Scholarly training of OHSU Neonatal-Perinatal Medicine Fellowship trainees to become physician-scientists is central to the training program. Discovery is integral to this training, and research can be accomplished with mentors within and outside of the OHSU Division of Neonatology. OHSU offers a rich array of basic, translational, clinical, and health services research, more than a dozen shared resources that support this research, as well as nationally-recognized centers of excellence, including the Knight Cancer Institute, the Knight Cardiovascular Institute, and the Oregon National Primate Research Institute.
The research interests of the program's faculty are diverse and can be classed into five areas – basic science research, translational sciences, clinical investigation, simulation medicine, epidemiology and health policy, and global neonatal health research. The interests of the Division's faculty are described below.
Fellow scholars meet with the Program Director and Division faculty to delineate research interests within the first several months of fellowship. Significant effort is dedicated to this process to maximize opportunity for success in a successful investigative career. This is followed by the choice of a research mentor and project, with scholarly activities to commence within the first year of fellowship. As part of their career development, fellows may choose to pursue an advanced degree, including a Masters of Public Health and Clinical Research.
Pratt Foundation Fellowship
The Pratt Foundation Fellowship is a generous gift to the OHSU Division of Neonatology in support of the scholarly training of OHSU Neonatal-Perinatal Medicine fellows. $50,000 per year is available for OHSU NPM fellow research; fellows and their mentors must apply for this grant mechanism, and are expected to use this source to fund and propel their investigations forward. This fellowship represents a significant achievement in a young investigator career.
Critical to an early investigator's academic career is support for presentation of their work at regional, national and international meetings. OHSU NPM Fellowship Program scholars may draw on Department of Pediatrics support for such meeting presentations, as well as a Division of Neonatology funds through a generous gift in support of trainee presentations.
As one of the eight National Primate Research Centers in the United States, our mandate as a Center is to provide Nonhuman Primate (NHP) resources for the very best scientific programs, both within the Oregon Health & Science University community and beyond.
Dr. Howard Cohen received his Pediatric and Neonatology training at the University of Chicago. Following that, he held a variety of clinical and administrative positions and academic positions during his extensive career. He also participated in two post graduate programs at Virginia Commonwealth University and the University of Illinois focused on patient safety. He is the Medical Director of the Neonatal Intensive Care Unit at Salem Hospital in capitol city of Oregon.
Dr. Cohen’s main research interests are related to patient safety in the NICU and more broadly across organizations. He is particularly interested in newborn resuscitation and stabilization and the use of video and simulation to improve reliability of technical and teamwork aspects of resuscitation. He is also very interested in quality improvement in the NICU, particularly related to both using the tools and methods, and understanding how NICUs are able to make successful, sustained improvements. To that end, Dr. Cohen has served on the faculty of a multitude of Vermont Oxford Network Quality Collaboratives, and is nationally recognized for his contributions to increasing reliability of care.
Dr. Dukhovny is an Assistant Professor of Pediatrics and directs the Division's Health Services research. He attended medical school the Boston University School of Medicine, and completed his pediatric residency at Boston Children's Hospital and received his neonatal-perinatal medicine training in the Harvard Neonatal-Perinatal Medicine Program. Dr. Dukhovny is a leading young researcher in Neonatal-Perinatal Medicine cost-benefit analysis, particularly in regard to clinical trials, as well as quality improvement. Dr. Dukhovny is a recent arrival from the Harvard Neonatal Health Services Research Group, where he trained under John Zupancic, MD, ScD. His research seeks to analyze neonatal treatments to maximize the efficiency with which scarce resources are used to improve the health of newborns and critically ill neonates. Dr. Dukhovny's work provides economic evaluations alongside neonatal clinical trials, and uses computer modeling to determine best practice where evidence is currently lacking or where empirical studies are infeasible. He is involved in a number of epidemiologic and health services investigations, and has been a mentor for several Harvard NPM Trainees.
Dr. Huynh is an Assistant Professor of Pediatrics and is the medical director for the OHSU Neonatology Telemedicine network. She completed her pediatric residency at DuPont Hospital for Children at Philadelphia, and her neonatal-perinatal medicine fellowship at Columbia University. Dr. Huynh's laboratory focuses on Neonatal Simulation, with a specific interest in the efficacy of simulation delivered via telemedicine, as well as a new research interest in simulation for parents. Dr. Huynh has used simulation-based neonatal resuscitation education with pediatric residents, neonatal fellows, NICU nursing staff, well baby and labor and delivery room medical staff to improve skills, confidence, and team communication. Her research has been on the use of deliberate practice in the mastery and retention of neonatal resuscitation skills as well as manikin studies to assess the most effective ways of delivering CPR in the neonate. As director of the OHSU Neonatal Telemedicine Program, Dr. Huynh is extending her research interests to studying the efficacy of telesimulation for remote but critical access care hospitals in Oregon to help improve patient care. Additionally, Neonatal ICU patients are often discharged to home with higher than background risk for a need for resuscitation at home, and yet parents receive either no or minimal CPR instruction. Dr. Huynh's lab aims to improve the preparation for these parents for home resuscitation by studying the efficacy of simulation as an improvement for home CPR skill acquisition, using lessons learned from Simulation Medicine.
