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Clinical Services (Newborn Medicine):
Summer Student Research Program

Mentors & Areas of Research Interest
Pankaj Agrawal, MD, MMSc
Image Dr. Agrawal's research focuses on the genetic basis and molecular mechanisms of congenital skeletal muscle disorders that present in early age. His goals are to:

  • Understand the role of cofilin-2 protein in skeletal muscle. He recently created a mouse knockin model of a missense cofilin-2 mutation that he identified in a consanguineous family of nemaline myopathy. He is also creating a cofilin-2 knockout mouse to further understand the role of cofilin-2 in skeletal muscle.
  • Elucidate the function of selenoprotein N protein that is altered in various congenital myopathies. He is evaluating the gene expression profile of muscles from patients with SEPN1 (selenoprotein N) mutation and comparing them with normal to get functional clues.
  • Screen patients of congenital myopathies for mutations in various candidate genes including tropomodulins, troponins and various selenoproteins.

Ultimately, Dr. Agrawal's research will help diagnose and treat patients with congenital muscle disorders and decipher the molecular mechanisms of skeletal muscle functioning.

Selected Publications
  • P.B. Agrawal, C.D. Strickland, C. Midgett, M.Poulos, A. Morales, D. Newberger, M.M. Ryan, S. T. Iannaccone, A.H. Beggs (2004). Heterogeneity of nemaline myopathy cases with skeletal muscle aactin gene mutations. Annals of Neurology 56: 86-96.
  • Pankaj B Agrawal, Rebecca S. Greenleaf, Kinga K. Tomczak, Vilma-Lotta Lehtokari, Carina Wallgren-Pettersson, William Wallefeld, Nigel G. Laing, Basil T. Darras, Sutherland K. Maciver, Philip R. Dormitzer and Alan H. Beggs (2007). Nemaline myopathy with minicores caused by mutation of the CFL2 gene encoding the skeletal muscle actin-binding protein, cofilin-2. American Journal of Human Genetics 80: 162-7.
  • Pierson CR, Agrawal PB, Blasko J, Beggs AH (2007). Myofiber size correlates with MTM1 mutation type and outcome in X-linked myotubular myopathy. Neuromuscul Disorders 17:562-8.
Dara Brodsky, MD
Image Dr. Brodsky is interested in examining the short- and long-term impact of simulator-based training, and plans to evaluate changes that may occur in clinical practice. Her goals are to:

  • Determine whether the Neonatal Resuscitation Program is effective at teaching resuscitation skills.
  • Assess the effectiveness of teaching the differential diagnosis of respiratory distress to medical students using standard methods compared with simulator-based training.

By examining the short- and long-term effects of simulator-based training, Dr. Brodsky hopes to demonstrate the benefit of simulator training, with the ultimate goal of incorporating simulation into the newborn medicine curriculum of trainees at multiple levels.

Selected Publications
  • Brodsky D and Martin C. Neonatology Review. 1st ed. Philadelphia: Hanley & Belfus, Inc.; 2003.
  • Brodsky D and Ouellette MA. Primary Care of the Premature Infant. Elsevier, Inc.; 2007. In press.
Sule Cataltepe, MD
Image Dr. Cataltepe's research focuses on molecular mechanisms underlying the response of the immature lung to injury. Her goals are to:

  • Understand the role of proteinase/antiproteinase imbalance in the development of chronic lung disease (CLD) in premature infants.
  • Investigate mechanisms of normal and abnormal angiogenesis in the lung.

Ultimately, Dr. Cataltepe's research may enhance our understanding of the pathogenesis of CLD of prematurity, and facilitate development of novel preventive and therapeutic interventions for this disease.

Selected Publications
  • Yasumatsu R, Altiok O, Benarafa C, Yasumatsu C, Bingol-Karakoc G, Remold-O'Donnell E, Cataltepe S. SERPINB1 upregulation is associated with in vivo complex formation with neutrophil elastase and cathepsin G in a baboon model of bronchopulmonary dysplasia. Am J Physiol Lung Cell Mol Physiol. 2006 Oct;291(4):L619-27.
  • Altiok O, Yasumatsu R, Bingol-Karakoc G, Riese RJ, Stahlman MT, Dwyer W, Pierce RA, Bromme D, Weber E, Cataltepe S. Imbalance between cysteine proteases and inhibitors in a baboon model of bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2006 Feb 1;173(3):318-26.
  • Hirakawa H, Pierce RA, Bingol-Karakoc G, Karaaslan C, Weng M, Shi GP, Saad A, Weber E, Mariani TJ, Starcher B, Shapiro SD, Cataltepe S. Cathepsin S deficiency confers protection from neonatal hyperoxia-induced lung injury. Am J Respir Crit Care Med. 2007 Oct 15; 176(8):778-85.
Helen Christou, MD
Image Dr. Christou's research focuses on the molecular mechanisms underlying vascular cell responses to extracellular acidosis. Her goals are to:

  • Define the molecular mechanisms underlying regulation of gene expression by extracellular acidosis in vascular cells.
  • Examine the functional significance of acidosis-induced changes in gene expression in vascular cells.
  • Determine the in vivo effects of extracellular acidosis in animal models of pulmonary hypertension.
The experimental design involves physiologic measurements in animal models of pulmonary hypertension, histochemical and morphometric analysis of lung tissue sections, and molecular and functional assays in isolated primary pulmonary vascular cells.

Ultimately, Dr. Christou's research will define the role of induced metabolic acidosis as a novel therapeutic approach in patients with pulmonary hypertension.

Selected Publications
  • Minamino T, Christou H, Hsieh C-M, Liu Y, Dhawan V, Abraham NG, Perrella MA, Mitsialis SA, Kourembanas S. Targeted expression of heme oxygenase-1 prevents the pulmonary inflammatory and vascular responses to hypoxia. Proceedings of the National Academy of Sciences USA 2001;98: 8798-8803.
  • Christou H, Bailey N, Kluger M, Mitsialis SA, Kourembanas S. Extracellular acidosi induces Heme Oxygenase-1 expression in vascular smooth muscle cells. American Journal of Physiology (Heart and Circ Physiol) 2005;288: 2647-2652.
  • Guan J., Wu X., Arons E., Christou H. The p38 Mitogen-Activated Protein kinase pathway is involved in the regulation of Heme Oxygenase-1 by acidic extracellular pH in aortic smooth muscle cells. Journal of Cellular Biochemistry 2008. In press.
James Gray, MD
Image Dr. Gray's previous research includes development of methods for performing cross-institutional assessments of NICU outcomes. Currently, his research is focused on advancing the integration of evolving information technologies into the practice and evaluation of newborn care. He is currently working to evaluate the impact of medical device technologies in Neonatal Intensive Care.

Selected Publications
  • Gray JE, Safran CA, Davis RB, Pompilio-Weitzner G, Stewart JE, Zaccagnini L, Pursley DM. Baby CareLink: Using the Internet and Telemedicine to Improve Care for High Risk Infants. Pediatrics. 2000;106:1318-1324.
  • Gray JE, Goldmann DA. Medication errors in the NICU: Special Patients, Unique Issues. Arch Dis Child. November 2004; 89 (11) 472-473.
  • Gray JE, Ursprung R, Edwards WH, Horbar JD, Nickerson J, Plsek P, Shiono PH, Suresh G, and Goldman DA. Patient MisIdentification in the NICU: Quantification of Risk. Pediatrics. Jan 2006; 117:e43-47.
Munish Gupta, MD, MMSc
Image Dr. Gupta is interested in quality improvement in neonatal intensive care, and his research interests focus on clinical determinants of chronic lung disease in premature infants. His goals are:

  • To understand clinical factors that are associated with the development of chronic lung disaease.
  • To explore how variations in clinical practice can affect the risk of chronic lung disease.
  • To develop targeted interventions in clinical practice that might reduce this risk.

Ultimately, Dr. Gupta hopes to contribute to improving the respiratory management of preterm infants and reducing the incidence of chronic lung disease in this population.

