics. 2020 Aug;146:e20194113. [Epub ahead of print] Pfaff KE, Tumin D, Miller R, Beltran RJ, Tobias JD, Uffman JC. Perioperative aspiration events in children: A report from the Wake-Up Safe Collaborative. Pediatric Anesthesia. 2020 Apr 22. [Epub ahead of print]

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM ANESTHESIOLOGY AND PAIN MEDICINE Emmanuel Alalade, MD Sorochi Esochaghi, MD Grant Heydinger, MD Teresa Murray-Torres, MD Steven Zadora, MD

Giorgio Veneziano, MD Brittany Willer, MD Peter Winch, MD The Department of Anesthesiology and Pain Medicine includes 43 pediatric anesthesiologists, four palliative care physicians and 50 certified registered nurse anesthetists who provide care at 43 sites per day. Last year, the department provided anesthetic care and sedation services for approximately 40,000 procedures. Members of the faculty are fellowshiptrained in pediatric anesthesiology and board certified

126 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 127

ANESTHESIOLOGY AND PAIN MEDICINE

Department Report

ANESTHESIOLOGY AND PAIN MEDICINE The Department of Anesthesiology and Pain Medicine at Nationwide Children’s Hospital consists of fellowship-trained, board-certified pediatric anesthesiologists. The department provides anesthesiology and pain-management services for pediatric patients of all ages, from neonates through adolescents, requiring all types of surgical procedures, procedural sedation outside the operating room, acute and chronic pain management, and palliative care.

FACULTY

Senthil G. Krishna, MD David Martin, MD Gregory Maves, MD Christopher McKee, DO Renata Miketic, MD Alok Moharir, MD Olubukola Nafiu, MD Aymen Naguib, MD

Joseph D. Tobias, MD Chief Emmanuel Alalade, MD Graciela Argote-Romero, MD Rita Banoub, MD Ralph Beltran, MD Jason Bryant, MD Candice Burrier, MD Gregory Cambier, MD Richard Cartabuke, MD Kristin Chenault, MD Marco Corridore, MD Olamide Dairo, MD Ajay D’Mello, MD Sujana Dontukurthy, MD Nicole Elsey, MD Seth Hayes, MD Renee Heng, MD Grant Heydinger, MD Lisa Humphrey, MD Natalie Jacobowski, MD Sarah Khan, MD

Vanessa Ng, MD Priyal Patel, DO Vidya Raman, MD Leila Reduque, MD Lance Relland, MD Devin Sanders, MD Brian Schloss, MD Erica Sivak, MD Ashley Smith, MD Steven Smith, MD Timothy Smith, MD Ahsan Syed, MD Arlyne Thung, MD Joshua Uffman, MD

in anesthesiology and pediatric anesthesiology by the American Board of Anesthesiology. Additional board certification is held in pediatric critical care medicine (two faculty), pain medicine (eight faculty) and general pediatrics (four faculty). An attending pediatric anesthesiologist is present in the hospital at all times for emergency cases. There is a division of cardiac anesthesia that includes six physicians dedicated to the care of patients with acquired and congenital heart disease.

We also have an active acute pain service that provides pain management services, including patient-controlled analgesia and regional anesthesia. The department also provides palliative care and hospice services with four full-time palliative care physicians.

The fellowship program provides subspecialty training in pediatric anesthesiology for fellows in both an ACGMEaccredited program and international fellows from all over the world. Advanced subspecialty training is offered in pediatric cardiac anesthesia, pediatric regional anesthesia, quality improvement and safety, acute pain management, chronic pain management and palliative care.

Departmental research initiatives are led by a Vice-Chair for Academic Affairs and supported by two postdoctoral research scientists, two full-time clinical research nurses, a data analyst and two research associates.

The department participates in an active clinical research program with numerous ongoing prospective investigations in various areas of pediatric anesthesiology, including novel approaches to airway management, techniques of regional anesthesia, perioperative implications of comorbid conditions, including obstructive sleep apnea and COVID-19, the use of novel pharmacologic agents in the pediatric population, outcomes research and quality improvement initiatives.

The department published more than 50 manuscripts in peer-reviewed journals and presented more than 50 abstracts at national meetings last year.

In response to the COVID-19 crisis, the perioperative team has put into place measures to effectively allow the safe continuation of all operating room and pain management activities. We anticipate that our surgical cases will see continued growth into the fall and winter months. An additional operating room site will be opened in the spring of 2021 to allow for expansion of our surgical volumes to meet the demands of newly hired surgical colleagues. We anticipate increases in the solid organ transplantation program and the development of a fetal surgery program. There will be continued growth of chronic pain initiatives, including expansion of palliative care services, the inpatient rehabilitation program for patients with complex pain issues and the chronic pain clinic.

SELECTED PUBLICATIONS Cartabuke RS, Anderson BJ, Elmaraghy C, Rice J, Tumin D, Tobias JD. Hemodynamic and pharmacokinetic analysis of oxymetazoline use during nasal surgery in children. The Laryngoscope. 2019 Dec;129(12):2775-2781.

Hodge AB, Thornton BA, Gajarski R, Hersey D, Cannon M, Naguib AN, Joy BF, McConnell PI. Quality improvement project in congenital cardiothoracic surgery patients: reducing surgical site infections. Pediatric Quality & Safety. 2019 Jul 22;4(4):e188.

Miller R, Tumin D, Hayes D Jr, Uffman JC, Raman VT, Tobias JD. Unmet need for care coordination among children with special health care needs. Population Health Management. 2019 Jun;22:255-261.

Nafiu OO, Mpody C, Kim SS, Uffman JC, Tobias JD. Race, postoperative complications and death in apparently healthy children. Pediatrics. 2020 Aug;146:e20194113. [Epub ahead of print] Pfaff KE, Tumin D, Miller R, Beltran RJ, Tobias JD, Uffman JC. Perioperative aspiration events in children: A report from the Wake-Up Safe Collaborative. Pediatric Anesthesia. 2020 Apr 22. [Epub ahead of print]

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM ANESTHESIOLOGY AND PAIN MEDICINE Emmanuel Alalade, MD Sorochi Esochaghi, MD Grant Heydinger, MD Teresa Murray-Torres, MD Steven Zadora, MD

Giorgio Veneziano, MD Brittany Willer, MD Peter Winch, MD The Department of Anesthesiology and Pain Medicine includes 43 pediatric anesthesiologists, four palliative care physicians and 50 certified registered nurse anesthetists who provide care at 43 sites per day. Last year, the department provided anesthetic care and sedation services for approximately 40,000 procedures. Members of the faculty are fellowshiptrained in pediatric anesthesiology and board certified

126 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 127

PATHOLOGY AND LABORATORY MEDICINE

Department Report

PATHOLOGY AND LABORATORY MEDICINE The Department of Pathology and Laboratory Medicine at Nationwide Children’s Hospital provides a wide range of pediatric diagnostic services for hospitalized and ambulatory infants, children and adolescent patients. Laboratory services are provided through the main campus anatomic and clinical pathology laboratories, as well as multiple outpatient/reference laboratory testing facilities, Nationwide Children’s Close To HomeSM and Urgent Care centers, and our freestanding Emergency Department.

FACULTY

Selene Koo, MD, PhD Amy L. Leber, PhD Huifei Liu, MD, PhD Rachel Mariani, MD Erin K. Meyer, DO, MPH Jeffery Papiernik, MD Christopher R. Pierson, MD, PhD Vinay Prasad, MD

Shamlal Mangray, MB, BS Chief, Pathology and Laboratory Medicine Section Chief, Anatomic Pathology

Amy L. Pyle-Eilola, PhD Nilsa Del Carmen Ramirez-Milan, MD Archana Shenoy, MD Diana Thomas, MD Huanyu Wang, PhD AFFILIATED FACULTY Biochemical Genetics Dennis W. Bartholomew, MD Kim L. McBride, MD, MS Steve and Cindy Rasmussen Institute for Genomic Medicine Clinical Laboratory

Kathleen K. Nicol, MD Medical Director Section Chief, Clinical Pathology Roshini Abraham, PhD Peter B. Baker III, MD Laura Biederman, MD Daniel R. Boue, MD, PhD Dustin Bunch, PhD Catherine Chung, MD Miriam R. Conces, MD Bonita R. Fung, MD

Catherine Cottrell, PhD Jesse Hunter, PhD Kristy Lee, PhD Marco Leung, PhD Mariam Mathew, PhD Ruthann B. Pfau, PhD Shalini C. Reshmi, PhD Matthew Schultz, PhD Neuromuscular Pathology Zarife Sahenk, MD, PhD

Sophonie Jean, PhD

The department includes more than 25 pathologists and doctoral scientists with subspecialty expertise in pediatric pathology and laboratory medicine. This professional staff is supported by more than 400 technical staff who provide 24/7 coverage in critical patient care areas. As an integral part of Nationwide Children’s operations, our team provides specimen collection and diagnostic services in multiple service centers across Ohio.

In the last year, the Anatomic Pathology Laboratory processed close to 10,000 surgical cases, 1,300 cytology specimens and 90 autopsies. Clinical laboratories performed more than 3.1 million tests in various subspecialty areas. As part of our core mission, we were actively involved in undergraduate and graduate medical education, and our faculty served in multiple leadership roles locally and on the national scene. Faculty highlights include the appointment of Shamlal Mangray, MB, BS, as chief of Pathology and Laboratory Medicine; Kathy Nicol, MD, as medical director; Miriam Conces, MD, as director of surgical pathology; and Selene Koo, MD, PhD, as director of autopsy pathology. Additionally, two anatomic pathologists and three molecular pathologists were recruited in the last year.

PhD, director of Diagnostic Immunology Laboratory, was the recipient of the Carl R. Jolliff Award for Lifetime Achievement in Clinical or Diagnostic Immunology.

GRANTS AWARDED JULY 1, 2019– JUNE 30, 2020 $1,185,529 SELECTED PUBLICATIONS Conces MR, Hughes A, Pierson CR. Neuropathology of Mowat-Wilson Syndrome.

Pediatric and Developmental Pathology. 2020;23(4):322-325.

Liu H, Guinipero TL, Schieffer KM, et al. De novo Primary Central Nervous System Pure Erythroid Leukemia/Sarcoma with t(1;16)(p31;q24) NFIA/CBFA2T3 Translocation.

Haematologica. 2020;105(4):e194-e197.

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, Kelly BJ, White P, Magrini V, Wilson RK, Mardis ER, Cottrell CE. High Frequency of Disease-Associated Mosaic Variation in Clinical Exome Sequencing: A Two-Year Pediatric Tertiary Care Cohort Experience. Cold Spring Harbor Molecular Case Studies. 2020 Jun 12;6(3):a005231.

Sacco KA, Smith MJ, Bahna SL, Buchbinder D, Burkhardt J, Cooper MA, Hartog NL, Kobrynski L, Patel KP, Abraham RS. NAPDH Oxidase-Specific Flow Cytometry Allows for Rapid Genetic Triage and Classification of Novel Variants in Chronic Granulomatous Disease. The Journal of Clinical Immunology. 2020 Jan;40(1):191-202.

Wang H, Diaz A, Moyer K, Mele-Casas M, Ara-Montojo MF, Torrus I, McCoy K, Mejias A, Leber AL. Molecular and Clinical Comparison of Enterovirus D68 Outbreaks among Hospitalized Children, Ohio, USA, 2014 and 2018. Emerging Infectious Diseases. 2019 Nov;25(11):2055-2063.

Dustin Bunch, PhD, who joined our team as assistant director of clinical chemistry, is also assistant director of laboratory informatics. Dr. Bunch has made enormous contributions to our laboratory informatics initiatives and coordinated efforts between the laboratory and Nationwide Children’s Clinical Informatics teams in the short time he has been here.

Most recently, Amy Leber, PhD, Huanyu Wang, PhD, and Sophonie Jean, PhD, worked feverishly with their microbiology team to make Nationwide Children’s the first hospital in central Ohio to go live with COVID-19 polymerase chain reaction (PCR) testing. In addition, they helped other institutions with trouble-shooting to get testing online. This team also brought on COVID-19 antibody testing. Kathy Nicol, MD, and Roshini Abraham, PhD, coordinated with our clinical team for the administration of convalescent plasma as part of the treatment regimen for one of our patients. Jade Wilson MBA, MT (ASCP), has worked closely with leaders in epidemiology and administration to support the Nationwide Children’s response to the pandemic.

Many of our faculty serve in professional committees at the level including leadership roles. Nilsa Ramirez, MD, director of the Biopathology Center, was the recipient of the College of American Pathologists Lifetime Achievement Award for 2019, and Roshini Abraham,

Samir Kahwash, MD 128 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 129

PATHOLOGY AND LABORATORY MEDICINE

Department Report

PATHOLOGY AND LABORATORY MEDICINE The Department of Pathology and Laboratory Medicine at Nationwide Children’s Hospital provides a wide range of pediatric diagnostic services for hospitalized and ambulatory infants, children and adolescent patients. Laboratory services are provided through the main campus anatomic and clinical pathology laboratories, as well as multiple outpatient/reference laboratory testing facilities, Nationwide Children’s Close To HomeSM and Urgent Care centers, and our freestanding Emergency Department.

FACULTY

Selene Koo, MD, PhD Amy L. Leber, PhD Huifei Liu, MD, PhD Rachel Mariani, MD Erin K. Meyer, DO, MPH Jeffery Papiernik, MD Christopher R. Pierson, MD, PhD Vinay Prasad, MD

Shamlal Mangray, MB, BS Chief, Pathology and Laboratory Medicine Section Chief, Anatomic Pathology

Amy L. Pyle-Eilola, PhD Nilsa Del Carmen Ramirez-Milan, MD Archana Shenoy, MD Diana Thomas, MD Huanyu Wang, PhD AFFILIATED FACULTY Biochemical Genetics Dennis W. Bartholomew, MD Kim L. McBride, MD, MS Steve and Cindy Rasmussen Institute for Genomic Medicine Clinical Laboratory

Kathleen K. Nicol, MD Medical Director Section Chief, Clinical Pathology Roshini Abraham, PhD Peter B. Baker III, MD Laura Biederman, MD Daniel R. Boue, MD, PhD Dustin Bunch, PhD Catherine Chung, MD Miriam R. Conces, MD Bonita R. Fung, MD

Catherine Cottrell, PhD Jesse Hunter, PhD Kristy Lee, PhD Marco Leung, PhD Mariam Mathew, PhD Ruthann B. Pfau, PhD Shalini C. Reshmi, PhD Matthew Schultz, PhD Neuromuscular Pathology Zarife Sahenk, MD, PhD

Sophonie Jean, PhD

The department includes more than 25 pathologists and doctoral scientists with subspecialty expertise in pediatric pathology and laboratory medicine. This professional staff is supported by more than 400 technical staff who provide 24/7 coverage in critical patient care areas. As an integral part of Nationwide Children’s operations, our team provides specimen collection and diagnostic services in multiple service centers across Ohio.

In the last year, the Anatomic Pathology Laboratory processed close to 10,000 surgical cases, 1,300 cytology specimens and 90 autopsies. Clinical laboratories performed more than 3.1 million tests in various subspecialty areas. As part of our core mission, we were actively involved in undergraduate and graduate medical education, and our faculty served in multiple leadership roles locally and on the national scene. Faculty highlights include the appointment of Shamlal Mangray, MB, BS, as chief of Pathology and Laboratory Medicine; Kathy Nicol, MD, as medical director; Miriam Conces, MD, as director of surgical pathology; and Selene Koo, MD, PhD, as director of autopsy pathology. Additionally, two anatomic pathologists and three molecular pathologists were recruited in the last year.

PhD, director of Diagnostic Immunology Laboratory, was the recipient of the Carl R. Jolliff Award for Lifetime Achievement in Clinical or Diagnostic Immunology.

GRANTS AWARDED JULY 1, 2019– JUNE 30, 2020 $1,185,529 SELECTED PUBLICATIONS Conces MR, Hughes A, Pierson CR. Neuropathology of Mowat-Wilson Syndrome.

Pediatric and Developmental Pathology. 2020;23(4):322-325.

Liu H, Guinipero TL, Schieffer KM, et al. De novo Primary Central Nervous System Pure Erythroid Leukemia/Sarcoma with t(1;16)(p31;q24) NFIA/CBFA2T3 Translocation.

Haematologica. 2020;105(4):e194-e197.

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, Kelly BJ, White P, Magrini V, Wilson RK, Mardis ER, Cottrell CE. High Frequency of Disease-Associated Mosaic Variation in Clinical Exome Sequencing: A Two-Year Pediatric Tertiary Care Cohort Experience. Cold Spring Harbor Molecular Case Studies. 2020 Jun 12;6(3):a005231.

Sacco KA, Smith MJ, Bahna SL, Buchbinder D, Burkhardt J, Cooper MA, Hartog NL, Kobrynski L, Patel KP, Abraham RS. NAPDH Oxidase-Specific Flow Cytometry Allows for Rapid Genetic Triage and Classification of Novel Variants in Chronic Granulomatous Disease. The Journal of Clinical Immunology. 2020 Jan;40(1):191-202.

Wang H, Diaz A, Moyer K, Mele-Casas M, Ara-Montojo MF, Torrus I, McCoy K, Mejias A, Leber AL. Molecular and Clinical Comparison of Enterovirus D68 Outbreaks among Hospitalized Children, Ohio, USA, 2014 and 2018. Emerging Infectious Diseases. 2019 Nov;25(11):2055-2063.

Dustin Bunch, PhD, who joined our team as assistant director of clinical chemistry, is also assistant director of laboratory informatics. Dr. Bunch has made enormous contributions to our laboratory informatics initiatives and coordinated efforts between the laboratory and Nationwide Children’s Clinical Informatics teams in the short time he has been here.

Most recently, Amy Leber, PhD, Huanyu Wang, PhD, and Sophonie Jean, PhD, worked feverishly with their microbiology team to make Nationwide Children’s the first hospital in central Ohio to go live with COVID-19 polymerase chain reaction (PCR) testing. In addition, they helped other institutions with trouble-shooting to get testing online. This team also brought on COVID-19 antibody testing. Kathy Nicol, MD, and Roshini Abraham, PhD, coordinated with our clinical team for the administration of convalescent plasma as part of the treatment regimen for one of our patients. Jade Wilson MBA, MT (ASCP), has worked closely with leaders in epidemiology and administration to support the Nationwide Children’s response to the pandemic.

Many of our faculty serve in professional committees at the level including leadership roles. Nilsa Ramirez, MD, director of the Biopathology Center, was the recipient of the College of American Pathologists Lifetime Achievement Award for 2019, and Roshini Abraham,

Samir Kahwash, MD 128 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 129

PHYSICAL MEDICINE AND REHABILITATION

Department Report

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 boardcertified 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.

FACULTY

service and the following outpatient clinics: general rehabilitation, myelomeningocele, botulinum toxin, concussion, gait lab, neuro-oncology and nonaccidental 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 Chief

Total Discharges:........................................................... 106

Carl D. Gelfius, MD

Average Daily Census*:.................................................. 6.7

Karl W. Klamar, MD

Patient Days*:............................................................. 2,451

Wilawan Nopkhun, MD

Inpatient Consults:......................................................... 419

Jonathan S. Pedrick, MD Nathan S. Rosenberg, MD Reginald D. Talley, MD Physical Medicine and Rehabilitation was actively involved in the teaching of medical students, medical residents and fellows over the past year. We offer a pediatric rehabilitation rotation to the Physical Medicine and Rehabilitation residents from Larkin Community Hospital and the Palm Spring Branch of Larkin. Presentations on pediatric rehabilitation, concussion, neuromuscular disorders, musculoskeletal disorders, spasticity management and pediatric traumatic brain injury were made at local, regional, national and international levels.

Average Length of Stay*:.............................................. 23.8

Number of Beds:............................................................. 12 Physical Medicine Clinic Visits:................................... 5,329 Myelomeningocele (Spina Bifida) Clinic Visits:............... 626 School-based Seating Clinic Visits:.................................. 11 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC REHABILITATION MEDICINE Amy Hiller, DO Noel Pristas, MD

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

130 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 131

PHYSICAL MEDICINE AND REHABILITATION

Department Report

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 boardcertified 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.

FACULTY

service and the following outpatient clinics: general rehabilitation, myelomeningocele, botulinum toxin, concussion, gait lab, neuro-oncology and nonaccidental 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 Chief

Total Discharges:........................................................... 106

Carl D. Gelfius, MD

Average Daily Census*:.................................................. 6.7

Karl W. Klamar, MD

Patient Days*:............................................................. 2,451

Wilawan Nopkhun, MD

Inpatient Consults:......................................................... 419

Jonathan S. Pedrick, MD Nathan S. Rosenberg, MD Reginald D. Talley, MD Physical Medicine and Rehabilitation was actively involved in the teaching of medical students, medical residents and fellows over the past year. We offer a pediatric rehabilitation rotation to the Physical Medicine and Rehabilitation residents from Larkin Community Hospital and the Palm Spring Branch of Larkin. Presentations on pediatric rehabilitation, concussion, neuromuscular disorders, musculoskeletal disorders, spasticity management and pediatric traumatic brain injury were made at local, regional, national and international levels.

Average Length of Stay*:.............................................. 23.8

Number of Beds:............................................................. 12 Physical Medicine Clinic Visits:................................... 5,329 Myelomeningocele (Spina Bifida) Clinic Visits:............... 626 School-based Seating Clinic Visits:.................................. 11 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC REHABILITATION MEDICINE Amy Hiller, DO Noel Pristas, MD

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

130 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 131

PSYCHIATRY AND COMMUNITY BEHAVIORAL HEALTH

Department Report

BIG LOTS BEHAVIORAL HEALTH SERVICE LINE David A. Axelson, MD

Medical Director of Behavioral Health Services and Chief, Psychiatry and Behavioral Health, Nationwide Children’s Hospital Chief, Division of Child and Family, Department of Psychiatry and Behavioral Health, The Ohio State University Big Lots Behavioral Health Services at Nationwide Children’s Hospital is a comprehensive service line dedicated to children and adolescents affected by mental illness and problems of emotion, behavior, development, thought and adaptation to life challenges, including those associated with physical illness and trauma. We are committed to partnering with patients, families and referring primary care clinicians and specialists to deliver services of public health relevance and to achieve the best possible clinical outcomes. Because no single discipline or professional can adequately address the needs of every child, our approach is deliberately multidisciplinary and collaborative.

Care is typically delivered by a team composed of a combination of child and adolescent psychiatrists, developmental and behavioral pediatricians, psychologists and neuropsychologists, nurses, social workers, family therapists and counselors. By working together, we aim to deliver team-based care that transcends the work of individual professionals, incorporating evidence-based practices into active clinical settings and establishing high standards of quality, safety and customer satisfaction.

Faculty from the Department of Pediatrics and the Child and Adolescent Division of the Department of Psychiatry and Behavioral Health provide clinical care for the service line.

In March 2020, Nationwide Children’s opened the Big Lots Behavioral Health Pavilion, a new facility fully dedicated to children and adolescents with mental and behavioral health conditions. As the most comprehensive pediatric facility of its kind nationally, the Pavilion houses integrated behavioral health services, including inpatient psychiatric beds, a psychiatric crisis evaluation center with observation beds, a crisis stabilization unit, a partial hospital, and intensive outpatient and outpatient programs. The Pavilion will serve as a place to conduct trainings on the wide range of disciplines in pediatric mental and behavioral health, as well as foster collaboration with Nationwide Children’s research teams and community partner agencies.

In addition to being one of the largest outpatient service lines at Nationwide Children’s, we are also the largest pediatric behavioral health network of any children’s

hospital in the country, with over 250,000 outpatient visits completed in the last year. Clinical services within behavioral health serve as a setting for training a wide range of disciplines. Associated training programs include pre-professional internships in psychology, social work and clinical counseling; fellowships in developmental behavioral pediatrics; postdoctoral psychology fellowships in Pediatric Psychology, Neuropsychology, Intellectual and Developmental Disabilities, and Autism Treatment; Child Clinical, a post-graduate fellowship program in child and adolescent mental health for advanced practice nurses; and externships for psychiatric and mental health advanced practice nurses, clinical counselors, social workers, family therapists and psychologists. In addition, medical students, residents in psychiatry, pediatric and family-practice, and nursing students all have training experiences and rotations within the service line. The service line supports a diverse portfolio of clinical research studies, many of which are led by investigators from the Center for Biobehavioral Health, the Center for Innovation in Pediatric Practice, the Center for Suicide Research and Prevention, and the Child Development Center Research Program.

By integrating clinical, educational, research and advocacy efforts, we strive to improve the lives of children and families in central Ohio and beyond. The programs within Behavioral Health Services are described below.

The Child Development Center and Center for Autism Spectrum Disorders provide services to individuals with intellectual and developmental disabilities, including those with autism spectrum disorders. The Child Development Center offers a wide range of services to address the developmental and behavioral needs of children, adolescents and families of those with autism spectrum disorders and other developmental disabilities.

These services include interdisciplinary assessment and treatment, psychological evaluation and treatment, family interventions, advocacy support and care coordination with medical, speech and additional services. The Child Development Center provides integrated care in more than a dozen pediatric subspecialty clinics. It also serves as a site for the Autism Speaks Autism Treatment Network, a network of 13 sites across the United States and Canada.

The Center for Autism Spectrum Disorders provides comprehensive, multidisciplinary care focusing on evidence-

132 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

based treatment, education, research and advocacy for children diagnosed with autism spectrum disorder. Services include intensive behavioral intervention and consultation, school support and educational consultation, Asperger’s counseling, social skills groups, parent teaching, advocacy and community education.

Pediatric Psychology and Neuropsychology provides clinical services in two primary areas: Pediatric Psychology provides specialized assessment and intervention services that focus on the relationship between cognitive, social, and emotional functioning and physical health, typically for children with co-occurring medical conditions (e.g., cancer, diabetes, sickle cell disease); Pediatric Neuropsychology performs specialized evaluations for children and adolescents with a range of medical and neurological disorders that impact thinking or behavior (e.g., brain tumors, epilepsy, seizure disorders, traumatic brain injury). The section provides care throughout the hospital, including inpatient medical units, medical specialty outpatient clinics and the Psychology Clinic at Nationwide Children’s.

Psychologists act as liaisons to divisions within the Departments of Pediatrics and Psychiatry to provide expertise in clinical care and to assist in development of research and quality initiatives around the psychosocial care for patients and families. In 2019, Pediatric Psychology had continued growth in patient volume for both inpatient consultation and liaison and outpatient services.

One area of continued expansion has been integrating pediatric psychologists into our Primary Care Centers with new integration sites added in 2019. Also, Pediatric Psychology realized growth in integrated care within our Nephrology, GI, Complex Care and Neonatology services. Neuropsychology expanded to support integrated services in our Rheumatology clinics. Psychologists also began preparing for integration into psychiatric acute care services on a larger scale with the opening of the Big Lots Behavioral Health Pavilion; three psychologists, two psychology fellows, and a psychology intern/resident are not part of the Psychiatric Acute Care Service. Additionally, there is a history of psychologists providing leadership in several programs within the Department of Pediatrics at Nationwide Children’s, with roles such as director of Psychosocial Services for the Division of Hematology, Oncology & Blood and Marrow Transplant, psychosocial leadership in areas of gastrointestinal care and the Newborn Intensive Care Unit, program leadership in the interdisciplinary feeding program for children with feeding aversions, and the comprehensive interdisciplinary pain program. In 2019, Pediatric Psychology began providing clinical program leadership in Nationwide Children’s new Intensive Pain Rehabilitation and Education Program.

See page 110 for a list of faculty, selected publications and grants awarded.

Psychiatry and Community Behavioral Health is the largest and most clinically diverse section of Behavioral Health Services. This integrated program of care for pediatric mental disorders spans a comprehensive spectrum, from prevention services to inpatient psychiatric units. Services currently available include pediatric crisis assessment and treatment within an expanded Youth Crisis Stabilization Unit, consultation-liaison services for youth who are hospitalized at Nationwide Children’s, psychiatric inpatient beds at Nationwide Children’s, Partial Hospital Program, multiple levels of care for eating disorders in collaboration with Adolescent Medicine, intensive outpatient services within the Mood and Anxiety Program, intermediate levels of behavioral health care in the community courts and school, specialized services for early child mental health, outpatient treatment clinics and a novel program to integrate mental health service delivery in primary care settings. Over the past year, the focus has been on the opening of the Big Lots Behavioral Health Pavilion. See page 134 for a list of faculty, selected publications and grants awarded.

Center for Biobehavioral Health: See page 181 for information about the Center for Biobehavioral Health in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED TO CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $4,176,057

FAST FACTS July 2019 through June 2020 Child Development Center and Center for Autism Spectrum Disorders Child Development Center Visits: ...........................10,628 Child Development Center Medical Clinic/Outpatient Consultation Visits: .......................1,432 Center for Autism Spectrum Disorders Visits: ........38,628 Behavioral Health Total Outpatient Visits/Consults: ..........................250,748 Total Inpatient Consults: ..........................................5,501 Total Inpatient Discharges: ......................................1,568 Total Inpatient Days: ...............................................9,104

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 133

PSYCHIATRY AND COMMUNITY BEHAVIORAL HEALTH

Department Report

BIG LOTS BEHAVIORAL HEALTH SERVICE LINE David A. Axelson, MD

Medical Director of Behavioral Health Services and Chief, Psychiatry and Behavioral Health, Nationwide Children’s Hospital Chief, Division of Child and Family, Department of Psychiatry and Behavioral Health, The Ohio State University Big Lots Behavioral Health Services at Nationwide Children’s Hospital is a comprehensive service line dedicated to children and adolescents affected by mental illness and problems of emotion, behavior, development, thought and adaptation to life challenges, including those associated with physical illness and trauma. We are committed to partnering with patients, families and referring primary care clinicians and specialists to deliver services of public health relevance and to achieve the best possible clinical outcomes. Because no single discipline or professional can adequately address the needs of every child, our approach is deliberately multidisciplinary and collaborative.

Care is typically delivered by a team composed of a combination of child and adolescent psychiatrists, developmental and behavioral pediatricians, psychologists and neuropsychologists, nurses, social workers, family therapists and counselors. By working together, we aim to deliver team-based care that transcends the work of individual professionals, incorporating evidence-based practices into active clinical settings and establishing high standards of quality, safety and customer satisfaction.

Faculty from the Department of Pediatrics and the Child and Adolescent Division of the Department of Psychiatry and Behavioral Health provide clinical care for the service line.

In March 2020, Nationwide Children’s opened the Big Lots Behavioral Health Pavilion, a new facility fully dedicated to children and adolescents with mental and behavioral health conditions. As the most comprehensive pediatric facility of its kind nationally, the Pavilion houses integrated behavioral health services, including inpatient psychiatric beds, a psychiatric crisis evaluation center with observation beds, a crisis stabilization unit, a partial hospital, and intensive outpatient and outpatient programs. The Pavilion will serve as a place to conduct trainings on the wide range of disciplines in pediatric mental and behavioral health, as well as foster collaboration with Nationwide Children’s research teams and community partner agencies.

In addition to being one of the largest outpatient service lines at Nationwide Children’s, we are also the largest pediatric behavioral health network of any children’s

hospital in the country, with over 250,000 outpatient visits completed in the last year. Clinical services within behavioral health serve as a setting for training a wide range of disciplines. Associated training programs include pre-professional internships in psychology, social work and clinical counseling; fellowships in developmental behavioral pediatrics; postdoctoral psychology fellowships in Pediatric Psychology, Neuropsychology, Intellectual and Developmental Disabilities, and Autism Treatment; Child Clinical, a post-graduate fellowship program in child and adolescent mental health for advanced practice nurses; and externships for psychiatric and mental health advanced practice nurses, clinical counselors, social workers, family therapists and psychologists. In addition, medical students, residents in psychiatry, pediatric and family-practice, and nursing students all have training experiences and rotations within the service line. The service line supports a diverse portfolio of clinical research studies, many of which are led by investigators from the Center for Biobehavioral Health, the Center for Innovation in Pediatric Practice, the Center for Suicide Research and Prevention, and the Child Development Center Research Program.

By integrating clinical, educational, research and advocacy efforts, we strive to improve the lives of children and families in central Ohio and beyond. The programs within Behavioral Health Services are described below.

The Child Development Center and Center for Autism Spectrum Disorders provide services to individuals with intellectual and developmental disabilities, including those with autism spectrum disorders. The Child Development Center offers a wide range of services to address the developmental and behavioral needs of children, adolescents and families of those with autism spectrum disorders and other developmental disabilities.

These services include interdisciplinary assessment and treatment, psychological evaluation and treatment, family interventions, advocacy support and care coordination with medical, speech and additional services. The Child Development Center provides integrated care in more than a dozen pediatric subspecialty clinics. It also serves as a site for the Autism Speaks Autism Treatment Network, a network of 13 sites across the United States and Canada.

The Center for Autism Spectrum Disorders provides comprehensive, multidisciplinary care focusing on evidence-

132 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

based treatment, education, research and advocacy for children diagnosed with autism spectrum disorder. Services include intensive behavioral intervention and consultation, school support and educational consultation, Asperger’s counseling, social skills groups, parent teaching, advocacy and community education.

Pediatric Psychology and Neuropsychology provides clinical services in two primary areas: Pediatric Psychology provides specialized assessment and intervention services that focus on the relationship between cognitive, social, and emotional functioning and physical health, typically for children with co-occurring medical conditions (e.g., cancer, diabetes, sickle cell disease); Pediatric Neuropsychology performs specialized evaluations for children and adolescents with a range of medical and neurological disorders that impact thinking or behavior (e.g., brain tumors, epilepsy, seizure disorders, traumatic brain injury). The section provides care throughout the hospital, including inpatient medical units, medical specialty outpatient clinics and the Psychology Clinic at Nationwide Children’s.

Psychologists act as liaisons to divisions within the Departments of Pediatrics and Psychiatry to provide expertise in clinical care and to assist in development of research and quality initiatives around the psychosocial care for patients and families. In 2019, Pediatric Psychology had continued growth in patient volume for both inpatient consultation and liaison and outpatient services.

One area of continued expansion has been integrating pediatric psychologists into our Primary Care Centers with new integration sites added in 2019. Also, Pediatric Psychology realized growth in integrated care within our Nephrology, GI, Complex Care and Neonatology services. Neuropsychology expanded to support integrated services in our Rheumatology clinics. Psychologists also began preparing for integration into psychiatric acute care services on a larger scale with the opening of the Big Lots Behavioral Health Pavilion; three psychologists, two psychology fellows, and a psychology intern/resident are not part of the Psychiatric Acute Care Service. Additionally, there is a history of psychologists providing leadership in several programs within the Department of Pediatrics at Nationwide Children’s, with roles such as director of Psychosocial Services for the Division of Hematology, Oncology & Blood and Marrow Transplant, psychosocial leadership in areas of gastrointestinal care and the Newborn Intensive Care Unit, program leadership in the interdisciplinary feeding program for children with feeding aversions, and the comprehensive interdisciplinary pain program. In 2019, Pediatric Psychology began providing clinical program leadership in Nationwide Children’s new Intensive Pain Rehabilitation and Education Program.

See page 110 for a list of faculty, selected publications and grants awarded.

Psychiatry and Community Behavioral Health is the largest and most clinically diverse section of Behavioral Health Services. This integrated program of care for pediatric mental disorders spans a comprehensive spectrum, from prevention services to inpatient psychiatric units. Services currently available include pediatric crisis assessment and treatment within an expanded Youth Crisis Stabilization Unit, consultation-liaison services for youth who are hospitalized at Nationwide Children’s, psychiatric inpatient beds at Nationwide Children’s, Partial Hospital Program, multiple levels of care for eating disorders in collaboration with Adolescent Medicine, intensive outpatient services within the Mood and Anxiety Program, intermediate levels of behavioral health care in the community courts and school, specialized services for early child mental health, outpatient treatment clinics and a novel program to integrate mental health service delivery in primary care settings. Over the past year, the focus has been on the opening of the Big Lots Behavioral Health Pavilion. See page 134 for a list of faculty, selected publications and grants awarded.

Center for Biobehavioral Health: See page 181 for information about the Center for Biobehavioral Health in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

GRANTS AWARDED TO CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $4,176,057

FAST FACTS July 2019 through June 2020 Child Development Center and Center for Autism Spectrum Disorders Child Development Center Visits: ...........................10,628 Child Development Center Medical Clinic/Outpatient Consultation Visits: .......................1,432 Center for Autism Spectrum Disorders Visits: ........38,628 Behavioral Health Total Outpatient Visits/Consults: ..........................250,748 Total Inpatient Consults: ..........................................5,501 Total Inpatient Discharges: ......................................1,568 Total Inpatient Days: ...............................................9,104

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 133

Department Report

PSYCHIATRY AND COMMUNITY BEHAVIORAL HEALTH Psychiatry and Community Behavioral Health at Nationwide Children’s Hospital is the largest and most clinically diverse section of Behavioral Health. This integrated program of care for pediatric mental health conditions spans a comprehensive spectrum of care from prevention services to inpatient psychiatric units.

The Child and Family Division in The Ohio State University Department of Psychiatry and Behavioral Health has faculty at Nationwide Children’s and The Ohio State University. See page 132 for details and for information about all Behavioral Health services.

FACULTY

Robert A. Kowatch, MD, PhD Rajeev Krishna, MD, PhD, MBA Scott Leibowitz, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $ 1,013,189

FAST FACTS July 2019 through June 2020

SELECTED PUBLICATIONS

Psychiatry Inpatient Consultations:...........................1,337

Axelson D. Meeting the Demand for Pediatric Mental Health Care. Pediatrics. 2019 Dec;144(6):e20192646.

Psychiatry Inpatient Unit Discharges:..........................570

Johnson B, Leibowitz S, Chavez A, Herbert SE. Risk Versus Resiliency: Addressing Depression in Lesbian, Gay, Bisexual, and Transgender Youth. Child & Adolescent Psychiatric Clinics of North America. 2019;28(3): 509-521.

Ramtekkar U, Bridge J, Thomas G, Butter E, Reese J, Logan E, Lin S, Axelson D. Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19. JMIR Mental Health. 2020; 10:10.

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 Psychiatry Training and Recruitment. Academic Psychiatry. 2019; 43(5): 542-546.

Community-Based Visits:.......................................44,646 Outpatient Therapy Visits:......................................88,264 Partial Hospital/Intensive Outpatient Program Visits:...2,979 Psychiatry Clinic Visits:..........................................29,201 Youth Crisis Stabilization Unit Discharges:...................998 Psychiatric Crisis Department\PEEC:........................5,580

Petronella Mbu, MD Molly Meers, PhD Jennifer Munoz, PhD Maura Munoz, MD. MA Mary Ann Murphy, MD, PhD David A. Axelson, MD Chief John Ackerman, PhD Benjamin Albrecht, DO Kento Akasaka, DO Jeffrey A. Bridge, PhD Meredith Chapman, MD Joyce Chen, MD Nancy Cunningham, PsyD Ben Fields, PhD Michael Flores, PhD Bela M. Gandhi, MD

Sarah Nayeem, MD Ujjwal Ramtekkar, MD, MBA, MPE Jennifer Reese, PsyD Nadine Schwartz, MD Lacramioara Spetie, MD Maria Stamatakos, MD Griffin A. Stout, MD Glenn Thomas, PhD Raymond Troy, MD Pankhuree Vandana, MD Elizabeth Vickery, PhD Kelly Wesolowski, PsyD Kris West, PhD

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

134 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 135

Department Report

PSYCHIATRY AND COMMUNITY BEHAVIORAL HEALTH Psychiatry and Community Behavioral Health at Nationwide Children’s Hospital is the largest and most clinically diverse section of Behavioral Health. This integrated program of care for pediatric mental health conditions spans a comprehensive spectrum of care from prevention services to inpatient psychiatric units.