Dr. Jordan is an Assistant Professor of Pediatrics, and is a co-founder of the OHSU Disorders of Sexual Differentiation Clinic. He attended medical school and graduate school at the UCLA Geffen School of Medicine, where he completed a PhD in Human Genetics as well as his MD. He was a resident in the combined Internal Medicine/Pediatrics Program at the University of Michigan, where he was also chief resident of the pediatrics residency, followed by his fellowship in neonatal-perinatal medicine, also at the University of Michigan. He is Board Certified in pediatrics, internal medicine, and neonatology. Dr. Jordan is interested in expanding our understanding of the relationship between maternal risk factors and pulmonary mechanics in premature infants with a special interest in antenatal corticosteroids and postnatal surfactant administration. Recently, he completed a project in extremely low birth weight (ELBW) infants that demonstrated a direct correlation between the number of postnatal surfactant doses administered and mortality risk. Presently, building on previous work with the McEvoy laboratory on rescue antenatal corticosteroids (ANS), he is evaluating whether or not the early benefits to pulmonary function shown by infants whose mother's received "rescue" ANS persist throughout their hospitalization. In a related project, Dr. Jordan's group is using infant pulmonary function testing (PFT) to compare the longitudinal pulmonary function of ELBWs who benefited from maternal ANS to ELBWs who did not. Continuing his earlier work on sex determination as a graduate student, he has worked with Pediatric Endocrinology faculty to initiate OHSU's first clinic for disorders of sexual differentiation.
Dr. Kim has joined the faculty as an Assistant Professor of Pediatrics; she provides neonatal medical direction for the OHSU Fetal Therapy Program. She attended medical school at the University of Washington, and completed her pediatric and neonatal-perinatal medicine training at OHSU. Dr. Kim's research focuses on the efficacy and effects of neonatal consults for women with high-risk pregnancies. Little is known regarding the efficacy of such consults, the methods used to deliver the information, or on the recall and effect that such consults have for the families involved. Dr. Kim is using a broad-based approach to gather such data, using scripts and images to improve recall, tools to assess recall, and determination of parental and fetal stress via biomarker sampling. Dr. Kim eventually aims to standardize the manner in which neonatologists carry out prenatal consults based on evidence and best practices, such that all neonatologists can have validated, reliable tools to be effective communicators to families.
Dr. MacDonald is an Assistant Professor Pediatrics in the Division of Pediatric Pulmonology. Dr. MacDonald's laboratory is interested in maternal programming of neonatal lung disease, and is working closely on several projects with Dr. McEvoy's laboratory. Using a mouse model of maternal obesity, Dr. MacDonald has shown that offspring of obese mothers receiving high fat diets have simplified air spaces and are far more likely to have reactive airways. The research will include defining the structural, functional, biochemical, and genetic elements of the lung in such offspring. The MacDonald lab is also pursuing two projects involving the influence of constant positive airway pressure on lung development. The research includes a clinical component which is currently underway in the NICU in conjunction with Drs. McEvoy and Scottoline, and a new, NIH R01-funded study on rhesus monkey neonates at ONPRC. The goal of the proposed research is to study the effect of CPAP on lung structure, function, and growth in premature non-human primates.
Dr. McEvoy is a physician scientist with a long-term research goal to advance the understanding and treatment of the fetal origins of neonatal and infant lung disease. She is accomplishing this goal by conducting clinical and translational projects that incorporate the use of newborn and infant pulmonary function tests (PFTs). She has conducted a number of randomized clinical trials examining the impact of different regimes of antenatal and postnatal steroids on newborn pulmonary function and bronchopulmonary dysplasia (BPD). She recently completed a randomized trial demonstrating that daily supplemental vitamin C given to pregnant smokers improved their newborn’s PFTs and decreased the incidence of wheezing through one year of age. This improvement was influenced by nicotine receptor polymorphisms. With her current R01 funding ( www.vcsip.org ), she is collaborating with Indiana University to measure forced expiratory flows in infants born to pregnant smokers randomized to vitamin C versus placebo and with the Oregon National Primate Research Center to investigate the mechanism of action of vitamin C in the face of in-utero smoke exposure. Dr. McEvoy is also interested in the impact of late preterm delivery, extended duration of continuous positive airway pressure, and the impact of maternal obesity on infant respiratory disease and PFTs. She is collaborating with Dr. Kelvin MacDonald to investigate the effect of maternal diet and obesity on PFTs in a murine model and working with Dr. Peta Grigsby in a primate model of antenatal Ureaplasma colonization. These projects reach across many campuses in the Pacific Northwest including the Oregon National Primate Research Center, the Kaiser Research Center, and Obstetric clinics in both Portland, Oregon and Vancouver, Washington. Dr. McEvoy is also a member of an International Collaborative Study Group conducting an individual patient data (IPD) meta-analysis on repeat dosing of antenatal steroids and recently served on a NIH task force on the primary prevention of BPD.