Selected Publications
  • Gupta M, Mestan KK, Martin CR, Pearson C, Ortiz K, Fu L, Stubblefield P, Cerda S, Kasnica JM, Wang X. Impact of clinical and histologic correlates of maternal and fetal inflammatory responses on gestational age in preterm births. Journal of Maternal-Fetal and Neonatal Medicine 2007:20:39-46.
Stella Kourembanas, MD
Image Dr. Kourembanas' area of research is in newborn lung vascular biology. Using bench to bedside approaches, her group is investigating the vascular responses to hypoxia at the molecular, cellular, and in vivo level. The long term goals of her research program are to:

  • Understand better the pathobiology of pulmonary hypertension (PHtn) and the molecular mechanisms of developmental lung injury and repair leading to bronchopulmonary dysplasia (BPD). Studies in animal physiology and basic molecular biology are validated with studies in infants with lung disease using patient-derived material.
  • Ongoing work in the laboratory also explores the role of mesenchymal stem cells (MSC) in the prevention and treatment of lung disorders that affect neonates and children. Dr. Kourembanas has demonstrated both prevention and reversal of lung vascular disease, and is actively pursuing molecular and cellular mechanisms of action.

Ultimately, Dr. Kourembanas' research may identify specific molecular targets for therapies of lung diseases, both to prevent and to reverse established injury.

Selected Publications
  • Minamino T, Christou H, Hsieh C-M, Liu Y, Dhawan V, Abraham NG, Perrella MA, Mitsialis SA, Kourembanas S. Targeted expression of heme oxygenase-1 prevents the pulmonary inflammatory and vascular responses to hypoxia. Proc. Natl. Acad. Sci. USA 2001;98(15):8798-8803.
  • Zampetaki A, Mitsialis SA, Pfeilschifter J, Kourembanas S. Hypoxia induces macrophage inflammatory protein-2 (MIP-2) gene expression via NFkB. FASEB J. 2004, 18:1090-1092.
  • Wu X, Chang MS, Mitsialis SA., Kourembanas S. Hypoxia regulates bone morphogenetic protein signaling in vascular smooth muscle cells through CtBP-1. Circ. Res. 2006; 99:240-247.
Paul Lerou, MD
Image Dr. Lerou's research focuses on embryonic stem cell derivation and early embryonic development under the supervision of George Daley, MD, PhD. His goals are to:

  • Develop experimental tools to study cell fate specification in the pre-implantation mouse embryo.
  • Develop defined culture conditions for deriving human embryonic stem cells (hESC).
  • Derive hESCs using nuclear transfer.

Ultimately, Dr. Lerou's research hopes to lay the groundwork for combined genetic and cell based therapies.

Selected Publications
  • Megonigal MD, Rappaport Ef, Jones DH, Williams TM, Lovett BD, Lelly KM, Lerou PH, Moulton T, Budaerf ML, Felix CA. t (11;22) (q23;q11.2) in acute myeloid leukemia of infant twins fuses MLL with hCDCrel, a cell division cycle gene in the genomic region of deletion in Digeorge and velocardiofacial syndromes. Proceedings of the National Academy of Science of the United States of America. 95(11):6413-8, 1998 May 26.
  • Lerou PH. Lower respiratory tract infections in children. Current Opinion in Pediatrics. 13(2):200-6, 2001 Ap
  • Lerou PH and Daley GQ. Therapeutic potential of embryonic stem cells. Blood Reviews. 2005;19(6):321-31.
Marie C. McCormick, MD, ScD
Image Dr. McCormick's work focuses on the outcomes of high-risk neonates and interventions to improve their outcomes.

Her most recent project involved the follow-up at age 18 of a cohort of youth who had participated in a multi-site, randomized trial of early educational intervention for premature, low birth weight infants. These data are available for secondary analysis for students with fluency in SAS and statistics, and an interest in longitudinal development. To facilitate the follow-up of high-risk neonates, the members of the follow-up team are conducting a comparison of parental report on a structured questionnaire with the results of developmental testing in the clinic by trained professional observers. In addition, she is initiating a study on the predictors of depression in the mothers of NICU patients.

The outcome of this research is to define further the factors influencing the outcome of premature infants, especially those that may point to interventions to improve their outcomes.

Selected Publications
  • McCormick MC, Brooks-Gunn J, Buka SL, Goldman J, Yu J, et al. Early intervention in low birth weight premature infants: Results at 18 years for the Infant Health and Development Program. Pediatrics 2006; 117:771-780.
  • McCormick MC, Behrman RE. The quiet epidemic of premature birth: commentary on a recent Institute of Medicine report. Ambul Pediatr 2007; 7:8-9.
Richard Parad, MD, MPH
Image Dr. Parad has several areas of interest in molecular genetics (genotype-phenotype relationships and screening) and clinical research, particularly with regard to respiratory diseases in newborns (including chronic lung disease and cystic fibrosis). His goals are to:

  • Understand the pathophysiologic mechanisms that lead to predisposition and development of chronic lung disease in premature newborns.
  • Develop optimal clinical strategies for prevention and treatment of chronic lung disease.
  • Evaluate the therapeutic potential for the antioxidant, SOD, for the prevention of chronic lung disease, retinopathy of prematurity, and neurologic injury.
  • Optimize strategies for newborn screening for cystic fibrosis.