The Child and Family Division in The Ohio State University Department of Psychiatry and Behavioral Health has faculty at Nationwide Children’s and The Ohio State University. See page 132 for details and for information about all Behavioral Health services.

FACULTY

Robert A. Kowatch, MD, PhD Rajeev Krishna, MD, PhD, MBA Scott Leibowitz, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $ 1,013,189

FAST FACTS July 2019 through June 2020

SELECTED PUBLICATIONS

Psychiatry Inpatient Consultations:...........................1,337

Axelson D. Meeting the Demand for Pediatric Mental Health Care. Pediatrics. 2019 Dec;144(6):e20192646.

Psychiatry Inpatient Unit Discharges:..........................570

Johnson B, Leibowitz S, Chavez A, Herbert SE. Risk Versus Resiliency: Addressing Depression in Lesbian, Gay, Bisexual, and Transgender Youth. Child & Adolescent Psychiatric Clinics of North America. 2019;28(3): 509-521.

Ramtekkar U, Bridge J, Thomas G, Butter E, Reese J, Logan E, Lin S, Axelson D. Pediatric Telebehavioral Health: A Transformational Shift in Care Delivery in the Era of COVID-19. JMIR Mental Health. 2020; 10:10.

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 Psychiatry Training and Recruitment. Academic Psychiatry. 2019; 43(5): 542-546.

Community-Based Visits:.......................................44,646 Outpatient Therapy Visits:......................................88,264 Partial Hospital/Intensive Outpatient Program Visits:...2,979 Psychiatry Clinic Visits:..........................................29,201 Youth Crisis Stabilization Unit Discharges:...................998 Psychiatric Crisis Department\PEEC:........................5,580

Petronella Mbu, MD Molly Meers, PhD Jennifer Munoz, PhD Maura Munoz, MD. MA Mary Ann Murphy, MD, PhD David A. Axelson, MD Chief John Ackerman, PhD Benjamin Albrecht, DO Kento Akasaka, DO Jeffrey A. Bridge, PhD Meredith Chapman, MD Joyce Chen, MD Nancy Cunningham, PsyD Ben Fields, PhD Michael Flores, PhD Bela M. Gandhi, MD

Sarah Nayeem, MD Ujjwal Ramtekkar, MD, MBA, MPE Jennifer Reese, PsyD Nadine Schwartz, MD Lacramioara Spetie, MD Maria Stamatakos, MD Griffin A. Stout, MD Glenn Thomas, PhD Raymond Troy, MD Pankhuree Vandana, MD Elizabeth Vickery, PhD Kelly Wesolowski, PsyD Kris West, PhD

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

134 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 135

RADIOLOGY

Department Report

RADIOLOGY

Jerome Rusin, MD

The Department of Pediatric Radiology at Nationwide Children’s Hospital is one of the nation’s premier imaging programs for children, with subspecialty expertise in abdominal, cardiac, chest, fetal/neonatal, interventional, musculoskeletal, neuroimaging and nuclear imaging. We provide expert care in imageguided diagnosis and therapy. Our mission is to improve children’s lives through innovative imaging. The major philosophical consideration that drives our mission is that children are not small adults. Technology must be adapted to meet the needs of pediatric patients to create imaging biomarkers specific for pediatric disease. Our vision of the reinvented imaging department, the Children’s Imaging Biomarker Alliance (CIBA), was born with the following goals:

Summit Shah, MD

• Develop and validate imaging biomarkers specific to pediatric disease • Determine quality, safety and cost-effectiveness of validated imaging biomarkers for discrete patient care pathways • Integrate imaging biomarkers across the basic/translational /clinical spectrum • Integrate pediatric research across departments, imaging modalities and populations The imaging infrastructure is located in the Pediatric Advanced Imaging Resource (PAIR), which brings together strategic partnerships and shared cutting-edge resources with optimized distribution of imaging technology and skilled personnel, an integrated model of imaging informatics, a robust quality and safety infrastructure and an advanced image-processing program which includes 3D modeling and 3D printing for personalized treatment planning and creation of patient-specific devices.

FACULTY

Eric Diaz, MD Stephen Druhan, MD Elizabeth Hingsbergen, MD Mai-Lan Ho, MD Mark Hogan, MD Jeremy Jones, MD Section Chief, Neuroradiology Imaging Anna Lillis, MD Lisa Martin, MD

Rajesh Krishnamurthy, MD Radiologist-in-Chief

Aaron McAllister, MD

Brent H. Adler, MD

James Murakami, MD

David Gregory Bates, MD

Becky Murray, MD

Adam Bobbey, MD Section Chief, Nuclear Medicine and Molecular Imaging

Julie O’Donovan, MD

Leah Braswell, MD Associate Section Chief, Interventional Imaging Ellen Chung, MD Associate Radiologist-in-Chief

Kathryn Milks, MD

Andrew Rabe, DO Mitch Rees, MD Diana Rodriguez, MD Lynne Ruess, MD

136 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

College of Radiology’s (ACR) Innovation Fund for the creation of “I-ROAR: Imaging Registry for Orphan And Rare Disease.”

Sally Smith, DO

Rajesh Krishnamurthy, MD, was elected to the board of the Society of Pediatric Radiology in 2020, and is the current chair of the ACR Pediatric Imaging Research Committee.

Benjamin Thompson, DO Patrick Warren, MD Section Chief, Interventional Imaging Cody Young, DO

SELECTED PUBLICATIONS

Nicholas Zumberge, MD Radiology has had several clinical advancements over the past year. Most notably, we have grown subspecialized programs to include: • Cardiac Imaging: especially neonatal/infant cardiac CT, new blood pool contrast program and myocardial stress perfusion program

Begley KA, Braswell LE, Noritz GH, Murakami JW. Salivary gland ablation: introducing an interventional radiology treatment alternative in the management of sialorrhea. Pediatric Radiology. 2020 May;50(6):869-876.

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 disorders: Summary from the 2019 ISMRM Workshop. Magnetic Resonance in Medicine.

2020;83(5):1565-1576.

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 Neurol. 2020 Jun 15:e201484. [Epub ahead of print].

• Musculoskeletal Imaging: with a new Ultrasound contrast program and joint injections in collaboration with Rheumatology

Molossi S, Agrawal H, Mery CM, Krishnamurthy R, Masand P, Sexson Tejtel SK, Noel 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: Cardiovascular Interventions. 2020;13(2):e008445. [Epub ahead of print].

• Oncologic Imaging: utilizing Tumor Metrics to quantify tumor mass and novel targeted antibody treatment

Schooler GR, Squires JH, Alazraki A, Chavhan GB, Chernyak V, Davis JT, Khanna G, Krishnamurthy R, Lungren MP, Masand PM, Podberesky DJ, Sirlin CB, Towbin AJ. Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: Consensus Imaging Recommendations from American College of Radiology Pediatric Liver Reporting and Data System (LI-RADS) Working Group. Radiology. 2020;296(3):493-497.

• Neuroimaging: with the utilization of Emergent Stroke Programs

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

• Vascular Anomalies: creating new lymphatic channel imaging and intervention programs

PEDIATRIC RADIOLOGY Nathan Fagan, MD (Interventional Radiology Fellow) Eric Morgan, MD (Pediatric Cardiovascular Imaging Fellow)

We successfully organized and hosted a hands-on workshop and the largest international meeting on pediatric cardiovascular magnetic resonance in October 2019 at Nationwide Children’s, partnered with 3D Imaging for Interventional Catheterization interventional cardiology group. Through a unique collaboration with the World Federation of Pediatric Imaging (WFPI), we furthered the education and training of radiologists in Argentina, Philippines, Nigeria and India. We also welcomed our first fellow in Pediatric Cardiac Imaging.

Finally, we have several advancements in research. Our research team is now led by Mai-Lan Ho, MD. Our Interventional Radiology team is administering targeted gene delivery to support gene therapy research. We have been a key imaging partner for the tissue engineering group. We are the grant award recipient of the American

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 137

RADIOLOGY

Department Report

RADIOLOGY

Jerome Rusin, MD

The Department of Pediatric Radiology at Nationwide Children’s Hospital is one of the nation’s premier imaging programs for children, with subspecialty expertise in abdominal, cardiac, chest, fetal/neonatal, interventional, musculoskeletal, neuroimaging and nuclear imaging. We provide expert care in imageguided diagnosis and therapy. Our mission is to improve children’s lives through innovative imaging. The major philosophical consideration that drives our mission is that children are not small adults. Technology must be adapted to meet the needs of pediatric patients to create imaging biomarkers specific for pediatric disease. Our vision of the reinvented imaging department, the Children’s Imaging Biomarker Alliance (CIBA), was born with the following goals:

Summit Shah, MD

• Develop and validate imaging biomarkers specific to pediatric disease • Determine quality, safety and cost-effectiveness of validated imaging biomarkers for discrete patient care pathways • Integrate imaging biomarkers across the basic/translational /clinical spectrum • Integrate pediatric research across departments, imaging modalities and populations The imaging infrastructure is located in the Pediatric Advanced Imaging Resource (PAIR), which brings together strategic partnerships and shared cutting-edge resources with optimized distribution of imaging technology and skilled personnel, an integrated model of imaging informatics, a robust quality and safety infrastructure and an advanced image-processing program which includes 3D modeling and 3D printing for personalized treatment planning and creation of patient-specific devices.

FACULTY

Eric Diaz, MD Stephen Druhan, MD Elizabeth Hingsbergen, MD Mai-Lan Ho, MD Mark Hogan, MD Jeremy Jones, MD Section Chief, Neuroradiology Imaging Anna Lillis, MD Lisa Martin, MD

Rajesh Krishnamurthy, MD Radiologist-in-Chief

Aaron McAllister, MD

Brent H. Adler, MD

James Murakami, MD

David Gregory Bates, MD

Becky Murray, MD

Adam Bobbey, MD Section Chief, Nuclear Medicine and Molecular Imaging

Julie O’Donovan, MD

Leah Braswell, MD Associate Section Chief, Interventional Imaging Ellen Chung, MD Associate Radiologist-in-Chief

Kathryn Milks, MD

Andrew Rabe, DO Mitch Rees, MD Diana Rodriguez, MD Lynne Ruess, MD

136 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

College of Radiology’s (ACR) Innovation Fund for the creation of “I-ROAR: Imaging Registry for Orphan And Rare Disease.”

Sally Smith, DO

Rajesh Krishnamurthy, MD, was elected to the board of the Society of Pediatric Radiology in 2020, and is the current chair of the ACR Pediatric Imaging Research Committee.

Benjamin Thompson, DO Patrick Warren, MD Section Chief, Interventional Imaging Cody Young, DO

SELECTED PUBLICATIONS

Nicholas Zumberge, MD Radiology has had several clinical advancements over the past year. Most notably, we have grown subspecialized programs to include: • Cardiac Imaging: especially neonatal/infant cardiac CT, new blood pool contrast program and myocardial stress perfusion program

Begley KA, Braswell LE, Noritz GH, Murakami JW. Salivary gland ablation: introducing an interventional radiology treatment alternative in the management of sialorrhea. Pediatric Radiology. 2020 May;50(6):869-876.

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 disorders: Summary from the 2019 ISMRM Workshop. Magnetic Resonance in Medicine.

2020;83(5):1565-1576.

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 Neurol. 2020 Jun 15:e201484. [Epub ahead of print].

• Musculoskeletal Imaging: with a new Ultrasound contrast program and joint injections in collaboration with Rheumatology

Molossi S, Agrawal H, Mery CM, Krishnamurthy R, Masand P, Sexson Tejtel SK, Noel 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: Cardiovascular Interventions. 2020;13(2):e008445. [Epub ahead of print].

• Oncologic Imaging: utilizing Tumor Metrics to quantify tumor mass and novel targeted antibody treatment

Schooler GR, Squires JH, Alazraki A, Chavhan GB, Chernyak V, Davis JT, Khanna G, Krishnamurthy R, Lungren MP, Masand PM, Podberesky DJ, Sirlin CB, Towbin AJ. Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: Consensus Imaging Recommendations from American College of Radiology Pediatric Liver Reporting and Data System (LI-RADS) Working Group. Radiology. 2020;296(3):493-497.

• Neuroimaging: with the utilization of Emergent Stroke Programs

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

• Vascular Anomalies: creating new lymphatic channel imaging and intervention programs

PEDIATRIC RADIOLOGY Nathan Fagan, MD (Interventional Radiology Fellow) Eric Morgan, MD (Pediatric Cardiovascular Imaging Fellow)

We successfully organized and hosted a hands-on workshop and the largest international meeting on pediatric cardiovascular magnetic resonance in October 2019 at Nationwide Children’s, partnered with 3D Imaging for Interventional Catheterization interventional cardiology group. Through a unique collaboration with the World Federation of Pediatric Imaging (WFPI), we furthered the education and training of radiologists in Argentina, Philippines, Nigeria and India. We also welcomed our first fellow in Pediatric Cardiac Imaging.

Finally, we have several advancements in research. Our research team is now led by Mai-Lan Ho, MD. Our Interventional Radiology team is administering targeted gene delivery to support gene therapy research. We have been a key imaging partner for the tissue engineering group. We are the grant award recipient of the American

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 137

SURGICAL SERVICES

Department, Section and Center Reports

Surgical Services

THE HEART CENTER / CARDIOTHORACIC SURGERY 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 Nationwide Children’s Hospital’s surgical departments have come together with a single, clear focus — to provide optimal outcomes for every child — inside and outside the walls of the operating room. This work 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.

Our faculty are helping to improve the care provided to children around the world by training the next generation of surgeons. Our departments offer the most surgical residency and fellowship programs of any free-standing pediatric hospital in the United States. Training programs are also offered to other surgeons, providing opportunities for them to advance their skills in more advanced techniques such as minimally invasive laparoscopic and robot-assisted surgery.

Mark E. Galantowicz, MD Chief, Cardiothoracic Surgery Co-Director, Heart Center

Sergio A. Carrillo, MD Pediatric Cardiothoracic Surgeon

Patrick I. McConnell, MD Director, Cardiopulmonary Mechanical Assist Program

Toshiharu Shinoka, MD, PhD Director, Cardiovascular Tissue Engineering Program

GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971 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 • Cardiothoracic Surgery • •

• Ophthalmology

•

Pediatric Surgery

Colorectal and Pelvic Reconstruction

• Orthopaedics

•

Plastic and Reconstructive Surgery

Dentistry

•

• Neurosurgery

• Otolaryngology Pediatric and Adolescent Gynecology

• Transplant

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 Jun 30. [Epub ahead of print] 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 during vascular remodeling in an arterial bioresorbable vascular graft. Journal of Vascular Surgery: Vascular Science. 2020; 1©:57-67.

• Trauma • Urology

138 138 | | NATIONWIDE NATIONWIDECHILDREN’S CHILDREN’SHOSPITAL HOSPITAL | | 2019-20 2019-20Annual AnnualReport Report | | NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 139

SURGICAL SERVICES

Department, Section and Center Reports

Surgical Services

THE HEART CENTER / CARDIOTHORACIC SURGERY 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 Nationwide Children’s Hospital’s surgical departments have come together with a single, clear focus — to provide optimal outcomes for every child — inside and outside the walls of the operating room. This work 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.

Our faculty are helping to improve the care provided to children around the world by training the next generation of surgeons. Our departments offer the most surgical residency and fellowship programs of any free-standing pediatric hospital in the United States. Training programs are also offered to other surgeons, providing opportunities for them to advance their skills in more advanced techniques such as minimally invasive laparoscopic and robot-assisted surgery.

Mark E. Galantowicz, MD Chief, Cardiothoracic Surgery Co-Director, Heart Center

Sergio A. Carrillo, MD Pediatric Cardiothoracic Surgeon

Patrick I. McConnell, MD Director, Cardiopulmonary Mechanical Assist Program

Toshiharu Shinoka, MD, PhD Director, Cardiovascular Tissue Engineering Program

GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971 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 • Cardiothoracic Surgery • •

• Ophthalmology

•

Pediatric Surgery

Colorectal and Pelvic Reconstruction

• Orthopaedics

•

Plastic and Reconstructive Surgery

Dentistry

•

• Neurosurgery

• Otolaryngology Pediatric and Adolescent Gynecology

• Transplant

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 Jun 30. [Epub ahead of print] 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 during vascular remodeling in an arterial bioresorbable vascular graft. Journal of Vascular Surgery: Vascular Science. 2020; 1©:57-67.

• Trauma • Urology

138 138 | | NATIONWIDE NATIONWIDECHILDREN’S CHILDREN’SHOSPITAL HOSPITAL | | 2019-20 2019-20Annual AnnualReport Report | | NationwideChildrens.org/2020-Report NationwideChildrens.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

The Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s Hospital is leading the way in providing high-quality care for children diagnosed with colorectal and pelvic conditions. There is a direct correlation between the number of patients a clinical program sees and the high-quality outcomes they can deliver to their patients. Colorectal and Pelvic Reconstruction is the busiest program of its kind anywhere in the world, having performed more than 764 operations last year. Every child diagnosed with a colorectal or pelvic condition is handled with an individualized treatment plan. Because of the complexity of many conditions, most children require care throughout their life. Our team is committed to providing optimal outcomes and quality of life for patients ranging from newborns, through toilet training, puberty and adulthood, including bowel, urinary, sexual function and childbearing.

Stephanie Vyrostek, BSN, RN

Ahmad H, Halleran DR, Maloof E, Baek J, Gasior AC, Langer JC, Levitt MA, Wood RJ. Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal malformations. Journal of Pediatric Surgery. 2020 Jun 1:S0022-3468(20)30360-2.

FACULTY

Karla Vaz, MD Kent C. Williams, MD Desale Yacob, MD Motility Director, Colorectal and Pelvic Reconstruction DIAGNOSTIC RADIOLOGY Brent H. Adler, MD David Gregory Bates, MD Benjamin P. Thompson, DO

Richard J. Wood, MD Chief

NEUROSURGERY Jeffrey R. Leonard, MD PEDIATRIC AND ADOLESCENT GYNECOLOGY

COLORECTAL AND PELVIC RECONSTRUCTIVE SURGERY Karen A. Diefenbach, MD Allesandra Gasior, DO Transitional Care Director Ihab Halaweish, MD

CLINICAL LEADERS

Ahmad H, Nordin AB, Halleran DR, Kenney B, Jaggi P, Gasior A, Weaver L, Sanchez AV, Wood RJ, Levitt MA. Decreasing surgical site infections in pediatric stoma closures.

Journal of Pediatric Surgery. 2020 Jan;55(1):90-95.

Marissa Condon, BSN, RN Natalie Rose, BSN, RN ADVANCE PRACTICE NURSE COORDINATORS Kristina Booth, MSN, CFNP Onnalisa Nash, MS, CPNP-PC The Center for Colorectal and Pelvic Reconstruction complex reconstruction program, working closely with urologists, gynecologists and gastroenterologists, continues to help children from around the world, thus far providing guidance and surgery for children from all 50 states and 73 countries. The use of minimally invasive surgery has expanded as well, offering both robot-assisted and pure laparoscopic surgical treatment of complex conditions, including bladder neck reconstruction, and appendicovesicostomy and/or Malone procedures for severe incontinence, both urinary and fecal, and offering unique opportunities to share tissues such as a shared appendix used for both procedures. The Colorectal and Pelvic Reconstruction team travels to provide surgical education across the globe. Surgeons train fellow surgeons and nurses train nurses.

The Center for Colorectal and Pelvic Reconstruction has a growing transition of care program for children as they become young adults and move into adulthood.

With the expertise of Alessandra Gasior, DO, the first surgeon in the world trained in both pediatric and adult colorectal surgery, this unique program will collaborate with The Ohio State University Wexner Medical Center.

The center has changed the lives of many adult patients through our collaborative approach to care.

Halleran DR, Ahmad H, Maloof E, Paradiso M, Lehmkuhl H, Minneci PC, Levitt MA, Wood RJ. Does Hirschsprung-Associated Enterocolitis Differ in Children With and Without Down Syndrome? Journal of Surgical Research. 2020 Jan;245:564-568.

Vilanova-Sanchez A, Halleran DR, Reck CA, McCracken K, Hewitt G, Gasior AC, Weaver L, Ahmad H, Akers A, Jaggers J, Rentea RM, Levitt MA, Wood RJ. Factors predicting the need for vaginal replacement at the time of primary reconstruction of a cloacal malformation. Journal of Pediatric Surgery. 2020 Jan;55(1):71-74.

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 fecal incontinence after repair of their anorectal malformation. Journal of Pediatric Surgery.

2020 Jun;17:S0022-3468(20)30423-1.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC COLORECTAL RESEARCH Hira Ahmad, MD PEDIATRIC COLORECTAL SURGERY Yousef El-Gohary, MD INTERNATIONAL PELVIC RECONSTRUCTION Marion Arnold, MBChB, MMed (Red Cross War Memorial Children’s Hospital, South Africa) Clare Skerritt, MD (Bristol Royal Hospital for Children, United Kingdom)

Geri D. Hewitt, MD Gynecology Director, Colorectal and Pelvic Reconstruction Katherine A. McCracken, MD UROLOGY

GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION

Daniel G. DaJusta, MD Urology Director, Colorectal and Pelvic Reconstruction

Neetu Bali, MD

Molly Fuchs, MD

Carlo Di Lorenzo, MD

V. Rama Jayanthi, MD

Peter Lu, MD

140 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 141

Surgical Services

COLORECTAL AND PELVIC RECONSTRUCTION

PROGRAM MANAGER

SELECTED PUBLICATIONS

The Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s Hospital is leading the way in providing high-quality care for children diagnosed with colorectal and pelvic conditions. There is a direct correlation between the number of patients a clinical program sees and the high-quality outcomes they can deliver to their patients. Colorectal and Pelvic Reconstruction is the busiest program of its kind anywhere in the world, having performed more than 764 operations last year. Every child diagnosed with a colorectal or pelvic condition is handled with an individualized treatment plan. Because of the complexity of many conditions, most children require care throughout their life. Our team is committed to providing optimal outcomes and quality of life for patients ranging from newborns, through toilet training, puberty and adulthood, including bowel, urinary, sexual function and childbearing.

Stephanie Vyrostek, BSN, RN

Ahmad H, Halleran DR, Maloof E, Baek J, Gasior AC, Langer JC, Levitt MA, Wood RJ. Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal malformations. Journal of Pediatric Surgery. 2020 Jun 1:S0022-3468(20)30360-2.

FACULTY

Karla Vaz, MD Kent C. Williams, MD Desale Yacob, MD Motility Director, Colorectal and Pelvic Reconstruction DIAGNOSTIC RADIOLOGY Brent H. Adler, MD David Gregory Bates, MD Benjamin P. Thompson, DO

Richard J. Wood, MD Chief

NEUROSURGERY Jeffrey R. Leonard, MD PEDIATRIC AND ADOLESCENT GYNECOLOGY

COLORECTAL AND PELVIC RECONSTRUCTIVE SURGERY Karen A. Diefenbach, MD Allesandra Gasior, DO Transitional Care Director Ihab Halaweish, MD

CLINICAL LEADERS

Ahmad H, Nordin AB, Halleran DR, Kenney B, Jaggi P, Gasior A, Weaver L, Sanchez AV, Wood RJ, Levitt MA. Decreasing surgical site infections in pediatric stoma closures.

Journal of Pediatric Surgery. 2020 Jan;55(1):90-95.

Marissa Condon, BSN, RN Natalie Rose, BSN, RN ADVANCE PRACTICE NURSE COORDINATORS Kristina Booth, MSN, CFNP Onnalisa Nash, MS, CPNP-PC The Center for Colorectal and Pelvic Reconstruction complex reconstruction program, working closely with urologists, gynecologists and gastroenterologists, continues to help children from around the world, thus far providing guidance and surgery for children from all 50 states and 73 countries. The use of minimally invasive surgery has expanded as well, offering both robot-assisted and pure laparoscopic surgical treatment of complex conditions, including bladder neck reconstruction, and appendicovesicostomy and/or Malone procedures for severe incontinence, both urinary and fecal, and offering unique opportunities to share tissues such as a shared appendix used for both procedures. The Colorectal and Pelvic Reconstruction team travels to provide surgical education across the globe. Surgeons train fellow surgeons and nurses train nurses.

The Center for Colorectal and Pelvic Reconstruction has a growing transition of care program for children as they become young adults and move into adulthood.

With the expertise of Alessandra Gasior, DO, the first surgeon in the world trained in both pediatric and adult colorectal surgery, this unique program will collaborate with The Ohio State University Wexner Medical Center.

The center has changed the lives of many adult patients through our collaborative approach to care.

Halleran DR, Ahmad H, Maloof E, Paradiso M, Lehmkuhl H, Minneci PC, Levitt MA, Wood RJ. Does Hirschsprung-Associated Enterocolitis Differ in Children With and Without Down Syndrome? Journal of Surgical Research. 2020 Jan;245:564-568.

Vilanova-Sanchez A, Halleran DR, Reck CA, McCracken K, Hewitt G, Gasior AC, Weaver L, Ahmad H, Akers A, Jaggers J, Rentea RM, Levitt MA, Wood RJ. Factors predicting the need for vaginal replacement at the time of primary reconstruction of a cloacal malformation. Journal of Pediatric Surgery. 2020 Jan;55(1):71-74.

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 fecal incontinence after repair of their anorectal malformation. Journal of Pediatric Surgery.

2020 Jun;17:S0022-3468(20)30423-1.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC COLORECTAL RESEARCH Hira Ahmad, MD PEDIATRIC COLORECTAL SURGERY Yousef El-Gohary, MD INTERNATIONAL PELVIC RECONSTRUCTION Marion Arnold, MBChB, MMed (Red Cross War Memorial Children’s Hospital, South Africa) Clare Skerritt, MD (Bristol Royal Hospital for Children, United Kingdom)

Geri D. Hewitt, MD Gynecology Director, Colorectal and Pelvic Reconstruction Katherine A. McCracken, MD UROLOGY

GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION

Daniel G. DaJusta, MD Urology Director, Colorectal and Pelvic Reconstruction

Neetu Bali, MD

Molly Fuchs, MD

Carlo Di Lorenzo, MD

V. Rama Jayanthi, MD

Peter Lu, MD

140 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 141

Surgical Services

DENTISTRY

Benjamin Kwok, DDS, MS

The Department of Dentistry at Nationwide Children’s Hospital is comprised of dedicated professionals in the fields of pediatric dentistry, orthodontics, oral surgery, endodontics, periodontics, general dentistry, dental hygiene, and dental assisting who provide comprehensive preventive, therapeutic, urgent, and emergency oral health care services for infants, children, and adolescents, including those with special health care needs. Our mission is to optimize oral health for the children who need us most through a balanced program dedicated to providing quality clinical care and specialty services while advancing knowledge through research, advocacy, and community partnerships within a premier educational environment. Scientific discoveries focus on caries prevention, behavior management, oral microbiome, and dental trauma outcomes.

Joshua M. Leavitt, DMD, MS Jeffrey S. Lee, DDS Sean E. Lindsey, DDS Eileen M. Martinez, DDS Monte E. Masonbrink, DDS, MS Yoon-Mi L. Matracia, DMD, MS Jeffrey T. Milton, DDS, MS Kara M. Morris, DDS, MS Cecilia A. Moy, DDS. MS

FACULTY

Peter E. Larsen, DDS Section Chief, Oral and Maxillofacial Surgery Dennis J. McTigue, DDS, MS Ana M. Mercado, DMD, MS, PhD Beau Meyer, DDS, MPH Gregory M. Ness, DDS Diego A. Solis, DDS COMMUNITY-BASED FACULTY Ashley E. Anderson, DDS

Janice A. Townsend, DDS, MS Chief

Carolyn A. Barber, DDS

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

Jennifer Bryk-Hechko, DDS, MS

Janet J. Brown, DDS

Homa Amini, DDS, MS, MPH

Emily R. Burns, DDS, MS

Ehsan Azadani, DDS, MS

Alexis Capeci, DDS, MS

Paul S. Casamassimo, DDS, MS

Andre Carranco, DDS, MS

Daniel B. Claman, DDS

George Chen, DMD, MS

Kimberly Hammersmith, DDS, MPH, MS Program Director

Jackson Cockley, DDS

Ashok Kumar, BDS, MS Director of Clinical Operations and General Anesthesia

Johnathan W. Draney, DDS, MS

Rosa Ortega, DDS, MS OSU-AFFILIATE FACULTY Hany A. Emam, BDS, MS Henry W. Fields, DDS, MS, MSD Section Chief, Orthodontics

Joseph DePalo, DMD, MS Kylene H. Fernandez, DDS, MS Timothy J. Frey, DDS Lucia C. Gerstmann, DDS, MS Kimberly M. Gill, DDS, MS Jillian N. Gray, DDS

Ann L. Griffen, DDS, MS

Marcus Heffner, DDS

Erin L. Gross, DDS, PhD, MS

Mitzi L. Hines, DDS

Courtney A. Jatana, DDS, MS, FACS

Gary M. Judis, DDS

Kelly S. Kennedy, DDS, MS

Patrick M. Kennedy, DDS Nicholas M. Kerns, DDS, MS

142 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Andrea M. Myers, DDS Scott W. Nieman, DDS DaAdrian T. Norman, DDS Colleen C. Orellana, DDS, MS Andree-Anne Page, DMD Sachin S. Parulkar, DDS Monica R. Patel, DMD, MS Nira S. Patel, DDS Matthew L. Pingel, DMD Jessica Pizano, DMD Mindy A. Price, DDS, MS Sidney D. Price, DDS, MS Joel J. Richards, DDS Shaun A. Rotenberg, DMD, MS Avneet K. Sandhu, DDS Marlina M. Shah, DDS, MS Anuradha Shelar, DDS David S. Silverglade, DDS, MS David A. Smeltzer, DDS Randall M. Speer, DDS Mallary St. John, DDS, MS Rob S. Steiner, DMD Heidi Steinkamp, DDS, PhD Kumar Subramanian, DDS, MS Claire E. Towning, DDS Eric C. Van Gilder, DDS Kevin T. Weitzel, DMD, MS Stephen Wilson, Phd, DMD

In the past year, the department has continued to provide access for patients, including children with special health care needs. Although altered operations due to the COVID-19 pandemic decreased the number of patient visits, the department provided continuous care for children with urgent and emergent needs in clinic, emergency department, and operating room settings.

The department has been a leader in how to continue patient care and training activities during COVID-19 with a nationwide shared resident curriculum and four publications on our experiences. To continue to improve clinical access to care and to promote scholarly activity in the department, Beau Meyer, DDS, MPH, has been hired in a joint recruitment effort with The Ohio State University College of Dentistry.

Additional highlights: National and local faculty and resident recognitions: • Homa Amini, DDS, MS, MPH, received an additional year of funding for Ohio Medicaid, Medicaid Equity Simulation Project, "MEDTAPP: Access to Dental Care for Immigrant Families."

• Ehsan Azadani, DDS, MS, was appointed as a graduate faculty member at The Ohio State College of Dentistry.

• Paul Casamassimo, DDS, was awarded the Gustav O. Kruger Career Achievement Award from Georgetown University on May 28, 2020.

• Dan Claman, DDS, completed the Quality Improvement Education Course.

• Ann Griffen, DDS, MS, was appointed chair of the Graduate Studies Committee at the Ohio State University College of Dentistry.

• Erin Gross, DDS, MS, was appointed chair-elect of the faculty council at The Ohio State University College of Dentistry.

• Kim Hammersmith, DDS, MPH, MS, was awarded $2,250,000 by the U.S. Department of Health and Human Services for the Health Resources and Services Administration postdoctoral training in general, pediatric and public health dentistry and dental hygiene.

• Beau Meyer, DDS, MPH, was awarded the Olav Alvares Award for Early Career Scholars who Published Outstanding Articles in the Journal of Dental Education in 2019 by the American Dental Education Association.

•

Ashok Kumar, DDS, MS, completed the "Communicate With Me" training course.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 143

Surgical Services

DENTISTRY

Benjamin Kwok, DDS, MS

The Department of Dentistry at Nationwide Children’s Hospital is comprised of dedicated professionals in the fields of pediatric dentistry, orthodontics, oral surgery, endodontics, periodontics, general dentistry, dental hygiene, and dental assisting who provide comprehensive preventive, therapeutic, urgent, and emergency oral health care services for infants, children, and adolescents, including those with special health care needs. Our mission is to optimize oral health for the children who need us most through a balanced program dedicated to providing quality clinical care and specialty services while advancing knowledge through research, advocacy, and community partnerships within a premier educational environment. Scientific discoveries focus on caries prevention, behavior management, oral microbiome, and dental trauma outcomes.

Joshua M. Leavitt, DMD, MS Jeffrey S. Lee, DDS Sean E. Lindsey, DDS Eileen M. Martinez, DDS Monte E. Masonbrink, DDS, MS Yoon-Mi L. Matracia, DMD, MS Jeffrey T. Milton, DDS, MS Kara M. Morris, DDS, MS Cecilia A. Moy, DDS. MS

FACULTY

Peter E. Larsen, DDS Section Chief, Oral and Maxillofacial Surgery Dennis J. McTigue, DDS, MS Ana M. Mercado, DMD, MS, PhD Beau Meyer, DDS, MPH Gregory M. Ness, DDS Diego A. Solis, DDS COMMUNITY-BASED FACULTY Ashley E. Anderson, DDS

Janice A. Townsend, DDS, MS Chief

Carolyn A. Barber, DDS

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

Jennifer Bryk-Hechko, DDS, MS

Janet J. Brown, DDS

Homa Amini, DDS, MS, MPH

Emily R. Burns, DDS, MS

Ehsan Azadani, DDS, MS

Alexis Capeci, DDS, MS

Paul S. Casamassimo, DDS, MS

Andre Carranco, DDS, MS

Daniel B. Claman, DDS

George Chen, DMD, MS

Kimberly Hammersmith, DDS, MPH, MS Program Director

Jackson Cockley, DDS

Ashok Kumar, BDS, MS Director of Clinical Operations and General Anesthesia

Johnathan W. Draney, DDS, MS

Rosa Ortega, DDS, MS OSU-AFFILIATE FACULTY Hany A. Emam, BDS, MS Henry W. Fields, DDS, MS, MSD Section Chief, Orthodontics

Joseph DePalo, DMD, MS Kylene H. Fernandez, DDS, MS Timothy J. Frey, DDS Lucia C. Gerstmann, DDS, MS Kimberly M. Gill, DDS, MS Jillian N. Gray, DDS

Ann L. Griffen, DDS, MS

Marcus Heffner, DDS

Erin L. Gross, DDS, PhD, MS

Mitzi L. Hines, DDS

Courtney A. Jatana, DDS, MS, FACS

Gary M. Judis, DDS

Kelly S. Kennedy, DDS, MS

Patrick M. Kennedy, DDS Nicholas M. Kerns, DDS, MS

142 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Andrea M. Myers, DDS Scott W. Nieman, DDS DaAdrian T. Norman, DDS Colleen C. Orellana, DDS, MS Andree-Anne Page, DMD Sachin S. Parulkar, DDS Monica R. Patel, DMD, MS Nira S. Patel, DDS Matthew L. Pingel, DMD Jessica Pizano, DMD Mindy A. Price, DDS, MS Sidney D. Price, DDS, MS Joel J. Richards, DDS Shaun A. Rotenberg, DMD, MS Avneet K. Sandhu, DDS Marlina M. Shah, DDS, MS Anuradha Shelar, DDS David S. Silverglade, DDS, MS David A. Smeltzer, DDS Randall M. Speer, DDS Mallary St. John, DDS, MS Rob S. Steiner, DMD Heidi Steinkamp, DDS, PhD Kumar Subramanian, DDS, MS Claire E. Towning, DDS Eric C. Van Gilder, DDS Kevin T. Weitzel, DMD, MS Stephen Wilson, Phd, DMD

In the past year, the department has continued to provide access for patients, including children with special health care needs. Although altered operations due to the COVID-19 pandemic decreased the number of patient visits, the department provided continuous care for children with urgent and emergent needs in clinic, emergency department, and operating room settings.

The department has been a leader in how to continue patient care and training activities during COVID-19 with a nationwide shared resident curriculum and four publications on our experiences. To continue to improve clinical access to care and to promote scholarly activity in the department, Beau Meyer, DDS, MPH, has been hired in a joint recruitment effort with The Ohio State University College of Dentistry.

Additional highlights: National and local faculty and resident recognitions: • Homa Amini, DDS, MS, MPH, received an additional year of funding for Ohio Medicaid, Medicaid Equity Simulation Project, "MEDTAPP: Access to Dental Care for Immigrant Families."

• Ehsan Azadani, DDS, MS, was appointed as a graduate faculty member at The Ohio State College of Dentistry.

• Paul Casamassimo, DDS, was awarded the Gustav O. Kruger Career Achievement Award from Georgetown University on May 28, 2020.

• Dan Claman, DDS, completed the Quality Improvement Education Course.

• Ann Griffen, DDS, MS, was appointed chair of the Graduate Studies Committee at the Ohio State University College of Dentistry.

• Erin Gross, DDS, MS, was appointed chair-elect of the faculty council at The Ohio State University College of Dentistry.

• Kim Hammersmith, DDS, MPH, MS, was awarded $2,250,000 by the U.S. Department of Health and Human Services for the Health Resources and Services Administration postdoctoral training in general, pediatric and public health dentistry and dental hygiene.

• Beau Meyer, DDS, MPH, was awarded the Olav Alvares Award for Early Career Scholars who Published Outstanding Articles in the Journal of Dental Education in 2019 by the American Dental Education Association.

•

Ashok Kumar, DDS, MS, completed the "Communicate With Me" training course.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 143

Surgical Services •

Janice Townsend, DDS, MS, was a contributor to the surgeon general’s report.

Research (funded) highlights: •

Improved Access to Care with Homa Amini, DDS, MPH, MS

•

Oral Microbiome Studies with Ann Griffen, DDS, MS, and research team, The Ohio State University College of Dentistry

•

Postdoctoral Training Grant with Kimberly Hammersmith, DDS, MPH, MS

2019 – 2020 NATIONWIDE CHILDREN’S RESIDENCY PROGRAM PEDIATRIC DENTISTRY Seth Bradbury, DDS Madeleine DiPaolo, DDS Joshua Evans, DDS

NEUROSURGERY Ranked sixth in the country by U.S. News & World Report, the Department of Pediatric Neurosurgery at Nationwide Children’s Hospital provides evaluation and treatment for problems of the central nervous system in patients from birth through 21 years of age and in selected adults with congenital neurological disorders. The staff works closely with members of the departments of Anesthesia, Hematology, Oncology & Blood and Marrow Transplant, Neurology, Physical Medicine and Rehabilitation, Pediatric Surgery, Plastic and Reconstructive Surgery, and many other pediatric disciplines.

