Medical College of Wisconsin Neonatology Division Research
The Division of Neonatology and Department of Pediatrics identified research in pulmonary hypertension and vascular biology as a priority area and the research program was established under the direction of Dr. G. Ganesh Konduri. This research is currently conducted at the Children's Research Institute since he is no longer under the Medical College of Wisconsin Cardiovascular Research Center.
Dr. Krishna Acharya's research interests are in understanding the epidemiology, NICU care, and outcomes of infants with congenital anomalies. Her research includes large database analyses for understanding NICU care and outcomes of infants with rare conditions, assessing concordance between prenatal counseling and postnatal outcomes, and improving communication with families faced with complicated pregnancies, both before birth, during their NICU stay, and as they transition home.”
Dr. Adeleye Afolayan’s research focuses on understanding the mechanisms that modulate mitochondrial oxidative stress in persistent pulmonary hypertension in the newborn (PPHN). SOD2 is the gatekeeper in the mitochondrial matrix that removes the damaging superoxide radical. The ability of stress-inducible heat shock protein 70 (hsp70) to target SOD2 to the mitochondria, places the chaperone in a pivotal point in the regulation of mitochondrial oxidative stress. Our lab is using basic science approach to understand the mechanisms by which hsp70-mediated import of SOD2 into the mitochondria is regulated using the fetal lamb model.
Dr. Mir Basir believes that the best patient outcomes are achieved when parents are involved in the medical care of their child. Most parents have little knowledge about diseases and problems of newborn infants. Having a sick newborn is stressful for the parents. Easy to understand and reliable information about their child’s medical problem and expected health outcomes decreases parental stress. The goal of Dr. Basir’s research is to empower and encourage parents to be involved in their child’s medical care. He plans to achieve this goal by making medical information easier for parents to understand, overcome barriers that limit parental access to their child’s hospital medical records, encourage parents to participate in morning rounds and improve doctor-parent communication. These interventions will help parents become better advocates for their child.
Dr. Gary Cohen teaches medical education research to the medical students and pediatric residents and conducts quality assurance projects in Froedtert Hospital’s Newborn Nursery.
Dr. Joanne Lagatta and her research team studies health care utilization and patient (parent) reported outcomes for infants after NICU discharge, focused primarily on infants with bronchopulmonary dysplasia. Our goal is to improve the transition home from the NICU and subsequent post-discharge outcomes for infants with chronic lung disease. We have shown that pragmatic NICU illness risk stratification provides important information about duration of outpatient therapies, which in turn has important implications for infants and parents. Our next steps are to validate disease-specific patient-reported outcomes monitoring tools in this unique population. The group has experience mentoring trainees using a variety of approaches, including secondary analysis of large complex datasets, prospective cohort studies, qualitative and quality improvement work. Dr. Lagatta is proud of her team’s multidisciplinary approach, which includes representation and collaboration between neonatology, pulmonology, critical care, complex care, nursing, and the graduate school. Dr. Lagatta is on the executive board for the Children’s Hospitals Neonatal Consortium, and serves as co-chair of their BPD focus group; she is also part of the Pediatric Health Information System’s NICU Research Node. These national roles help her provide trainees with national networking opportunities. Her work has been funded by the NIH as well as internal support from the Medical College of Wisconsin Research Affairs Committee, Children’s Research Institute, Collaborative for Healthcare Delivery Science, and Advancing a Healthier Wisconsin
Dr. Akiko Mammoto's lab is interested in the role of angiogenesis in organ development, regeneration, and pathology and focuses on the following projects. (1) The role of angiogenesis in lung regeneration: We are trying to understand the mechanism by which endothelial cells control lung development and regeneration using multidisciplinary approaches. In particular, we focus on Wnt and the related signaling pathways (e.g. Twist1 and Yap1) using transgenic animal models. (2) Mechanism of age-dependent decline in angiogenesis: We are investigating the molecular mechanism by which aging inhibits lung vascular and alveolar morphogenesis. In addition to soluble growth factors, biophysical factors such as changes in cell size, ECM stiffness, stretching forces, and flow control endothelial cell growth and differentiation. Thus, we also focus on the mechanosensitive mechanism of age-related decline in angiogenesis using various in vitro systems and transgenic animal models. Since it has been known that the common signaling pathways are involved in age-related lung diseases and neonatal lung developmental disorders, this work has potential to develop efficient strategies for neonatal lung and heart diseases. (3) Pulmonary hypertension: We investigate the role of endothelial signaling in vascular smooth muscle cell behaviors. We focus on Twist1 which is upregulated in the lungs of patients with pulmonary arterial hypertension and study the mechanism by which endothelial Twist1 and the related genes control smooth muscle cell behaviors using in vitro assays, an in vivo pulmonary hypertension model, and transgenic animal models.