Ultimately, Dr. Parad's research may protect premature newborn lungs from injury and optimize their pulmonary outcomes; and improve outcomes in cystic fibrosis.

Selected Publications
  • Davis JM, Parad RB, Michele T, Allred E, Price A, Rosenfeld W, Pulmonary outcome at 1 year corrected age in premature infants treated at birth with recombinant human CuZn superoxide dismutase. Pediatrics. 2003;111(3):469-76.
  • Parad RB, Comeau AM. Diagnostic dilemmas resulting from the immunoreactive trypsinogen/DNA cystic fibrosis newborn screening algorithm. J Pediatr. 2005;147(3 Suppl):S78-82.
  • OSullivan BP, Zwerdling RG, Dorkin HL,Comeau AM, Parad RB . Early Pulmonary Manifestation of Cystic Fibrosis in Children with the DF508/R117H-7T Genotype. Pediatrics. 2006;118(3):1260-5.
Xianhua Piao, MD, PhD
Image Dr. Piao's research focuses on the molecular mechanisms that control normal brain development and malformation. Her goals are to:

  • Conduct biochemical analyses of GPR56 and its signaling pathways.
  • Characterize the GPR56 function in mouse models.

Ultimately, Dr. Piao's research may delineate a novel signaling pathway in normal brain development and malformation.

Selected Publications
  • Piao X, Basel-Vanagaite L, Straussberg R, Grant PE, Pugh EW, Doheny K, Doan B, Hong SE, Shugart YY, Walsh CA: An Autosomal Recessive Form of Bilateral Frontoparietal Polymicrogyria Maps to Chromosome 16q12.2-21. Am J Hum. Genet 70:1028-33, 2002.
  • Piao X, Hill RS, Bodell A, Chang B., Basel-Vanagaite L., Straussberg R., Dobyns W. B., Qasrawi B., Winter R., Innes A. M., Voit T., Ross E., Michaud J., Descarie J., Barkovich A. J., Walsh C. A. G-Protein-Coupled Receptor-Dependent Development of Human Frontal Cortex. Science 303:2033-2036, 2004.
  • Piao X, Chang B, Bodell A, Woods K, BenZeev B, Topcu M, Guerrini R, Goldberg-Stern H, Sztriha L, Dobyns WB, Barkovich AJ, and Walsh CA. Genotype-phenotype Analysis of Human Frontoparietal Polymicrogyria Syndromes. Annals of Neurology 58:680-687, 2005.
Karen M. Puopolo, MD, PhD
Image Dr. Puopolo's basic research focuses on mechanisms of transcriptional regulation and stress response that mediate virulence in Group B Streptococcus (GBS). Her clinical research focuses on the epidemiology of neonatal early-onset and nosocomial sepsis.

  • The overall goal of her basic research is to determine how GBS transition from harmless commensal organisms to invasive pathogens. The specific aims of her research are to determine how GBS respond to changes in environmental temperature and pH, and to antibiotic exposure, by studying the global transcriptional responses to such changes mediated by two-component regulatory systems.
  • The overall goals of her clinical research are to evaluate the impact of intrapartum antibiotic prophylaxis for neonatal GBS disease on the incidence and microbiology of early-onset sepsis; and to determine the clinical and microbiological factors mediating methicillin-resistant and methicillin-sensitive Staphylococcus aureus colonization and infection in the neonatal intensive care unit.

Ultimately, Dr. Puopolo's basic research may identify specific GBS virulence factors that can be used in the development of new approaches to the prevention and treatment of gram-positive bacterial infections. Her clinical research may identify factors associated with neonatal sepsis that can be used to devise clinical strategies for the prevention of such infections.