Taylor Harlan, DDS Kaitlin Laxer, DDDS Shayna Mattox, DDS 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, Hammersmith K, Moffitt J, Shui AM, Parker RA, Coury DL et al. Access to Dental Visits and Correlates of Preventive Dental Care in Children with Autism Spectrum Disorder. The Journal of Autism and Developmental Disorders. 2020 Feb 27.

Andrew Vo, DDS

Sulyanto RM, Thompson ZA, Beall CJ, Leys EJ, Griffen AL. The Predominant Oral Microbiota is Acquired Early in an Organized Pattern. Scientific Reports. 2019 Jul;9(1):10550.

Victoria Tran, DDS Stormi Winter, DDS

FACULTY

growth. Outreach efforts have been successful, as the team has provided care to patients from all around the world, including 31 states and nine countries. The pediatric epilepsy surgery program is steadily expanding and is on pace to perform over 50 epilepsy cases this year.

Chloe Wong, DDS Misa Yoshioka, DDS

Townsend JA, Spiller H, Hammersmith K, Casamassimo PS. Dental Local AnesthesiaRelated Pediatric Cases Reported to U.S. Poison Control Centers. Pediatric Dentistry.

2020 March;42(2):116-122.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:......................................................... 2 Observation and Outpatient-in-a-Bed Discharges:.......... 16 Total Discharges:............................................................. 19

Jeffrey R. Leonard, MD Chief

Average Length of Stay*:................................................ 1.0

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

Patient Days*:.................................................................... 2 Dental Clinic Visits:................................................... 35,586 Mobile Dental Unit Visits:................................................. 85

Annie I. Drapeau, MD

The scholarly output of the program has increased markedly with over 30 publications (journals, chapters and manuscripts) and 20 presentations in national and international meetings. We have enrolled over 600 patients in either clinical trials or registry projects, and as a member of the Hydrocephalus Clinical Research Network (HCRN), we continue to participate in multi-institutional studies focusing on the treatment of hydrocephalus. In addition, the department is a part of many other research endeavors, studying Chiari I malformations, cerebral palsy, epilepsy and brain tumors.

Jonathan A. Pindrik, MD

Dental Clinic and Sedation:............................................ 366

Ammar Shaikhouni, MD, PhD

Total Surgical Procedures:.......................................... 4,289

Eric A. Sribnick, MD, PhD

*Excludes observation and outpatient-in-a-bed patients.

OSU-AFFILIATE FACULTY John M. McGregor, MD Ehud U. Mendel, MD Shahid Nimjee, MD Ciaran J. Powers, MD, PhD Daniel Prevedello, MD Patrick Youssef, MD With over 850 surgical cases and more than 5,500 clinic visits performed in 2019 alone, the Department of Pediatric Neurosurgery has continued with significant

144 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Selective Dorsal Rhizotomy Program continues to provide comprehensive care for patients with spastic cerebral palsy, including care provided by colleagues in Physical Medicine and Rehabilitation, as well as in Therapy Services. Our program is one of very few in the country that perform this procedure with great success.

Our out-of-state referrals have grown significantly, as demonstrated by increases in new patient clinic visits, inpatient hospital days and case volume.

Jonathan A. Pindrik, MD, is co-director of the Epilepsy Surgery Program and the site principal investigator for the HCRN. Eric A. Sribnick, MD, PhD, continues a basic science research program on the role of immunology in traumatic brain injury and is the trauma liaison for the department. Both have submitted and presented multiple abstracts at national meetings over

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 145

Surgical Services •

Janice Townsend, DDS, MS, was a contributor to the surgeon general’s report.

Research (funded) highlights: •

Improved Access to Care with Homa Amini, DDS, MPH, MS

•

Oral Microbiome Studies with Ann Griffen, DDS, MS, and research team, The Ohio State University College of Dentistry

•

Postdoctoral Training Grant with Kimberly Hammersmith, DDS, MPH, MS

2019 – 2020 NATIONWIDE CHILDREN’S RESIDENCY PROGRAM PEDIATRIC DENTISTRY Seth Bradbury, DDS Madeleine DiPaolo, DDS Joshua Evans, DDS

NEUROSURGERY Ranked sixth in the country by U.S. News & World Report, the Department of Pediatric Neurosurgery at Nationwide Children’s Hospital provides evaluation and treatment for problems of the central nervous system in patients from birth through 21 years of age and in selected adults with congenital neurological disorders. The staff works closely with members of the departments of Anesthesia, Hematology, Oncology & Blood and Marrow Transplant, Neurology, Physical Medicine and Rehabilitation, Pediatric Surgery, Plastic and Reconstructive Surgery, and many other pediatric disciplines.

Taylor Harlan, DDS Kaitlin Laxer, DDDS Shayna Mattox, DDS 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, Hammersmith K, Moffitt J, Shui AM, Parker RA, Coury DL et al. Access to Dental Visits and Correlates of Preventive Dental Care in Children with Autism Spectrum Disorder. The Journal of Autism and Developmental Disorders. 2020 Feb 27.

Andrew Vo, DDS

Sulyanto RM, Thompson ZA, Beall CJ, Leys EJ, Griffen AL. The Predominant Oral Microbiota is Acquired Early in an Organized Pattern. Scientific Reports. 2019 Jul;9(1):10550.

Victoria Tran, DDS Stormi Winter, DDS

FACULTY

growth. Outreach efforts have been successful, as the team has provided care to patients from all around the world, including 31 states and nine countries. The pediatric epilepsy surgery program is steadily expanding and is on pace to perform over 50 epilepsy cases this year.

Chloe Wong, DDS Misa Yoshioka, DDS

Townsend JA, Spiller H, Hammersmith K, Casamassimo PS. Dental Local AnesthesiaRelated Pediatric Cases Reported to U.S. Poison Control Centers. Pediatric Dentistry.

2020 March;42(2):116-122.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:......................................................... 2 Observation and Outpatient-in-a-Bed Discharges:.......... 16 Total Discharges:............................................................. 19

Jeffrey R. Leonard, MD Chief

Average Length of Stay*:................................................ 1.0

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

Patient Days*:.................................................................... 2 Dental Clinic Visits:................................................... 35,586 Mobile Dental Unit Visits:................................................. 85

Annie I. Drapeau, MD

The scholarly output of the program has increased markedly with over 30 publications (journals, chapters and manuscripts) and 20 presentations in national and international meetings. We have enrolled over 600 patients in either clinical trials or registry projects, and as a member of the Hydrocephalus Clinical Research Network (HCRN), we continue to participate in multi-institutional studies focusing on the treatment of hydrocephalus. In addition, the department is a part of many other research endeavors, studying Chiari I malformations, cerebral palsy, epilepsy and brain tumors.

Jonathan A. Pindrik, MD

Dental Clinic and Sedation:............................................ 366

Ammar Shaikhouni, MD, PhD

Total Surgical Procedures:.......................................... 4,289

Eric A. Sribnick, MD, PhD

*Excludes observation and outpatient-in-a-bed patients.

OSU-AFFILIATE FACULTY John M. McGregor, MD Ehud U. Mendel, MD Shahid Nimjee, MD Ciaran J. Powers, MD, PhD Daniel Prevedello, MD Patrick Youssef, MD With over 850 surgical cases and more than 5,500 clinic visits performed in 2019 alone, the Department of Pediatric Neurosurgery has continued with significant

144 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The Selective Dorsal Rhizotomy Program continues to provide comprehensive care for patients with spastic cerebral palsy, including care provided by colleagues in Physical Medicine and Rehabilitation, as well as in Therapy Services. Our program is one of very few in the country that perform this procedure with great success.

Our out-of-state referrals have grown significantly, as demonstrated by increases in new patient clinic visits, inpatient hospital days and case volume.

Jonathan A. Pindrik, MD, is co-director of the Epilepsy Surgery Program and the site principal investigator for the HCRN. Eric A. Sribnick, MD, PhD, continues a basic science research program on the role of immunology in traumatic brain injury and is the trauma liaison for the department. Both have submitted and presented multiple abstracts at national meetings over

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 145

Surgical Services the last year. Annie I. Drapeau, MD, is Neurosurgery co-director of the craniosynostosis program, as part of the Center for Complex Craniofacial Disorders.

She is the medical co-director of the Neurology/ Neurosurgery inpatient floor and is Neurosurgery's quality improvement lead. Dr. Drapeau has several research and quality improvement projects focusing on optimizing care for craniosynostosis patients. Our 2018-19 fellow, Ammar Shaikhouni, MD, PhD, is a faculty member working with both Nationwide Children’s and The Ohio State University Wexner Medical Center. He has a clinical and research focus on both adult and pediatric epilepsy, movement disorders and stereotactic surgery for gene and drug delivery.

Chief Jeffrey Leonard, MD, continues his focus on spasticity, cerebral palsy and improving treatment for childhood brain tumors. He is currently participating as the neurosurgical lead for a multi-institutional

collaboration dedicated to treatment of cerebral palsy in the pediatric and adult populations. He also serves on the editorial boards and the scientific peer review panel for SRA International, the Journal of Pediatric Neurology and World Neurosurgery, and is associate editor of neurosurgery for Pediatrics.

SELECTED PUBLICATIONS 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 Population. The Journal of Neurosurgery. 2020 Apr 10;1-6.

Drapeau A, Walz PC, Eide JG, et al. Pediatric Craniopharyngioma. Child’s Nervous System. 2019 Nov;35(11):2133-2145.

Pindrik J, Riva-Cambrin J, Kulkarni AV, et al. Surgical Resource Utilization After Initial Treatment of Infant Hydrocephalus: Comparing ETV, Early Experience of ETV with Choroid Plexus Cauterization, and Shunt Insertion in the Hydrocephalus Clinical Research Network. The Journal of Neurosurgery. 2020 Jun 19;1-9.

OPHTHALMOLOGY The Department of Ophthalmology at Nationwide Children’s Hospital is dedicated to providing comprehensive eye care for children and adults. The department includes the Eye Clinic and the Electrophysiology Testing Laboratory. The Eye Clinic serves in-house patient referrals, provides comprehensive outpatient eye care and offers special testing on the patients of community-based physicians.

The clinic staff includes pediatric ophthalmologists, optometrists, a pediatric ophthalmology fellow and ophthalmology residents from The Ohio State University College of Medicine, as well as low vision and rehabilitation specialists. In addition, the Eye Clinic offers specialty clinics staffed by ophthalmologists and other subspecialists and eye care professionals for patients with issues related to glaucoma, retina, oculoplastics, cornea and external disease, intracranial hypertension and low vision.

FACULTY

Megan M. Chambers, MD Raymond I. Cho, MD Louis J. Chorich, III, MD

Sribnick EA, Hensley J, Moore-Clingenpeel M, Muszynski JA, Thakkar RK, Hall MW. Nosocomial Infection Following Severe Traumatic Injury in Children. Pediatric Critical Care Medicine. 2020 May;21(5):443-450.

Frederick H. Davidorf, MD Jill A Foster, MD Andrew J. Hendershot, MD

FAST FACTS

Charles J. Hickey, MD

July 2019 through June 2020 Inpatient Discharges:..................................................... 582 Observation and Outpatient-in-a-Bed Discharges:........ 196 Total Discharges:........................................................... 766 Average Length of Stay*:................................................... 6 Average Daily Census*:..................................................... 9

Patient Days*:............................................................. 3,293 Total Surgical Procedures:............................................. 720 Neurosurgery Main Campus Clinic Visits:................... 5,517 *Excludes observation and outpatient-in-a-bed patients.

Steven E. Katz, MD

Don L. Bremer, MD Cybil B. Cassady, MD Richard P. Golden, MD Hilliary E. Inger, MD

PEDIATRIC NEUROSURGERY Jillian Ploof, DO

Catherine Olson Jordan, MD Julie M. Lange, MD

A Decade of Remarkable Transformation Jeffrey Leonard, MD, Named Neurosurgery Chief

2010 New Neurosurgical OR Equipped with iMRI and Stereotactic Guidance

2014

2015 Selective Dorsal Rhizotomy Program Helps Children with Spasticity from Across U.S.

Mary Lou McGregor, MD Gary L. Rogers, MD New Craniofacial Disorders Center Provides Multidisciplinary Care for Craniosynostosis

Joined Hydrocephalus Clinical Research Network (HCRN) as 1 of only 13 Sites in North America

2013 2017

2016

Among First in U.S. to Provide Responsive Neurostimulation Therapy for Children With Intractable Epilepsy

Amanda L. Way, MD OSU-AFFILIATE FACULTY

2017 2020 2017 2019 Ranked in Top 7 by U.S. News & World Report 4th Consecutive Year

From the recruitment of highly skilled neurosurgeons with diverse experience to the launch of a pediatric neurosurgery 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

Johnstone M. Kim, MD

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

NEUROSURGERY

Curtin G. Kelley, MD

David L. Rogers, MD Chief

Sayoko Moroi, MD, PhD Chair, Ophthalmology and Visual Sciences N. Douglas Baker, MD Dominic M. Buzzacco, MD Kenneth V. Cahill, MD Colleen M. Cebulla, MD

Dino D. Klisovic, MD Rebecca A. Kuennen, MD Carrie A. Lembach, MD Cameron B. Nabavi, MD Matthew P. Ohr, MD Tyler Oostry, MD Daniel G. Straka, MD Ana M. Suelves Cogollos, MD Michael B. Wells, MD The Department of Ophthalmology supports research and teaching programs that ensure delivery of the highest quality pediatric care for our patients, now and in the future. We are participating in amblyopia, cataract, myopia and retinopathy of prematurity (ROP) studies sponsored by the Pediatric Eye Disease Investigator Group. We are actively engaged in studies focused on preserving vision in children with Batten disease. Research continues on projects concerning infantile cataracts, intracranial hypertension, secondary intraocular lens placement, pediatric drusen and children with cystic fibrosis. We are also one of 15

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 147

Surgical Services the last year. Annie I. Drapeau, MD, is Neurosurgery co-director of the craniosynostosis program, as part of the Center for Complex Craniofacial Disorders.

She is the medical co-director of the Neurology/ Neurosurgery inpatient floor and is Neurosurgery's quality improvement lead. Dr. Drapeau has several research and quality improvement projects focusing on optimizing care for craniosynostosis patients. Our 2018-19 fellow, Ammar Shaikhouni, MD, PhD, is a faculty member working with both Nationwide Children’s and The Ohio State University Wexner Medical Center. He has a clinical and research focus on both adult and pediatric epilepsy, movement disorders and stereotactic surgery for gene and drug delivery.

Chief Jeffrey Leonard, MD, continues his focus on spasticity, cerebral palsy and improving treatment for childhood brain tumors. He is currently participating as the neurosurgical lead for a multi-institutional

collaboration dedicated to treatment of cerebral palsy in the pediatric and adult populations. He also serves on the editorial boards and the scientific peer review panel for SRA International, the Journal of Pediatric Neurology and World Neurosurgery, and is associate editor of neurosurgery for Pediatrics.

SELECTED PUBLICATIONS 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 Population. The Journal of Neurosurgery. 2020 Apr 10;1-6.

Drapeau A, Walz PC, Eide JG, et al. Pediatric Craniopharyngioma. Child’s Nervous System. 2019 Nov;35(11):2133-2145.

Pindrik J, Riva-Cambrin J, Kulkarni AV, et al. Surgical Resource Utilization After Initial Treatment of Infant Hydrocephalus: Comparing ETV, Early Experience of ETV with Choroid Plexus Cauterization, and Shunt Insertion in the Hydrocephalus Clinical Research Network. The Journal of Neurosurgery. 2020 Jun 19;1-9.

OPHTHALMOLOGY The Department of Ophthalmology at Nationwide Children’s Hospital is dedicated to providing comprehensive eye care for children and adults. The department includes the Eye Clinic and the Electrophysiology Testing Laboratory. The Eye Clinic serves in-house patient referrals, provides comprehensive outpatient eye care and offers special testing on the patients of community-based physicians.

The clinic staff includes pediatric ophthalmologists, optometrists, a pediatric ophthalmology fellow and ophthalmology residents from The Ohio State University College of Medicine, as well as low vision and rehabilitation specialists. In addition, the Eye Clinic offers specialty clinics staffed by ophthalmologists and other subspecialists and eye care professionals for patients with issues related to glaucoma, retina, oculoplastics, cornea and external disease, intracranial hypertension and low vision.

FACULTY

Megan M. Chambers, MD Raymond I. Cho, MD Louis J. Chorich, III, MD

Sribnick EA, Hensley J, Moore-Clingenpeel M, Muszynski JA, Thakkar RK, Hall MW. Nosocomial Infection Following Severe Traumatic Injury in Children. Pediatric Critical Care Medicine. 2020 May;21(5):443-450.

Frederick H. Davidorf, MD Jill A Foster, MD Andrew J. Hendershot, MD

FAST FACTS

Charles J. Hickey, MD

July 2019 through June 2020 Inpatient Discharges:..................................................... 582 Observation and Outpatient-in-a-Bed Discharges:........ 196 Total Discharges:........................................................... 766 Average Length of Stay*:................................................... 6 Average Daily Census*:..................................................... 9

Patient Days*:............................................................. 3,293 Total Surgical Procedures:............................................. 720 Neurosurgery Main Campus Clinic Visits:................... 5,517 *Excludes observation and outpatient-in-a-bed patients.

Steven E. Katz, MD

Don L. Bremer, MD Cybil B. Cassady, MD Richard P. Golden, MD Hilliary E. Inger, MD

PEDIATRIC NEUROSURGERY Jillian Ploof, DO

Catherine Olson Jordan, MD Julie M. Lange, MD

A Decade of Remarkable Transformation Jeffrey Leonard, MD, Named Neurosurgery Chief

2010 New Neurosurgical OR Equipped with iMRI and Stereotactic Guidance

2014

2015 Selective Dorsal Rhizotomy Program Helps Children with Spasticity from Across U.S.

Mary Lou McGregor, MD Gary L. Rogers, MD New Craniofacial Disorders Center Provides Multidisciplinary Care for Craniosynostosis

Joined Hydrocephalus Clinical Research Network (HCRN) as 1 of only 13 Sites in North America

2013 2017

2016

Among First in U.S. to Provide Responsive Neurostimulation Therapy for Children With Intractable Epilepsy

Amanda L. Way, MD OSU-AFFILIATE FACULTY

2017 2020 2017 2019 Ranked in Top 7 by U.S. News & World Report 4th Consecutive Year

From the recruitment of highly skilled neurosurgeons with diverse experience to the launch of a pediatric neurosurgery 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

Johnstone M. Kim, MD

FULL-TIME NATIONWIDE CHILDREN’S FACULTY

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

NEUROSURGERY

Curtin G. Kelley, MD

David L. Rogers, MD Chief

Sayoko Moroi, MD, PhD Chair, Ophthalmology and Visual Sciences N. Douglas Baker, MD Dominic M. Buzzacco, MD Kenneth V. Cahill, MD Colleen M. Cebulla, MD

Dino D. Klisovic, MD Rebecca A. Kuennen, MD Carrie A. Lembach, MD Cameron B. Nabavi, MD Matthew P. Ohr, MD Tyler Oostry, MD Daniel G. Straka, MD Ana M. Suelves Cogollos, MD Michael B. Wells, MD The Department of Ophthalmology supports research and teaching programs that ensure delivery of the highest quality pediatric care for our patients, now and in the future. We are participating in amblyopia, cataract, myopia and retinopathy of prematurity (ROP) studies sponsored by the Pediatric Eye Disease Investigator Group. We are actively engaged in studies focused on preserving vision in children with Batten disease. Research continues on projects concerning infantile cataracts, intracranial hypertension, secondary intraocular lens placement, pediatric drusen and children with cystic fibrosis. We are also one of 15

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 147

sites currently participating in the multicenter Artisan Aphakia Lens study. The Artisan Aphakia lens is unique because it is fixed to the iris and therefore allows for lens implantation in patients who do not have the support structure for a traditional implant. Without an implant lens, these children must wear extremely strong and cosmetically unappealing glasses or highly customized, and often poorly tolerated, hard contact lenses. These patients now have an option to live with much more normal visual function. These lenses are not FDA approved, and we expect this study will help gain future FDA approval.

The Visual Electrophysiology Clinic at Nationwide Children’s is led by Julie Racine, PhD. This clinic performs electroretinograms, multifocal electroretinograms, electro-oculograms and visual evoked potential on patients of all ages, including adults, to assess retinal and retino-cortical function.

The department also manages and acts as the physical location for the office of the Ohio Amblyope Registry program (funded by the Ohio Department of Health’s Save Our Sight Fund), the first and only statewide program in the United States designed to serve the needs of children with amblyopia. It is a voluntary registration program to increase knowledge about amblyopia, its causes, treatment and prevention. It also provides free eye patches and other important services to help families of children with amblyopia.

The department is equipped with state-of-the-art technology for utilization in standard dilated eye exams and for specialty testing, including ultrasound (A/B scans), retinal photography, visual field, optical 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.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $586,310 SELECTED PUBLICATIONS 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 Investigator Group. Secondary 12-month Ocular Outcomes of a Phase 1 Dosing Study of Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmology. 2020 Jan 1;138(1):14-20.

Dsouza S, Aylward BS, Rogers DL. Aylward SC. Presenting Symptomatology and Risk Factors in Pediatric Secondary Intracranial Hypertension due to Venous Sinus Thrombosis. Pediatric Neurology. 2019 Dec;101:53-56.

Inger HE, Jordan CO, Yanoga F, Rogers DL. Equivalence of Oral Fluorescein Angiography to Intravenous Fluorescein Angiography in Evaluating Pediatric Optic Nerve Pathology. Journal of Pediatric Ophthalmology and Strabismus. 2019 Dec 9;56:e68-e72.

Kornbluh AB, Thompson K, Memahen G, Rogers DL, Jordan CO, Aylward SC, Lehwald LM. Sleep Disturbance in Pediatric Intracranial Hypertension. The Journal of Clinical Sleep Medicine. 2020 Mar 24. [Epub ahead of print] Wallace DK, Kraker RT, Freedman SF, Crouch ER, Bhatt AR, Hartnett ME, Yang MB, 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 Eye Disease Investigator Group (PEDIG). Short-term Outcomes After Very Low-Dose Intravitreous Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmology. 2020 Jun 1;138(6):698-701.

FAST FACTS July 2019 through June 2020 Inpatient Discharges: ........................................................ 1 Observation and Outpatient-in-a-Bed Discharges: ......... 12 Total Discharges: ............................................................ 13 Total Surgical Procedures: ......................................... 1,684 Inpatient Consults: ..................................................... 2,692 Eye Clinic and Low Vision Eye Clinic Visits: ................ 8,088 *Excludes observation and outpatient-in-a-bed patients.

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

sites currently participating in the multicenter Artisan Aphakia Lens study. The Artisan Aphakia lens is unique because it is fixed to the iris and therefore allows for lens implantation in patients who do not have the support structure for a traditional implant. Without an implant lens, these children must wear extremely strong and cosmetically unappealing glasses or highly customized, and often poorly tolerated, hard contact lenses. These patients now have an option to live with much more normal visual function. These lenses are not FDA approved, and we expect this study will help gain future FDA approval.

The Visual Electrophysiology Clinic at Nationwide Children’s is led by Julie Racine, PhD. This clinic performs electroretinograms, multifocal electroretinograms, electro-oculograms and visual evoked potential on patients of all ages, including adults, to assess retinal and retino-cortical function.

The department also manages and acts as the physical location for the office of the Ohio Amblyope Registry program (funded by the Ohio Department of Health’s Save Our Sight Fund), the first and only statewide program in the United States designed to serve the needs of children with amblyopia. It is a voluntary registration program to increase knowledge about amblyopia, its causes, treatment and prevention. It also provides free eye patches and other important services to help families of children with amblyopia.

The department is equipped with state-of-the-art technology for utilization in standard dilated eye exams and for specialty testing, including ultrasound (A/B scans), retinal photography, visual field, optical 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.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $586,310 SELECTED PUBLICATIONS 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 Investigator Group. Secondary 12-month Ocular Outcomes of a Phase 1 Dosing Study of Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmology. 2020 Jan 1;138(1):14-20.

Dsouza S, Aylward BS, Rogers DL. Aylward SC. Presenting Symptomatology and Risk Factors in Pediatric Secondary Intracranial Hypertension due to Venous Sinus Thrombosis. Pediatric Neurology. 2019 Dec;101:53-56.

Inger HE, Jordan CO, Yanoga F, Rogers DL. Equivalence of Oral Fluorescein Angiography to Intravenous Fluorescein Angiography in Evaluating Pediatric Optic Nerve Pathology. Journal of Pediatric Ophthalmology and Strabismus. 2019 Dec 9;56:e68-e72.

Kornbluh AB, Thompson K, Memahen G, Rogers DL, Jordan CO, Aylward SC, Lehwald LM. Sleep Disturbance in Pediatric Intracranial Hypertension. The Journal of Clinical Sleep Medicine. 2020 Mar 24. [Epub ahead of print] Wallace DK, Kraker RT, Freedman SF, Crouch ER, Bhatt AR, Hartnett ME, Yang MB, 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 Eye Disease Investigator Group (PEDIG). Short-term Outcomes After Very Low-Dose Intravitreous Bevacizumab for Retinopathy of Prematurity. JAMA Ophthalmology. 2020 Jun 1;138(6):698-701.

FAST FACTS July 2019 through June 2020 Inpatient Discharges: ........................................................ 1 Observation and Outpatient-in-a-Bed Discharges: ......... 12 Total Discharges: ............................................................ 13 Total Surgical Procedures: ......................................... 1,684 Inpatient Consults: ..................................................... 2,692 Eye Clinic and Low Vision Eye Clinic Visits: ................ 8,088 *Excludes observation and outpatient-in-a-bed patients.

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

150150| NATIONWIDE CHILDREN’S HOSPITAL Annual Report | NATIONWIDE CHILDREN’S HOSPITAL| 2019-20 | 2019-20 Annual Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 151

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

150150| NATIONWIDE CHILDREN’S HOSPITAL Annual Report | NATIONWIDE CHILDREN’S HOSPITAL| 2019-20 | 2019-20 Annual Report| NationwideChildrens.org/2020-Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 151

Surgical Services

ORTHOPAEDICS The Department of Orthopaedics at Nationwide Children’s Hospital provides diagnosis, evaluation and treatment for all orthopedic conditions and disorders in infants, children and adolescents. Inpatient, outpatient and emergency services are provided to patients with a wide range of developmental, congenital, neuromuscular and posttraumatic problems of the musculoskeletal system, trauma and fractures, scoliosis and other spinal abnormalities.

Faculty members participate in the education of health care professionals at several levels. Residents, medical students and nurses from The Ohio State University Wexner Medical Center, OhioHealth, and 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 extensive educational program.

FACULTY

Craig N. Dimitris, MD Jonathan B. Feibel, MD Robert T. Gorsline, MD James E. Popp, MD Desmond J. Stutzman, DO Corey L. Van Hoff, MD Raymond K. Wurapa, MD

Kevin E. Klingele, MD Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Allan C. Beebe, MD Matthew C. Beran, MD Reid C. Chambers, DO Christopher A. Iobst, MD John R. Kean, MD Jan E. Klamar, MD Julie Balch Samora, MD, PhD, MPH Walter P. Samora III, MD Craig A. Smith, MD Amanda T. Whitaker, MD OSU-AFFILIATE FACULTY Hisham M. Awan, MD Joel L. Mayerson, MD Thomas J. Scharschmidt, MD COMMUNITY-BASED FACULTY

In 2019, the Department of Orthopedics maintained its stature as a top 10 ranked pediatric orthopedic provider, developed surgically innovative techniques and protocols, and flourished within a very active research division. Recruiting efforts were highlighted with the addition of Reid Chambers, DO, and Craig Smith, MD. Dr. Chambers partnered within a very busy spine program and Dr. Smith joined the Center for Limb Lengthening and Reconstruction as well as quickly built a successful hip arthroscopy program within the Center for Hip Preservation.

The Spine Program officially expanded to become the Center for Comprehensive Spine Care (CCSC). Under the direction of Allan Beebe, MD, the CCSC provides team-centered care for patients with spinal deformity, ranging from newborns with congenital anomalies to adults with chronic conditions. Such a comprehensive approach, built with collaboration among many services, including Neurosurgery, Pain Services, and the Honda Center for Gait Analysis and Mobility Enhancement, ensures optimal outcomes for our patients. The CCSC holds an outstanding track record within quality improvement and dual surgeon operative techniques, producing one of the lowest infection rates within the country, as well as very low complication and reoperation rates.

Brent A. Bickel, MD 152 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SELECTED PUBLICATIONS Research efforts were highlighted by two projects being Abousamra O, Deliberato D, Singh S, Klingele KE. Closed vs Open Reduction in recognized at this year’s Pediatric Orthopaedic Society 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. dynamization accelerated bone healing in a large animal Davis RL, Samora WP, Persinger F, Klingele KE. Treatment of Unstable Versus Stable Slipped 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.

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. senior author Kevin Klingele, MD, achieved runner-up as R, Lin JS, Popp JE, Samora JB. Delayed Presentation of Seymour Fractures: best clinical paper. Both projects were enabled by Baruch Samade A Single Institution Experience and Management Recommendations. Hand. 2019 Oct Danino, MD, who completed his year as the department’s 9:1558944719878846. first international exchange research scholar.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:................................................. 437 Observation and Outpatient-in-a-Bed Discharges:.... 527 Total Discharges:....................................................... 959 Average Length of Stay*:............................................ 3.5 Average Daily Census*:.............................................. 4.1 Patient Days*:......................................................... 1,490 Total Surgical Cases:.............................................. 2,640 Inpatient Consults:..................................................... 286 Main Campus Orthopaedic Clinic Visits:............... 14,705

Canal Winchester Orthopaedic Clinic Visits:............... 378 Dublin Orthopaedic Clinic Visits:........................... 10,216 East Broad Orthopaedic Clinic Visits:......................... 788 Hilliard Orthopaedic Clinic Visits:............................... 293 New Albany Orthopaedic Clinic Visits:..................... 1,886 Westerville Orthopaedic Clinic Visits:...................... 8,240 Orthopaedic Oncology Clinic Visits:............................ 590 Total Orthopaedic Clinic Visits:.............................. 37,096 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC ORTHOPEDICS Michael Fisher, DO

A Decade of Remarkable Transformation

ORTHOPAEDICS

Kevin Klingele, MD, Named Chief of Orthopaedics

2010

2013

Nationwide Children's Launches Both the Center for Hip Preservation and the Center for Comprehensive Spine Care

Dr. Christopher Iobst Joins to Head the New Center for Limb Lengthening and Reconstruction

2016 Nationwide Children's Develops Orthopaedic Quality Improvement and Research Divisions

2016

2017 Gift from Honda Helps Build Center for Gait Analysis and Mobility Enhancement

2019

2020 Ranked #8 by U.S. News & World Report — Fourth Consecutive Year in Top 10

From limb lengthening to hip preservation, from comprehensive spine care to sports medicine and adaptive sports medicine, and from advanced care for musculoskeletal oncology patients to basic science research that moves the field forward, the Department of Orthopaedics has established a designated initiative to solve the most complex programs of the field over the last decade.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 153

Surgical Services

ORTHOPAEDICS The Department of Orthopaedics at Nationwide Children’s Hospital provides diagnosis, evaluation and treatment for all orthopedic conditions and disorders in infants, children and adolescents. Inpatient, outpatient and emergency services are provided to patients with a wide range of developmental, congenital, neuromuscular and posttraumatic problems of the musculoskeletal system, trauma and fractures, scoliosis and other spinal abnormalities.

Faculty members participate in the education of health care professionals at several levels. Residents, medical students and nurses from The Ohio State University Wexner Medical Center, OhioHealth, and 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 extensive educational program.

FACULTY

Craig N. Dimitris, MD Jonathan B. Feibel, MD Robert T. Gorsline, MD James E. Popp, MD Desmond J. Stutzman, DO Corey L. Van Hoff, MD Raymond K. Wurapa, MD

Kevin E. Klingele, MD Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Allan C. Beebe, MD Matthew C. Beran, MD Reid C. Chambers, DO Christopher A. Iobst, MD John R. Kean, MD Jan E. Klamar, MD Julie Balch Samora, MD, PhD, MPH Walter P. Samora III, MD Craig A. Smith, MD Amanda T. Whitaker, MD OSU-AFFILIATE FACULTY Hisham M. Awan, MD Joel L. Mayerson, MD Thomas J. Scharschmidt, MD COMMUNITY-BASED FACULTY

In 2019, the Department of Orthopedics maintained its stature as a top 10 ranked pediatric orthopedic provider, developed surgically innovative techniques and protocols, and flourished within a very active research division. Recruiting efforts were highlighted with the addition of Reid Chambers, DO, and Craig Smith, MD. Dr. Chambers partnered within a very busy spine program and Dr. Smith joined the Center for Limb Lengthening and Reconstruction as well as quickly built a successful hip arthroscopy program within the Center for Hip Preservation.

The Spine Program officially expanded to become the Center for Comprehensive Spine Care (CCSC). Under the direction of Allan Beebe, MD, the CCSC provides team-centered care for patients with spinal deformity, ranging from newborns with congenital anomalies to adults with chronic conditions. Such a comprehensive approach, built with collaboration among many services, including Neurosurgery, Pain Services, and the Honda Center for Gait Analysis and Mobility Enhancement, ensures optimal outcomes for our patients. The CCSC holds an outstanding track record within quality improvement and dual surgeon operative techniques, producing one of the lowest infection rates within the country, as well as very low complication and reoperation rates.

Brent A. Bickel, MD 152 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SELECTED PUBLICATIONS Research efforts were highlighted by two projects being Abousamra O, Deliberato D, Singh S, Klingele KE. Closed vs Open Reduction in recognized at this year’s Pediatric Orthopaedic Society 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. dynamization accelerated bone healing in a large animal Davis RL, Samora WP, Persinger F, Klingele KE. Treatment of Unstable Versus Stable Slipped 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.

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. senior author Kevin Klingele, MD, achieved runner-up as R, Lin JS, Popp JE, Samora JB. Delayed Presentation of Seymour Fractures: best clinical paper. Both projects were enabled by Baruch Samade A Single Institution Experience and Management Recommendations. Hand. 2019 Oct Danino, MD, who completed his year as the department’s 9:1558944719878846. first international exchange research scholar.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:................................................. 437 Observation and Outpatient-in-a-Bed Discharges:.... 527 Total Discharges:....................................................... 959 Average Length of Stay*:............................................ 3.5 Average Daily Census*:.............................................. 4.1 Patient Days*:......................................................... 1,490 Total Surgical Cases:.............................................. 2,640 Inpatient Consults:..................................................... 286 Main Campus Orthopaedic Clinic Visits:............... 14,705

Canal Winchester Orthopaedic Clinic Visits:............... 378 Dublin Orthopaedic Clinic Visits:........................... 10,216 East Broad Orthopaedic Clinic Visits:......................... 788 Hilliard Orthopaedic Clinic Visits:............................... 293 New Albany Orthopaedic Clinic Visits:..................... 1,886 Westerville Orthopaedic Clinic Visits:...................... 8,240 Orthopaedic Oncology Clinic Visits:............................ 590 Total Orthopaedic Clinic Visits:.............................. 37,096 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC ORTHOPEDICS Michael Fisher, DO

A Decade of Remarkable Transformation

ORTHOPAEDICS

Kevin Klingele, MD, Named Chief of Orthopaedics

2010

2013

Nationwide Children's Launches Both the Center for Hip Preservation and the Center for Comprehensive Spine Care

Dr. Christopher Iobst Joins to Head the New Center for Limb Lengthening and Reconstruction

2016 Nationwide Children's Develops Orthopaedic Quality Improvement and Research Divisions

2016

2017 Gift from Honda Helps Build Center for Gait Analysis and Mobility Enhancement

2019

2020 Ranked #8 by U.S. News & World Report — Fourth Consecutive Year in Top 10

From limb lengthening to hip preservation, from comprehensive spine care to sports medicine and adaptive sports medicine, and from advanced care for musculoskeletal oncology patients to basic science research that moves the field forward, the Department of Orthopaedics has established a designated initiative to solve the most complex programs of the field over the last decade.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 153

Surgical Services

OTOLARYNGOLOGY

Blaize A. O’Brien, MD

The Department of Pediatric Otolaryngology, Head and Neck Surgery at Nationwide Children’s Hospital provides comprehensive diagnosis and treatment for children who have diseases of the ears, nose and throat.

These problems include congenital and acquired diseases of the head and neck, hearing loss, ear infections, tonsillitis, sinusitis, acute and chronic nasal problems, airway disorders, voice disorders, sleep apnea, skull base tumors, salivary gland problems and many other related diseases.

David M. Powell, MD

FACULTY

Brandon Kim, MD Leslie R. Kim, MD, MPH Jameson K. Mattingly, MD Aaron C. Moberly, MD Matthew O. Old, MD Bradley A. Otto, MD Robert S. Pema, DO Minka L. Schofield, MD

Charles A. Elmaraghy, MD, FAAP, FACS Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Oliver F. Adunka, MD, FACS Ethan Bassett, MD Tendy Chiang, MD Jonathan M. Grischkan, MD, FAAP, FACS Kris R. Jatana, MD, FAAP, FACS Spencer Lindsey, MD Prashant S. Malhotra, MD, FAAP, FACS Meredith Merz-Lind, MD, FAAP, FACS James M. Ruda, MD Patrick C. Walz, MD Gregory J. Wiet, MD, FAAP, FACS OSU-AFFILIATE FACULTY Amit Agrawal, MD Eugene Ge-Hink Chio, MD Brad W. deSilva, MD Edward E. Dodson, MD Garth F. Essig Jr., MD L. Arick Forrest, MD

COMMUNITY-BASED FACULTY Patrick L. Bockenstedt, MD Jacob P. Burkhart, DO Roberto J. Castellon, MD Daniel W. Chase, MD

rate has decreased, as has our rate of hemorrhage. In addition, we continue to reduce our use of opioids following surgery. Otolaryngology has been the surgical leader with reduction of new prescriptions for narcotics.

Cherie Ryoo, MD John M. Ryzenman, MD Ashish Shah, MD Thomas M. Shirck, DO

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Stephen P. Smith Jr., MD

$313,165

Adam C. Spiess, MD

SELECTED PUBLICATIONS

Evan J. Tobin, MD

Dharmadhikari S, Liu L, Shontz K, Wiet M, White A, Goins A, Akula H, Johnson J, Reynolds SD, Breuer CK, Chiang T. Deconstructing Tissue Engineered Trachea: Assessing the Role of Synthetic Scaffolds, Segmental Replacement and Cell Seeding on Graft Performance. Acta Biomaterialia. 2020 Jan 15;102:181-191.