Dr. Hang Nghiem-Rao conducts clinical and translational research examining the role of altered lipid metabolism in the development of liver diseases such as parenteral nutrition associated cholestasis (PNAC) and non-alcoholic fatty liver disease (NAFLD). Her lab uses induced pluripotent stem cell-derived hepatocytes to investigate the vulnerability of the developing liver to lipotoxicity. Current projects include 1) examining alterations in the gut microbiome of infants with PNAC and 2) examining the contribution of excess intrauterine fatty acid exposure to hepatic oxidative stress in offspring of obese mothers.
Dr. Erin Rholl works with the Neonatology Division, Palliative Care Team and Children's Wisconsin Ethics Committee. She specializes in qualitative and mixed methods research. Her interests include the overlap of perinatal and neonatal palliative care and ethics. Her current projects are focused on better understanding the parent and provider experience with uncertainty in clinical care. She has written on ethical topics such as withdrawing and withholding life sustaining medical therapies in the NICU. She also works with Dr. Steven Leuthner to provide neonatology fellow education on ethics and palliative care.
Dr. Kelsey Ryan is a newborn hospitalist in the Froedtert Milwaukee Birth Center whose research focuses on high value care for newborns in Level I and II nursery settings. Ongoing work includes optimizing care for families experiencing neonatal opioid withdrawal syndrome, early onset sepsis, hypoglycemia and hyperbilirubinemia. She has a particular interest in linking educational and clinical interventions for the benefit of both families and learners.
Dr. Kris Saudek does Medical Education Research. Past projects include piloting Team-Based Learning on the pediatric clerkship and implementing a hand-over curriculum for third year medical students. Current projects include predictors of resident success and a study on letters of recommendation. She also mentors pediatric residents on a variety of QI and medical education research projects. Clinically, she has recently piloted a SCAMPS in the newborn nursery studying late preterm feeding.
Dr. Jeff Segar has and established record of basic, clinical and translational research focused on developmental cardiovascular, renal and metabolic physiology. For over 20 years Dr. Segar utilized a fetal and newborn sheep model to study the functional role of the autonomic nervous system in early life as well as cardiac adaptation to pressure and volume load. Over the past half decade, Dr. Segar has focused his work on the role of early life sodium deficiency on growth, metabolism and neurobehavior. His clinical work has established that many preterm infants experience sodium deficiency which impairs optimal somatic growth. He has published a number of research articles and reviews regarding early life renal function and physiological approaches to fluid and electrolyte management in NICU patients. His current basic research work, which is funded by the Children’s Research Institute and the NIH utilizes mouse models of early life sodium depletion to examine the molecular mechanisms by which sodium impacts growth, energy expenditure, sympathetic nervous system activity, neurobehavior and cardiovascular function.
Dr. Alicia Sprecher is involved in quality improvement initiatives within the Children’s Wisconsin NICU. She serves as a co-chair of the NICU QI Committee providing mentorship for ongoing QI projects. Her own QI work has included efforts to improve pain management post-operatively, address thermoregulation after birth, improve human milk provision in the NICU, and implement less invasive surfactant delivery in the CW NICU.
Dr. Ru-Jeng Teng has published several papers about biological function of Nogo-B receptor on pulmonary vasculature and liver. He demonstrated Nogo-B receptor deficiency not only impairs endothelial cell function but also promotes pulmonary vascular smooth muscle cell proliferation both of which contribute to the phenotype of pulmonary hypertension in infants. His also contributes to the finding that Nogo-B deficiency leads to hepatic steatosis. His recent work is focused on how oxidative stress affects endoplasmic reticulum function in lungs and how Nogo-B receptor modulates endoplasmic reticulum and mitochondrial function in vascular endothelial cells. He obtained 2016 CTSI Pilot Initiative Grant for his work.
Dr. Michael Uhing is involved in all Quality Improvement and Patient Safety initiatives involving the NICU. Along with the help of two research nurses, he maintains Children’s Wisconsin’s participation in the Vermont Oxford Database, the Children’s Neonatal Database (CND) through the Children’s Neonatal Consortium (CNC), and the Congenital Diaphragmatic Hernia Database. In addition, he maintains an internal NICU clinical database to support internal clinical research and quality improvement projects. His primary clinical interests are nutritional and respiratory support of critically ill infants.
Dr. Scott Welak received his Neonatal-Perinatal Fellowship Training at the Medical College of Wisconsin. He serves as the Program Director for the Neonatal-Perinatal Fellowship at MCW. Dr. Welak serves as the Liaison for the Residents and Medical Students rotating through the NICU. His primary academic interests are training housestaff and students in pediatrics and neonatology. He has mentored many learners that have matched into competitive fellowships and residencies. His academic interests are curriculum and program development, feedback, evaluations, and the professional development of learners.