Dr. Dan Morrow is an Assistant Professor of Pediatrics. He completed his Pediatric Residency and Neonatology Fellowship at Oregon Health and Science University. He is the lead for the OHSU Vermont Oxford Network quality effort. Dr. Morrow is interested in the development, diagnosis, and management of bronchopulmonary dysplasia (BPD) and BPD-related pulmonary hypertension (PH). He has investigated the role of specific apoptotic mediators in lung growth and injury; clinically, he is interested in the vascular development in the lungs of premature and growth-restricted infants. He is currently a PI for a retrospective and prospective study of BPD-related PH, as well the PI for a retrospective study of patients with gastroschisis. He is also interested in the management of short-gut physiology in neonates, particularly in maximizing growth, including intestinal growth, in these challenging patients.
Dr. Magda Petryniak is an Assistant Professor of Pediatrics. She completed her Pediatric residency at the St. Louis University Children’s Hospital and received her Neonatology training at UCSF. When not caring for patients, Dr. Petryniak is head of her laboratory and is a member of the OHSU Neuroscience training program.
Congenital and acquired diseases characterized by loss or damage to myelin affect tens of thousands of children and are a major cause of neurologic morbidity in the pediatric population. These range from periventricular white matter loss associated with preterm birth, hereditary leukodystrophies and primary disorders of myelin formation, as well as immune-based diseases such as multiple sclerosis. Dr. Petryniak’s lab is interested in understanding the immune mechanisms that regulate myelin loss in leukodystrophies, and current investigations utilize a new mouse model of Krabbe disease that genetically matches a human Krabbe disease mutation. She suspects that insight into the immune mechanisms mediating myelin loss in Krabbe disease will provide insight into immune function in other leukodystrophies as well as allow rational approach for use of immune modulators in this group of disorders.
Additionally, Dr. Petryniak’s lab is interested in the molecular mechanisms that regulate oligodendrocyte production and differentiation. The lab utilizes transgenic and knock-out mouse models, cellular transplantation, in vitro myelination assays, immunohistochemistry, in situ hybridization and a diverse range of molecular neurobiology techniques to connect the basic biology of myelination and innate immune function with pathophysiological events that occur in leukodystrophies.
Robert L. Schelonka
Dr Schelonka holds the Credit Union for Kids Endowed Professorship in Pediatrics, and is the Division Chief for Neonatology at OHSU. He received his MD at Case Western Reserve University (Case) in Cleveland, OH, and completed his pediatric residency and neonatology fellowship at Wilford Hall Medical Center in San Antonio, TX. He completed his military obligation as a neonatologist and Head of Neonatology and Pediatrics at the US Naval Hospital in Okinawa, Japan. Upon returning to the United States in 2000, Dr. Schelonka joined the faculty at the University of Alabama at Birmingham (UAB). In 2009, Dr. Schelonka accepted the position of Head of the Division of Neonatology at the Oregon Health and Sciences University where he is actively growing the academic and clinical programs.
Under his leadership the Division of Neonatology has assumed medical direction and coverage for two additional regional, level III nurseries. In addition, he co-founded the Oregon Perinatal and Neonatal Network to improve perinatal and neonatal care throughout Oregon and in Southwest Washington by real-time telehealth consultation, coordination of care, research and education. He has been invited to give keynote addresses at the Southern and Western Societies for Pediatric Research and been an invited speaker at the Pediatrics Academic Societies annual meeting. He has served on grant review committees for the Thrasher Foundation and the American Heart Association. He is often invited to be an international speaker and teacher, having served in such diverse places as Japan, Guam, Canada, Chile, El Salvador, Peru, Argentina, Austria and Saudi Arabia. He has served as an ad hoc reviewer for more than a dozen journals and is Editor-in-Chief of the peer-reviewed, open access journal, Research and Reports in Neonatology.