Andrew Tompkins, MD Darryl N. Willett, MD The department continues its clinical growth of services with over 32,000 clinic visits and over 9,000 surgical procedures. The department has grown both clinically and academically. New clinical programs include our same-day ear tube surgery pilot program that allows for a single visit for evaluation and surgery. We have published over 50 original research manuscripts in peer-reviewed journals and numerous other national presentations. We have developed a new protocol based on an initiative to reduce post-operative complications following tonsillectomy. As a result, our readmission

Essig GF Jr, Sheehan CC, Niermeyer WL, Lopez JJ, Elmaraghy CA. Treatment of Facial Dog Bite Injuries in the Emergency Department Compared to the Operating Room.

OTO Open. 2019 Jul 11;3(3):2473974X19858328.

King A, Elmaraghy C, Lind M, Tobias JD. A Review of Dexamethasone as an Adjunct to Adenotonsillectomy in the Pediatric Population. The Journal of Anesthesia. 2020 Jun;34(3):445-452.

Martyn L, Sethia R, Chon R, Novotny L, Goodman SD, Elmaraghy C, Bakaletz LO. Antibodies Against the DNABII Protein Integration Host Factor (IHF) Inhibit Sinus Implant Biofilms. Laryngoscope. 2020 Jun;130(6):1364-1371.

Subinoy Das, MD Timothy P. Drankwalter, DO

FAST FACTS

Alexander A. Farag, MD Alfred J. Fleming Jr., MD Akash Gupta, MD Joseph E. Hall, MD Jeffrey B. Hiltbrand, MD

July 2019 through June 2020 Inpatient Discharges:....................................................... 56

Lima ENT Clinic Visits:..................................................... 95

Observation and Outpatient-in-a-Bed-Discharges:..... 1,866

Mansfield ENT Clinic Visits:............................................ 377

Total Discharges:........................................................ 2,607

Marysville ENT Clinic Visits:........................................... 448

Average Length of Stay*:................................................ 3.8

Pediatric Aerodigestive Disorders Clinic Visits:................. 68

Steven M. Hirsch, MD

Average Daily Census*:.................................................. 0.8

Rhinology Clinic Vists:...................................................... 51

Clifton R. Hood, DO

Patient Days*:................................................................ 275

Springfield ENT Clinic Visits:.......................................... 300

Richard T. Irene, MD

Total Surgical Cases:.................................................. 9,457

Westerville ENT Clinic Visits:....................................... 7,954

Scott T. Kramer, MD

Inpatient Consults:......................................................... 792

Total ENT Clinic Visits:.............................................. 35,792

Michael J. Loochtan, MD

Dublin ENT Clinic Visits:.............................................. 8,198

*Excludes observation and outpatient-in-a-bed patients.

James D. Lowery, MD

ENT (Main Campus) Clinic Visits:.............................. 14,852

Michael D. Martyn, MD Douglas D. Massick, MD Timothy J. Nash, DO Stephen J. Nogan, MD

154 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC OTOLARYNGOLOGY Erin Hamersly, DO Gustavo Rangel, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 155

Surgical Services

OTOLARYNGOLOGY

Blaize A. O’Brien, MD

The Department of Pediatric Otolaryngology, Head and Neck Surgery at Nationwide Children’s Hospital provides comprehensive diagnosis and treatment for children who have diseases of the ears, nose and throat.

These problems include congenital and acquired diseases of the head and neck, hearing loss, ear infections, tonsillitis, sinusitis, acute and chronic nasal problems, airway disorders, voice disorders, sleep apnea, skull base tumors, salivary gland problems and many other related diseases.

David M. Powell, MD

FACULTY

Brandon Kim, MD Leslie R. Kim, MD, MPH Jameson K. Mattingly, MD Aaron C. Moberly, MD Matthew O. Old, MD Bradley A. Otto, MD Robert S. Pema, DO Minka L. Schofield, MD

Charles A. Elmaraghy, MD, FAAP, FACS Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Oliver F. Adunka, MD, FACS Ethan Bassett, MD Tendy Chiang, MD Jonathan M. Grischkan, MD, FAAP, FACS Kris R. Jatana, MD, FAAP, FACS Spencer Lindsey, MD Prashant S. Malhotra, MD, FAAP, FACS Meredith Merz-Lind, MD, FAAP, FACS James M. Ruda, MD Patrick C. Walz, MD Gregory J. Wiet, MD, FAAP, FACS OSU-AFFILIATE FACULTY Amit Agrawal, MD Eugene Ge-Hink Chio, MD Brad W. deSilva, MD Edward E. Dodson, MD Garth F. Essig Jr., MD L. Arick Forrest, MD

COMMUNITY-BASED FACULTY Patrick L. Bockenstedt, MD Jacob P. Burkhart, DO Roberto J. Castellon, MD Daniel W. Chase, MD

rate has decreased, as has our rate of hemorrhage. In addition, we continue to reduce our use of opioids following surgery. Otolaryngology has been the surgical leader with reduction of new prescriptions for narcotics.

Cherie Ryoo, MD John M. Ryzenman, MD Ashish Shah, MD Thomas M. Shirck, DO

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020

Stephen P. Smith Jr., MD

$313,165

Adam C. Spiess, MD

SELECTED PUBLICATIONS

Evan J. Tobin, MD

Dharmadhikari S, Liu L, Shontz K, Wiet M, White A, Goins A, Akula H, Johnson J, Reynolds SD, Breuer CK, Chiang T. Deconstructing Tissue Engineered Trachea: Assessing the Role of Synthetic Scaffolds, Segmental Replacement and Cell Seeding on Graft Performance. Acta Biomaterialia. 2020 Jan 15;102:181-191.

Andrew Tompkins, MD Darryl N. Willett, MD The department continues its clinical growth of services with over 32,000 clinic visits and over 9,000 surgical procedures. The department has grown both clinically and academically. New clinical programs include our same-day ear tube surgery pilot program that allows for a single visit for evaluation and surgery. We have published over 50 original research manuscripts in peer-reviewed journals and numerous other national presentations. We have developed a new protocol based on an initiative to reduce post-operative complications following tonsillectomy. As a result, our readmission

Essig GF Jr, Sheehan CC, Niermeyer WL, Lopez JJ, Elmaraghy CA. Treatment of Facial Dog Bite Injuries in the Emergency Department Compared to the Operating Room.

OTO Open. 2019 Jul 11;3(3):2473974X19858328.

King A, Elmaraghy C, Lind M, Tobias JD. A Review of Dexamethasone as an Adjunct to Adenotonsillectomy in the Pediatric Population. The Journal of Anesthesia. 2020 Jun;34(3):445-452.

Martyn L, Sethia R, Chon R, Novotny L, Goodman SD, Elmaraghy C, Bakaletz LO. Antibodies Against the DNABII Protein Integration Host Factor (IHF) Inhibit Sinus Implant Biofilms. Laryngoscope. 2020 Jun;130(6):1364-1371.

Subinoy Das, MD Timothy P. Drankwalter, DO

FAST FACTS

Alexander A. Farag, MD Alfred J. Fleming Jr., MD Akash Gupta, MD Joseph E. Hall, MD Jeffrey B. Hiltbrand, MD

July 2019 through June 2020 Inpatient Discharges:....................................................... 56

Lima ENT Clinic Visits:..................................................... 95

Observation and Outpatient-in-a-Bed-Discharges:..... 1,866

Mansfield ENT Clinic Visits:............................................ 377

Total Discharges:........................................................ 2,607

Marysville ENT Clinic Visits:........................................... 448

Average Length of Stay*:................................................ 3.8

Pediatric Aerodigestive Disorders Clinic Visits:................. 68

Steven M. Hirsch, MD

Average Daily Census*:.................................................. 0.8

Rhinology Clinic Vists:...................................................... 51

Clifton R. Hood, DO

Patient Days*:................................................................ 275

Springfield ENT Clinic Visits:.......................................... 300

Richard T. Irene, MD

Total Surgical Cases:.................................................. 9,457

Westerville ENT Clinic Visits:....................................... 7,954

Scott T. Kramer, MD

Inpatient Consults:......................................................... 792

Total ENT Clinic Visits:.............................................. 35,792

Michael J. Loochtan, MD

Dublin ENT Clinic Visits:.............................................. 8,198

*Excludes observation and outpatient-in-a-bed patients.

James D. Lowery, MD

ENT (Main Campus) Clinic Visits:.............................. 14,852

Michael D. Martyn, MD Douglas D. Massick, MD Timothy J. Nash, DO Stephen J. Nogan, MD

154 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC OTOLARYNGOLOGY Erin Hamersly, DO Gustavo Rangel, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 155

Surgical Services

PEDIATRIC AND ADOLESCENT GYNECOLOGY 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 adulthood. These services are provided within a wide array of clinical services including: • Pediatric and Adolescent Gynecology

• Fertility and Reproductive Health Program

• Center for Colorectal and Pelvic Reconstruction

• Teen and Pregnant Program

• Endometriosis and Chronic Pain Program • Family AIDS Clinic and Education Services (FACES) FACULTY

• THRIVE Program (differences of sexual development and complex urological and gender concerns)

Stephen F. Thung, MD, MSCI Courtney Ware, MD Pediatric and Adolescent Gynecology at Nationwide Children’s continues to grow in all aspects of medical services provided: ambulatory and telehealth visits, in-patient consultations and surgical procedures performed. The geographic region we serve continues to expand as well.

Pediatric and Adolescent Gynecology Geri D. Hewitt, MD Dana Lenobel, APN Kate A. McCracken, MD Teen and Pregnant Program Kara Malone, MD Lesley Manson, WHNP-BC Natasha Reno, WHNP Family AIDS Clinic and Education Services Maggie Rosen, MD Maternal-Fetal Medicine Staff Michael P. Cackovic, MD Maged Costantine, MD Heather Frey, MD Mark Landon, MD Kara Rood, MD Philip Samuels, MD

SELECTED PUBLICATIONS Hewitt GD. Dysmenorrhea and Endometriosis: Diagnosis and Management in Adolescents. Clinical Obstetrics and Gynecology. 2020 Sep;63(3): 536-543.

Hewitt GD, Yoost, J. ACOG Committee Opinion No. 806: Gynecologic Management of Young Women and Adolescents with Seizure Disorders. Obstetrics & Gynecology. 2020 May;135(5):1242-3.

O’Brien SH, Stanek JR, Kaur D, McCracken K, Vesely SK. Laboratory monitoring during pregnancy and post-partum hemorrhage in women with VonWillebrand disease.

Journal of Thrombosis and Haemostasis. 2019 Dec 5.

FAST FACTS Patrick Schneider, MD Cynthia S. Shellhaas, MD

Geri D. Hewitt, MD Chief

multidisciplinary care in both traditional and centering obstetrical care models.

Gynecology continues to work collaboratively within CCPR to address the reproductive health needs of females born with anorectal malformations across their lifespan. This work encompasses direct surgical and medical patient care, research projects and educational initiatives. We also work collaboratively with the ARM transitional program at OSUMC.

July 2019 through June 2020 Downtown Teen and Pregnant Clinic Visits:................ 1,282 Dublin Pediatric and Adolescent Gynecology Clinic Visits:.............................. 625 Linden Teen and Pregnant Clinic Visits:......................... 283 Main Campus Pediatric and Adolescent Gynecology Clinic Visits:........................... 2,542 Westerville Pediatric and Adolescent Gynecology Clinic Visits:.............................. 765 Total Pediatric and Adolescent Gynecology Clinic Visits:........................... 5,497 Total Surgical Procedures:............................................. 352

The Endometriosis and Chronic Pelvic Pain program provides streamlined, comprehensive care for patients with chronic pelvic pain. The multidisciplinary collaboration includes providers from numerous disciplines across the medical center working together to enhance quality of life and reproductive outcomes for these patients.

The Fertility and Reproductive Health Program provides clinical services and best practices for patients at risk of diminished fertility. Nationwide Children’s is part of the international Oncofertility Consortium, and we continue to offer ovarian tissue cryopreservation and cancer survivorship care.

The Teen and Pregnant Program clinic continues to serve pregnant patients in central Ohio offering

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

Surgical Services

PEDIATRIC AND ADOLESCENT GYNECOLOGY 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 adulthood. These services are provided within a wide array of clinical services including: • Pediatric and Adolescent Gynecology

• Fertility and Reproductive Health Program

• Center for Colorectal and Pelvic Reconstruction

• Teen and Pregnant Program

• Endometriosis and Chronic Pain Program • Family AIDS Clinic and Education Services (FACES) FACULTY

• THRIVE Program (differences of sexual development and complex urological and gender concerns)

Stephen F. Thung, MD, MSCI Courtney Ware, MD Pediatric and Adolescent Gynecology at Nationwide Children’s continues to grow in all aspects of medical services provided: ambulatory and telehealth visits, in-patient consultations and surgical procedures performed. The geographic region we serve continues to expand as well.

Pediatric and Adolescent Gynecology Geri D. Hewitt, MD Dana Lenobel, APN Kate A. McCracken, MD Teen and Pregnant Program Kara Malone, MD Lesley Manson, WHNP-BC Natasha Reno, WHNP Family AIDS Clinic and Education Services Maggie Rosen, MD Maternal-Fetal Medicine Staff Michael P. Cackovic, MD Maged Costantine, MD Heather Frey, MD Mark Landon, MD Kara Rood, MD Philip Samuels, MD

SELECTED PUBLICATIONS Hewitt GD. Dysmenorrhea and Endometriosis: Diagnosis and Management in Adolescents. Clinical Obstetrics and Gynecology. 2020 Sep;63(3): 536-543.

Hewitt GD, Yoost, J. ACOG Committee Opinion No. 806: Gynecologic Management of Young Women and Adolescents with Seizure Disorders. Obstetrics & Gynecology. 2020 May;135(5):1242-3.

O’Brien SH, Stanek JR, Kaur D, McCracken K, Vesely SK. Laboratory monitoring during pregnancy and post-partum hemorrhage in women with VonWillebrand disease.

Journal of Thrombosis and Haemostasis. 2019 Dec 5.

FAST FACTS Patrick Schneider, MD Cynthia S. Shellhaas, MD

Geri D. Hewitt, MD Chief

multidisciplinary care in both traditional and centering obstetrical care models.

Gynecology continues to work collaboratively within CCPR to address the reproductive health needs of females born with anorectal malformations across their lifespan. This work encompasses direct surgical and medical patient care, research projects and educational initiatives. We also work collaboratively with the ARM transitional program at OSUMC.

July 2019 through June 2020 Downtown Teen and Pregnant Clinic Visits:................ 1,282 Dublin Pediatric and Adolescent Gynecology Clinic Visits:.............................. 625 Linden Teen and Pregnant Clinic Visits:......................... 283 Main Campus Pediatric and Adolescent Gynecology Clinic Visits:........................... 2,542 Westerville Pediatric and Adolescent Gynecology Clinic Visits:.............................. 765 Total Pediatric and Adolescent Gynecology Clinic Visits:........................... 5,497 Total Surgical Procedures:............................................. 352

The Endometriosis and Chronic Pelvic Pain program provides streamlined, comprehensive care for patients with chronic pelvic pain. The multidisciplinary collaboration includes providers from numerous disciplines across the medical center working together to enhance quality of life and reproductive outcomes for these patients.

The Fertility and Reproductive Health Program provides clinical services and best practices for patients at risk of diminished fertility. Nationwide Children’s is part of the international Oncofertility Consortium, and we continue to offer ovarian tissue cryopreservation and cancer survivorship care.

The Teen and Pregnant Program clinic continues to serve pregnant patients in central Ohio offering

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.

“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.”

– Katherine Deans, MD

158 | | NATIONWIDE NATIONWIDECHILDREN’S CHILDREN’SHOSPITAL HOSPITAL | | 2019-20 2019-20Annual AnnualReport Report | | NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report 158

“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 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.”

REFERENCES: 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 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].

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 159

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.

“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.”

– Katherine Deans, MD

158 | | NATIONWIDE NATIONWIDECHILDREN’S CHILDREN’SHOSPITAL HOSPITAL | | 2019-20 2019-20Annual AnnualReport Report | | NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report 158

“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 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.”

REFERENCES: 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 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].

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 159

Surgical Services

PEDIATRIC SURGERY The mission of the Department of Pediatric Surgery at Nationwide Children’s Hospital is to provide collaborative, comprehensive and multidisciplinary care for infants, children and adolescents with surgical disorders. The members of the department are all full-time faculty of the Department of Surgery at The Ohio State University College of Medicine and are committed to excellence in clinical care, surgical education and research.

FACULTY

Kristine Orion, MD Amer Rajab, MD, PhD Timur Sarac, MD Jean E. Starr, MD Patrick S. Vaccaro, MD William K. Washburn, MD

Gail E. Besner, MD Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Jennifer H. Aldrink, MD Christopher K. Breuer, MD David R. Brigstock, PhD Katherine J. Deans, MD, MHSc Karen A. Diefenbach, MD Renata B. Fabia, MD, PhD Jonathan I. Groner, MD Ihab Halaweish, MD Brian D. Kenney, MD, MPH Marc P. Michalsky, MD, MBA Peter C. Minneci, MD, MHSc Benedict C. Nwomeh, MD, MPH Oluyinka O. Olutoye, MD, PhD Surgeon-in-Chief Rajan K. Thakkar, MD Richard J. Wood, MD OSU-AFFILIATE FACULTY Michael R. Go, MD Mounir J. Haurani, MD

The Department of Pediatric Surgery is one of the largest and most diverse departments of its kind. The department maintains active clinical programs focused on general pediatric surgery, minimally invasive surgery, robotic surgery, surgical oncology, surgical endocrinology, trauma, burns, chest wall deformities, bariatric surgery, inflammatory bowel disease, hepatobiliary surgery, neuromodulation and pediatric colorectal surgery. The Trauma Program has been verified by the American College of Surgeons as a Level 1 Trauma Program since 1991, and the Burn Program has been verified by the American Burn Association as a verified Burn Center since 2003.

Each of the 16 faculty members in the department bring individual strengths and talents to the department, and are recognized for their expertise in clinical care, research and education. One of the most important aspects of the program is the opportunity to train the next generation of pediatric surgeons through our highly desirable training programs in pediatric surgery, as well as several additional specialty training programs. Several faculty members received awards this year for their excellent clinical care and educational expertise, including the Art of Medicine Award received by Jennifer H. Aldrink, MD; the Physician of the Year Award received by Benedict C. Nwomeh, MD, MPH; the Golden Apple Teaching Award received by Dr. Aldrink; and the Denis R. King Teacher of the Year Award received by Rajan K. Thakkar, MD. In addition, Gail E. Besner, MD, was inducted into the OSU Mazzaferri-Ellison Society of Master Clinicians. Seven faculty members were listed as Castle Connolly 2020 Top Doctors.

Bradley J. Needleman, MD

160 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The department continues to have one of the busiest robotic surgery programs of any children’s hospital in the United States. This year the hospital acquired a new, state-of-the-art Da Vinci Xi Robot, which will allow us to perform more diverse, complex operations on even smaller children. Our original robot will be housed in the new Nationwide Children’s Hospital Conference and Simulation Center, and will be a wonderful addition to the numerous simulation and training opportunities available for faculty, staff and visitors. In addition, laparoscopic training simulation devices have been produced in our department and represent unique training tools for surgeons.

The Burn Program at Nationwide Children’s uses stateof-the-art techniques to accelerate burn wound healing and reduce pain. One of the newest techniques being used is using Re-cell, a technique that uses a small sample of the patient's own skin to produce spray-on skin cells that cover an area 30 times larger than previous methods and improves pigmentation. Other new products being used include the skin substrate biodegradable transient matrix (BTM), which promotes the formation of granulation tissue over very deep burn wounds, and Suprathel, an absorbable microporous membrane that decreases pain in the treatment of burns and donor sites. Use of a new smart phone virtual reality game is used as a distraction technique to reduce pain during dressing changes.

The research conducted in the department is broad and encompasses a range of basic, clinical, translational and outcomes research projects. The department continues as a leader in the nation in presentations at national academic meetings. For the ninth year in a row, our research trainees have received prestigious national awards for their highquality research, bringing our total number of research awards to an unprecedented 35 in the past nine years.

Faculty members in the department are highly prolific, publishing 150 to 200 papers a year.

Ihab Halaweish, MD, joined the department in 2019.

He obtained his medical degree from Case Western Reserve University, did his General Surgery and Trauma Translational and Clinical Research training at the University of Michigan, and did his Fellowship in Pediatric Surgery at Texas Children’s Hospital. His clinical interests focus on colorectal surgery and general pediatric surgery.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $3,294,715

SELECTED PUBLICATIONS 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 Dec;144(6):e20193224.

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, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Matsuzaki Y, Breuer J, Heuer 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 of Stenosis in TissueEngineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537):eaax6919.

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 A Role in Global Burn Relief. Burns. 2020 Jun;46(4):804-816.

Lawrence AE, Gonzalez DO, Fallat ME, Aldrink JH, Hewitt GD, Hertweck SP, Onwuka A, 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, Deans KJ. Factors Associated with Management of Pediatric Ovarian Neoplasms. Pediatrics. 2019 Jul;144(1):e20182537.

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. 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.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:.................................................. 1,274 Observation and Outpatient-in-a-Bed Discharges:........ 909 Total Discharges:........................................................ 2,629 Average Length of Stay*:................................................... 5 Average Daily Census*:................................................... 23 Patient Days*:............................................................. 8,504 Total Surgical Procedures:.......................................... 4,616 Inpatient Consults:......................................................... 981 Colorectal Clinic Visits:................................................ 2,274 Dublin Surgery Clinic Visits:........................................... 251 Mansfield Surgery Clinic Visits:........................................ 40 Surgery/Burn Clinic Visits:.......................................... 6,155 Westerville Surgery Clinic Visits:.................................... 363 Total Surgery Clinic Visits:........................................... 9,083 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC MINIMALLY INVASIVE SURGERY Maria Carmen Mora, MD PEDIATRIC SURGERY Dani Gonzalez, MD Afif Kulaylat, MD SURGICAL CRITICAL CARE Kate Savoie, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 161

Surgical Services

PEDIATRIC SURGERY The mission of the Department of Pediatric Surgery at Nationwide Children’s Hospital is to provide collaborative, comprehensive and multidisciplinary care for infants, children and adolescents with surgical disorders. The members of the department are all full-time faculty of the Department of Surgery at The Ohio State University College of Medicine and are committed to excellence in clinical care, surgical education and research.

FACULTY

Kristine Orion, MD Amer Rajab, MD, PhD Timur Sarac, MD Jean E. Starr, MD Patrick S. Vaccaro, MD William K. Washburn, MD

Gail E. Besner, MD Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Jennifer H. Aldrink, MD Christopher K. Breuer, MD David R. Brigstock, PhD Katherine J. Deans, MD, MHSc Karen A. Diefenbach, MD Renata B. Fabia, MD, PhD Jonathan I. Groner, MD Ihab Halaweish, MD Brian D. Kenney, MD, MPH Marc P. Michalsky, MD, MBA Peter C. Minneci, MD, MHSc Benedict C. Nwomeh, MD, MPH Oluyinka O. Olutoye, MD, PhD Surgeon-in-Chief Rajan K. Thakkar, MD Richard J. Wood, MD OSU-AFFILIATE FACULTY Michael R. Go, MD Mounir J. Haurani, MD

The Department of Pediatric Surgery is one of the largest and most diverse departments of its kind. The department maintains active clinical programs focused on general pediatric surgery, minimally invasive surgery, robotic surgery, surgical oncology, surgical endocrinology, trauma, burns, chest wall deformities, bariatric surgery, inflammatory bowel disease, hepatobiliary surgery, neuromodulation and pediatric colorectal surgery. The Trauma Program has been verified by the American College of Surgeons as a Level 1 Trauma Program since 1991, and the Burn Program has been verified by the American Burn Association as a verified Burn Center since 2003.

Each of the 16 faculty members in the department bring individual strengths and talents to the department, and are recognized for their expertise in clinical care, research and education. One of the most important aspects of the program is the opportunity to train the next generation of pediatric surgeons through our highly desirable training programs in pediatric surgery, as well as several additional specialty training programs. Several faculty members received awards this year for their excellent clinical care and educational expertise, including the Art of Medicine Award received by Jennifer H. Aldrink, MD; the Physician of the Year Award received by Benedict C. Nwomeh, MD, MPH; the Golden Apple Teaching Award received by Dr. Aldrink; and the Denis R. King Teacher of the Year Award received by Rajan K. Thakkar, MD. In addition, Gail E. Besner, MD, was inducted into the OSU Mazzaferri-Ellison Society of Master Clinicians. Seven faculty members were listed as Castle Connolly 2020 Top Doctors.

Bradley J. Needleman, MD

160 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

The department continues to have one of the busiest robotic surgery programs of any children’s hospital in the United States. This year the hospital acquired a new, state-of-the-art Da Vinci Xi Robot, which will allow us to perform more diverse, complex operations on even smaller children. Our original robot will be housed in the new Nationwide Children’s Hospital Conference and Simulation Center, and will be a wonderful addition to the numerous simulation and training opportunities available for faculty, staff and visitors. In addition, laparoscopic training simulation devices have been produced in our department and represent unique training tools for surgeons.

The Burn Program at Nationwide Children’s uses stateof-the-art techniques to accelerate burn wound healing and reduce pain. One of the newest techniques being used is using Re-cell, a technique that uses a small sample of the patient's own skin to produce spray-on skin cells that cover an area 30 times larger than previous methods and improves pigmentation. Other new products being used include the skin substrate biodegradable transient matrix (BTM), which promotes the formation of granulation tissue over very deep burn wounds, and Suprathel, an absorbable microporous membrane that decreases pain in the treatment of burns and donor sites. Use of a new smart phone virtual reality game is used as a distraction technique to reduce pain during dressing changes.

The research conducted in the department is broad and encompasses a range of basic, clinical, translational and outcomes research projects. The department continues as a leader in the nation in presentations at national academic meetings. For the ninth year in a row, our research trainees have received prestigious national awards for their highquality research, bringing our total number of research awards to an unprecedented 35 in the past nine years.

Faculty members in the department are highly prolific, publishing 150 to 200 papers a year.

Ihab Halaweish, MD, joined the department in 2019.

He obtained his medical degree from Case Western Reserve University, did his General Surgery and Trauma Translational and Clinical Research training at the University of Michigan, and did his Fellowship in Pediatric Surgery at Texas Children’s Hospital. His clinical interests focus on colorectal surgery and general pediatric surgery.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $3,294,715

SELECTED PUBLICATIONS 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 Dec;144(6):e20193224.

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, Cheatham SL, King N, Reinhardt JW, Sugiura T, Miyachi H, Matsuzaki Y, Breuer J, Heuer 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 of Stenosis in TissueEngineered Vascular Grafts. Science Translational Medicine. 2020 Apr 1;12(537):eaax6919.

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 A Role in Global Burn Relief. Burns. 2020 Jun;46(4):804-816.

Lawrence AE, Gonzalez DO, Fallat ME, Aldrink JH, Hewitt GD, Hertweck SP, Onwuka A, 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, Deans KJ. Factors Associated with Management of Pediatric Ovarian Neoplasms. Pediatrics. 2019 Jul;144(1):e20182537.

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. 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.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:.................................................. 1,274 Observation and Outpatient-in-a-Bed Discharges:........ 909 Total Discharges:........................................................ 2,629 Average Length of Stay*:................................................... 5 Average Daily Census*:................................................... 23 Patient Days*:............................................................. 8,504 Total Surgical Procedures:.......................................... 4,616 Inpatient Consults:......................................................... 981 Colorectal Clinic Visits:................................................ 2,274 Dublin Surgery Clinic Visits:........................................... 251 Mansfield Surgery Clinic Visits:........................................ 40 Surgery/Burn Clinic Visits:.......................................... 6,155 Westerville Surgery Clinic Visits:.................................... 363 Total Surgery Clinic Visits:........................................... 9,083 *Excludes observation and outpatient-in-a-bed patients.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC MINIMALLY INVASIVE SURGERY Maria Carmen Mora, MD PEDIATRIC SURGERY Dani Gonzalez, MD Afif Kulaylat, MD SURGICAL CRITICAL CARE Kate Savoie, MD

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 161

Surgical Services

PLASTIC AND RECONSTRUCTIVE SURGERY

SELECTED PUBLICATIONS

The Department of Plastic and Reconstructive Surgery at Nationwide Children’s Hospital provides comprehensive, interdisciplinary management of cleft lip and palate, congenital and traumatic craniofacial anomalies, 22q deletion syndrome, velopharyngeal dysfunction, hemangiomas and vascular anomalies, pigmented birthmarks, burn injuries, microtia and other ear anomalies, breast abnormalities, and congenital and traumatic hand and upper extremity anomalies and peripheral nerve disorders.

Haenssler AE, Baylis A, Perry JL, Kollara L, Fang X, Kirschner R. Impact of Cranial Base Abnormalities on Cerebellar Volume and the Velopharynx in 22q11. 2 Deletion Syndrome.

The Cleft Palate-Craniofacial Journal. 2020; 57(4), 412-419.

PEDIATRIC PLASTIC AND CRANIOFACIAL SURGERY Chinwe Kpaduwa, MD

Madhoun LL, Crerand CE, Keim S, Baylis AL. Breast Milk Feeding Practices and Barriers and Supports Experienced by Mother–Infant Dyads with Cleft Lip and/or Palate. The Cleft Palate-Craniofacial Journal. 2020;57(4), 477-486.

CRANIOFACIAL SPEECH Brittany Bilitzo, MA, CCC-SLP

FACULTY

Richard E. Kirschner, MD, FAAP, FACS Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Adriane Baylis, PhD, CCC-SLP Kim Bjorklund, MD Ibrahim Khansa, MD Lauren Madhoun, PhD Ana Mercado, DMD, PhD Kara Morris, DDS, MS Gregory D. Pearson, MD OSU-AFFILIATE FACULTY Albert Chao, MD Matthew Chetta, MD Jeffrey E. Janis, MD Clara N. Lee, MD Amy Moore, MD Stephen J. Poteet, MD Ryan Schmucker, MD Steven Schulz, MD Geoffrey Sisk, MD Roman Skoracki, MD

The Department of Plastic and Reconstructive Surgery takes the leading role in several interdisciplinary teams at Nationwide Children’s to provide comprehensive care for the restoration of both form and function. The department offers advanced fellowship training in both pediatric plastic/craniofacial surgery and craniofacial speech science. Both the Cleft Lip and Palate Center and the Center for Complex Craniofacial Disorders once again received national recognition as leading American Cleft Palate-Craniofacial Association (ACPA)-approved programs. The 22q Center continued to fulfill its mission to provide comprehensive, coordinated services to patients and families from across the nation.

In 2020, Lauren Madhoun, PhD, CCC-SLP, BCS-S, was recruited to lead the Craniofacial Infant Feeding Program and was appointed as assistant professor of Plastic Surgery at The Ohio State University. This unique program serves the Cleft Lip and Palate Center and the Center for Complex Craniofacial Disorders, providing feeding and dietary support to infants with cleft palate and other craniofacial differences.

Crerand CE, Da Silveira AC, Kapa H, Litteral J, Markey MK, Mercado A, Scott M. Adherence to Orthodontic Treatment in Youth with Cleft Lip and/or Palate. The Cleft PalateCraniofacial Journal. 2020 Feb;57(2):218-227.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

Perry JL, Kotlarek KJ, Spoloric K, Baylis A, Kollara L, Grischkan JM, Kirschner R, Bates 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 Journal. 2020 Mar;57(3):302-309.

Rangwani S, Baylis A, Khansa I, Pearson G. Outcomes in Velopharyngeal Dysfunction Treatment: Comparing Two Approaches for Pharyngeal Flaps. The Journal of Craniofacial Surgery. 2020 Jun 26.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:....................................................... 59

Ortho Center Plastic Surgery Clinic Visits:........................ 67

Observation and Outpatient-in-Bed Discharges:............ 239

Orthodontics Treatment Program Visits:...................... 2,688

Total Discharges:........................................................... 317

Cleft Lip/Craniofacial Clinic Visits:............................... 2,151

Average Length of Stay*:................................................ 4.3

Hilliard Plastic Surgery Clinic Visits:............................... 284

Average Daily Census*:.................................................. 1.0

Plastic Surgery Clinic Visits:........................................ 3,764

Patient Days*:................................................................ 371

Westerville Plastic Surgery Clinic Visits:......................... 406

Total Surgical Procedures:.......................................... 1,412

East Broad Plastic Surgery Clinic Visits:........................... 66

Inpatient Consults:........................................................... 53

Total Plastic Surgery Clinic Visits:............................... 9,426

*Excludes observation and outpatient-in-a-bed patients.

Dr. Amy Moore, chief of the Department of Plastic Surgery at The Ohio State University Wexner Medical Center, joined the Nationwide Children’s team in 2020.

An expert in pediatric peripheral nerve reconstruction, Dr. Moore has joined Dr. Kim Bjorklund to establish the Brachial Plexus and Peripheral Nerve Program at Nationwide Children’s. In March, Dr. Moore and Dr. Bjorklund performed the first lower extremity nerve transfer surgery for an acute flaccid myelitis patient at Nationwide Children’s, making the hospital one of the only sites in the world performing this surgery.

In March of 2020, the Nationwide Children’s team implemented one of the first and most comprehensive multidisciplinary cleft/craniofacial/22q telehealth team clinics in the nation, providing uninterrupted team care during the COVID-19 pandemic to patients with cleft lip or palate and other craniofacial differences, as well as those with 22q deletion syndrome, from across the United States.

162 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 163

Surgical Services

PLASTIC AND RECONSTRUCTIVE SURGERY

SELECTED PUBLICATIONS

The Department of Plastic and Reconstructive Surgery at Nationwide Children’s Hospital provides comprehensive, interdisciplinary management of cleft lip and palate, congenital and traumatic craniofacial anomalies, 22q deletion syndrome, velopharyngeal dysfunction, hemangiomas and vascular anomalies, pigmented birthmarks, burn injuries, microtia and other ear anomalies, breast abnormalities, and congenital and traumatic hand and upper extremity anomalies and peripheral nerve disorders.

Haenssler AE, Baylis A, Perry JL, Kollara L, Fang X, Kirschner R. Impact of Cranial Base Abnormalities on Cerebellar Volume and the Velopharynx in 22q11. 2 Deletion Syndrome.

The Cleft Palate-Craniofacial Journal. 2020; 57(4), 412-419.

PEDIATRIC PLASTIC AND CRANIOFACIAL SURGERY Chinwe Kpaduwa, MD

Madhoun LL, Crerand CE, Keim S, Baylis AL. Breast Milk Feeding Practices and Barriers and Supports Experienced by Mother–Infant Dyads with Cleft Lip and/or Palate. The Cleft Palate-Craniofacial Journal. 2020;57(4), 477-486.

CRANIOFACIAL SPEECH Brittany Bilitzo, MA, CCC-SLP

FACULTY

Richard E. Kirschner, MD, FAAP, FACS Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Adriane Baylis, PhD, CCC-SLP Kim Bjorklund, MD Ibrahim Khansa, MD Lauren Madhoun, PhD Ana Mercado, DMD, PhD Kara Morris, DDS, MS Gregory D. Pearson, MD OSU-AFFILIATE FACULTY Albert Chao, MD Matthew Chetta, MD Jeffrey E. Janis, MD Clara N. Lee, MD Amy Moore, MD Stephen J. Poteet, MD Ryan Schmucker, MD Steven Schulz, MD Geoffrey Sisk, MD Roman Skoracki, MD

The Department of Plastic and Reconstructive Surgery takes the leading role in several interdisciplinary teams at Nationwide Children’s to provide comprehensive care for the restoration of both form and function. The department offers advanced fellowship training in both pediatric plastic/craniofacial surgery and craniofacial speech science. Both the Cleft Lip and Palate Center and the Center for Complex Craniofacial Disorders once again received national recognition as leading American Cleft Palate-Craniofacial Association (ACPA)-approved programs. The 22q Center continued to fulfill its mission to provide comprehensive, coordinated services to patients and families from across the nation.

In 2020, Lauren Madhoun, PhD, CCC-SLP, BCS-S, was recruited to lead the Craniofacial Infant Feeding Program and was appointed as assistant professor of Plastic Surgery at The Ohio State University. This unique program serves the Cleft Lip and Palate Center and the Center for Complex Craniofacial Disorders, providing feeding and dietary support to infants with cleft palate and other craniofacial differences.

Crerand CE, Da Silveira AC, Kapa H, Litteral J, Markey MK, Mercado A, Scott M. Adherence to Orthodontic Treatment in Youth with Cleft Lip and/or Palate. The Cleft PalateCraniofacial Journal. 2020 Feb;57(2):218-227.

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM

Perry JL, Kotlarek KJ, Spoloric K, Baylis A, Kollara L, Grischkan JM, Kirschner R, Bates 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 Journal. 2020 Mar;57(3):302-309.

Rangwani S, Baylis A, Khansa I, Pearson G. Outcomes in Velopharyngeal Dysfunction Treatment: Comparing Two Approaches for Pharyngeal Flaps. The Journal of Craniofacial Surgery. 2020 Jun 26.

FAST FACTS July 2019 through June 2020 Inpatient Discharges:....................................................... 59

Ortho Center Plastic Surgery Clinic Visits:........................ 67

Observation and Outpatient-in-Bed Discharges:............ 239

Orthodontics Treatment Program Visits:...................... 2,688

Total Discharges:........................................................... 317

Cleft Lip/Craniofacial Clinic Visits:............................... 2,151

Average Length of Stay*:................................................ 4.3

Hilliard Plastic Surgery Clinic Visits:............................... 284

Average Daily Census*:.................................................. 1.0

Plastic Surgery Clinic Visits:........................................ 3,764

Patient Days*:................................................................ 371

Westerville Plastic Surgery Clinic Visits:......................... 406

Total Surgical Procedures:.......................................... 1,412

East Broad Plastic Surgery Clinic Visits:........................... 66

Inpatient Consults:........................................................... 53

Total Plastic Surgery Clinic Visits:............................... 9,426

*Excludes observation and outpatient-in-a-bed patients.

Dr. Amy Moore, chief of the Department of Plastic Surgery at The Ohio State University Wexner Medical Center, joined the Nationwide Children’s team in 2020.

An expert in pediatric peripheral nerve reconstruction, Dr. Moore has joined Dr. Kim Bjorklund to establish the Brachial Plexus and Peripheral Nerve Program at Nationwide Children’s. In March, Dr. Moore and Dr. Bjorklund performed the first lower extremity nerve transfer surgery for an acute flaccid myelitis patient at Nationwide Children’s, making the hospital one of the only sites in the world performing this surgery.

In March of 2020, the Nationwide Children’s team implemented one of the first and most comprehensive multidisciplinary cleft/craniofacial/22q telehealth team clinics in the nation, providing uninterrupted team care during the COVID-19 pandemic to patients with cleft lip or palate and other craniofacial differences, as well as those with 22q deletion syndrome, from across the United States.