Selected Publications
  • Puopolo KM, Hollingshead SK, Carey VJ, Madoff LC. Tandem repeat deletion in the alpha C protein of group B streptococcus is recA-independent. Infection and Immunity 2001;69(8):5037-45.
  • Puopolo, KM and Madoff, LC. Upstream short sequence repeats regulate expression of the alpha C protein of group B streptococcus. Molecular Microbiology 2003;50(3):977-991.
  • Puopolo, KM, Madoff, LC, Eichenwald, EC. Early-Onset Group B Streptococcal Disease in the Era of Maternal Screening. Pediatrics 2005;115(5):1240-6.
Lawrence Rhein, MD
Image Dr. Rhein's basic science research focuses on mouse models of host defense against lung pathogens, including mechanisms of interaction between chemokines and immunoglobulin receptors. His translational research focuses on long-term pulmonary outcomes of neonatal lung diseases, especially chronic lung disease of prematurity. His goals are to:

  • Determine the roles and mechanisms of action of chemokine receptors and immunoglobulin receptors in host defense against Pseudomonas and RSV pneumonia.
  • Define risk factors for pulmonary hypertension in patients with chronic lung disease of prematurity, and determine the significance of pulmonary hypertension in long-term pulmonary morbidities in premature infants.

Ultimately, Dr. Rhein's research hopes to identify specific molecular targets that could lead to therapies for pulmonary infectious or inflammatory diseases. His research also hopes to determine which premature infants will require evaluation or therapy for pulmonary hypertension.

Selected Publications
  • Rhein L, Fleisher GR, Harper MB. Lack of reduction in hospitalizations and emergency department visits for varicella in the first 2 years post-vaccine licensure. Pediatric Emergency Care. 2001;2:101-3.
  • Khemani E, McElhinney DB, Rhein LM, Andrade O, Lacro RV, Thomas KC, Mullen MP. Pulmonary Hypertension in Former Premature Infants with Bronchopulmonary Dysplasia: Clinical Features and Outcomes in the Surfactant Era . Pediatrics. 2007;21(4):244-52.
  • Rhein L, Perkins M, Gerard N, and Gerard C. Fc{gamma}RIII is Protective Against Pseudomonas aeruginosa Pneumonia. American Journal of Respiratory Cell and Molecular Biology. 2007;doi:10.1165/rcmb.2007-0309OC.
Vincent Smith, MD, MPH
Image Dr. Smith's conducts Health Services research on former preterm infants and their families. His goals are to:

  • Understand why some preterm infants and their families do well after discharge from the NICU and others do not.

Ultimately, the goal of Dr. Smith's research is to create interventions to improve outcomes for all preterm infants and their families.

Selected Publications
  • Smith VC, Zupancic JA, McCormick MC, Croen LA, Greene J, Escobar GJ, Richardson DK. Rehospitalization in the first year of life among infants with bronchopulmonary dysplasia. J Pediatr. 2004;144(6):799-803.
  • Smith VC, Zupancic JA, McCormick MC, Croen LA, Greene J, Escobar GJ, Richardson DK. Trends in severe bronchopulmonary dysplasia rates between 1994 and 2002. J Pediatr. 2005;146(4):469-73.
  • Smith VC, Svoren BM, Wolfsdorf, JI. ; 149: 566-7. Hypothyroidism in a breast-fed preterm infant resulting from maternal topical iodine exposure. J Pediatr. 2006;149:566-7.
Martha Sola-Visner, MD
Image Dr. Sola-Visner's research focuses on mechanisms underlying quantitative platelet disorders in neonates. Her goals are to:

  • Establish the differences between neonatal and adult megakaryocytopoiesis at the molecular level, using microarray analysis.
  • Examine the ability of neonates to up-regulate platelet production in response to increased platelet consumption, as compared to adults.
  • Determine the in vivo effects of thrombopoietic growth factor administration on neonatal megakaryocytopoiesis.

Ultimately, Dr. Sola-Visner's research hopes to lead to better therapies for neonatal thrombocytopenia.