Dr. Schelonka’s research focuses on the developing immune system and the newborn infant’s unusually high predilection to infection. This work has resulted in more than 80 peerreviewed publications, state-of the art-reviews, commentaries and chapters. His research group currently utilizes a non-human primate model of intra-amniotic infection to better understand thefetal origins of later lung disease and central nervous system injury leading to developmental disability. A unique resource in this research is the Primate NICU at the Oregon National Primate Research Center (ONPRC). He has served as (site) principal investigator for a number of clinical trials examining the diagnosis, treatment and prevention of neonatal infectious diseases.
Dr Schelonka continues to find his greatest satisfaction at the bedside, taking care of patients, and teaching the next generation of neonatologists the art and science of medicine.
Dr. Scottoline is an Associate Professor of Clinical Pediatrics and is Program Director for the OHSU Neonatal-Perinatal Medicine Training Program, as well as providing neonatal medical direction for the OHSU Pediatric and Neonatal Doernbecher Transport Team (PANDA). He is the medical director for the Doernbecher NICU congenital diaphragmatic hernia and ECMO program, for neonatal congenital heart disease, and neonatal neurologic intensive care. He obtained his MD and PhD in Biochemistry at Stanford University, and completed his pediatric residency training at Packard Children's Hospital at Stanford. His received his neonatal-perinatal medicine training in the Harvard Neonatal-Perinatal Medicine Training Program. Dr. Scottoline's research interests are in several areas, each of which represents continuing problems in neonatal medicine. His research group, along with a group at UCSF, is carrying out a prospective clinical trial to translate for clinical use a novel biochemical method to assess lean muscle mass accrual in neonates, well infants, and children. The aim of the study is to validate a simple, non-invasive method to assess growth in children, potentially providing a simple tool for not only evaluating nutrition but also improved interventions for extra-uterine growth restriction and growth stunting. He is also working on evaluating prolonged CPAP for preterm neonates with lung disease using pulmonary function testing (PFTs), and investigating PFTs as a potential tool for evaluating congenital diaphragmatic hernia (CDH) severity. He is working together with several members of the Divisions of Neonatology and Pediatric Cardiology to develop functional and biomarker methods for identifying and managing neonates with pulmonary hypertension. Finally, Dr. Scottoline is working to develop methods to decrease reactive oxygen species (ROS) generation as a means to decrease ischemia-reperfusion injury, which is a significant source if tissue damage in ischemic organs. The target of these efforts is at the level of the mitochondrion, a major source of ROS, and involves both biochemical as well as translational work.
Recent Publications from Neonatology Fellows
Kim AJH, Warren JB. Optimal timing of umbilical cord clamping: Is the debate settled? Part 1 of 2: History, rationale, influencing factors, and concerns. Neoreviews 2015; 16(5): e263-e269.
Kim AJH, Warren JB. Optimal timing of umbilical cord clamping: Is the debate settled? Part 2 of 2: History, rationale, influencing factors, and concerns. Neoreviews 2015; 16(5): e270-e277.
Knapp J, Platteau A. Visual Diagnosis: Newborn With Hypoxia, Respiratory Distress, and Unusual Chest Radiograph. Neoreviews 2013; 14:e153.
Leadford AE, Warren JB, Manasyan A, Chomba E, Salas AA, Schelonka R, Carlo WA. Plastic bags for prevention of hypothermia in preterm and low birth weight infants.
Pediatrics. 2013 Jul;132(1):e128-34.
Warren JB, Lambert WE, Fu R, Anderson JM, Edelman AB. Global neonatal and perinatal mortality: a review and case study for the Loreto Province of Peru. Research and Reports in Neonatology 2012, 2:103-113.
Kair LR, Leonard DT, Anderson JM. Bronchopulmonary dysplasia. Pediatr Rev. 2012 Jun;33(6):255-63.
Warren JB, Phillipi CA. Care of the well newborn. Pediatr Rev. 2012 Jan;33(1):4-18.
Warren JB, Anderson JM. Visual Diagnosis: Severe Hydrocephalus and Respiratory Distress. Neoreviews 2011; 12:e416.
Maheshwari A, Corbin LL, Schelonka RL. Neonatal necrotizing enterocolitis. Research and Reports in Neonatology 2011, 1:39-53
Go HD, Emeis C, Guise JM, Schelonka RL. Fetal and neonatal morbidity and mortality following delivery after previous cesarian. Clin Perinatol. 2011 Jun;38(2):311-9.
Anderson JM, Warren JB. Using Simulation to Enhance the Acquisition and Retention of Clinical Skills in Neonatology. Semin Perinatol. 2011 Apr;35(2):59-67.