162 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 163

Surgical Services

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 Chief of Transplant Director of Abdominal Transplant ABDOMINAL TRANSPLANT

Rolla F. Abu-Arja, MD Clinical Director Blood and Marrow Transplant

Jeffery J. Auletta, MD Medical Director Blood and Marrow Transplant

Stephen E. Kirkby, MD Medical Director Lung and Heart-Lung Transplant

Mark E. Galantowicz, Hiren MD P. Patel, MDHiren P. Patel, MD Stephen E. Kirkby,Mark MD E. Galantowicz, MD Surgical Director Clinical Director Surgical Director Medical Director Medical Director Lung and Heart-Lung Transplant Lung and Heart-Lung Transplant Lung and Heart-Lung Transplant Kidney Transplant Kidney Transplant

The Abdominal Transplant Program at Nationwide Children’s offers specialized and comprehensive care to patients with end-stage liver disease due to congenital and acquired hepatic and biliary disorders, and end-stage renal disease due to kidney and urinary tract disorders.

We perform both living- and deceased-donor kidney transplants and deceased-donor liver transplants for infants, children and adolescents. Both the Kidney and Liver Transplant Programs are certified by the United Network for Organ Sharing (UNOS). The Kidney Transplant Program is certified by the Centers for Medicare and Medicaid Services (CMS) and is a member of the Improving Renal Outcomes Collaborative (IROC). The Liver Transplant Program is accepted into the Ohio Solid Organ Transplant Consortium (OSOTC) and is an active member of the Society of Pediatric Liver Transplantation (SPLIT). In addition, the programs partner with The Ohio State University Abdominal Organ Transplant Program to provide the full continuum of care to patients as they age and transition to adult care. In the past year, the Nationwide Children’s Kidney Transplant Program performed six transplant surgeries, three of which were from a living donor. The Nationwide Children’s Liver Transplant Program performed two liver transplants during the period, one of which was a combined liver-kidney transplantation with the kidney transplant team, the first such combination transplant surgery at Nationwide Children’s.

BLOOD AND MARROW TRANSPLANT

Amer Rajab, MD, PhD Surgical Director Kidney Transplant

Patrick McConnell, MD Surgical Director Heart Transplant

164 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Robert J. Gajarski, MD, MHSA Medical Director Heart Transplant

The Blood and Marrow Transplant (BMT) Program uses a family-centered, holistic care model in utilizing hematopoietic cell transplantation (HCT) as the definitive cure for pediatric and adolescent/young adult patients

Alexander Weymann, MD Medical Director Liver Transplant with malignant and nonmalignant disorders. Our team is dedicated to optimizing clinical applications of HCT by reducing transplant-associated morbidity and mortality through novel care and innovative therapies, including immune-directed cellular therapies. The BMT Program is supported by the Foundation for Accreditation of Cellular Therapy (FACT)-accredited Apheresis Program at Nationwide Children’s, which offers extracorporeal photopheresis for patients with graft-versus-host disease, and The James and W.W. Williams Company Cell Therapy Laboratory at The James Cancer Hospital and Solove Research Institute at The Ohio State University, which offers unique forms of hematopoietic cell graft manipulation and processing. Our Cellular Therapy and Cancer Immunotherapy Program (CTCIP) provides logistic support for cell therapy manufacturing and protocol development for novel investigator-initiated cellular therapies. The BMT Program educates the next generation of HCT and cell therapy physicians through its fourth-year Pediatric BMT/Cell Therapy Fellowship Program.

The BMT Program is FACT-accredited and is affiliated with the National Marrow Donor Program (NMDP), the Center for International Blood and Marrow Transplant Research (CIBMTR), the Children’s Oncology Group (COG), the Pediatric Transplant and Cell Therapy Consortium (PTCTC), the Primary Immune Deficiency Treatment Consortium (PIDTC), the Blood and Marrow Transplant Clinical Trials Network (BMT CTN), the Sickle Transplant Alliance for Research (STAR) Consortium, and the New Approaches to Neuroblastoma Therapy (NANT) Consortium. We actively collaborate in cutting-edge research and investigator-initiated clinical trials with The Ohio State University Comprehensive Cancer Center. Autologous and allogeneic hematopoietic cell transplants are performed using all types of stem cell

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 165

Surgical Services

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 Chief of Transplant Director of Abdominal Transplant ABDOMINAL TRANSPLANT

Rolla F. Abu-Arja, MD Clinical Director Blood and Marrow Transplant

Jeffery J. Auletta, MD Medical Director Blood and Marrow Transplant

Stephen E. Kirkby, MD Medical Director Lung and Heart-Lung Transplant

Mark E. Galantowicz, Hiren MD P. Patel, MDHiren P. Patel, MD Stephen E. Kirkby,Mark MD E. Galantowicz, MD Surgical Director Clinical Director Surgical Director Medical Director Medical Director Lung and Heart-Lung Transplant Lung and Heart-Lung Transplant Lung and Heart-Lung Transplant Kidney Transplant Kidney Transplant

The Abdominal Transplant Program at Nationwide Children’s offers specialized and comprehensive care to patients with end-stage liver disease due to congenital and acquired hepatic and biliary disorders, and end-stage renal disease due to kidney and urinary tract disorders.

We perform both living- and deceased-donor kidney transplants and deceased-donor liver transplants for infants, children and adolescents. Both the Kidney and Liver Transplant Programs are certified by the United Network for Organ Sharing (UNOS). The Kidney Transplant Program is certified by the Centers for Medicare and Medicaid Services (CMS) and is a member of the Improving Renal Outcomes Collaborative (IROC). The Liver Transplant Program is accepted into the Ohio Solid Organ Transplant Consortium (OSOTC) and is an active member of the Society of Pediatric Liver Transplantation (SPLIT). In addition, the programs partner with The Ohio State University Abdominal Organ Transplant Program to provide the full continuum of care to patients as they age and transition to adult care. In the past year, the Nationwide Children’s Kidney Transplant Program performed six transplant surgeries, three of which were from a living donor. The Nationwide Children’s Liver Transplant Program performed two liver transplants during the period, one of which was a combined liver-kidney transplantation with the kidney transplant team, the first such combination transplant surgery at Nationwide Children’s.

BLOOD AND MARROW TRANSPLANT

Amer Rajab, MD, PhD Surgical Director Kidney Transplant

Patrick McConnell, MD Surgical Director Heart Transplant

164 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Robert J. Gajarski, MD, MHSA Medical Director Heart Transplant

The Blood and Marrow Transplant (BMT) Program uses a family-centered, holistic care model in utilizing hematopoietic cell transplantation (HCT) as the definitive cure for pediatric and adolescent/young adult patients

Alexander Weymann, MD Medical Director Liver Transplant with malignant and nonmalignant disorders. Our team is dedicated to optimizing clinical applications of HCT by reducing transplant-associated morbidity and mortality through novel care and innovative therapies, including immune-directed cellular therapies. The BMT Program is supported by the Foundation for Accreditation of Cellular Therapy (FACT)-accredited Apheresis Program at Nationwide Children’s, which offers extracorporeal photopheresis for patients with graft-versus-host disease, and The James and W.W. Williams Company Cell Therapy Laboratory at The James Cancer Hospital and Solove Research Institute at The Ohio State University, which offers unique forms of hematopoietic cell graft manipulation and processing. Our Cellular Therapy and Cancer Immunotherapy Program (CTCIP) provides logistic support for cell therapy manufacturing and protocol development for novel investigator-initiated cellular therapies. The BMT Program educates the next generation of HCT and cell therapy physicians through its fourth-year Pediatric BMT/Cell Therapy Fellowship Program.

The BMT Program is FACT-accredited and is affiliated with the National Marrow Donor Program (NMDP), the Center for International Blood and Marrow Transplant Research (CIBMTR), the Children’s Oncology Group (COG), the Pediatric Transplant and Cell Therapy Consortium (PTCTC), the Primary Immune Deficiency Treatment Consortium (PIDTC), the Blood and Marrow Transplant Clinical Trials Network (BMT CTN), the Sickle Transplant Alliance for Research (STAR) Consortium, and the New Approaches to Neuroblastoma Therapy (NANT) Consortium. We actively collaborate in cutting-edge research and investigator-initiated clinical trials with The Ohio State University Comprehensive Cancer Center. Autologous and allogeneic hematopoietic cell transplants are performed using all types of stem cell

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 165

sources (bone marrow, peripheral blood, and umbilical cord blood) from human leukocyte antigen (HLA)matched related, unrelated and haploidentical donors.

In the last year, patients have been treated with a wide range of modified stem cell grafts and cellular therapies, including Kymriah® CD19 CAR T-cell therapy.

Hematopoietic stem cell transplants were given under early phase FDA-approved clinical trials, including αβT-cell and CD19 B-cell depleted haploidentical stem cell grafts for patients with hematologic malignancies, and a novel approach to eliminating graft-versus-host disease for patients with sickle cell disease. Virus-specific T cells (VSTs) were isolated from healthy donors to treat life-threatening viral infections, and natural killer (NK) cells were manufactured and delivered to patients with high-risk acute myeloid leukemia (AML). The FDA approved five novel studies for NK cell therapy of brain tumors, relapsed/refractory neuroblastoma, sarcomas, and COVID-19.

HEART TRANSPLANT The Heart Failure and Transplant Program aims to provide advanced cardiac support to any patient with end-stage heart failure refractory to conventional therapies. This includes advanced mechanical circulatory support with state-of-the-art ventricular assist devices (VAD) used as a bridge to transplant in appropriate patients nonresponsive to pharmacologic heart failure therapies. The program is certified by UNOS, approved by the Ohio Department of Health and Human Services and remains a member in good standing within the Ohio Solid Organ Transplant Consortium.

In the last year, the program experienced a nearly 75% increase in transplant referrals and completed six heart transplants. Six VADs were implanted as a bridge to recovery or heart transplant, and a young infant was successfully supported for over five months prior to transplant using the Berlin EXCOR VAD, the longest infant support to date at Nationwide Children’s.

There is expected to be continued growth in the VAD program as it strives to meet the needs of an increasing population of older pediatric and young adult patients with congenital heart disease. A novel cardio-oncology program continues to grow in volume and provide ongoing cardiac care to long-term survivors of childhood cancers at risk for or developing cardiomyopathy. Finally, the program remains an active member of a recently formed multicenter international quality research 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.

LUNG AND HEART-LUNG TRANSPLANT The Lung and Heart-Lung Transplant Program is part of an advanced lung disease center consisting of programs for cystic fibrosis, congenital heart disease, pulmonary vascular disorders, interstitial lung disease and neonatal lung disease. Our transplant team also works in conjunction with The Heart Center, offering combined heart-lung transplantation to patients with advanced cardiopulmonary disease.

We offer a full spectrum of lung assist devices and ambulatory extracorporeal membrane oxygenation (ECMO) to children with advanced lung disease, including acute respiratory decompensation, and have the capability of transporting patients to our center on lung assist devices and ECMO.

FAST FACTS July 2019 through June 2020 Blood and Marrow Transplants: ...................................... 53 Heart Transplants: ............................................................ 5 Lung Transplants: ............................................................. 1 Kidney Transplants: .......................................................... 6 Liver Transplants: ............................................................. 1

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC BONE MARROW TRANSPLANT AND CELL THERAPY Margaret Lamb, MD PEDIATRIC RENAL TRANSPLANT Jessica Greco, MD Reeti Kumar, MD Emily Stonebrook, MD Jason Thomas, MD

SELECTED PUBLICATIONS Bhunia N, Abu-Arja R, Bajwa RPS, Auletta JJ, Rangarajan HG. Successful Treatment with Eculizumab for Posterior Reversible Encephalopathy Syndrome Due to TransplantAssociated Thrombotic Microangiopathy in Patients Transplanted for Sickle Cell Disease.

Pediatric Blood & Cancer. 2019 Oct;66(10):e27912.

Giafaglione J, Morrison A, Gowda C, Gajarski R, Nandi D, Giafaglione J. Pediatric Donor Heart Allocation in the United States, 2006-2017: Current Patterns and Potential for Improvement. Pediatric Transplantation. 2020 May 19.

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 Initiative. Pediatric Quality and Safety. 2019 Sep 19;4(5):e209.

Jay CL, Washburn WK, Rogers J, Harriman D, Heimbach J, Stratta RJ. Difference in Survival in Early Kidney after Liver Transplantation Compared with Simultaneous LiverKidney Transplantation: Evaluating the Potential of the "Safety Net." The Journal of the American College of Surgeons. 2020 Apr;230(4):463-473.

Ling S, Ye W, Leung D, Navarro O, Weymann A, Karnsakul W, Freeman A, Magee J, Narkewicz M. Liver Ultrasound Patterns in Children With Cystic Fibrosis Correlate With Noninvasive Tests of Liver Disease. Journal of Pediatric Gastroenterology and Nutrition.

2019 Sep;69(3):351-357.

Lorts A, Smyth L, Gajarski RJ, VanderPluym CJ, Mehegan M, Villa CR, Murray JM, Niebler RA, Almond CS, Thrush P, O'Connor MJ, Conway J, Sutcliffe DL, Lantz JE, 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 ASAIO Journal. 2020 Apr;66(4):441-446.

Nguyen MC, Avila CL, Brock GN, Benedict JA, James I, El-Hinnawi A, Rajab A, Elkhammas E, Pelletier RP, Henry M, Bumgardner GL. “Early” and “Late” Hospital Readmissions in the First Year after Kidney Transplant at a Single Center. Clinical Transplantation. 2020 Mar;34(3):e13822.

O'Connor MJ, Lorts A, Davies RR, Fynn-Thompson F, Joong A, Maeda K, Mascio CE, McConnell PI, Mongé MC, Nandi D, Peng DM, Rosenthal DN, Si MS, Sutcliffe 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 Patients and Patients with Congenital Heart Disease: A Multicenter Registry Analysis. The Journal of Heart and Lung Transplantation. 2020 Jun;39(6):573-579.

Tullius BP, Setty BA, Lee DA. Natural Killer Cell Immunotherapy for Osteosarcoma.

Advances in Experimental Medicine and Biology. 2020;1257:141-54.

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 Quantity of Human Peripheral Blood CXCR5+IFN-γ+CD8+T cells with de novo DSA Production in the First Year after Kidney Transplant. Transplantation. 2020 Feb 6.

166 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 167

sources (bone marrow, peripheral blood, and umbilical cord blood) from human leukocyte antigen (HLA)matched related, unrelated and haploidentical donors.

In the last year, patients have been treated with a wide range of modified stem cell grafts and cellular therapies, including Kymriah® CD19 CAR T-cell therapy.

Hematopoietic stem cell transplants were given under early phase FDA-approved clinical trials, including αβT-cell and CD19 B-cell depleted haploidentical stem cell grafts for patients with hematologic malignancies, and a novel approach to eliminating graft-versus-host disease for patients with sickle cell disease. Virus-specific T cells (VSTs) were isolated from healthy donors to treat life-threatening viral infections, and natural killer (NK) cells were manufactured and delivered to patients with high-risk acute myeloid leukemia (AML). The FDA approved five novel studies for NK cell therapy of brain tumors, relapsed/refractory neuroblastoma, sarcomas, and COVID-19.

HEART TRANSPLANT The Heart Failure and Transplant Program aims to provide advanced cardiac support to any patient with end-stage heart failure refractory to conventional therapies. This includes advanced mechanical circulatory support with state-of-the-art ventricular assist devices (VAD) used as a bridge to transplant in appropriate patients nonresponsive to pharmacologic heart failure therapies. The program is certified by UNOS, approved by the Ohio Department of Health and Human Services and remains a member in good standing within the Ohio Solid Organ Transplant Consortium.

In the last year, the program experienced a nearly 75% increase in transplant referrals and completed six heart transplants. Six VADs were implanted as a bridge to recovery or heart transplant, and a young infant was successfully supported for over five months prior to transplant using the Berlin EXCOR VAD, the longest infant support to date at Nationwide Children’s.

There is expected to be continued growth in the VAD program as it strives to meet the needs of an increasing population of older pediatric and young adult patients with congenital heart disease. A novel cardio-oncology program continues to grow in volume and provide ongoing cardiac care to long-term survivors of childhood cancers at risk for or developing cardiomyopathy. Finally, the program remains an active member of a recently formed multicenter international quality research 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.

LUNG AND HEART-LUNG TRANSPLANT The Lung and Heart-Lung Transplant Program is part of an advanced lung disease center consisting of programs for cystic fibrosis, congenital heart disease, pulmonary vascular disorders, interstitial lung disease and neonatal lung disease. Our transplant team also works in conjunction with The Heart Center, offering combined heart-lung transplantation to patients with advanced cardiopulmonary disease.

We offer a full spectrum of lung assist devices and ambulatory extracorporeal membrane oxygenation (ECMO) to children with advanced lung disease, including acute respiratory decompensation, and have the capability of transporting patients to our center on lung assist devices and ECMO.

FAST FACTS July 2019 through June 2020 Blood and Marrow Transplants: ...................................... 53 Heart Transplants: ............................................................ 5 Lung Transplants: ............................................................. 1 Kidney Transplants: .......................................................... 6 Liver Transplants: ............................................................. 1

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC BONE MARROW TRANSPLANT AND CELL THERAPY Margaret Lamb, MD PEDIATRIC RENAL TRANSPLANT Jessica Greco, MD Reeti Kumar, MD Emily Stonebrook, MD Jason Thomas, MD

SELECTED PUBLICATIONS Bhunia N, Abu-Arja R, Bajwa RPS, Auletta JJ, Rangarajan HG. Successful Treatment with Eculizumab for Posterior Reversible Encephalopathy Syndrome Due to TransplantAssociated Thrombotic Microangiopathy in Patients Transplanted for Sickle Cell Disease.

Pediatric Blood & Cancer. 2019 Oct;66(10):e27912.

Giafaglione J, Morrison A, Gowda C, Gajarski R, Nandi D, Giafaglione J. Pediatric Donor Heart Allocation in the United States, 2006-2017: Current Patterns and Potential for Improvement. Pediatric Transplantation. 2020 May 19.

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 Initiative. Pediatric Quality and Safety. 2019 Sep 19;4(5):e209.

Jay CL, Washburn WK, Rogers J, Harriman D, Heimbach J, Stratta RJ. Difference in Survival in Early Kidney after Liver Transplantation Compared with Simultaneous LiverKidney Transplantation: Evaluating the Potential of the "Safety Net." The Journal of the American College of Surgeons. 2020 Apr;230(4):463-473.

Ling S, Ye W, Leung D, Navarro O, Weymann A, Karnsakul W, Freeman A, Magee J, Narkewicz M. Liver Ultrasound Patterns in Children With Cystic Fibrosis Correlate With Noninvasive Tests of Liver Disease. Journal of Pediatric Gastroenterology and Nutrition.

2019 Sep;69(3):351-357.

Lorts A, Smyth L, Gajarski RJ, VanderPluym CJ, Mehegan M, Villa CR, Murray JM, Niebler RA, Almond CS, Thrush P, O'Connor MJ, Conway J, Sutcliffe DL, Lantz JE, 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 ASAIO Journal. 2020 Apr;66(4):441-446.

Nguyen MC, Avila CL, Brock GN, Benedict JA, James I, El-Hinnawi A, Rajab A, Elkhammas E, Pelletier RP, Henry M, Bumgardner GL. “Early” and “Late” Hospital Readmissions in the First Year after Kidney Transplant at a Single Center. Clinical Transplantation. 2020 Mar;34(3):e13822.

O'Connor MJ, Lorts A, Davies RR, Fynn-Thompson F, Joong A, Maeda K, Mascio CE, McConnell PI, Mongé MC, Nandi D, Peng DM, Rosenthal DN, Si MS, Sutcliffe 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 Patients and Patients with Congenital Heart Disease: A Multicenter Registry Analysis. The Journal of Heart and Lung Transplantation. 2020 Jun;39(6):573-579.

Tullius BP, Setty BA, Lee DA. Natural Killer Cell Immunotherapy for Osteosarcoma.

Advances in Experimental Medicine and Biology. 2020;1257:141-54.

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 Quantity of Human Peripheral Blood CXCR5+IFN-γ+CD8+T cells with de novo DSA Production in the First Year after Kidney Transplant. Transplantation. 2020 Feb 6.

166 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 167

Surgical Services

TRAUMA

PHYSICIAN TRAUMA/BURN LIAISONS

Nationwide Children’s Hospital is one of the largest Level 1 pediatric trauma centers in the nation to be verified by the American College of Surgeons. We are also one of the few free-standing pediatric burn centers in the United States to be verified by the American Burn Association. The trauma and burn programs provide clinical care for injured children, a robust quality improvement program to ensure that the highest quality of care is provided, and research to improve outcomes through the Center for Pediatric Trauma Research at Nationwide Children’s. Our nationally recognized trauma and burn service provides care for injured children from infancy through adolescence. Pediatric trauma and burn experts are involved in all aspects of patient care, including pre-hospital, emergency department, critical care, inpatient, operative management and rehabilitation. Our multidisciplinary, collaborative approach allows us to provide patients with exceptional care. Our center serves as a resource for injury prevention and education for our primary service area and beyond.

Graciela Argote-Romero, MD (Anesthesia) Allan Beebe, MD (Orthopedics) Maria Estrada, DO (Critical Care)

Lee Ann Wurster, MS, RN, CPNP, TCRN RN, MS, led the COVID-19 Pediatric Trauma Society Nurse Leadership Group.

•

Carrie Rhodes, CPST-I, BA, was appointed to the steering committee for the Pediatric Trauma Society Injury Prevention Committee.

•

Kathy Haley, MS, RN, was reappointed to the board of the Central Ohio Trauma System.

Mark Hogan, MD (Radiology) Jeff Lutmer, MD (Critical Care) David Martin, MD (Anesthesia) Ellen McManus, MD (Emergency Medicine) Eric Sribnik, MD (Neurosurgery) Kathy Haley, MS, RN

Renata Fabia, MD Co-Director Burn Program

•

Greg Cambier, MD (Anesthesia)

Highlights from the past year:

Rajan Thakkar, MD Trauma Medical Director Co-Director Burn Program

Sheila Giles, RN, BSN, was instrumental in acquiring the American Nursing Association’s recognition of burn nursing as a specialty.

Morgan Wurtz, MD (Emergency Medicine)

TRAUMA PROGRAM MANAGER FACULTY

•

•

Renata Fabia, MD, was nominated as presidentelect 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 Burn Program launched its first full year of its Laser Therapy Program for burn scar reconstruction.

The trauma team provides expertise and leadership through the Central Ohio Trauma System, the state trauma system, and nationally through the Pediatric Trauma Society, the Verification Review Committee of the American College of Surgeons, and other national trauma and burn organizations.

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 Jonathan I. Groner, MD Trauma Quality Medical Director

Marc P. Michalsky, MD Peter C. Minneci, MD Benedict C. Nwomeh, MD Oluyinka Olutoye, MD Richard Wood, MD

168 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Henry Xiang, MD, MPH, PhD Director

Jonathan I. Groner, MD Medical Director

Julie Leonard, MD, MPH Associate Director

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 169

Surgical Services

TRAUMA

PHYSICIAN TRAUMA/BURN LIAISONS

Nationwide Children’s Hospital is one of the largest Level 1 pediatric trauma centers in the nation to be verified by the American College of Surgeons. We are also one of the few free-standing pediatric burn centers in the United States to be verified by the American Burn Association. The trauma and burn programs provide clinical care for injured children, a robust quality improvement program to ensure that the highest quality of care is provided, and research to improve outcomes through the Center for Pediatric Trauma Research at Nationwide Children’s. Our nationally recognized trauma and burn service provides care for injured children from infancy through adolescence. Pediatric trauma and burn experts are involved in all aspects of patient care, including pre-hospital, emergency department, critical care, inpatient, operative management and rehabilitation. Our multidisciplinary, collaborative approach allows us to provide patients with exceptional care. Our center serves as a resource for injury prevention and education for our primary service area and beyond.

Graciela Argote-Romero, MD (Anesthesia) Allan Beebe, MD (Orthopedics) Maria Estrada, DO (Critical Care)

Lee Ann Wurster, MS, RN, CPNP, TCRN RN, MS, led the COVID-19 Pediatric Trauma Society Nurse Leadership Group.

•

Carrie Rhodes, CPST-I, BA, was appointed to the steering committee for the Pediatric Trauma Society Injury Prevention Committee.

•

Kathy Haley, MS, RN, was reappointed to the board of the Central Ohio Trauma System.

Mark Hogan, MD (Radiology) Jeff Lutmer, MD (Critical Care) David Martin, MD (Anesthesia) Ellen McManus, MD (Emergency Medicine) Eric Sribnik, MD (Neurosurgery) Kathy Haley, MS, RN

Renata Fabia, MD Co-Director Burn Program

•

Greg Cambier, MD (Anesthesia)

Highlights from the past year:

Rajan Thakkar, MD Trauma Medical Director Co-Director Burn Program

Sheila Giles, RN, BSN, was instrumental in acquiring the American Nursing Association’s recognition of burn nursing as a specialty.

Morgan Wurtz, MD (Emergency Medicine)

TRAUMA PROGRAM MANAGER FACULTY

•

•

Renata Fabia, MD, was nominated as presidentelect 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 Burn Program launched its first full year of its Laser Therapy Program for burn scar reconstruction.

The trauma team provides expertise and leadership through the Central Ohio Trauma System, the state trauma system, and nationally through the Pediatric Trauma Society, the Verification Review Committee of the American College of Surgeons, and other national trauma and burn organizations.

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 Jonathan I. Groner, MD Trauma Quality Medical Director

Marc P. Michalsky, MD Peter C. Minneci, MD Benedict C. Nwomeh, MD Oluyinka Olutoye, MD Richard Wood, MD

168 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Henry Xiang, MD, MPH, PhD Director

Jonathan I. Groner, MD Medical Director

Julie Leonard, MD, MPH Associate Director

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 169

FACULTY Jennifer Cooper, PhD Renata Fabia, MD, PhD Brian Kenney, MD, MPH Jeffrey Leonard, MD Eric Sribnick, MD, PhD Rachel Stanley, MD Gerry Taylor, PhD Rajan Thakkar, MD Ginger Yang, PhD, MPH AFFILIATE FACULTY Allan C. Beebe, MD Mark Hall, MD, FAAP, FCCM Bo Lu, PhD (The Ohio State University) Jennifer Lundine, PhD, CCC-SLP, BC-ANCDS Keith Yeates, PhD NURSE RESEARCHERS Kathy Haley, MS, RN Sheila Giles, BSN, RN Dana Noffsinger, CPNP-AC LeeAnn Wurster, MS, RN, CPNP SENIOR RESEARCH ASSOCIATE Megan Armstrong, MPH Center for Pediatric Trauma Research Achievements •

Julie Leonard, MD, MPH, won the Outstanding Mentor Award from the Abigail Wexner Research Institute.

•

Ginger Yang, PhD, was featured by the U.S. Centers for Disease Control and Prevention in its Injury Control Research Centers success story about Ohio concussion laws.

•

Ginger Yang, PhD, received a multiyear NIH grant to study the effectiveness of parentfocused driving safety interventions on safedriving practices among teen drivers who have committed a traffic violation.

•

•

•

Yuyang Zhang, graduate student of Bo Lu, PhD, was the third-place winner of 2019 Ohio State University Center for Clinical and Translational Science Annual Scientific Meeting poster competition in the graduate students section.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 Trauma-related research funding spans multiple centers which include Emergency Medicine, Center for Biobehavioral Health, Pediatric Psychology and Neuropsychology, Center for Injury Research and Policy, and Center for Innovation in Pediatric Practices. $2,546,672 SELECTED PUBLICATIONS Leonard JC, Browne LR, Ahmad FA, Schwartz H, Wallendorf M, Leonard JR, Lerner EB, Kuppermann N. Cervical Spine Injury Risk Factors in Children with Blunt Trauma.

Pediatrics. 2019 Jul. 144(1):e20183221.

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 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 of manual and machine assigned injury severity scores in US trauma registry data. Injury Prevention. 2020 Aug. 26(4):330-333.

Petranovich DL, Smith-Payne J, Wade SL, Yeates KO, Taylor HG, Stancin T, Kurowski 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.

2020;35(3):226-239.

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.

Schilling S, Mansour A, Sullivan L, Ding K, Pommering T, Yang JZ. Symptom Burden and Profiles in Concussed Children with and without Prolonged Recovery. The International Journal of Environmental Research and Public Health. 2020 Jan 4;17(1):351.

FAST FACTS July 2019 through June 2020 Admissions:................................................................ 1,575 Average Length of Stay:................................................. 3.0

Henry Xiang, MD, MPH, PhD, received a research grant from the Ohio Department of Public Safety Emergency Medical Services to evaluate smart phone virtual reality for pediatric home burn-dressing pain management.

Blunt Injury Admissions:............................................. 1,192

Jennifer Lundine, PhD, received a multiyear CDC grant as the co-investigator to assess return to school following pediatric traumatic brain injury.

Orthopedic Trauma Admissions:.................................... 499

Penetrating Injury Admissions:...................................... 142 Burn Injury Admissions:................................................. 215 Asphyxial Injury Admissions:........................................... 26 Neurosurgery Trauma Admissions:................................ 187 Pediatric Surgery Trauma Admissions:........................... 769 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

FACULTY Jennifer Cooper, PhD Renata Fabia, MD, PhD Brian Kenney, MD, MPH Jeffrey Leonard, MD Eric Sribnick, MD, PhD Rachel Stanley, MD Gerry Taylor, PhD Rajan Thakkar, MD Ginger Yang, PhD, MPH AFFILIATE FACULTY Allan C. Beebe, MD Mark Hall, MD, FAAP, FCCM Bo Lu, PhD (The Ohio State University) Jennifer Lundine, PhD, CCC-SLP, BC-ANCDS Keith Yeates, PhD NURSE RESEARCHERS Kathy Haley, MS, RN Sheila Giles, BSN, RN Dana Noffsinger, CPNP-AC LeeAnn Wurster, MS, RN, CPNP SENIOR RESEARCH ASSOCIATE Megan Armstrong, MPH Center for Pediatric Trauma Research Achievements •

Julie Leonard, MD, MPH, won the Outstanding Mentor Award from the Abigail Wexner Research Institute.

•

Ginger Yang, PhD, was featured by the U.S. Centers for Disease Control and Prevention in its Injury Control Research Centers success story about Ohio concussion laws.

•

Ginger Yang, PhD, received a multiyear NIH grant to study the effectiveness of parentfocused driving safety interventions on safedriving practices among teen drivers who have committed a traffic violation.

•

•

•

Yuyang Zhang, graduate student of Bo Lu, PhD, was the third-place winner of 2019 Ohio State University Center for Clinical and Translational Science Annual Scientific Meeting poster competition in the graduate students section.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 Trauma-related research funding spans multiple centers which include Emergency Medicine, Center for Biobehavioral Health, Pediatric Psychology and Neuropsychology, Center for Injury Research and Policy, and Center for Innovation in Pediatric Practices. $2,546,672 SELECTED PUBLICATIONS Leonard JC, Browne LR, Ahmad FA, Schwartz H, Wallendorf M, Leonard JR, Lerner EB, Kuppermann N. Cervical Spine Injury Risk Factors in Children with Blunt Trauma.

Pediatrics. 2019 Jul. 144(1):e20183221.

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 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 of manual and machine assigned injury severity scores in US trauma registry data. Injury Prevention. 2020 Aug. 26(4):330-333.

Petranovich DL, Smith-Payne J, Wade SL, Yeates KO, Taylor HG, Stancin T, Kurowski 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.

2020;35(3):226-239.

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.

Schilling S, Mansour A, Sullivan L, Ding K, Pommering T, Yang JZ. Symptom Burden and Profiles in Concussed Children with and without Prolonged Recovery. The International Journal of Environmental Research and Public Health. 2020 Jan 4;17(1):351.

FAST FACTS July 2019 through June 2020 Admissions:................................................................ 1,575 Average Length of Stay:................................................. 3.0

Henry Xiang, MD, MPH, PhD, received a research grant from the Ohio Department of Public Safety Emergency Medical Services to evaluate smart phone virtual reality for pediatric home burn-dressing pain management.

Blunt Injury Admissions:............................................. 1,192

Jennifer Lundine, PhD, received a multiyear CDC grant as the co-investigator to assess return to school following pediatric traumatic brain injury.

Orthopedic Trauma Admissions:.................................... 499

Penetrating Injury Admissions:...................................... 142 Burn Injury Admissions:................................................. 215 Asphyxial Injury Admissions:........................................... 26 Neurosurgery Trauma Admissions:................................ 187 Pediatric Surgery Trauma Admissions:........................... 769 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.

“We now need to show how these biomarkers behave in a larger group of patients.”

– Christina Ching, MD

REFERENCES: Gupta S, Jackson AR, DaJusta DG, McLeod DJ, Alpert SA, Jayanthi VR, McHugh K, Schwaderer AR, Becknell B, Ching CB. Urinary antimicrobial peptides: 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 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 173

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.

“We now need to show how these biomarkers behave in a larger group of patients.”

– Christina Ching, MD

REFERENCES: Gupta S, Jackson AR, DaJusta DG, McLeod DJ, Alpert SA, Jayanthi VR, McHugh K, Schwaderer AR, Becknell B, Ching CB. Urinary antimicrobial peptides: 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 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 173

Surgical Services

UROLOGY The Department of Urology at Nationwide Children’s Hospital provides comprehensive diagnostic and therapeutic services for a wide range of urological disorders in children of all ages, including teenagers and young adults. Advanced services include reconstructive surgery of the urinary tract, genitalia and urinary sphincter, as well as consultations for urinary tract abnormalities detected in utero. The department participates in several multispecialty clinics, including THRIVE (a program specializing in care for differences of sexual development, complex urological problems and gender concerns), the Center for Colorectal and Pelvic Reconstruction (CCPR), the Urology/Nephrology Combined Clinic, the Stone Clinic and the Myelomeningocele Program.

The mission of the department is to provide the highest quality pediatric urological care in the safest and 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 and are committed to cutting-edge medical research and surgical education.

FACULTY

V. Rama Jayanthi, MD Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Seth A. Alpert, MD Christopher T. Brown, MD Christina B. Ching, MD Daniel G. DaJusta, MD Molly E. Fuchs, MD Daryl J. McLeod, MD Donald H. Nguyen, MD COMMUNITY-BASED FACULTY Nima Baradaran, MD Roy R. Brown, Jr., MD George T. Ho, MD Adam C. Weiser, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $177,395

Fuchs ME, Halleran DR, Shin YJ, Sebastião Y, Weaver L, Ahmad H, Booth K, Ching CB, Levitt MA, Wood RJ, Dajusta DG. Anatomic Factors Predict Urinary Continence in Patient with Anorectal Malformation. The Journal of Pediatric Urology. 2020 Jun 21;S1477-5131(20)30387-9.

SELECTED PUBLICATIONS

Gupta S, Junquera GY, Nicassio L, Becknell B, Ching CB. Trans IL-6 Signaling Does 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.

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 Journal of Robotic Surgery. 2020 Mar 21.

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 Children with Differences of Sex Development. The Journal of Pediatric Urology. 2019 Oct;15(5):522.e1-522.e8.

Sebastião YV, Cooper JN, Becknell B, Ching CB, McLeod DJ. Prediction of Kidney Failure in Children with Chronic Kidney Disease and Obstructive Uropathy. Pediatric Nephrology. 2020 Jun 25. [Epub ahead of print.]

FAST FACTS July 2019 through June 2020 Inpatient Discharges:..................................................... 119

Dayton Children’s Clinic Visits:....................................... 623

Observation and Outpatient–in-a-Bed Discharges:........ 117

Dublin Urology Clinic Visits:........................................ 1,311

Total Discharges:........................................................... 297

Lima Urology Clinic Visits:.............................................. 172

The academic productivity of the program has continued to increase. In the last year, the department had 30 publications, 63 presentations at national and international meetings and nine book chapters published. Dr. Christina Ching is the first member of the department to be a National Institutes of Healthfunded researcher.

Average Length of Stay*:................................................ 2.9

Mansfield Urology Clinic Visits:...................................... 244

Average Daily Census*:.................................................. 1.3

Portsmouth Urology Clinic Visits:................................... 288

Patient Days*:................................................................ 472

Urology (Main Campus) Clinic Visits:........................... 7,242

Total Surgical Procedures:.......................................... 2,030

Urology/Nephrology (Main Campus) Clinic Visits:........... 194

Inpatient Consults:......................................................... 111

Westerville Urology Clinic Visits:................................. 1,364

Urodynamics:................................................................ 828

Total Urology Clinic Visits:......................................... 11,650

The department continues to provide care to multiple areas in the region, acknowledging that it is vital for a premier program to go to families as opposed to always having them come to main campus. To that end we have expanded long-distance Ohio outreach clinics in Lima, Mansfield and Wheelersburg. In addition, the joint venture with Dayton Children’s Hospital continues to serve southwest Ohio, with two Nationwide Children’s Urology faculty members offering full-time service to the Dayton metropolitan area.

Canal Winchester Urology Clinic Visits:.......................... 272

*Excludes observation and outpatient-in-a-bed patients.

The Robot-Assisted Laparoscopic Surgery Program is robust, performing a wide range of surgical procedures, from routine kidney level operations such as pyeloplasties and nephrectomies, to more complex procedures such as bladder neck reconstructions and appendicovesicostomy. Only a handful of centers around the country are performing the latter, but at Nationwide Children’s they have become commonplace. Our six robotically trained pediatric urologists are among the most active in the country with regard to surgical volumes.

Urology continues to place great importance on multispecialty collaborative clinics. These include the THRIVE program for differences of sexual development, the Center for Colorectal and Pelvic Reconstruction (CCPR), and the Urology/Nephrology Combined Clinic.

174 174| |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| |2019-20 2019-20 Annual Annual Report Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC UROLOGY Kristin Ebert, MD Michael Ernst, MD

A Decade of Remarkable Transformation UROLOGY

Partnership with Dayton Children’s Enhances Regional Pediatric Urology Care

Rama Jayanthi, MD, Appointed Chief of Urology

2010 Nephrology-Urology Research Affinity Group (NURAG) Expands, Leading to More Than 100 Collaborative Publications Since Inception

2012

2013 Center For Colorectal & Pelvic Reconstruction is World’s First to Formally Integrate Clinical and Surgical Specialties

2016

Nationwide Children’s Urologists and Researchers Create the Urinary Tract Infection Global Alliance (UTIGA) — A Professional Society Focused on Solving Challenges Related to UTI management

2017

2013 2020

Nationwide Children's Joins Four Other Premier Children’s Hospitals to Form Pediatric Urology Midwest Alliance (PUMA)

For the past decade, the Department of Urology has consistently led peers in collaborative innovation efforts such as PUMA, UTIGA and NURAG. The team has also been part of surgical firsts, including the first team to integrate clinical and surgical specialties for conditions requiring advanced colorectal and pelvic reconstruction interventions.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 175

Surgical Services

UROLOGY The Department of Urology at Nationwide Children’s Hospital provides comprehensive diagnostic and therapeutic services for a wide range of urological disorders in children of all ages, including teenagers and young adults. Advanced services include reconstructive surgery of the urinary tract, genitalia and urinary sphincter, as well as consultations for urinary tract abnormalities detected in utero. The department participates in several multispecialty clinics, including THRIVE (a program specializing in care for differences of sexual development, complex urological problems and gender concerns), the Center for Colorectal and Pelvic Reconstruction (CCPR), the Urology/Nephrology Combined Clinic, the Stone Clinic and the Myelomeningocele Program.