Selected Publications
  • Pastos KM, Slayton WB, Rimsza LM, Sola-Visner MC: Differential effects of recombinant thrombopoietin and bone marrow stromal conditioned media on neonatal vs. adult megakaryocytes. Blood 108:3360-3362, 2006.
  • Sola-Visner MC, Christensen RD, Hutson A, Rimsza LM: Megakaryocyte size and concentration in the marrow of thrombocytopenic and non-thrombocytopenic neonates. Pediatric Research 61:479-484, 2007.
  • Brown R, Rimsza LM, Pastos KM, Lawrence RM, Young L, Saxonhouse MA, Sola-Visner MC: Effects of sepsis on neonatal thrombopoiesis. Pediatric Research [Epub ahead of print] 2008.
Linda Van Marter, MD, MPH
Image Dr. Van Marter's focus is on the epidemiology of neonatal cardiopulmonary disorders, in particular, Bronchopulmonary Dysplasia (BPD) and Persistent Pulmonary Hypertension of the Newborn (PPHN). She studies the antecedents of BPD, one of the commonest and most significant sequelae of prematurity, in an effort to understand how immaturity and care practices interact to modulate a preterm infant's risk of developing BPD. Her research also aims to eucidate the epidemiologic exposures of a pregnant woman and/or the newborn infant that cause or modify risk of Persistent Pulmonary Hypertension among full-term infants. This life-threatening disorder cannot be diagnosed prenatally and usually affects otherwise normal term infants. The goals of Dr. Van Marter's resarch are to:

  • Advance scientific understanding of the interaction of epidemiologic exposures of these two important neonatal cardiopulmonary disorders.
  • Identify preventable exposures that will prevent or ameliorate the risk of BPD and/or PPHN.
Selected Publications
  • Van Marter L, Leviton A, Allred E, Pagano M, Sanocka U, Parad R, and Moore M, for the Developmental Epidemiology Network. Do markers of barotrauma and oxygen toxicity explain inter-hospital variation in rates of chronic lung disease? Pediatrics 2000; 105: 1194-1201.
  • Van Marter L, Leviton A, Allred E, Pagano M, Sullivan K, Cohen A, Epstein M. Persistent pulmonary hypertension of the newborn and smoking and aspirin and nonsteroidal antiinflammatory drug consumption during pregnancy. Pediatrics 1996; 97:658-63.
  • Van Marter LJ, Dammann O, Allred EN, Leviton A, Pagano M, Moore M, Martin C for the Developmental Epidemiology Network. Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants. J Pediatr 2002;140:171-6.
John A. F. Zupancic, MD, ScD
Image Dr. Zupancic's research focuses on improving the efficiency with which scarce health care resources are used in improving the health of children, and in particular, newborns. His two approaches to this area of health policy are to:

  • Perform and improve the validity of economic evaluations alongside neonatal clinical trials. A systematic review of the neonatal literature showed that fewer than 1% of randomized controlled trials have associated economic evaluations, and that the methodological quality of those performed is poor (Pediatric Research. 2001; 49(4): 364A.). Economic evaluations currently underway by Dr. Zupancic and colleagues alongside multi-center clinical trials include (i) high versus low red blood cell transfusion thresholds for newborns; (ii) drug therapy for prevention of neonatal chronic lung disease; (iii) high versus low oxygen saturation thresholds for the prevention of retinopathy of prematurity; (iv) intermittent nasal ventilation for the reduction of chronic lung disease in premature infants; and (v) peer support for post-prevention of post-partum depression.
  • Perform computer modeling to determine best practice when evidence is currently lacking or where empirical studies are infeasible. Most recently, this has focused on the use of discrete event simulation to assess the impact of diffusion and regionalization on the cost and efficacy of new device technologies.
Selected Publications
  • Zupancic JAF, Horbar JD, Richardson DK, Carpenter JH, Lee SK, Escobar GJ and the Vermont Oxford Network SNAP Pilot Project Participants. Revalidation of the Score for Neonatal Acute Physiology in the Vermont Oxford Network. Pediatrics. In press.
  • Zupancic JAF, Richardson DK, O'Brien BJ, Cronin CG, Schmidt B, Roberts R, Weinstein MC and the Trial of Indomethacin Prophylaxis in Preterms Investigators. Retrospective economic evaluation of a controlled trial of indomethacin prophylaxis for patent ductus arteriosus in premature infants. Early Human Development. 2006;82(2):97-103.
  • Zupancic JA, Richardson DK, O'Brien BJ, Eichenwald EC, Weinstein MC. Cost-effectiveness analysis of predischarge monitoring for apnea of prematurity. Pediatrics. 2003;111(1):146-152.
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