The mission of the department is to provide the highest quality pediatric urological care in the safest and 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 and are committed to cutting-edge medical research and surgical education.

FACULTY

V. Rama Jayanthi, MD Chief FULL-TIME NATIONWIDE CHILDREN’S FACULTY Seth A. Alpert, MD Christopher T. Brown, MD Christina B. Ching, MD Daniel G. DaJusta, MD Molly E. Fuchs, MD Daryl J. McLeod, MD Donald H. Nguyen, MD COMMUNITY-BASED FACULTY Nima Baradaran, MD Roy R. Brown, Jr., MD George T. Ho, MD Adam C. Weiser, MD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $177,395

Fuchs ME, Halleran DR, Shin YJ, Sebastião Y, Weaver L, Ahmad H, Booth K, Ching CB, Levitt MA, Wood RJ, Dajusta DG. Anatomic Factors Predict Urinary Continence in Patient with Anorectal Malformation. The Journal of Pediatric Urology. 2020 Jun 21;S1477-5131(20)30387-9.

SELECTED PUBLICATIONS

Gupta S, Junquera GY, Nicassio L, Becknell B, Ching CB. Trans IL-6 Signaling Does 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.

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 Journal of Robotic Surgery. 2020 Mar 21.

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 Children with Differences of Sex Development. The Journal of Pediatric Urology. 2019 Oct;15(5):522.e1-522.e8.

Sebastião YV, Cooper JN, Becknell B, Ching CB, McLeod DJ. Prediction of Kidney Failure in Children with Chronic Kidney Disease and Obstructive Uropathy. Pediatric Nephrology. 2020 Jun 25. [Epub ahead of print.]

FAST FACTS July 2019 through June 2020 Inpatient Discharges:..................................................... 119

Dayton Children’s Clinic Visits:....................................... 623

Observation and Outpatient–in-a-Bed Discharges:........ 117

Dublin Urology Clinic Visits:........................................ 1,311

Total Discharges:........................................................... 297

Lima Urology Clinic Visits:.............................................. 172

The academic productivity of the program has continued to increase. In the last year, the department had 30 publications, 63 presentations at national and international meetings and nine book chapters published. Dr. Christina Ching is the first member of the department to be a National Institutes of Healthfunded researcher.

Average Length of Stay*:................................................ 2.9

Mansfield Urology Clinic Visits:...................................... 244

Average Daily Census*:.................................................. 1.3

Portsmouth Urology Clinic Visits:................................... 288

Patient Days*:................................................................ 472

Urology (Main Campus) Clinic Visits:........................... 7,242

Total Surgical Procedures:.......................................... 2,030

Urology/Nephrology (Main Campus) Clinic Visits:........... 194

Inpatient Consults:......................................................... 111

Westerville Urology Clinic Visits:................................. 1,364

Urodynamics:................................................................ 828

Total Urology Clinic Visits:......................................... 11,650

The department continues to provide care to multiple areas in the region, acknowledging that it is vital for a premier program to go to families as opposed to always having them come to main campus. To that end we have expanded long-distance Ohio outreach clinics in Lima, Mansfield and Wheelersburg. In addition, the joint venture with Dayton Children’s Hospital continues to serve southwest Ohio, with two Nationwide Children’s Urology faculty members offering full-time service to the Dayton metropolitan area.

Canal Winchester Urology Clinic Visits:.......................... 272

*Excludes observation and outpatient-in-a-bed patients.

The Robot-Assisted Laparoscopic Surgery Program is robust, performing a wide range of surgical procedures, from routine kidney level operations such as pyeloplasties and nephrectomies, to more complex procedures such as bladder neck reconstructions and appendicovesicostomy. Only a handful of centers around the country are performing the latter, but at Nationwide Children’s they have become commonplace. Our six robotically trained pediatric urologists are among the most active in the country with regard to surgical volumes.

Urology continues to place great importance on multispecialty collaborative clinics. These include the THRIVE program for differences of sexual development, the Center for Colorectal and Pelvic Reconstruction (CCPR), and the Urology/Nephrology Combined Clinic.

174 174| |NATIONWIDE NATIONWIDE CHILDREN’S CHILDREN’S HOSPITAL HOSPITAL| |2019-20 2019-20 Annual Annual Report Report| |NationwideChildrens.org/2020-Report NationwideChildrens.org/2020-Report

2019 – 2020 NATIONWIDE CHILDREN’S FELLOWSHIP PROGRAM PEDIATRIC UROLOGY Kristin Ebert, MD Michael Ernst, MD

A Decade of Remarkable Transformation UROLOGY

Partnership with Dayton Children’s Enhances Regional Pediatric Urology Care

Rama Jayanthi, MD, Appointed Chief of Urology

2010 Nephrology-Urology Research Affinity Group (NURAG) Expands, Leading to More Than 100 Collaborative Publications Since Inception

2012

2013 Center For Colorectal & Pelvic Reconstruction is World’s First to Formally Integrate Clinical and Surgical Specialties

2016

Nationwide Children’s Urologists and Researchers Create the Urinary Tract Infection Global Alliance (UTIGA) — A Professional Society Focused on Solving Challenges Related to UTI management

2017

2013 2020

Nationwide Children's Joins Four Other Premier Children’s Hospitals to Form Pediatric Urology Midwest Alliance (PUMA)

For the past decade, the Department of Urology has consistently led peers in collaborative innovation efforts such as PUMA, UTIGA and NURAG. The team has also been part of surgical firsts, including the first team to integrate clinical and surgical specialties for conditions requiring advanced colorectal and pelvic reconstruction interventions.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 175

ABIGAIL WEXNER RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL

Department, Section and Center Reports INSTITUTE LEADERSHIP

John A. Barnard, MD President

Deena J. Chisolm, PhD Vice President, Health Services Research

William E. Smoyer, MD Vice President, Clinical Research

Veronica J. Vieland, PhD Vice President, Computational Research

Dennis R. Durbin, MD, MSCE Chief Scientific Officer

ABIGAIL WEXNER RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL 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 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, postdoctoral fellows, graduate students, residents and other students.

176 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Lauren O. Bakaletz, PhD Vice President, Basic Sciences Research

INSTITUTES AND CENTERS OF EMPHASIS

•

Battelle Center for Mathematical Medicine

•

•

Biopathology Center

•

Center for Gene Therapy

•

Center for Biobehavioral Health

•

•

Center for Cardiovascular Research

•

Center for Childhood Cancer and Blood Diseases

Center for Clinical and Translational Research

•

Center for Perinatal Research

•

Center for Regenerative Medicine

Center for Injury Research and Policy

•

Center for Vaccines and Immunity

•

Center for Innovation in Pediatric Practice

•

•

Center for Microbial Pathogenesis

Steve and Cindy Rasmussen Institute for Genomic Medicine

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 177

ABIGAIL WEXNER RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL

Department, Section and Center Reports INSTITUTE LEADERSHIP

John A. Barnard, MD President

Deena J. Chisolm, PhD Vice President, Health Services Research

William E. Smoyer, MD Vice President, Clinical Research

Veronica J. Vieland, PhD Vice President, Computational Research

Dennis R. Durbin, MD, MSCE Chief Scientific Officer

ABIGAIL WEXNER RESEARCH INSTITUTE AT NATIONWIDE CHILDREN’S HOSPITAL 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 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, postdoctoral fellows, graduate students, residents and other students.

176 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Lauren O. Bakaletz, PhD Vice President, Basic Sciences Research

INSTITUTES AND CENTERS OF EMPHASIS

•

Battelle Center for Mathematical Medicine

•

•

Biopathology Center

•

Center for Gene Therapy

•

Center for Biobehavioral Health

•

•

Center for Cardiovascular Research

•

Center for Childhood Cancer and Blood Diseases

Center for Clinical and Translational Research

•

Center for Perinatal Research

•

Center for Regenerative Medicine

Center for Injury Research and Policy

•

Center for Vaccines and Immunity

•

Center for Innovation in Pediatric Practice

•

•

Center for Microbial Pathogenesis

Steve and Cindy Rasmussen Institute for Genomic Medicine

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 177

Research Institute Reports

Research Institute Reports

BATTELLE CENTER FOR MATHEMATICAL MEDICINE

BIOPATHOLOGY CENTER

Faculty from the Battelle Center for Mathematical Medicine in the Abigail Wexner Research Institute at Nationwide Children’s Hospital apply state-of-the-art, quantitative methods to basic and clinical research in order to better inform and ultimately improve clinical care in pediatrics. A primary goal of the center is to provide a unique environment in which specialists from a variety of mathematical, statistical and computational areas can share their professional “home” in order to facilitate creative, collaborative research within the group.

The Biopathology Center provides a full range of services related to biospecimen procurement, banking, processing, testing and distribution. The Biopathology Center is accredited by the College of American Pathologists Biorepository Accreditation Program (CAP BAP) and houses numerous National Cancer Institute (NCI) funded biospecimen collection efforts, including the biorepositories of the Children’s Oncology Group (COG) and SWOG. Also part of the Biopathology Center are the NCI-funded Pediatric 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

SELECTED PUBLICATIONS Álvarez-Machancoses Ó, De Andrés-Galiana EJ, Fernández-Martínez JL, Kloczkowski A. Robust Prediction of Single and Multiple Point Protein Mutations Stability Changes.

Biomolecules. 2019 Dec 31;10(1):67.

Bartlett CW, Klamer BG, Buyske S, Petrill SA, Ray WC. Forming Big Datasets through Latent Class Concatenation of Imperfectly Matched Databases Features. Genes (Basel).

2019 Sep 19;10(9):727.

Veronica J. Vieland, PhD Director Christopher W. Bartlett, PhD Jayajit Das, PhD David A. Greenberg, PhD

Komarov M, Malerba P, Golden R, Nunez P, Halgren E, Bazhenov M. Selective recruitment of cortical neurons by electrical stimulation. PLoS Computational Biology.

2019 Aug 26;15(8):e1007277.

Pathak S, Stewart WCL, Burd CE, Hester ME, Greenberg DA. Brd2 haploinsufficiency extends lifespan and healthspan in C57B6/J mice. PLoS One. 2020 Jun 19;15(6):e0234910.

Wethington D, Harder O, Uppulury K, Stewart WCL, Chen P, King T, Reynolds SD, Perelson A, Peeples ME, Niewiesk S, Das J. Mathematical modelling identifies the role of adaptive immunity as a key controller of respiratory syncytial virus in cotton rats. Journal of the Royal Society, Interface. 2019 Nov 29;16(160):20190389.

Nilsa Del Carmen Ramirez-Milan, MD, FCAP Medical Director and Principal Investigator

Andrzej Kloczkowski, PhD Paola Malerba, PhD William C. Ray, PhD William Stewart, PhD Battelle Center for Mathematical Medicine faculty continued their tradition of active collaboration with one another, with investigators across the Nationwide Children’s organization and with colleagues at The Ohio State University and other institutions. This year saw the publication of 19 peer-reviewed research papers and the filing of one patent, the awarding of several new research grants and the presentation of 16 invited research talks at high-profile national and international venues spanning seven countries. Our faculty also participated in organizing five national and international conferences on several topics in computational biology.

Jay Bowen, MS Principal Investigator

We continuously pursue grant-supported, biorepositorybased studies aimed to advance medical research. The Biopathology Center was awarded three NCI-sponsored U24 grants for the period of 2020 to 2026: two for supporting the ongoing biobanking efforts of COG and SWOG and a new one to support the Early-Phase and Experimental Clinical Trials (EET) Biobank. Also awarded was funding to support the NRG Oncology-Columbus biobank. The COG, SWOG and NRG OncologyColumbus biobanks are part of the NCI-sponsored National Clinical Trials Network and support large phase 2 and phase 3 clinical trials; the EET Biobank supports phase 1 clinical trials.

The CCG BCR was awarded contracts to support pathology review and nucleic acid isolation for the NCI Division of Cancer Epidemiology and Genetics (to study environmental causes of cancer), the Clinical Trial Sequencing Project (to analyze cancer genomes from the ECOG-ACRIN 2805 renal cancer trial), Early Onset Malignancies Initiative (to investigate why certain racial and 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, tumor-derived culture models annotated with genomic and clinical data).

Mr. Bowen replaced Dr. Gastier-Foster as PI of the Biospecimen Core Resource of the Center for Cancer Genomics in October 2019. In June 2020 he and Dr. Gastier-Foster were recipients of the American Association for Cancer Research (AACR) Team Science Award: The Cancer Genome Atlas. Dr. Nicol is contact-PI of the EET Biobank. Dr. Ramirez-Milan is contact-PI of the COG and SWOG biobanks and PI of the NRG OncologyColumbus 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 178 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 179

Research Institute Reports

Research Institute Reports

BATTELLE CENTER FOR MATHEMATICAL MEDICINE

BIOPATHOLOGY CENTER

Faculty from the Battelle Center for Mathematical Medicine in the Abigail Wexner Research Institute at Nationwide Children’s Hospital apply state-of-the-art, quantitative methods to basic and clinical research in order to better inform and ultimately improve clinical care in pediatrics. A primary goal of the center is to provide a unique environment in which specialists from a variety of mathematical, statistical and computational areas can share their professional “home” in order to facilitate creative, collaborative research within the group.

The Biopathology Center provides a full range of services related to biospecimen procurement, banking, processing, testing and distribution. The Biopathology Center is accredited by the College of American Pathologists Biorepository Accreditation Program (CAP BAP) and houses numerous National Cancer Institute (NCI) funded biospecimen collection efforts, including the biorepositories of the Children’s Oncology Group (COG) and SWOG. Also part of the Biopathology Center are the NCI-funded Pediatric 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

SELECTED PUBLICATIONS Álvarez-Machancoses Ó, De Andrés-Galiana EJ, Fernández-Martínez JL, Kloczkowski A. Robust Prediction of Single and Multiple Point Protein Mutations Stability Changes.

Biomolecules. 2019 Dec 31;10(1):67.

Bartlett CW, Klamer BG, Buyske S, Petrill SA, Ray WC. Forming Big Datasets through Latent Class Concatenation of Imperfectly Matched Databases Features. Genes (Basel).

2019 Sep 19;10(9):727.

Veronica J. Vieland, PhD Director Christopher W. Bartlett, PhD Jayajit Das, PhD David A. Greenberg, PhD

Komarov M, Malerba P, Golden R, Nunez P, Halgren E, Bazhenov M. Selective recruitment of cortical neurons by electrical stimulation. PLoS Computational Biology.

2019 Aug 26;15(8):e1007277.

Pathak S, Stewart WCL, Burd CE, Hester ME, Greenberg DA. Brd2 haploinsufficiency extends lifespan and healthspan in C57B6/J mice. PLoS One. 2020 Jun 19;15(6):e0234910.

Wethington D, Harder O, Uppulury K, Stewart WCL, Chen P, King T, Reynolds SD, Perelson A, Peeples ME, Niewiesk S, Das J. Mathematical modelling identifies the role of adaptive immunity as a key controller of respiratory syncytial virus in cotton rats. Journal of the Royal Society, Interface. 2019 Nov 29;16(160):20190389.

Nilsa Del Carmen Ramirez-Milan, MD, FCAP Medical Director and Principal Investigator

Andrzej Kloczkowski, PhD Paola Malerba, PhD William C. Ray, PhD William Stewart, PhD Battelle Center for Mathematical Medicine faculty continued their tradition of active collaboration with one another, with investigators across the Nationwide Children’s organization and with colleagues at The Ohio State University and other institutions. This year saw the publication of 19 peer-reviewed research papers and the filing of one patent, the awarding of several new research grants and the presentation of 16 invited research talks at high-profile national and international venues spanning seven countries. Our faculty also participated in organizing five national and international conferences on several topics in computational biology.

Jay Bowen, MS Principal Investigator

We continuously pursue grant-supported, biorepositorybased studies aimed to advance medical research. The Biopathology Center was awarded three NCI-sponsored U24 grants for the period of 2020 to 2026: two for supporting the ongoing biobanking efforts of COG and SWOG and a new one to support the Early-Phase and Experimental Clinical Trials (EET) Biobank. Also awarded was funding to support the NRG Oncology-Columbus biobank. The COG, SWOG and NRG OncologyColumbus biobanks are part of the NCI-sponsored National Clinical Trials Network and support large phase 2 and phase 3 clinical trials; the EET Biobank supports phase 1 clinical trials.

The CCG BCR was awarded contracts to support pathology review and nucleic acid isolation for the NCI Division of Cancer Epidemiology and Genetics (to study environmental causes of cancer), the Clinical Trial Sequencing Project (to analyze cancer genomes from the ECOG-ACRIN 2805 renal cancer trial), Early Onset Malignancies Initiative (to investigate why certain racial and 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, tumor-derived culture models annotated with genomic and clinical data).

Mr. Bowen replaced Dr. Gastier-Foster as PI of the Biospecimen Core Resource of the Center for Cancer Genomics in October 2019. In June 2020 he and Dr. Gastier-Foster were recipients of the American Association for Cancer Research (AACR) Team Science Award: The Cancer Genome Atlas. Dr. Nicol is contact-PI of the EET Biobank. Dr. Ramirez-Milan is contact-PI of the COG and SWOG biobanks and PI of the NRG OncologyColumbus 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 178 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 179

Research Institute Reports GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $18,887,897 SELECTED PUBLICATIONS Conley BA, Staudt L, Takebe N, Wheeler DA, Wang L, Cardenas MF, Zenklusen JC, 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, 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 Cancer Institute. 2020 Apr 27;djaa061. [Epub ahead of print]

CENTER FOR BIOBEHAVIORAL HEALTH The mission of the Center for Biobehavioral Health in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to improve the health and health care of children and their families. This is achieved through state-of-the-art research using a biopsychosocial approach. A special focus is placed on identification of factors associated with developmental risk and resilience across the life span, design and evaluation of new interventions, and dissemination and implementation of effective interventions into routine practice.

FACULTY

the center is transforming the health care and well-being of children and families in our community and worldwide.

Several new grants were awarded in the center. Kathryn Vannatta, PhD, received a four-year, $2.29 million grant from the National Heart, Lung and Blood Institute (NHLBI). The study team will examine the developmental progression of youth with critical congenital heart defects, particularly the role of social cognition in peer relationships across elementary and middle school. The goal is to also identify family and environmental factors that may protect against difficulties for these children.

Makhlouf H, Watson MA, Lankes HA, Weil C, Dickler M, Birrer M, Moskaluk C, 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 Cancer Institute Clinical Trials. American Journal of Clinical Pathology. 2020 Jan 2;153(2):149-155.

Ponnapalli SP, Bradley MW, Devine K, Bowen J, Coppens SE, Leraas KM, Milash BA, Li F, Luo H, Qiu S, Wu K, Yang H, Wittwer CT, Palmer CA, Jensen RL, Gastier-Foster JM, Hanson HA, Barnholtz-Sloan JS, Alter O. Retrospective clinical trial experimentally validates glioblastoma genome-wide pattern of DNA copy-number alterations predictor of survival. APL Bioengineering, 2020 Apr;4(2):026106.

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, Vaksman Z, Mayoh C, Nance J, Mccoy K, Haber M, Evans K, McCalmont H, Bendak K, Böhm JW, Marshall GM, Tyrrell V, Kalletla K, Braun FK, Qi L, Du Y, Zhang H, Lindsay HB, Zhao S, Shu J, Baxter P, Morton C, Kurmashev D, Zheng S, Chen Y, Bowen J, Bryan AC, Leraas KM, Coppens SE, Doddapaneni H, Momin Z, Zhang W, Sacks GI, Hart LS, Krytska K, Mosse YP, Gatto GJ, Sanchez Y, Greene CS, Diskin SJ, Vaske OM, Haussler D, Gastier-Foster JM, Kolb EA, Gorlick R, Li X-N, Reynolds CP, Kurmasheva 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.

Cell Reports. 2019 Nov 5;29(6):1675-1689.e9.

Cynthia A. Gerhardt, PhD Director FULL-TIME NATIONWIDE CHILDREN’S FACULTY Canice E. Crerand, PhD Kristen E. Hoskinson, PhD Jamie L. Jackson, PhD Sarah A. Keim, PhD Laura Mackner, PhD Leena Nahata, MD Eric E. Nelson, PhD Joseph R. Rausch, PhD Jack H. Stevens, PhD H. Gerry Taylor, PhD Kathryn A. Vannatta, PhD OSU-AFFILIATE FACULTY Christine A. Fortney, PhD, RN Tondi Harrison, PhD, RN Kathy Lemanek, PhD Kelly McNally, PhD

H. Gerry Taylor, PhD, became the founding director of the Neurodevelopmental Research Affinity Group (NRAG), which now includes over 60 investigators across Nationwide Children’s and OSU. The NRAG provides pilot funding and fosters collaboration on neurodevelopmental studies across the institutions.

Kristen Hoskinson, PhD, was named the 2019 Department of Pediatrics Outstanding Junior Faculty Investigator for her research in the field of pediatric neuropsychology, particularly social outcomes in youth with traumatic brain injuries.

Behavioral Health: See page 132 for information about Behavioral Health services at Nationwide Children’s Hospital.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,638,242 SELECTED PUBLICATIONS

Our vision is to achieve the best possible outcomes for children and families by creating, disseminating and applying new knowledge related to the reciprocal influences of behavior and health. We are also committed to training the next generation of leaders in biobehavioral research.

Developmental, behavioral and social risk factors contribute to significant morbidity and mortality among youth. Childhood health conditions affect not only the psychosocial well-being of youth but also that of families. Through our research, 180 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Jamie Jackson, PhD, was awarded a pilot grant from NHLBI to adapt a physical activity intervention for young adults with congenital heart disease (CHD). The goal is to improve health outcomes among the growing population of CHD survivors as these youth mature into adulthood.

Crerand CE, Rumsey N, Kazak AE, Clark A, Rausch J, Sarwer DB. Sex differences in perceived stigmatization, body image disturbance, and satisfaction with facial appearance and speech among adolescents with craniofacial conditions. Body Image. 2020 Mar;32:190-198.

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 treatment and mental health after an emergency department visit among suicidal adolescents: A randomized 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 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.

Nahata L, Chen D, Quinn GP, Travis M, Grannis C, Nelson E, Tishelman AC. Reproductive attitudes and behaviors among transgender/nonbinary adolescents. Journal of Adolescent Health. 2020 Mar 1;66(3):372-4.

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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 181

Research Institute Reports GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $18,887,897 SELECTED PUBLICATIONS Conley BA, Staudt L, Takebe N, Wheeler DA, Wang L, Cardenas MF, Zenklusen JC, 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, 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 Cancer Institute. 2020 Apr 27;djaa061. [Epub ahead of print]

CENTER FOR BIOBEHAVIORAL HEALTH The mission of the Center for Biobehavioral Health in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to improve the health and health care of children and their families. This is achieved through state-of-the-art research using a biopsychosocial approach. A special focus is placed on identification of factors associated with developmental risk and resilience across the life span, design and evaluation of new interventions, and dissemination and implementation of effective interventions into routine practice.

FACULTY

the center is transforming the health care and well-being of children and families in our community and worldwide.

Several new grants were awarded in the center. Kathryn Vannatta, PhD, received a four-year, $2.29 million grant from the National Heart, Lung and Blood Institute (NHLBI). The study team will examine the developmental progression of youth with critical congenital heart defects, particularly the role of social cognition in peer relationships across elementary and middle school. The goal is to also identify family and environmental factors that may protect against difficulties for these children.

Makhlouf H, Watson MA, Lankes HA, Weil C, Dickler M, Birrer M, Moskaluk C, 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 Cancer Institute Clinical Trials. American Journal of Clinical Pathology. 2020 Jan 2;153(2):149-155.

Ponnapalli SP, Bradley MW, Devine K, Bowen J, Coppens SE, Leraas KM, Milash BA, Li F, Luo H, Qiu S, Wu K, Yang H, Wittwer CT, Palmer CA, Jensen RL, Gastier-Foster JM, Hanson HA, Barnholtz-Sloan JS, Alter O. Retrospective clinical trial experimentally validates glioblastoma genome-wide pattern of DNA copy-number alterations predictor of survival. APL Bioengineering, 2020 Apr;4(2):026106.

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, Vaksman Z, Mayoh C, Nance J, Mccoy K, Haber M, Evans K, McCalmont H, Bendak K, Böhm JW, Marshall GM, Tyrrell V, Kalletla K, Braun FK, Qi L, Du Y, Zhang H, Lindsay HB, Zhao S, Shu J, Baxter P, Morton C, Kurmashev D, Zheng S, Chen Y, Bowen J, Bryan AC, Leraas KM, Coppens SE, Doddapaneni H, Momin Z, Zhang W, Sacks GI, Hart LS, Krytska K, Mosse YP, Gatto GJ, Sanchez Y, Greene CS, Diskin SJ, Vaske OM, Haussler D, Gastier-Foster JM, Kolb EA, Gorlick R, Li X-N, Reynolds CP, Kurmasheva 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.

Cell Reports. 2019 Nov 5;29(6):1675-1689.e9.

Cynthia A. Gerhardt, PhD Director FULL-TIME NATIONWIDE CHILDREN’S FACULTY Canice E. Crerand, PhD Kristen E. Hoskinson, PhD Jamie L. Jackson, PhD Sarah A. Keim, PhD Laura Mackner, PhD Leena Nahata, MD Eric E. Nelson, PhD Joseph R. Rausch, PhD Jack H. Stevens, PhD H. Gerry Taylor, PhD Kathryn A. Vannatta, PhD OSU-AFFILIATE FACULTY Christine A. Fortney, PhD, RN Tondi Harrison, PhD, RN Kathy Lemanek, PhD Kelly McNally, PhD

H. Gerry Taylor, PhD, became the founding director of the Neurodevelopmental Research Affinity Group (NRAG), which now includes over 60 investigators across Nationwide Children’s and OSU. The NRAG provides pilot funding and fosters collaboration on neurodevelopmental studies across the institutions.

Kristen Hoskinson, PhD, was named the 2019 Department of Pediatrics Outstanding Junior Faculty Investigator for her research in the field of pediatric neuropsychology, particularly social outcomes in youth with traumatic brain injuries.

Behavioral Health: See page 132 for information about Behavioral Health services at Nationwide Children’s Hospital.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,638,242 SELECTED PUBLICATIONS

Our vision is to achieve the best possible outcomes for children and families by creating, disseminating and applying new knowledge related to the reciprocal influences of behavior and health. We are also committed to training the next generation of leaders in biobehavioral research.

Developmental, behavioral and social risk factors contribute to significant morbidity and mortality among youth. Childhood health conditions affect not only the psychosocial well-being of youth but also that of families. Through our research, 180 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Jamie Jackson, PhD, was awarded a pilot grant from NHLBI to adapt a physical activity intervention for young adults with congenital heart disease (CHD). The goal is to improve health outcomes among the growing population of CHD survivors as these youth mature into adulthood.

Crerand CE, Rumsey N, Kazak AE, Clark A, Rausch J, Sarwer DB. Sex differences in perceived stigmatization, body image disturbance, and satisfaction with facial appearance and speech among adolescents with craniofacial conditions. Body Image. 2020 Mar;32:190-198.

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 treatment and mental health after an emergency department visit among suicidal adolescents: A randomized 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 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.

Nahata L, Chen D, Quinn GP, Travis M, Grannis C, Nelson E, Tishelman AC. Reproductive attitudes and behaviors among transgender/nonbinary adolescents. Journal of Adolescent Health. 2020 Mar 1;66(3):372-4.

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.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 181

Research Institute Reports

Research Institute Reports

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 at Nationwide Children’s Hospital is to conduct innovative, mechanism-based research leading to improved therapies and outcomes for pediatric cardiovascular diseases and to foster preventive strategies and promote cardiovascular health in adults.

The mission of the Center for Childhood Cancer and Blood Diseases in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to transform the care of children, adolescents and young adults with cancer and blood diseases through research and clinical translation. Center investigators 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 Children’s, as well as with national and international colleagues, to translate these findings to the patient.

FACULTY

faculty members are investigating how the SARS-CoV-2 virus causes the heart damage observed in COVID-19 patients in collaboration with faculty in the Center for Vaccines and Immunity. Lastly, the center continues to support the cardiovascular research education of trainees at all levels. These efforts have been supported by an NIHfunded T32 postdoctoral training grant, along with an American Heart Association training award that supports summer research fellowships for undergraduate students.

FACULTY

the process of tumor development, and thereby support the development of new treatments for cancer in children.

These new teams are integrated with a growing collaborative of pediatric sarcoma research programs in the center. This collaborative has been leveraged in the form of multiple large, collaborative grants (U54 awards) from the National Institutes of Health and the National Cancer Institute as part of their Cancer Moonshot Initiative. One of these U54 awards is led by Stephen Lessnick, MD, PhD, and seeks to understand how the EWS/FLI mutant protein regulates genes that cause Ewing sarcoma. The second U54 award is led by Timothy Cripe, MD, PhD, and studies various aspects of how the immune system can be manipulated to treat pediatric cancers, including sarcomas.

The Heart Center: See page 40 for information about Cardiology and page 139 for Cardiovascular Surgery services.

Vidu Garg, MD Director Madhumita Basu, PhD Brenda Lilly, PhD Kim L. McBride, MD, MS Patrick I. McConnell, MD Aaron J. Trask, PhD Mingtao Zhao, DVM, PhD Our cardiovascular research projects span the spectrum from basic research, which occurs in the Center for Cardiovascular Research, to translational and clinical research that is performed in collaboration with clinicians in The Heart Center at Nationwide Children’s. Areas of focus include investigation into the genes and geneenvironment interactions that contribute to congenital heart defects, molecular and signaling pathways regulating normal heart and blood vessel development and how they are disrupted during disease development and progression.

The center faculty receive funding from the National Institutes of Health (NIH) and the American Heart Association (AHA) to support their cutting-edge research.

In the past year, Dr. Mingtao Zhao joined our center and brought expertise in stem cell biology to the center. Drs. Zhao, McBride and Garg along with other faculty in The Heart Center were awarded funding from the Additional Ventures Innovation Fund to study genetic and molecular aspects of single ventricle heart disease. Additionally,

GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971 SELECTED PUBLICATIONS Majumdar U, Yasuhara J, Garg V. In vivo and in vitro genetic models of congenital heart disease. Cold Spring Harbor Perspectives in Biology. 2019 Dec 9;a036764.

Manivannan SN, Darouich S, Masmoudi A, Gordon D, Zender G, Han Z, FitzgeraldButt S, White P, McBride KL, Kharrat M, Garg V. Novel frameshift variant in myl2 reveals molecular differences between dominant and recessive forms of hypertrophic cardiomyopathy. PLoS Genetics. 2020 May;16(5):e1008639.

McCallinhart PE, Biwer LA, Clark OE, Isakson BE, Lilly B, Trask AJ. Myoendothelial junctions of mature coronary vessels express notch signaling proteins. Frontiers in Physiology. 2020 Feb 4;11:29.

McCallinhart PE, Cho Y, Sun Z, Ghadiali S, Meininger GA, Trask AJ. Reduced stiffness and augmented traction force in type 2 diabetic coronary microvascular smooth muscle. American Journal of Physiology-Heart and Circulatory Physiology. 2020 Jun 1;318(6):H1410-H1419.

Zhao MT, Shao NY, Garg V. Subtype-specific cardiomyocytes for precision medicine: Where are we now? Stem Cells. 2020 Mar 30. [Epub ahead of print]

182 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Stephen L. Lessnick, MD, PhD Director

Hematology/Oncology/BMT: See page 80 for information about the Division of Hematology, Oncology & Blood and Marrow Transplant at Nationwide Children’s Hospital.

Kevin A. Cassady, MD Dawn S. Chandler, PhD Long-Sheng Chang, PhD Genevieve C. Kendall, PhD

GRANTS AWARDED TO CENTER AND DIVISION CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020

Dean A. Lee, MD, PhD

$15,198,205

Jeffrey R. Leonard, MD

SELECTED PUBLICATIONS

Timothy P. Cripe, MD, PhD

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 Mar;15(3):1209-1236.

Benjamin Z. Stanton, PhD Emily R. Theisen, PhD

Reinecke JB, Roberts RD. Targetable Intercellular Signaling Pathways Facilitate Lung Colonization in Osteosarcoma. Advances in Experimental Medicine and Biology.

2020;1258:111-123.

Ruoning Wang, PhD Genevieve Kendall, PhD, and Emily Theisen, PhD, are new investigators in the Center for Childhood Cancer and Blood Diseases. Dr. Kendall’s research focuses on how single gene mutations (called translocations, such as PAX3/FOXO) can cause sarcomas (such as alveolar rhabdomyosarcoma) in children. Dr. Kendall uses zebrafish as her primary model system as this organism allows for direct observation of tumor development while also allowing for genetic manipulation to better understand how different genes work together to cause cancer. Dr. Theisen also focuses on sarcoma development and her research examines the interplay between epigenetic regulators (such as lysine specific demethylase 1, or LSD1) and cancer-causing translocations (such as EWS/FLI in Ewing sarcoma). Both of these laboratories are deeply interested in identifying therapeutic opportunities to disrupt

Showpnil, IR, Miller, KR, Taslim, CR, Pishas, K, Lessnick SL, and Theisen, ER. Mapping the structure-function relationships of disordered oncogenic transcription factors using transcriptomic analysis. Journal of Visualized Experiments. 2020 Jun 27;(160).

Wang T, Gnanaprakasam JNR, Chen X, Kang S, Xu X, Sun H, Liu L, Rodgers H, Miller E, Cassel TA, Sun Q, Vicente-Muñoz S, Warmoes MO, Lin P, Piedra-Quintero ZL, Gueraude-Arellano M, Cassady KA, Zheng SG, Yang J, Lane AN, Song X, Fan TW, Wang R. Inosine is an alternative carbon source for CD8+-T-cell function under glucose restriction.

Nature Metabolism. 2020 Jul;2(7):635-647. [Epub 2020 Jun 15] Wedekind MF, Cripe TP. Oncolytic Viruses and Their Potential as a Therapeutic Opportunity in Osteosarcoma. Advances in Experimental Medicine and Biology.

2020;1258:77-89.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 183

Research Institute Reports

Research Institute Reports

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 at Nationwide Children’s Hospital is to conduct innovative, mechanism-based research leading to improved therapies and outcomes for pediatric cardiovascular diseases and to foster preventive strategies and promote cardiovascular health in adults.

The mission of the Center for Childhood Cancer and Blood Diseases in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to transform the care of children, adolescents and young adults with cancer and blood diseases through research and clinical translation. Center investigators 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 Children’s, as well as with national and international colleagues, to translate these findings to the patient.

FACULTY

faculty members are investigating how the SARS-CoV-2 virus causes the heart damage observed in COVID-19 patients in collaboration with faculty in the Center for Vaccines and Immunity. Lastly, the center continues to support the cardiovascular research education of trainees at all levels. These efforts have been supported by an NIHfunded T32 postdoctoral training grant, along with an American Heart Association training award that supports summer research fellowships for undergraduate students.

FACULTY

the process of tumor development, and thereby support the development of new treatments for cancer in children.

These new teams are integrated with a growing collaborative of pediatric sarcoma research programs in the center. This collaborative has been leveraged in the form of multiple large, collaborative grants (U54 awards) from the National Institutes of Health and the National Cancer Institute as part of their Cancer Moonshot Initiative. One of these U54 awards is led by Stephen Lessnick, MD, PhD, and seeks to understand how the EWS/FLI mutant protein regulates genes that cause Ewing sarcoma. The second U54 award is led by Timothy Cripe, MD, PhD, and studies various aspects of how the immune system can be manipulated to treat pediatric cancers, including sarcomas.

The Heart Center: See page 40 for information about Cardiology and page 139 for Cardiovascular Surgery services.

Vidu Garg, MD Director Madhumita Basu, PhD Brenda Lilly, PhD Kim L. McBride, MD, MS Patrick I. McConnell, MD Aaron J. Trask, PhD Mingtao Zhao, DVM, PhD Our cardiovascular research projects span the spectrum from basic research, which occurs in the Center for Cardiovascular Research, to translational and clinical research that is performed in collaboration with clinicians in The Heart Center at Nationwide Children’s. Areas of focus include investigation into the genes and geneenvironment interactions that contribute to congenital heart defects, molecular and signaling pathways regulating normal heart and blood vessel development and how they are disrupted during disease development and progression.

The center faculty receive funding from the National Institutes of Health (NIH) and the American Heart Association (AHA) to support their cutting-edge research.

In the past year, Dr. Mingtao Zhao joined our center and brought expertise in stem cell biology to the center. Drs. Zhao, McBride and Garg along with other faculty in The Heart Center were awarded funding from the Additional Ventures Innovation Fund to study genetic and molecular aspects of single ventricle heart disease. Additionally,

GRANTS AWARDED TO HEART CENTER AND CARDIOVASCULAR RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $2,302,971 SELECTED PUBLICATIONS Majumdar U, Yasuhara J, Garg V. In vivo and in vitro genetic models of congenital heart disease. Cold Spring Harbor Perspectives in Biology. 2019 Dec 9;a036764.

Manivannan SN, Darouich S, Masmoudi A, Gordon D, Zender G, Han Z, FitzgeraldButt S, White P, McBride KL, Kharrat M, Garg V. Novel frameshift variant in myl2 reveals molecular differences between dominant and recessive forms of hypertrophic cardiomyopathy. PLoS Genetics. 2020 May;16(5):e1008639.

McCallinhart PE, Biwer LA, Clark OE, Isakson BE, Lilly B, Trask AJ. Myoendothelial junctions of mature coronary vessels express notch signaling proteins. Frontiers in Physiology. 2020 Feb 4;11:29.

McCallinhart PE, Cho Y, Sun Z, Ghadiali S, Meininger GA, Trask AJ. Reduced stiffness and augmented traction force in type 2 diabetic coronary microvascular smooth muscle. American Journal of Physiology-Heart and Circulatory Physiology. 2020 Jun 1;318(6):H1410-H1419.

Zhao MT, Shao NY, Garg V. Subtype-specific cardiomyocytes for precision medicine: Where are we now? Stem Cells. 2020 Mar 30. [Epub ahead of print]

182 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Stephen L. Lessnick, MD, PhD Director

Hematology/Oncology/BMT: See page 80 for information about the Division of Hematology, Oncology & Blood and Marrow Transplant at Nationwide Children’s Hospital.

Kevin A. Cassady, MD Dawn S. Chandler, PhD Long-Sheng Chang, PhD Genevieve C. Kendall, PhD

GRANTS AWARDED TO CENTER AND DIVISION CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020

Dean A. Lee, MD, PhD

$15,198,205

Jeffrey R. Leonard, MD

SELECTED PUBLICATIONS

Timothy P. Cripe, MD, PhD

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 Mar;15(3):1209-1236.

Benjamin Z. Stanton, PhD Emily R. Theisen, PhD

Reinecke JB, Roberts RD. Targetable Intercellular Signaling Pathways Facilitate Lung Colonization in Osteosarcoma. Advances in Experimental Medicine and Biology.

2020;1258:111-123.

Ruoning Wang, PhD Genevieve Kendall, PhD, and Emily Theisen, PhD, are new investigators in the Center for Childhood Cancer and Blood Diseases. Dr. Kendall’s research focuses on how single gene mutations (called translocations, such as PAX3/FOXO) can cause sarcomas (such as alveolar rhabdomyosarcoma) in children. Dr. Kendall uses zebrafish as her primary model system as this organism allows for direct observation of tumor development while also allowing for genetic manipulation to better understand how different genes work together to cause cancer. Dr. Theisen also focuses on sarcoma development and her research examines the interplay between epigenetic regulators (such as lysine specific demethylase 1, or LSD1) and cancer-causing translocations (such as EWS/FLI in Ewing sarcoma). Both of these laboratories are deeply interested in identifying therapeutic opportunities to disrupt

Showpnil, IR, Miller, KR, Taslim, CR, Pishas, K, Lessnick SL, and Theisen, ER. Mapping the structure-function relationships of disordered oncogenic transcription factors using transcriptomic analysis. Journal of Visualized Experiments. 2020 Jun 27;(160).

Wang T, Gnanaprakasam JNR, Chen X, Kang S, Xu X, Sun H, Liu L, Rodgers H, Miller E, Cassel TA, Sun Q, Vicente-Muñoz S, Warmoes MO, Lin P, Piedra-Quintero ZL, Gueraude-Arellano M, Cassady KA, Zheng SG, Yang J, Lane AN, Song X, Fan TW, Wang R. Inosine is an alternative carbon source for CD8+-T-cell function under glucose restriction.

Nature Metabolism. 2020 Jul;2(7):635-647. [Epub 2020 Jun 15] Wedekind MF, Cripe TP. Oncolytic Viruses and Their Potential as a Therapeutic Opportunity in Osteosarcoma. Advances in Experimental Medicine and Biology.

2020;1258:77-89.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 183

Research Institute Reports

Research Institute Reports

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 Children’s Hospital is committed to improving the diagnosis, treatment and outcomes of society’s most important pediatric diseases by integrating high-caliber basic science research with innovative patient-based research.

The primary mission of the Center for Gene Therapy in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to develop novel genetically based therapies for inherited diseases in order to ease the burden of these diseases on children and their families. This mission is pursued by a dedicated team of laboratory scientists whose work is directed toward clinical applications, and by the efforts of clinicianscientists who are tasked with bringing these therapies into clinical trials. To do this, the center works closely with the regulatory expert staff of Nationwide Children’s Drug and Device Development Services and the Nationwide Children’s Good Manufacturing Practice Clinical Manufacturing Facility. This integrated approach allows us to accelerate the transfer of promising therapies from the bench to the bedside.

FACULTY

William E. Smoyer, MD, FASN Director Shipra Agrawal, PhD Carlos E. Alvarez, PhD M. Brian Becknell, MD, PhD Andrea E. Bonny, MD David R. Brigstock, PhD Christina B. Ching, MD Mitchell H. Grayson, MD Mark W. Hall, MD, FAAP, FCCM Bryce A. Kerlin, MD Kirk M. McHugh, PhD Jennifer A. Muszynski, MD Olubukola O. Nafiu, MD Lance M. Relland, MD, PhD John David Spencer, MD Eric A. Sribnick, MD, PhD Rachel M. Stanley, MD, MHSA Rajan K. Thakkar, MD The Center for Clinical and Translational Research strives to create an environment in which patients, families, researchers and clinicians all collaborate to integrate “evidence-based medicine” with “evidence-generating medicine” to ensure children benefit from the latest advances in both medical knowledge and innovative treatments to improve their health.

Our center has scientists investigating several diverse areas of research. The overarching theme of our research programs is to bring new knowledge from both bedside to bench and from bench to bedside to improve the lives

of children. Our faculty are from three departments and represent nine different subspecialties: Nephrology, Hematology/Oncology, Adolescent Medicine, Critical Care, Urology, Pediatric Surgery, Anesthesia, Allergy/ Immunology and Emergency Medicine. Our research programs are very diverse and include innate immunity in urinary tract infections, immunoparalysis after sepsis or trauma, pathophysiology of stored RBC-induced immune suppression, novel treatments for nephrotic syndrome, pathophysiology of thrombosis, pathophysiology of bladder dysfunction in urinary tract obstruction, burn injury, abdominal sepsis, hepatic fibrosis, cancer genetics, adolescent addiction, interventions for traumatic brain injury, spinal cord injuries, mechanisms behind viral infection and allergic disease, perioperative respiratory complications, neonatal pain assessments and the role of pain control in immune function.

FACULTY

Kathleen Church, Project Manager Tabatha Simmons, PhD, Project Manager/Director, Gene Therapy Clinical Research Unit The Center for Gene Therapy again had a highly productive and collaborative year, facilitated by the NIH/NIAMS P50-funded Center of Research Translation (CORT) in Muscular Dystrophy Therapeutic Development, which focuses on rapidly moving innovative therapies toward the clinic.

Our vision is to use the delivery of care to each pediatric patient as an opportunity to learn how to improve future care. We believe it is our responsibility to learn from every patient so that subsequent children will be able to benefit from evidence-based improved care.

Kevin M. Flanigan, MD Director

Clinical Research Services is a core service provided within the Center for Clinical and Translational Research and is designed to be a portal through which clinical investigators can access streamlined coordination of services necessary to initiate clinical research projects, regardless of the funding source. Clinical Research Services supports all clinical research studies, providing staff and/or services to manage investigators’ studies according to good clinical practice and federal, state and institutional regulations and guidelines.

Scott Harper, PhD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $7,156,998 SELECTED PUBLICATIONS Derebail VK, Rheault MN, Kerlin BA. Role of direct oral anticoagulants in patients with kidney disease. Kidney International. 2020 Apr;97(4):664-675.

Nafiu OO, Chimbira WT. Albuterol and Pediatric Perioperative Respiratory Complications. JAMA Pediatrics. 2019 Sep 16. [Epub ahead of print] Sribnick EA, Hensley J, Moore-Clingenpeel M, Muszynski JA, Thakkar RK, Hall MW. Nosocomial Infection Following Severe Traumatic Injury in Children. Pediatric Critical Care Medicine. 2020 May;21(5):443-450.

Sribnick EA, Weber MD, Hall MW. Innate immune suppression after traumatic brain injury and hemorrhage in a juvenile rat model of polytrauma. Journal of Neuroimmunology. 2019 Dec 15;337:577073.

Thakkar RK, Weiss SL, Fitzgerald JC, et al. Risk Factors for Mortality in Pediatric Postsurgical versus Medical Severe Sepsis. The Journal of Surgical Research. 2019 Oct;242:100-110.

184 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SUPPORT STAFF

This year saw the widespread adoption by the neuromuscular community of the first adeno-associated viral (AAV) treatment for spinal muscular atrophy (SMA) — onasemnogene abeparvovec, which was developed at Nationwide Children’s — as well as the first publication of highly promising data from the first-in-human trial of AAV-delivered microdystrophin in patients with Duchenne muscular dystrophy. In addition, the first clinical trial of viral-mediated exon skipping was initiated with Nationwide Children’s as the sole site, using an AAV-delivered U7 small nuclear RNA (U7snRNA) in patients with exon duplications, with a goal of expressing full-length dystrophin. Other gene therapy trials continued, including for two forms of limb girdle muscular dystrophy, for mucopolysaccharidosis types 3A and 3B, and for CLN3- and CLN6-related Batten disease.

The operationalization of new trials was facilitated by the establishment of the Gene Therapy Clinical Research Unit, made available to all investigators.

PRINCIPAL INVESTIGATORS Allison Bradbury, PhD Stephen Kaler, MD, MPH Linda Lowes, PhD Paul Martin, PhD Jerry R. Mendell, MD Kathrin Meyer, PhD Zarife Sahenk, MD Megan Waldrop, MD Nicolas Wein, MD ASSOCIATE FACULTY Kim McBride, MD Christopher Walker, PhD 2019-2020 FELLOWS Nicolas Abreu, MD (Gene Therapy Fellow) Renatta Knox, MD, PhD (Neuromuscular Fellow)

Two additional faculty joined the center. Dr. Stephen Kaler relocated from the NICHD/NIH, with a longstanding interest in disorders of inherited neurometabolic, motor neuron and copper transport diseases, and ongoing translational programs that address Menkes disease and choroid plexus–targeted gene therapy for alpha-mannosidosis, among others. Dr. Allison Bradbury joined from the University of Pennsylvania, to further develop her translational programs in the leukodystrophies, including Krabbe disease.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 185

Research Institute Reports

Research Institute Reports

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 Children’s Hospital is committed to improving the diagnosis, treatment and outcomes of society’s most important pediatric diseases by integrating high-caliber basic science research with innovative patient-based research.

The primary mission of the Center for Gene Therapy in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to develop novel genetically based therapies for inherited diseases in order to ease the burden of these diseases on children and their families. This mission is pursued by a dedicated team of laboratory scientists whose work is directed toward clinical applications, and by the efforts of clinicianscientists who are tasked with bringing these therapies into clinical trials. To do this, the center works closely with the regulatory expert staff of Nationwide Children’s Drug and Device Development Services and the Nationwide Children’s Good Manufacturing Practice Clinical Manufacturing Facility. This integrated approach allows us to accelerate the transfer of promising therapies from the bench to the bedside.

FACULTY

William E. Smoyer, MD, FASN Director Shipra Agrawal, PhD Carlos E. Alvarez, PhD M. Brian Becknell, MD, PhD Andrea E. Bonny, MD David R. Brigstock, PhD Christina B. Ching, MD Mitchell H. Grayson, MD Mark W. Hall, MD, FAAP, FCCM Bryce A. Kerlin, MD Kirk M. McHugh, PhD Jennifer A. Muszynski, MD Olubukola O. Nafiu, MD Lance M. Relland, MD, PhD John David Spencer, MD Eric A. Sribnick, MD, PhD Rachel M. Stanley, MD, MHSA Rajan K. Thakkar, MD The Center for Clinical and Translational Research strives to create an environment in which patients, families, researchers and clinicians all collaborate to integrate “evidence-based medicine” with “evidence-generating medicine” to ensure children benefit from the latest advances in both medical knowledge and innovative treatments to improve their health.

Our center has scientists investigating several diverse areas of research. The overarching theme of our research programs is to bring new knowledge from both bedside to bench and from bench to bedside to improve the lives

of children. Our faculty are from three departments and represent nine different subspecialties: Nephrology, Hematology/Oncology, Adolescent Medicine, Critical Care, Urology, Pediatric Surgery, Anesthesia, Allergy/ Immunology and Emergency Medicine. Our research programs are very diverse and include innate immunity in urinary tract infections, immunoparalysis after sepsis or trauma, pathophysiology of stored RBC-induced immune suppression, novel treatments for nephrotic syndrome, pathophysiology of thrombosis, pathophysiology of bladder dysfunction in urinary tract obstruction, burn injury, abdominal sepsis, hepatic fibrosis, cancer genetics, adolescent addiction, interventions for traumatic brain injury, spinal cord injuries, mechanisms behind viral infection and allergic disease, perioperative respiratory complications, neonatal pain assessments and the role of pain control in immune function.

FACULTY

Kathleen Church, Project Manager Tabatha Simmons, PhD, Project Manager/Director, Gene Therapy Clinical Research Unit The Center for Gene Therapy again had a highly productive and collaborative year, facilitated by the NIH/NIAMS P50-funded Center of Research Translation (CORT) in Muscular Dystrophy Therapeutic Development, which focuses on rapidly moving innovative therapies toward the clinic.

Our vision is to use the delivery of care to each pediatric patient as an opportunity to learn how to improve future care. We believe it is our responsibility to learn from every patient so that subsequent children will be able to benefit from evidence-based improved care.

Kevin M. Flanigan, MD Director

Clinical Research Services is a core service provided within the Center for Clinical and Translational Research and is designed to be a portal through which clinical investigators can access streamlined coordination of services necessary to initiate clinical research projects, regardless of the funding source. Clinical Research Services supports all clinical research studies, providing staff and/or services to manage investigators’ studies according to good clinical practice and federal, state and institutional regulations and guidelines.

Scott Harper, PhD

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $7,156,998 SELECTED PUBLICATIONS Derebail VK, Rheault MN, Kerlin BA. Role of direct oral anticoagulants in patients with kidney disease. Kidney International. 2020 Apr;97(4):664-675.

Nafiu OO, Chimbira WT. Albuterol and Pediatric Perioperative Respiratory Complications. JAMA Pediatrics. 2019 Sep 16. [Epub ahead of print] Sribnick EA, Hensley J, Moore-Clingenpeel M, Muszynski JA, Thakkar RK, Hall MW. Nosocomial Infection Following Severe Traumatic Injury in Children. Pediatric Critical Care Medicine. 2020 May;21(5):443-450.

Sribnick EA, Weber MD, Hall MW. Innate immune suppression after traumatic brain injury and hemorrhage in a juvenile rat model of polytrauma. Journal of Neuroimmunology. 2019 Dec 15;337:577073.

Thakkar RK, Weiss SL, Fitzgerald JC, et al. Risk Factors for Mortality in Pediatric Postsurgical versus Medical Severe Sepsis. The Journal of Surgical Research. 2019 Oct;242:100-110.

184 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

SUPPORT STAFF

This year saw the widespread adoption by the neuromuscular community of the first adeno-associated viral (AAV) treatment for spinal muscular atrophy (SMA) — onasemnogene abeparvovec, which was developed at Nationwide Children’s — as well as the first publication of highly promising data from the first-in-human trial of AAV-delivered microdystrophin in patients with Duchenne muscular dystrophy. In addition, the first clinical trial of viral-mediated exon skipping was initiated with Nationwide Children’s as the sole site, using an AAV-delivered U7 small nuclear RNA (U7snRNA) in patients with exon duplications, with a goal of expressing full-length dystrophin. Other gene therapy trials continued, including for two forms of limb girdle muscular dystrophy, for mucopolysaccharidosis types 3A and 3B, and for CLN3- and CLN6-related Batten disease.

The operationalization of new trials was facilitated by the establishment of the Gene Therapy Clinical Research Unit, made available to all investigators.

PRINCIPAL INVESTIGATORS Allison Bradbury, PhD Stephen Kaler, MD, MPH Linda Lowes, PhD Paul Martin, PhD Jerry R. Mendell, MD Kathrin Meyer, PhD Zarife Sahenk, MD Megan Waldrop, MD Nicolas Wein, MD ASSOCIATE FACULTY Kim McBride, MD Christopher Walker, PhD 2019-2020 FELLOWS Nicolas Abreu, MD (Gene Therapy Fellow) Renatta Knox, MD, PhD (Neuromuscular Fellow)

Two additional faculty joined the center. Dr. Stephen Kaler relocated from the NICHD/NIH, with a longstanding interest in disorders of inherited neurometabolic, motor neuron and copper transport diseases, and ongoing translational programs that address Menkes disease and choroid plexus–targeted gene therapy for alpha-mannosidosis, among others. Dr. Allison Bradbury joined from the University of Pennsylvania, to further develop her translational programs in the leukodystrophies, including Krabbe disease.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 185

Research Institute Reports Other highlights included development of a novel approach to visualizing the overexpression of DUX4, providing a novel tool for the study of the complex molecular mechanism responsible for facioscapulohumeral muscular dystrophy; a large animal study demonstrating the feasibility of systemic delivery of the GALGT2 gene as a surrogate gene therapy for DMD; and the validation of a novel reachable workspace as a measure of motor function in SMA.

CENTER FOR INJURY RESEARCH AND POLICY

Neurology: See page 104 for related information about the Section of Neurology at Nationwide Children’s.

FACULTY

The Center for Injury Research and Policy, located in the Abigail Wexner Research Institute at Nationwide Children’s Hospital, works globally to reduce injury-related pediatric death and disability. Established in 1999, the center serves as a pioneer by translating cutting-edge injury research into education, advocacy and advances in clinical care. From design changes in consumer products to new public policy, the Center for Injury Research and Policy’s influence is leading the way to a safer world. research to achieve the best outcomes for pediatric trauma patients. Focusing on pre-hospital emergency medical services, acute treatment and rehabilitation care, researchers associated with the Center for Pediatric Trauma Research help promote the Center for Injury Research and Policy’s mission.

GRANTS AWARDED TO CENTER FOR GENE THERAPY AND NEUROLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $17,070,837

The Make Safe Happen® app helps parents and caregivers overcome a perceived “overwhelming amount of advice” to make their homes safer for children. Developed by a team led by Lara McKenzie, PhD, MA, it addresses the difficulties parents and caregivers face when trying to keep their homes safe for their children. It provides parents and caregivers with room-by-room safety checklists, and links to purchase recommended safety products. Recognizing that not all homes are the same, the app offers different solutions for different situations. Users can set reminders for activities, such as monthly smoke alarm testing or annual replacement of smoke alarm batteries. In 2016, a Home Fire Drill feature was added, so families can choose a safe meeting place and practice getting out of the home in less than two minutes.

The Nationwide Make Safe Happen campaign for Home Fire Drill Day was the winner of the 2017 Halo Award in the category of Best Message-Focused Campaign. The free app is available for iOS and Android systems and has been downloaded more than 67,000 times since early 2015.

SELECTED PUBLICATIONS 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 Interactive Video Evaluation) workspace volume video game to quantify meaningful change in spinal muscular atrophy. Developmental Medicine & Child Neurology. 2020 Mar;62(3):303-309.

Amini Chermahini G, Rashnonejad A, Harper SQ. RNAscope in situ hybridization-based method for detecting DUX4 RNA expression in vitro. RNA. 2019 Sep;25(9):1211-1217.

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

Lowes LP, Alfano LN, Arnold WD, Shell R, Prior TW, McColly M, Lehman KJ, Church K, Sproule DM, Nagendran S, Menier M, Feltner DE, Wells C, Kissel JT, Al-Zaidy S, Mendell JR. Impact of Age and Motor Function in a Phase 1/2A Study of Infants With SMA Type 1 Receiving Single-Dose Gene Replacement Therapy. Pediatric Neurology. 2019 Sep;98:39-45.

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 Neurology. 2020 Jun 15:e201484.

Zygmunt DA, Xu R, Jia Y, Ashbrook A, Menke C, Shao G, Yoon JH, Hamilton S, Pisharath H, Bolon B, Martin PT. rAAVrh74.MCK. GALGT2 Demonstrates Safety and Widespread Muscle Glycosylation after Intravenous Delivery in C57BL/6J Mice.

Molecular Therapy – Methods & Clinical Development. 2019 Oct 21;15:305-319.

Gary A. Smith, MD, DrPH Director Julie C. Leonard, MD, MPH Lara B. McKenzie, PhD, MA Henry Xiang, MD, MPH, PhD Jinzghen (Ginger) Yang, PhD, MPH Motao Zhu, MD, MS, PhD POSTDOCTORAL FELLOWS Marco Benedetti, PhD Lindsay Sullivan, PhD The Center for Injury Research and Policy works from local to global levels to reduce death and disability due to injuries through research, education, advocacy and advances in clinical care. The center aims to improve the scientific understanding of the epidemiology, prevention, acute treatment, rehabilitation and biomechanics of injuries. It provides leadership in the development, implementation and scientific evaluation of public policy regarding control of injuries.

The center has been awarded designation as an Injury Control Research Center (ICRC) by the Centers for Disease Control and Prevention since 2008. This designation was recently renewed through 2024. CIRP is one of only 9 centers nationally with this designation, and it is the only ICRC focused on pediatric injury research and prevention.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $4,972,023 SELECTED PUBLICATIONS Coxe K, Sullivan L, Newton A, Yang JZ. Barriers to the implementation of State Concussion Laws within high schools. Journal of Adolescent Health. 2020 Feb;66(2):233-239.

Li A, Shen S, Nwosu A, Ratnapradipa K, Cooper J, Zhu M. Investigating traffic fatality trends and restraint use among rear-seat passengers in the United States, 2000-2016. Journal of Safety Research. 2020 Jun;73:9-16.

Merten JW, Roberts KJ, King JL, McKenzie LB. Pinterest Homemade Sunscreens: A Recipe for Sunburn. Health Communication. 2020 Aug;35(9):1123-1128.

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 Level. Journal of the American Statistical Association. 2020 Apr 3. [Epub ahead of print] 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 186 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 187

Research Institute Reports Other highlights included development of a novel approach to visualizing the overexpression of DUX4, providing a novel tool for the study of the complex molecular mechanism responsible for facioscapulohumeral muscular dystrophy; a large animal study demonstrating the feasibility of systemic delivery of the GALGT2 gene as a surrogate gene therapy for DMD; and the validation of a novel reachable workspace as a measure of motor function in SMA.

CENTER FOR INJURY RESEARCH AND POLICY

Neurology: See page 104 for related information about the Section of Neurology at Nationwide Children’s.

FACULTY

The Center for Injury Research and Policy, located in the Abigail Wexner Research Institute at Nationwide Children’s Hospital, works globally to reduce injury-related pediatric death and disability. Established in 1999, the center serves as a pioneer by translating cutting-edge injury research into education, advocacy and advances in clinical care. From design changes in consumer products to new public policy, the Center for Injury Research and Policy’s influence is leading the way to a safer world. research to achieve the best outcomes for pediatric trauma patients. Focusing on pre-hospital emergency medical services, acute treatment and rehabilitation care, researchers associated with the Center for Pediatric Trauma Research help promote the Center for Injury Research and Policy’s mission.

GRANTS AWARDED TO CENTER FOR GENE THERAPY AND NEUROLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $17,070,837

The Make Safe Happen® app helps parents and caregivers overcome a perceived “overwhelming amount of advice” to make their homes safer for children. Developed by a team led by Lara McKenzie, PhD, MA, it addresses the difficulties parents and caregivers face when trying to keep their homes safe for their children. It provides parents and caregivers with room-by-room safety checklists, and links to purchase recommended safety products. Recognizing that not all homes are the same, the app offers different solutions for different situations. Users can set reminders for activities, such as monthly smoke alarm testing or annual replacement of smoke alarm batteries. In 2016, a Home Fire Drill feature was added, so families can choose a safe meeting place and practice getting out of the home in less than two minutes.

The Nationwide Make Safe Happen campaign for Home Fire Drill Day was the winner of the 2017 Halo Award in the category of Best Message-Focused Campaign. The free app is available for iOS and Android systems and has been downloaded more than 67,000 times since early 2015.

SELECTED PUBLICATIONS 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 Interactive Video Evaluation) workspace volume video game to quantify meaningful change in spinal muscular atrophy. Developmental Medicine & Child Neurology. 2020 Mar;62(3):303-309.

Amini Chermahini G, Rashnonejad A, Harper SQ. RNAscope in situ hybridization-based method for detecting DUX4 RNA expression in vitro. RNA. 2019 Sep;25(9):1211-1217.

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

Lowes LP, Alfano LN, Arnold WD, Shell R, Prior TW, McColly M, Lehman KJ, Church K, Sproule DM, Nagendran S, Menier M, Feltner DE, Wells C, Kissel JT, Al-Zaidy S, Mendell JR. Impact of Age and Motor Function in a Phase 1/2A Study of Infants With SMA Type 1 Receiving Single-Dose Gene Replacement Therapy. Pediatric Neurology. 2019 Sep;98:39-45.

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 Neurology. 2020 Jun 15:e201484.

Zygmunt DA, Xu R, Jia Y, Ashbrook A, Menke C, Shao G, Yoon JH, Hamilton S, Pisharath H, Bolon B, Martin PT. rAAVrh74.MCK. GALGT2 Demonstrates Safety and Widespread Muscle Glycosylation after Intravenous Delivery in C57BL/6J Mice.

Molecular Therapy – Methods & Clinical Development. 2019 Oct 21;15:305-319.

Gary A. Smith, MD, DrPH Director Julie C. Leonard, MD, MPH Lara B. McKenzie, PhD, MA Henry Xiang, MD, MPH, PhD Jinzghen (Ginger) Yang, PhD, MPH Motao Zhu, MD, MS, PhD POSTDOCTORAL FELLOWS Marco Benedetti, PhD Lindsay Sullivan, PhD The Center for Injury Research and Policy works from local to global levels to reduce death and disability due to injuries through research, education, advocacy and advances in clinical care. The center aims to improve the scientific understanding of the epidemiology, prevention, acute treatment, rehabilitation and biomechanics of injuries. It provides leadership in the development, implementation and scientific evaluation of public policy regarding control of injuries.

The center has been awarded designation as an Injury Control Research Center (ICRC) by the Centers for Disease Control and Prevention since 2008. This designation was recently renewed through 2024. CIRP is one of only 9 centers nationally with this designation, and it is the only ICRC focused on pediatric injury research and prevention.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $4,972,023 SELECTED PUBLICATIONS Coxe K, Sullivan L, Newton A, Yang JZ. Barriers to the implementation of State Concussion Laws within high schools. Journal of Adolescent Health. 2020 Feb;66(2):233-239.

Li A, Shen S, Nwosu A, Ratnapradipa K, Cooper J, Zhu M. Investigating traffic fatality trends and restraint use among rear-seat passengers in the United States, 2000-2016. Journal of Safety Research. 2020 Jun;73:9-16.

Merten JW, Roberts KJ, King JL, McKenzie LB. Pinterest Homemade Sunscreens: A Recipe for Sunburn. Health Communication. 2020 Aug;35(9):1123-1128.

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 Level. Journal of the American Statistical Association. 2020 Apr 3. [Epub ahead of print] 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 186 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 187

Research Institute Reports

Research Institute Reports

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 Nationwide Children’s Hospital is to advance child health and well-being through research in and across clinical care, health services, health policy and community initiatives. We aspire to lead the nation in groundbreaking research that produces reduced disparities, vibrant communities, flourishing families and equitable and best outcomes for all children. Investigators at the center develop and test new health service delivery and payment systems in partnership with pediatricians, payers and Nationwide Children’s to improve quality and equity of care — especially for those patients most at risk.

The emphasis of the Center for Microbial Pathogenesis in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to develop a greater understanding of the molecular mechanisms by which microorganisms cause disease, as well as how the host responds to these disease states. Faculty within the center identify virulence mechanisms and define host response patterns, with the overall objective of elucidating a detailed description of the structure, function and control of biological systems in health and disease via use of molecular and cellular, as well as genomic, proteomic, transcriptomic and metabolomic 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, community development as an intervention for health and the health system’s role in advancing population health.

FACULTY

Center for Surgical Outcomes Research faculty published results from their groundbreaking research on non-operative treatment of uncomplicated appendicitis along with research on disparities in pediatric tonsillectomy and opioid prescribing. The center welcomed Dr. Prasanth Pattisapu, ENT, as a new investigator.

Deena J. Chisolm, PhD Director Susan E. Creary, MD, MSc Jennifer L. Dotson, MD, MPH Laura C. Hart, MD Kelly J. Kelleher, MD, MPH Alex R. Kemper, MD Amrik S. Khalsa, MD Sarah H. O’Brien, MD, MSc Jordee M. Wells, MD, MPH CENTER FOR SURGICAL OUTCOMES RESEARCH Jennifer N. Cooper, PhD Katherine J. Deans, MD, MHSc, Co-Director Daryl J. McLeod, MD Peter C. Minneci, MD, MHSc, Co-Director Prasanth Pattisapu, MD, MPH CENTER FOR SUICIDE PREVENTION AND RESEARCH Jeffrey A. Bridge, PhD, Director Arielle H. Sheftall, PhD Ohio Department of Medicaid, Dr. Deena Chisolm was awarded a $14.9 million Integrated Care for Kids (InCK) cooperative agreement from CMS to study innovative approaches to reducing out of home placement in rural, Medicaid-enrolled youth. Dr. Jordee Wells was awarded an NICHD diversity supplement to study racial disparities in pediatric head trauma follow-up care. Dr. Sarah O’Brien was named co-investigator on a new R21 awarded to Texas Children’s Hospital, studying iron deficiency anemia in

Center for Suicide Prevention and Research investigators explored early correlates of pediatric suicidality, trends in youth suicidal behavior and intensive crisis intervention. The center moved to its new space in the Big Lots Behavioral Health Pavilion, supporting expanded integration of research, treatment and prevention.

Faculty member achievements include: Dr. Katherine Deans appointed as the Chief Clinical Science Officer in the Abigail Wexner Research Institute and Dr. Chisolm named as Nationwide Foundation Endowed Chair in Health Equity Research and appointed to the state’s Minority Health Task Force for COVID-19, Dr. Jeffrey Bridge named as Nationwide Foundation Endowed Chair in Innovation in Behavioral Health Research and Dr. Arielle Sheftall received a Young Investigator Award from the American Foundation for Suicide Prevention.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,955,692 SELECTED PUBLICATIONS Chisolm DJ, Jones C, Root ED, Dolce M, Kelleher KJ. A Community Development Program and Reduction in High-Cost Health Care Use. Pediatrics. 2020 Aug;146(2):e20194053.

Creary S, Chisolm DJ, Stanek J, Neville K, Garg U, Hankins JS, O’Brien SH. Measuring hydroxyurea adherence by pharmacy and laboratory data compared with video observation in children with sickle cell disease. Pediatric Blood & Cancer. 2020 Aug;67(8):e28250.

Kemper AR, Kelleher KJ, Allen S, Sander C, Brilli RJ. Improving the Health of All Children in Our Community: The Nationwide Children’s Hospital and Franklin County, Ohio, Pediatric Vital Signs Project. The Journal of Pediatrics. 2020 Jul;222:227-230. [Epub May 13 2020] Minneci PC, Hade EM, Lawrence AE, Sebastião YV, Saito JM, Mak GZ, Fox C, Hirschl RB, Gadepalli S, Helmrath MA, Kohler JE, Leys CM, Sato TT, Lal DR, Landman MP, Kabre R, Fallat ME, Cooper JN, Deans KJ; Midwest Pediatric Surgery Consortium. Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis. JAMA. 2020 Jul 27;324(6):581-593.

Sheftall, A. H., Bergdoll, E. E., James, M., Bauer, C., Spector, E., Vakil, F., Armstrong, E., Allen, J., & Bridge, J. A. Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Study. Child Psychiatry and Human Development. 2020 Jun 1. [Epub ahead of print]

188 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Lauren O. Bakaletz, PhD Director Michael T. Bailey, PhD Jennifer L. Edwards, PhD Steven D. Goodman, PhD John S. Gunn, PhD Sheryl S. Justice, PhD Samantha J. King, PhD Benjamin T. Kopp, MD Ross M. Maltz, MD Kevin M. Mason, PhD Christopher P. Montgomery, MD Santiago Partida-Sanchez, PhD Chack-Yung Yu, PhD Each faculty member within the center highlighted a noteworthy accomplishment for the 2019-2020 academic year. Michael Bailey, PhD, and his team discovered that the production of reactive oxygen intermediates by intestinal epithelial cells, a primary mechanism by which the host response to stressful stimuli, leads to changes in the gut microbiome. Lauren Bakaletz, PhD, and Steven Goodman, PhD, cite both their recent publication in Proceedings of the National Academy of Sciences and the successful co-founding and

launch of Clarametyx Biosciences Inc. to move forward promising technology that disrupts diverse pathogenic biofilms. The laboratory of Jennifer Edwards, PhD, identified and patented two nontraditional antibiotics that can be used to prevent and cure female cervical infection by “untreatable” Neisseria gonorrhoeae. John Gunn, PhD, was awarded two new National Institutes of Health grants important to ongoing research into the mechanisms of gallstone biofilm-related chronic carriage of Salmonella. Sheryl Justice, PhD, demonstrated that bacterial mutants enhance formation of intracellular bacterial communities, providing more insight into the nutritional requirements for intracellular growth.

Samantha King, PhD, was awarded a new R21 grant by the National Institute of Allergy and Infectious Diseases to study the serine-rich repeat protein adhesin of the infective endocarditis pathogen Streptococcus oralis. Ben Kopp, MD, was awarded his first R01 National Institutes of Health/National Heart Lung and Blood Institute grant titled, “The role of CFTR during macrophage-mediated killing of bacteria.” The laboratory of Ross Maltz, MD, launched a longitudinal clinical trial in pediatric Crohn’s disease and developed two murine models for use in his research. Kevin Mason, PhD, developed a sequential model of otitis media to investigate microevolution through genetic mutations that modulate disease severity. The laboratory of Christopher Montgomery, MD, demonstrated that genetically determined immunodominance inhibits “natural” protective immunity against Staphylococcus aureus infection in mice, but vaccination overcomes this restriction. Santiago Partida-Sanchez, PhD, was awarded a grant by the Cystic Fibrosis Foundation and published six research articles. Chack-Yung Yu, PhD, obtained evidence for a role complement C4 and C3 phenotypic and genotypic diversity as risk factors for cardiovascular diseases.

Infectious Diseases: See page 88 for information about the Division of Infectious Diseases at Nationwide Children’s.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 189

Research Institute Reports

Research Institute Reports

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 Nationwide Children’s Hospital is to advance child health and well-being through research in and across clinical care, health services, health policy and community initiatives. We aspire to lead the nation in groundbreaking research that produces reduced disparities, vibrant communities, flourishing families and equitable and best outcomes for all children. Investigators at the center develop and test new health service delivery and payment systems in partnership with pediatricians, payers and Nationwide Children’s to improve quality and equity of care — especially for those patients most at risk.

The emphasis of the Center for Microbial Pathogenesis in the Abigail Wexner Research Institute at Nationwide Children’s Hospital is to develop a greater understanding of the molecular mechanisms by which microorganisms cause disease, as well as how the host responds to these disease states. Faculty within the center identify virulence mechanisms and define host response patterns, with the overall objective of elucidating a detailed description of the structure, function and control of biological systems in health and disease via use of molecular and cellular, as well as genomic, proteomic, transcriptomic and metabolomic 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, community development as an intervention for health and the health system’s role in advancing population health.

FACULTY

Center for Surgical Outcomes Research faculty published results from their groundbreaking research on non-operative treatment of uncomplicated appendicitis along with research on disparities in pediatric tonsillectomy and opioid prescribing. The center welcomed Dr. Prasanth Pattisapu, ENT, as a new investigator.

Deena J. Chisolm, PhD Director Susan E. Creary, MD, MSc Jennifer L. Dotson, MD, MPH Laura C. Hart, MD Kelly J. Kelleher, MD, MPH Alex R. Kemper, MD Amrik S. Khalsa, MD Sarah H. O’Brien, MD, MSc Jordee M. Wells, MD, MPH CENTER FOR SURGICAL OUTCOMES RESEARCH Jennifer N. Cooper, PhD Katherine J. Deans, MD, MHSc, Co-Director Daryl J. McLeod, MD Peter C. Minneci, MD, MHSc, Co-Director Prasanth Pattisapu, MD, MPH CENTER FOR SUICIDE PREVENTION AND RESEARCH Jeffrey A. Bridge, PhD, Director Arielle H. Sheftall, PhD Ohio Department of Medicaid, Dr. Deena Chisolm was awarded a $14.9 million Integrated Care for Kids (InCK) cooperative agreement from CMS to study innovative approaches to reducing out of home placement in rural, Medicaid-enrolled youth. Dr. Jordee Wells was awarded an NICHD diversity supplement to study racial disparities in pediatric head trauma follow-up care. Dr. Sarah O’Brien was named co-investigator on a new R21 awarded to Texas Children’s Hospital, studying iron deficiency anemia in

Center for Suicide Prevention and Research investigators explored early correlates of pediatric suicidality, trends in youth suicidal behavior and intensive crisis intervention. The center moved to its new space in the Big Lots Behavioral Health Pavilion, supporting expanded integration of research, treatment and prevention.

Faculty member achievements include: Dr. Katherine Deans appointed as the Chief Clinical Science Officer in the Abigail Wexner Research Institute and Dr. Chisolm named as Nationwide Foundation Endowed Chair in Health Equity Research and appointed to the state’s Minority Health Task Force for COVID-19, Dr. Jeffrey Bridge named as Nationwide Foundation Endowed Chair in Innovation in Behavioral Health Research and Dr. Arielle Sheftall received a Young Investigator Award from the American Foundation for Suicide Prevention.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,955,692 SELECTED PUBLICATIONS Chisolm DJ, Jones C, Root ED, Dolce M, Kelleher KJ. A Community Development Program and Reduction in High-Cost Health Care Use. Pediatrics. 2020 Aug;146(2):e20194053.

Creary S, Chisolm DJ, Stanek J, Neville K, Garg U, Hankins JS, O’Brien SH. Measuring hydroxyurea adherence by pharmacy and laboratory data compared with video observation in children with sickle cell disease. Pediatric Blood & Cancer. 2020 Aug;67(8):e28250.

Kemper AR, Kelleher KJ, Allen S, Sander C, Brilli RJ. Improving the Health of All Children in Our Community: The Nationwide Children’s Hospital and Franklin County, Ohio, Pediatric Vital Signs Project. The Journal of Pediatrics. 2020 Jul;222:227-230. [Epub May 13 2020] Minneci PC, Hade EM, Lawrence AE, Sebastião YV, Saito JM, Mak GZ, Fox C, Hirschl RB, Gadepalli S, Helmrath MA, Kohler JE, Leys CM, Sato TT, Lal DR, Landman MP, Kabre R, Fallat ME, Cooper JN, Deans KJ; Midwest Pediatric Surgery Consortium. Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis. JAMA. 2020 Jul 27;324(6):581-593.

Sheftall, A. H., Bergdoll, E. E., James, M., Bauer, C., Spector, E., Vakil, F., Armstrong, E., Allen, J., & Bridge, J. A. Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Study. Child Psychiatry and Human Development. 2020 Jun 1. [Epub ahead of print]

188 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Lauren O. Bakaletz, PhD Director Michael T. Bailey, PhD Jennifer L. Edwards, PhD Steven D. Goodman, PhD John S. Gunn, PhD Sheryl S. Justice, PhD Samantha J. King, PhD Benjamin T. Kopp, MD Ross M. Maltz, MD Kevin M. Mason, PhD Christopher P. Montgomery, MD Santiago Partida-Sanchez, PhD Chack-Yung Yu, PhD Each faculty member within the center highlighted a noteworthy accomplishment for the 2019-2020 academic year. Michael Bailey, PhD, and his team discovered that the production of reactive oxygen intermediates by intestinal epithelial cells, a primary mechanism by which the host response to stressful stimuli, leads to changes in the gut microbiome. Lauren Bakaletz, PhD, and Steven Goodman, PhD, cite both their recent publication in Proceedings of the National Academy of Sciences and the successful co-founding and

launch of Clarametyx Biosciences Inc. to move forward promising technology that disrupts diverse pathogenic biofilms. The laboratory of Jennifer Edwards, PhD, identified and patented two nontraditional antibiotics that can be used to prevent and cure female cervical infection by “untreatable” Neisseria gonorrhoeae. John Gunn, PhD, was awarded two new National Institutes of Health grants important to ongoing research into the mechanisms of gallstone biofilm-related chronic carriage of Salmonella. Sheryl Justice, PhD, demonstrated that bacterial mutants enhance formation of intracellular bacterial communities, providing more insight into the nutritional requirements for intracellular growth.

Samantha King, PhD, was awarded a new R21 grant by the National Institute of Allergy and Infectious Diseases to study the serine-rich repeat protein adhesin of the infective endocarditis pathogen Streptococcus oralis. Ben Kopp, MD, was awarded his first R01 National Institutes of Health/National Heart Lung and Blood Institute grant titled, “The role of CFTR during macrophage-mediated killing of bacteria.” The laboratory of Ross Maltz, MD, launched a longitudinal clinical trial in pediatric Crohn’s disease and developed two murine models for use in his research. Kevin Mason, PhD, developed a sequential model of otitis media to investigate microevolution through genetic mutations that modulate disease severity. The laboratory of Christopher Montgomery, MD, demonstrated that genetically determined immunodominance inhibits “natural” protective immunity against Staphylococcus aureus infection in mice, but vaccination overcomes this restriction. Santiago Partida-Sanchez, PhD, was awarded a grant by the Cystic Fibrosis Foundation and published six research articles. Chack-Yung Yu, PhD, obtained evidence for a role complement C4 and C3 phenotypic and genotypic diversity as risk factors for cardiovascular diseases.

Infectious Diseases: See page 88 for information about the Division of Infectious Diseases at Nationwide Children’s.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 189

Research Institute Reports GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $4,028,402 SELECTED PUBLICATIONS 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 Junction Recombination Intermediates. Proceedings of the National Academy of Sciences of the United States of America. Dec 2019;116(50):25068-25077.

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 Model Involves a Type 2 Immune Shift and T and B Cell Recruitment to the Gallbladder. mBio. Oct 2019;10(5):e02262-19.

CENTER FOR PERINATAL RESEARCH The Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s Hospital 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 Research is to conduct innovative basic, translational and clinical research focused on prevention of preterm birth and improvement of prematurity-related outcomes.

FACULTY

research delves into prematurity prevention and maternal health (Klebanoff), infant feeding disorders (Jadcherla), infectious diseases (Sanchez), comparative effectiveness in pharmacoepidemiology (Slaughter), cardiopulmonary deficiencies (Backes, Pavlek) and development of novel treatments and approaches for improving outcomes in infants with neurological disorders or injuries (Maitre, Neel, Benninger). The center received more than $600,000 in new prime NIH funding this year. Collectively, the Center for Perinatal Research brought in $4.1 million in NIH funding and $1.2 million in foundation and industry grants for the purpose of research. The center also is home to one of the sites of the Neonatal Research Network, a consortium of 17 institutions from across the United States funded by the NIH to conduct randomized, controlled trials of promising therapies and observational studies to advance care of highest risk newborns. In addition, our accomplished investigators have filed multiple patents for devices to improve infant outcomes.

Harrison A, Hardison RL, Fullen AR, Wallace RM, Gordon DM, White P, Jennings RN, Justice SS, Mason KM. Continuous Microevolution Accelerates Disease Progression During Sequential Episodes of Infection. Cell Reports. Mar 2020;30(9):2978-2988.

Poole J, Day CJ, Haselhorst T, Jen FE-C, Torres VJ, Edwards JL, Jennings MP. Repurposed Drugs that Block the Gonococcal-Complement Receptor 3 Interaction Can Prevent and Cure Gonococcal Infection of Primary Human Cervical Epithelial Cells. mBio. Mar 2020;11(2):e03046-19.

Si Y, Zhao F, Beesetty P, Weiskopf D, Li Z, Tian Q, Alegre ML, Sette A, Chong AS, Montgomery CP. Inhibition of Protective Immunity Against Staphylococcus aureus Infection by MHC-Restricted Immunodominance is Overcome by Vaccination. Science Advances. Apr 2020;6(14):eaaw7713.

Lynette K. Rogers, PhD Interim Director Carl H. Backes, MD Kristen Benninger, MD Gail E. Besner, MD Rodney Britt, PhD Bernadette Chen, MD Sudarshan R. Jadcherla, MD Mark A. Klebanoff, MD, MPH Yusen Liu, PhD Nathalie Maitre, MD, PhD Mary Lauren Neel, MD Leif D. Nelin, MD Leeann R. Pavlek, MD, MPH Susan Reynolds, PhD Pablo Sanchez, MD Jonathan L. Slaughter, MD, MPH Jennifer K. Trittmann, MD, MPH

Neonatology: See page 94 for information about Neonatology, home to one of the largest networks of clinical neonatal care in the United States.

GRANTS AWARDED TO NEONATOLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $5,562,391 SELECTED PUBLICATIONS

Complications from preterm birth are the leading cause of infant mortality and morbidity. The investigators in the Center for Perinatal Research focus on prevention of prematurity and understanding and treating the complications that occur in as a result of preterm birth.

Our diverse team encompasses expertise in both basic science and clinical investigations. The basic science group explores the mechanisms involved in development of chronic lung disease such as bronchopulmonary dysplasia (Rogers), pulmonary hypertension (Nelin, 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 190 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

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 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 Vesicles. Nutrients. 2020 Mar 11;12(3):745.

Jadcherla SR, Hasenstab KA, Wei L, Osborn EK, Viswanathan S, Gulati IK, Slaughter JL, 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.

[Epub ahead of print] Klebanoff MA, Wilkins DG, Keim SA. Marijuana Use during Pregnancy and Preterm Birth: A Prospective Cohort Study. American Journal of Perinatology. 2020 Apr 1. [Epub ahead of print] Pavlek LR, Vudatala S, Bartlett CW, Buhimschi IA, Buhimschi CS, Rogers LK. MiR-29b is associated with perinatal inflammation in extremely preterm infants. Pediatric Research. 2020 May 9. [Epub ahead of print]

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 191

Research Institute Reports GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $4,028,402 SELECTED PUBLICATIONS 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 Junction Recombination Intermediates. Proceedings of the National Academy of Sciences of the United States of America. Dec 2019;116(50):25068-25077.

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 Model Involves a Type 2 Immune Shift and T and B Cell Recruitment to the Gallbladder. mBio. Oct 2019;10(5):e02262-19.

CENTER FOR PERINATAL RESEARCH The Center for Perinatal Research in the Abigail Wexner Research Institute at Nationwide Children’s Hospital 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 Research is to conduct innovative basic, translational and clinical research focused on prevention of preterm birth and improvement of prematurity-related outcomes.

FACULTY

research delves into prematurity prevention and maternal health (Klebanoff), infant feeding disorders (Jadcherla), infectious diseases (Sanchez), comparative effectiveness in pharmacoepidemiology (Slaughter), cardiopulmonary deficiencies (Backes, Pavlek) and development of novel treatments and approaches for improving outcomes in infants with neurological disorders or injuries (Maitre, Neel, Benninger). The center received more than $600,000 in new prime NIH funding this year. Collectively, the Center for Perinatal Research brought in $4.1 million in NIH funding and $1.2 million in foundation and industry grants for the purpose of research. The center also is home to one of the sites of the Neonatal Research Network, a consortium of 17 institutions from across the United States funded by the NIH to conduct randomized, controlled trials of promising therapies and observational studies to advance care of highest risk newborns. In addition, our accomplished investigators have filed multiple patents for devices to improve infant outcomes.

Harrison A, Hardison RL, Fullen AR, Wallace RM, Gordon DM, White P, Jennings RN, Justice SS, Mason KM. Continuous Microevolution Accelerates Disease Progression During Sequential Episodes of Infection. Cell Reports. Mar 2020;30(9):2978-2988.

Poole J, Day CJ, Haselhorst T, Jen FE-C, Torres VJ, Edwards JL, Jennings MP. Repurposed Drugs that Block the Gonococcal-Complement Receptor 3 Interaction Can Prevent and Cure Gonococcal Infection of Primary Human Cervical Epithelial Cells. mBio. Mar 2020;11(2):e03046-19.

Si Y, Zhao F, Beesetty P, Weiskopf D, Li Z, Tian Q, Alegre ML, Sette A, Chong AS, Montgomery CP. Inhibition of Protective Immunity Against Staphylococcus aureus Infection by MHC-Restricted Immunodominance is Overcome by Vaccination. Science Advances. Apr 2020;6(14):eaaw7713.

Lynette K. Rogers, PhD Interim Director Carl H. Backes, MD Kristen Benninger, MD Gail E. Besner, MD Rodney Britt, PhD Bernadette Chen, MD Sudarshan R. Jadcherla, MD Mark A. Klebanoff, MD, MPH Yusen Liu, PhD Nathalie Maitre, MD, PhD Mary Lauren Neel, MD Leif D. Nelin, MD Leeann R. Pavlek, MD, MPH Susan Reynolds, PhD Pablo Sanchez, MD Jonathan L. Slaughter, MD, MPH Jennifer K. Trittmann, MD, MPH

Neonatology: See page 94 for information about Neonatology, home to one of the largest networks of clinical neonatal care in the United States.

GRANTS AWARDED TO NEONATOLOGY CLINICAL AND RESEARCH FACULTY JULY 1, 2019 – JUNE 30, 2020 $5,562,391 SELECTED PUBLICATIONS

Complications from preterm birth are the leading cause of infant mortality and morbidity. The investigators in the Center for Perinatal Research focus on prevention of prematurity and understanding and treating the complications that occur in as a result of preterm birth.

Our diverse team encompasses expertise in both basic science and clinical investigations. The basic science group explores the mechanisms involved in development of chronic lung disease such as bronchopulmonary dysplasia (Rogers), pulmonary hypertension (Nelin, 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 190 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

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 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 Vesicles. Nutrients. 2020 Mar 11;12(3):745.

Jadcherla SR, Hasenstab KA, Wei L, Osborn EK, Viswanathan S, Gulati IK, Slaughter JL, 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.

[Epub ahead of print] Klebanoff MA, Wilkins DG, Keim SA. Marijuana Use during Pregnancy and Preterm Birth: A Prospective Cohort Study. American Journal of Perinatology. 2020 Apr 1. [Epub ahead of print] Pavlek LR, Vudatala S, Bartlett CW, Buhimschi IA, Buhimschi CS, Rogers LK. MiR-29b is associated with perinatal inflammation in extremely preterm infants. Pediatric Research. 2020 May 9. [Epub ahead of print]

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 191

Research Institute Reports

Research Institute Reports

CENTER FOR REGENERATIVE MEDICINE

CENTER FOR VACCINES AND IMMUNITY

The Center for Regenerative Medicine in the Abigail Wexner Research Institute at Nationwide Children’s Hospital applies the principles of engineering, computer modeling and life sciences to develop biological substitutes to restore or improve tissue function. Regenerative medicine is the process of creating living, 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 a positive impact on children with congenital heart disease. Other areas of regenerative medicine research in progress include intestinal and tracheal replacement.

The Center for Vaccines and Immunity in the Abigail Wexner Research Institute at Nationwide Children’s Hospital has a single purpose: to improve the health of children through fundamental and applied research leading to a new generation of safe, protective vaccines against infection, cancer and allergy.

FACULTY

Christopher K. Breuer, MD Director Tendy Chiang, MD Oluyinka O. Olutoye, MD, PhD Toshiharu Shinoka, MD, PhD Mitchel R Stacy, PhD Medical advances have made it possible to save more patients from life-threatening injuries, diseases and congenital conditions. However, after the onset of these conditions, the damage is occasionally lifelong.

Often, symptoms can be treated with success, but the underlying tissue or organ damage remains unhealed and can cause further complications over time. To develop new clinical applications that address the unmet needs of these patients, the AWRI at Nationwide Children’s established the Center for Regenerative Medicine in 2017.

Center for Regenerative Medicine clinicians and researchers, led by Christopher Breuer, MD, are creating biological vessels, intestines and tracheas; identifying tissue progenitor cells, and developing ways to enhance tissue repair and growth. To further diversify the center’s research strengths, we are actively recruiting principal investigators.

Our vision is to pioneer new approaches in tissue regeneration and to develop next-generation reparative

FACULTY

immune response to RSV. Center researchers also study hepatitis virus infections. The hepatitis C virus (HCV) 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.

Jonathan Honegger, MD, published a study in the prestigious Journal of Clinical Investigation that linked recovery of a key mediator of antiviral immunity, the T helper cell, to unexpected control of chronic HCV infection in women after childbirth. Understanding how immune reconstitution occurs in the unique setting of pregnancy is expected to have a much broader impact on strategies to treat chronic infections and develop effective vaccines. Finally, Amit Kapoor, PhD, provided important new insight into how HCV-like viruses evade immunity to establish a persistent infection using a novel rodent infection model that he discovered. This model holds great promise to define mechanisms of protective immunity and to assess new vaccine concepts to protect against a virus that takes a great toll on public health in the United States and globally.

solutions. Further, we believe it is our responsibility to learn from every patient so our care for the next child will be improved.

This has been an exciting year for the center. Not only have we made significant progress on our NIH-funded research, we have fostered collaborations with outside sponsors to help develop the next generation of tissueengineered blood vessels. We have also brought on board Oluyinka Olutoye, MD, the new Surgeon-inChief at Nationwide Children’s, whose research focus is regenerating intestinal tissue to assist with infants battling necrotizing enterocolitis. Excitingly, we have also begun the second phase of our human TissueEngineered Vascular Graft (TEVG) clinical trial for patients undergoing a Fontan repair. This NIH funded project’s goal is to further our work on using the body’s innate repair mechanisms to assist patients with congenital heart defects.

Ultimately, this comprehensive approach means that the Center for Regenerative Medicine has the ability to turn promising laboratory discoveries into proven treatments and make them available to patients.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,145,809 SELECTED PUBLICATIONS Chou TH, Stacy MR. Clinical Applications for Radiotracer Imaging of Lower Extremity Peripheral Arterial Disease and Critical Limb Ischemia. Molecular Imaging and Biology.

2020;22(2):245-255.

Fukunishi T, Ong CS, Yesantharao P, Breuer CK, et al. Different degradation rates of nanofiber vascular grafts in small and large animal models. Journal of Tissue Engineering and Regenerative Medicine. 2020;14(2):203-214.

Liu L, Rodman C, Worobetz NE, Johnson J, Elmaraghy C, Chiang T. Topical biomaterials to prevent post-tonsillectomy hemorrhage. Journal of Otolaryngology - Head & Neck Surgery. 2019 Sep;48(1):45.

Molina TL, Stoll B, Mohammad M, Olutoye O, et al. New generation lipid emulsions increase brain DHA and improve body composition, but not short-term neurodevelopment in parenterally fed preterm piglets. Brain, Behavior, and Immunity.

2020;85:46-56.

Szafron JM, Ramachandra AB, Breuer CK, Marsden AL, Humphrey JD. Optimization of Tissue-Engineered Vascular Graft Design Using Computational Modeling. Tissue Engineering Part C: Methods. 2019;25(10):561-570.

192 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Chris Walker, PhD Director Zongdi Feng, PhD Jonathan Honegger, MD Amit Kapoor, PhD Asuncion Mejias, MD, PhD, MSCS Mark Peeples, PhD Octavio Ramilo, MD

Infectious Diseases: See page 88 for information about the Division of Infectious Diseases at Nationwide Children’s.

Masako Shimamura, MD Zhaohui Xu, PhD Nine investigators in the Center for Vaccines and Immunity study viral diseases of childhood.

Respiratory syncytial virus (RSV) is the leading cause of hospitalization for young children. Over the past year, center investigators made notable advances in RSV vaccine design and our understanding of factors contributing to the severity of airway disease. A key objective of RSV research is to identify predictive markers of mild and severe disease to facilitate development of vaccines and therapeutics. A study from Asuncion Mejias, MD, Octavio Ramilo, MD, and Mark Peeples, PhD, in the highly influential journal, Science Translational Medicine, described an immune profile that distinguishes mild from severe RSV disease.

Children with mild disease harbored more virus and produced more interferon, a key component of the early protective immune response. They also had lower levels of inflammation than children with severe disease.

These findings provide valuable insights into the host

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $5,044,969 SELECTED PUBLICATIONS Coss SL, Torres-Cornejo A, Prasad MR, Moore-Clingenpeel M, Grakoui A, Lauer GM, Walker CM, Honegger JR. CD4+ T Cell Restoration and Control of Hepatitis C Virus Replication after Childbirth. The Journal of Clinical Investigation. 2020 Feb 3;130(2):748753.

Hartlage AS, Walker CM, Kapoor A. Priming of Antiviral CD8 T Cells without Effector Function by a Persistently Replicating Hepatitis C-like Virus. The Journal of Virology. 2020 May 4;94(10):e00035-20.

Heinonen S, Velazquez VM, Ye F, Mertz S, Acero-Bedoya S, Smith B, Bunsow E, GarciaMauriño C, Oliva S, Cohen DM, Moore-Clingenpeel M, Peeples ME, 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.

Lu M, Zhang Z, Xue M, Zhao BS, Harder O, Li A, Liang X, Gao TZ, Xu Y, Zhou J, Feng Z, Niewiesk S, Peeples ME, He C, Li J. N6-methyladenosine Modification Enables Viral RNA to Escape Recognition by RNA Sensor RIG-I. Nature Microbiology. 2020 Apr;5(4):584-598.

Ramilo O, Rodriguez-Fernandez R, Peeples ME, Mejias A. Advanced Live Attenuated Vaccines for the Prevention of Respiratory Syncytial Virus Infections in Young Children.

The Journal of Infectious Diseases. 2020 Jun 16;222(1):4-6.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 193

Research Institute Reports

Research Institute Reports

CENTER FOR REGENERATIVE MEDICINE

CENTER FOR VACCINES AND IMMUNITY

The Center for Regenerative Medicine in the Abigail Wexner Research Institute at Nationwide Children’s Hospital applies the principles of engineering, computer modeling and life sciences to develop biological substitutes to restore or improve tissue function. Regenerative medicine is the process of creating living, 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 a positive impact on children with congenital heart disease. Other areas of regenerative medicine research in progress include intestinal and tracheal replacement.

The Center for Vaccines and Immunity in the Abigail Wexner Research Institute at Nationwide Children’s Hospital has a single purpose: to improve the health of children through fundamental and applied research leading to a new generation of safe, protective vaccines against infection, cancer and allergy.

FACULTY

Christopher K. Breuer, MD Director Tendy Chiang, MD Oluyinka O. Olutoye, MD, PhD Toshiharu Shinoka, MD, PhD Mitchel R Stacy, PhD Medical advances have made it possible to save more patients from life-threatening injuries, diseases and congenital conditions. However, after the onset of these conditions, the damage is occasionally lifelong.

Often, symptoms can be treated with success, but the underlying tissue or organ damage remains unhealed and can cause further complications over time. To develop new clinical applications that address the unmet needs of these patients, the AWRI at Nationwide Children’s established the Center for Regenerative Medicine in 2017.

Center for Regenerative Medicine clinicians and researchers, led by Christopher Breuer, MD, are creating biological vessels, intestines and tracheas; identifying tissue progenitor cells, and developing ways to enhance tissue repair and growth. To further diversify the center’s research strengths, we are actively recruiting principal investigators.

Our vision is to pioneer new approaches in tissue regeneration and to develop next-generation reparative

FACULTY

immune response to RSV. Center researchers also study hepatitis virus infections. The hepatitis C virus (HCV) 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.

Jonathan Honegger, MD, published a study in the prestigious Journal of Clinical Investigation that linked recovery of a key mediator of antiviral immunity, the T helper cell, to unexpected control of chronic HCV infection in women after childbirth. Understanding how immune reconstitution occurs in the unique setting of pregnancy is expected to have a much broader impact on strategies to treat chronic infections and develop effective vaccines. Finally, Amit Kapoor, PhD, provided important new insight into how HCV-like viruses evade immunity to establish a persistent infection using a novel rodent infection model that he discovered. This model holds great promise to define mechanisms of protective immunity and to assess new vaccine concepts to protect against a virus that takes a great toll on public health in the United States and globally.

solutions. Further, we believe it is our responsibility to learn from every patient so our care for the next child will be improved.

This has been an exciting year for the center. Not only have we made significant progress on our NIH-funded research, we have fostered collaborations with outside sponsors to help develop the next generation of tissueengineered blood vessels. We have also brought on board Oluyinka Olutoye, MD, the new Surgeon-inChief at Nationwide Children’s, whose research focus is regenerating intestinal tissue to assist with infants battling necrotizing enterocolitis. Excitingly, we have also begun the second phase of our human TissueEngineered Vascular Graft (TEVG) clinical trial for patients undergoing a Fontan repair. This NIH funded project’s goal is to further our work on using the body’s innate repair mechanisms to assist patients with congenital heart defects.

Ultimately, this comprehensive approach means that the Center for Regenerative Medicine has the ability to turn promising laboratory discoveries into proven treatments and make them available to patients.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $2,145,809 SELECTED PUBLICATIONS Chou TH, Stacy MR. Clinical Applications for Radiotracer Imaging of Lower Extremity Peripheral Arterial Disease and Critical Limb Ischemia. Molecular Imaging and Biology.

2020;22(2):245-255.

Fukunishi T, Ong CS, Yesantharao P, Breuer CK, et al. Different degradation rates of nanofiber vascular grafts in small and large animal models. Journal of Tissue Engineering and Regenerative Medicine. 2020;14(2):203-214.

Liu L, Rodman C, Worobetz NE, Johnson J, Elmaraghy C, Chiang T. Topical biomaterials to prevent post-tonsillectomy hemorrhage. Journal of Otolaryngology - Head & Neck Surgery. 2019 Sep;48(1):45.

Molina TL, Stoll B, Mohammad M, Olutoye O, et al. New generation lipid emulsions increase brain DHA and improve body composition, but not short-term neurodevelopment in parenterally fed preterm piglets. Brain, Behavior, and Immunity.

2020;85:46-56.

Szafron JM, Ramachandra AB, Breuer CK, Marsden AL, Humphrey JD. Optimization of Tissue-Engineered Vascular Graft Design Using Computational Modeling. Tissue Engineering Part C: Methods. 2019;25(10):561-570.

192 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Chris Walker, PhD Director Zongdi Feng, PhD Jonathan Honegger, MD Amit Kapoor, PhD Asuncion Mejias, MD, PhD, MSCS Mark Peeples, PhD Octavio Ramilo, MD

Infectious Diseases: See page 88 for information about the Division of Infectious Diseases at Nationwide Children’s.

Masako Shimamura, MD Zhaohui Xu, PhD Nine investigators in the Center for Vaccines and Immunity study viral diseases of childhood.

Respiratory syncytial virus (RSV) is the leading cause of hospitalization for young children. Over the past year, center investigators made notable advances in RSV vaccine design and our understanding of factors contributing to the severity of airway disease. A key objective of RSV research is to identify predictive markers of mild and severe disease to facilitate development of vaccines and therapeutics. A study from Asuncion Mejias, MD, Octavio Ramilo, MD, and Mark Peeples, PhD, in the highly influential journal, Science Translational Medicine, described an immune profile that distinguishes mild from severe RSV disease.

Children with mild disease harbored more virus and produced more interferon, a key component of the early protective immune response. They also had lower levels of inflammation than children with severe disease.

These findings provide valuable insights into the host

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $5,044,969 SELECTED PUBLICATIONS Coss SL, Torres-Cornejo A, Prasad MR, Moore-Clingenpeel M, Grakoui A, Lauer GM, Walker CM, Honegger JR. CD4+ T Cell Restoration and Control of Hepatitis C Virus Replication after Childbirth. The Journal of Clinical Investigation. 2020 Feb 3;130(2):748753.

Hartlage AS, Walker CM, Kapoor A. Priming of Antiviral CD8 T Cells without Effector Function by a Persistently Replicating Hepatitis C-like Virus. The Journal of Virology. 2020 May 4;94(10):e00035-20.

Heinonen S, Velazquez VM, Ye F, Mertz S, Acero-Bedoya S, Smith B, Bunsow E, GarciaMauriño C, Oliva S, Cohen DM, Moore-Clingenpeel M, Peeples ME, 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.

Lu M, Zhang Z, Xue M, Zhao BS, Harder O, Li A, Liang X, Gao TZ, Xu Y, Zhou J, Feng Z, Niewiesk S, Peeples ME, He C, Li J. N6-methyladenosine Modification Enables Viral RNA to Escape Recognition by RNA Sensor RIG-I. Nature Microbiology. 2020 Apr;5(4):584-598.

Ramilo O, Rodriguez-Fernandez R, Peeples ME, Mejias A. Advanced Live Attenuated Vaccines for the Prevention of Respiratory Syncytial Virus Infections in Young Children.

The Journal of Infectious Diseases. 2020 Jun 16;222(1):4-6.

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 193

Research Institute Reports

STEVE AND CINDY RASMUSSEN INSTITUTE FOR GENOMIC MEDICINE

Danielle E. Mouhlas, MS, LGC

The Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital is focused on improving outcomes for our patients through the use of molecular diagnostics. Since its inception in 2016, the mission of the institute is to build a seamless continuum between research, clinical testing and patient care.

The institute combines robust clinical diagnostics, leading-edge research and development, and high-performance computing to enable precision genomic medicine. Another area of emphasis is providing educational opportunities for care providers and all levels of trainees, as a means by which genome-based results are made accessible and meaningful to the patients and families we serve.

Ruthann B. Pfau, PhD, FACMG

FACULTY

Prajwal Rajappa, MD, MS

•

Shalini C. Reshmi, PhD, FACMG Maggie E. Stein, MS, LGC CLINICAL FELLOWS Sara Akhavanfard, MD, PhD Eleni Marina Melas, MSc, PhD Kathleen M. Schieffer, PhD, MLS(ASCP) RESEARCH FELLOWS Stephanie D. LaHaye, PhD Katherine E. Miller, PhD Blythe S. Moreland, PhD

Richard K. Wilson, PhD Executive Director

Vincent J. Magrini, PhD Senior Director

Elaine R. Mardis, PhD Co-Executive Director

Peter White, PhD Senior Director Bimal P. Chaudhari, MD, MPH, FAAP, FACMG Samantha S. Choi, MS, LGC Erin R. Crist, MMSc, LGC Sayaka Hashimoto, MS, LGC Daniel C. Koboldt, MS Christian L. Lauber, PhD

Catherine E. Cottrell, PhD, FACMG Senior Director

Kristy Lee, PhD, FACMG Marco L. Leung, PhD, FACMG Mariam T. Mathew, PhD, FACMG Theodora Jacobson Mathews, MS, LGC Theresa Mihalic Mosher, MS, LGC

194 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

In 2018, the Steve and Cindy Rasmussen Institute for Genomic Medicine launched a comprehensive protocol studying the genomes of children with cancer and hematologic disease. With a focus on rare, relapsed or treatment-refractory cancers, we can identify new treatment options, potentially leading to improved outcomes. All pertinent research results are confirmed under CAP/CLIA standards and communicated to our oncology providers to inform patient management, including prognostication, diagnosis and eligibility for targeted therapeutics and clinical trials. To date, we have studied more than 250 pediatric cancer patients on this protocol. In general, we returned at least one medically meaningful result for over 90% of patients studied to date.

Similarly, when pediatric patients display treatment refractory epilepsy, DNA from the affected brain tissue removed by surgery for curative intent can be evaluated by highly sensitive exome sequencing, with the demonstrated ability to detect mosaic genetic variation associated with disease. Importantly, these results have dual benefit: they better inform patients and parents about the root cause of the seizures, and they fuel additional research into how these altered genes lead to epilepsy. This is just one example of the virtuous cycle of discovery leading to treatment leading to discovery that fuels advances in our understanding of genetic diseases and their optimal treatment.

In 2019, the institute advanced additional programs in genomic medicine, including: •

An IRB-approved protocol to pilot a workflow for rapid turnaround, whole genome sequencing-

based diagnosis for patients in our neonatal intensive care unit who exhibit signs of genetically linked difficulties An IRB-approved protocol to study families with diagnoses of autism or bipolar disease and suicidality/depression, who are being treated in the new Big Lots Behavioral Health Pavilion

For children with rare or undiagnosed diseases, genomic testing often can provide additional resolution of the genetic causes, information relevant to reproductive decisions, and new treatment directions. Since early 2017, the institute has performed clinical exome sequencing to identify alterations in the protein-coding regions (“exons”) of all human genes. This testing has elucidated a genetic diagnosis for greater than one-third of families.

For patients in whom this test does not reveal a diagnostic answer, enrollment in the institute’s Rare Disease Genomics Study examines the genome more broadly for genetic clues underlying their disease. Clinical genetic testing was further expanded in 2019 to include Fragile X testing of a genetic locus associated with intellectual disability and developmental delays.

Advanced computational analysis is a critical component of precision medicine, and we have significantly grown our capacity to provide the accurate and timely analysis of the complex genomic data required to move Nationwide Children’s into the era of precision medicine. Our team has developed a state-of-the-art bioinformatics platform, built upon cloud-computing technology, that enables us to rapidly analyze the human genome, identifying rare genetic variants that lead to disease, and to perform comprehensive molecular profiling of a patient’s tumor sample. Over this past year we have implemented a cutting-edge laboratory information management system (LIMS) to improve laboratory processes and reduce our reliance on paper charts. We have developed a comprehensive sequence management tool that automates highly complex bioinformatics workflows and eliminates the chance for errors. We are advancing the understanding of genomic medicine through the development of novel computational tools and the application of big data technologies. By combining novel laboratory methods, state-of-the-art bioinformatics solutions and machine learning technologies, the institute is driven to create a future where no child with genetic disease goes undiagnosed and every child with cancer receives optimal treatment based on their genomic profile.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,465,172

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 195

Research Institute Reports

STEVE AND CINDY RASMUSSEN INSTITUTE FOR GENOMIC MEDICINE

Danielle E. Mouhlas, MS, LGC

The Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital is focused on improving outcomes for our patients through the use of molecular diagnostics. Since its inception in 2016, the mission of the institute is to build a seamless continuum between research, clinical testing and patient care.

The institute combines robust clinical diagnostics, leading-edge research and development, and high-performance computing to enable precision genomic medicine. Another area of emphasis is providing educational opportunities for care providers and all levels of trainees, as a means by which genome-based results are made accessible and meaningful to the patients and families we serve.

Ruthann B. Pfau, PhD, FACMG

FACULTY

Prajwal Rajappa, MD, MS

•

Shalini C. Reshmi, PhD, FACMG Maggie E. Stein, MS, LGC CLINICAL FELLOWS Sara Akhavanfard, MD, PhD Eleni Marina Melas, MSc, PhD Kathleen M. Schieffer, PhD, MLS(ASCP) RESEARCH FELLOWS Stephanie D. LaHaye, PhD Katherine E. Miller, PhD Blythe S. Moreland, PhD

Richard K. Wilson, PhD Executive Director

Vincent J. Magrini, PhD Senior Director

Elaine R. Mardis, PhD Co-Executive Director

Peter White, PhD Senior Director Bimal P. Chaudhari, MD, MPH, FAAP, FACMG Samantha S. Choi, MS, LGC Erin R. Crist, MMSc, LGC Sayaka Hashimoto, MS, LGC Daniel C. Koboldt, MS Christian L. Lauber, PhD

Catherine E. Cottrell, PhD, FACMG Senior Director

Kristy Lee, PhD, FACMG Marco L. Leung, PhD, FACMG Mariam T. Mathew, PhD, FACMG Theodora Jacobson Mathews, MS, LGC Theresa Mihalic Mosher, MS, LGC

194 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

In 2018, the Steve and Cindy Rasmussen Institute for Genomic Medicine launched a comprehensive protocol studying the genomes of children with cancer and hematologic disease. With a focus on rare, relapsed or treatment-refractory cancers, we can identify new treatment options, potentially leading to improved outcomes. All pertinent research results are confirmed under CAP/CLIA standards and communicated to our oncology providers to inform patient management, including prognostication, diagnosis and eligibility for targeted therapeutics and clinical trials. To date, we have studied more than 250 pediatric cancer patients on this protocol. In general, we returned at least one medically meaningful result for over 90% of patients studied to date.

Similarly, when pediatric patients display treatment refractory epilepsy, DNA from the affected brain tissue removed by surgery for curative intent can be evaluated by highly sensitive exome sequencing, with the demonstrated ability to detect mosaic genetic variation associated with disease. Importantly, these results have dual benefit: they better inform patients and parents about the root cause of the seizures, and they fuel additional research into how these altered genes lead to epilepsy. This is just one example of the virtuous cycle of discovery leading to treatment leading to discovery that fuels advances in our understanding of genetic diseases and their optimal treatment.

In 2019, the institute advanced additional programs in genomic medicine, including: •

An IRB-approved protocol to pilot a workflow for rapid turnaround, whole genome sequencing-

based diagnosis for patients in our neonatal intensive care unit who exhibit signs of genetically linked difficulties An IRB-approved protocol to study families with diagnoses of autism or bipolar disease and suicidality/depression, who are being treated in the new Big Lots Behavioral Health Pavilion

For children with rare or undiagnosed diseases, genomic testing often can provide additional resolution of the genetic causes, information relevant to reproductive decisions, and new treatment directions. Since early 2017, the institute has performed clinical exome sequencing to identify alterations in the protein-coding regions (“exons”) of all human genes. This testing has elucidated a genetic diagnosis for greater than one-third of families.

For patients in whom this test does not reveal a diagnostic answer, enrollment in the institute’s Rare Disease Genomics Study examines the genome more broadly for genetic clues underlying their disease. Clinical genetic testing was further expanded in 2019 to include Fragile X testing of a genetic locus associated with intellectual disability and developmental delays.

Advanced computational analysis is a critical component of precision medicine, and we have significantly grown our capacity to provide the accurate and timely analysis of the complex genomic data required to move Nationwide Children’s into the era of precision medicine. Our team has developed a state-of-the-art bioinformatics platform, built upon cloud-computing technology, that enables us to rapidly analyze the human genome, identifying rare genetic variants that lead to disease, and to perform comprehensive molecular profiling of a patient’s tumor sample. Over this past year we have implemented a cutting-edge laboratory information management system (LIMS) to improve laboratory processes and reduce our reliance on paper charts. We have developed a comprehensive sequence management tool that automates highly complex bioinformatics workflows and eliminates the chance for errors. We are advancing the understanding of genomic medicine through the development of novel computational tools and the application of big data technologies. By combining novel laboratory methods, state-of-the-art bioinformatics solutions and machine learning technologies, the institute is driven to create a future where no child with genetic disease goes undiagnosed and every child with cancer receives optimal treatment based on their genomic profile.

GRANTS AWARDED JULY 1, 2019 – JUNE 30, 2020 $1,465,172

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, DaveWala 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.

GO INTERACTIVE Visit NationwideChildrens.org/2020-Report for a fully interactive experience based on this publication, including Video Interviews, Patient Stories and Related Features. You can also access practice tools, referral information and training opportunities – including residencies and fellowships – at NationwideChildrens.org/For-Medical-Professionals.

PediatricsNationwide.org is an online publication providing articles on global pediatric issues, clinical programs, professional commentaries and novel research.

196 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 197

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, DaveWala 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.

GO INTERACTIVE Visit NationwideChildrens.org/2020-Report for a fully interactive experience based on this publication, including Video Interviews, Patient Stories and Related Features. You can also access practice tools, referral information and training opportunities – including residencies and fellowships – at NationwideChildrens.org/For-Medical-Professionals.

PediatricsNationwide.org is an online publication providing articles on global pediatric issues, clinical programs, professional commentaries and novel research.

196 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report | 197

Acknowledgements LEADERSHIP

EDITORIAL/WRITING

Tim Robinson Chief Executive Officer, Nationwide Children’s Hospital

Brian Justus Senior Account Manager, Physician & Referral Source Marketing Jeb Phillips Managing Editor, Executive Communication

John A. Barnard, MD President, Abigail Wexner Research Institute at Nationwide Children’s Hospital Chair, Department of Pediatrics, The Ohio State University College of Medicine

Abbie Roth Managing Editor, Science Communication

GRAPHIC DESIGN

Rustin Morse, MD Chief Medical Officer, Nationwide Children’s Hospital Professor of Pediatrics, Department of Pediatrics, The Ohio State University College of Medicine

Chris Garbrandt Director, Creative Services

Oluyinka Olutoye, MD, PhD Surgeon-in-Chief, Nationwide Children’s Hospital E. Thomas Boles Chair of Pediatric Surgery, The Ohio State University College of Medicine

Erin Nusbaum Senior Creative Designer

EDITORIAL LEADERSHIP

PHOTOGRAPHY

John Ordaz Art Director

Nikki Ginley Marketing Traffic Manager

Donna Teach Chief Marketing and Communication Officer

Brad Smith Senior Photographer

Alicia Shoemaker Senior Director, Integrated Marketing

Dan Smith Senior Photographer

Jan Arthur Senior Director, Communication and Content Strategy

WEBSITE: NATIONWIDECHILDRENS.ORG/2020-REPORT Aaron Stenhoff Senior Director, Digital Engagement

Scott Milburn 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 Melinda Akins Hannah Baker Jahaira Ballentine Andrew Banks Daryl Barker Daniel Barr Gina Benedict Danielle Bishop Jeffrey Burns Tara Casper Elena Chiappinelli Diana Crenshaw Robin Dalrymple Beth Deley Kim Dwyer

Dawn Edwards Phynesia Edwards Robin Egan Jennifer English Diane Eplin Bob Feeney Tony Felty Ann Fields Kelly Gibson Jamie Goodall Kaitlin Hall Hannah Hammeren Ellen Hanna Katie Johnson Laura Kelley Lisa Kluchurosky

Sarah Koster Marissa Larouere Molly Lebel Lanelle Lines Corinne Long Emily Loughley Angela Lyons Jamie Macklin Lindsay Maggs Bethany Malloy Kelly McCallum Nicole McClendon Susan Meyer Vannessa Moses Litsa Myers Jennifer Neelans

To request additional copies of this report, call (614) 355-0485.

Go interactive! Visit NationwideChildrens.org/2020-Report.

198 | NATIONWIDE CHILDREN’S HOSPITAL | 2019-20 Annual Report | NationwideChildrens.org/2020-Report

Linda Newport Brittany O’Brien Donna O’Connor Tiffini Payten Maria Penrose Charlotte Prewitt Sandhya Ramachandran Catherine Roebuck Cathleen Rooks Teaya Rough Stephen Sales Laurie Seipel Adrienne Sheline Rob Shepherd Kimberly Smitley Christina Stocker

Sara Styer Karen Sweitzer Ray Tam Laura Taylor Jordanna Tomblin Kristin Tomlinson Cyndie Trapasso Stephanie Vyrostek Kerry Wardlow Travis Wells Gail White Natalie Wilson Julie Zaremski Rachel Zbiegien