Under the new guidance, students in early education and kindergarten through first grade will have no weekly classroom screen time. Students in grades 2 and 3 will be limited to 1 hour and 40 minutes per week, with those in grades 4 and 5 limited to 2 1/2 hours, students in grades 6 through 8 limited to 6 hours per week, and high school students limited to 10 hours per week.

The limits include time spent on screen-based homework.

“Screen time is literally changing the trajectory of brain development. It’s growing the visual cortex at the expense of the areas responsible for language, reading and social skills,” said Jane Tavyev Asher, MD, pediatric neurologist and director of the Division of Pediatric Neurology at Cedars-Sinai Guerin Children’s. “Parents should actually be very delighted that their kids are going to have less screen time in the school setting, and they should view the school as working as their partner in helping with their child’s brain development.”

As the new policy takes effect this school year, the Cedars-Sinai Newsroom spoke with Tavyev Asher about why reducing screen time can benefit children’s brain development—and how parents can reinforce healthy screen habits at home.

Why were these new screen time policies needed?

Research continues to show that excessive screen time can affect how children’s brains grow and develop. During childhood, the brain is building important skills for language, reading, attention and social interaction. We want the brain to develop for reading, language and social skills. And screen time is really growing the visual cortex at the expense of all of the other parts of the brain.

Sharply reducing screen time at school can help create more opportunities for students to have active learning, conversation and deeper cognitive development in the long run.

Now that schools are seeing the neuroscience behind what screen time does to the developing brain, many are beginning to embrace this research and implement limits. They want what’s best for students’ brain development, just as parents do. At the end of the day, we’re all working toward the same goal: helping our children learn, grow and thrive.

Why is limiting screen time especially important during early childhood?

Early childhood is a critical period for learning to speak, read, write and develop social skills. During these years, the brain’s auditory and language centers are rapidly developing through conversation and human interaction.

For example, speech development begins around age 1, when children start learning how to speak. This process depends on the development of nerve signals and the continued growth of the auditory cortex, which develops significantly during the first few years of life. The auditory cortex is also the part that builds not just language but also social interaction.

Excessive screen use may interfere with these processes by overstimulating visual pathways while reducing opportunities for face-to-face communication, language development and recognizing social cues such as facial expressions and body language.

How can screen use affect brain development in middle schoolers?

Higher-level cognitive functions really begin to take off around age 12. This is when intellectual curiosity starts to develop. It’s a stage where children naturally begin making connections between ideas, such as reading one thing, connecting it to something else they’ve learned, asking questions, and wanting to find the answers. That’s exactly how we want their brains to develop.

But if everything is fed to them passively through AI or excessive screen-based learning, that part of the brain isn’t being exercised in the same way. They’re consuming information rather than actively thinking, questioning and making connections. It’s wonderful that our schools are finally coming to this realization and changing the way the curriculum is given to our children.

What screen time advice do you have for parents of high schoolers?

For a high schooler, I would try to keep the same guidelines in the home that you’ve done for the younger children. The reason for that is they still have that developing brain, and screen time is still very addictive.

I think at this age, they really do have the understanding as to why screens are not ideal for them. By the time they’re in high school, teenagers can understand the logic behind reducing screen time. This is the time when their intellect is developing. They can read the studies about it. As parents, this is also an ideal time to expose them to the studies that are showing what screen time addiction is doing to the brain in the long run.

How should parents approach smartphones for middle and high school students?

The smartphone is really the worst form of screen time because it is so easily accessible in the pocket. It’s easier to become addicted to that. So, it’s important to monitor how children access and use their smartphones.

There is so much social growth that happens in middle school. If you can just get the kids over that hump without a phone, then you can keep them from getting addicted to that phone.

There’s a program called “Wait Until 8th.” It’s a movement where parents sign a pledge to delay giving their child a smartphone until at least the end of eighth grade or until they’re 13 years old. When families make this commitment together, it creates a community where fewer kids have smartphones early on, which helps reduce the peer pressure to get one before they’re ready. It gives parents support in setting healthy boundaries and makes it easier for children to wait alongside their friends.

If you need to be in touch with your teenager, give them a simple flip phone that has no internet access. This way, they can call who they need to call. In some phones, you can also program who they call or receive calls from.

How can parents set and enforce screen time limits at home?

Parents have a huge influence on how children develop their relationship with screens. It’s much easier to not introduce screens than to set limits or take it away later in life. Instead of focusing only on taking screens away, parents can help children discover other activities, like reading, creative play, spending time outdoors and connecting as a family.

It’s important to point out that parents should model habits they hope to see by practicing healthy screen use themselves, since children are more likely to follow behaviors they observe at home.

Firstly, implement a no-screen-time rule at least two hours before bedtime. This will help kids avoid bright lights right before bed, promoting deeper sleep. Secondly, avoid screens during mealtime. Mealtime is a great time for the family to sit together and have conversations. There are so many positive studies about what family mealtime does for children’s social development and for their cognitive development.

Read more from Cedars-Sinai Stories and Insights: A Family Guide to Teens, Screens and Social Media

At the crib side, a guitarist and singer serenades newborns hooked up to loud, beeping and flashing monitors. The sounds of gentle humming and guitar strumming do more than soothe a fussy baby—they stabilize vital signs, aid neurological and auditory development, and enhance the overall wellbeing of infants in the NICU.

“Music therapy is a clinical and evidence-based practice using music to address nonmusical goals,” said Laura Cellini, Guerin Children’s board-certified music therapist. “Listening to music can help lower and stabilize heart rate, improve oxygen saturation levels and support a more regulated, calming state for newborns.”

According to Cellini, research has shown that music therapy can also help reduce NICU stays by as many as 12 days.

During a typical session in the NICU, Cellini works one-on-one with each infant, tailoring the therapy to meet every baby’s individual needs. She carefully monitors each newborn’s response to the music, including signs of overstimulation, and adjusts her music accordingly.

The music therapy program was made possible through a generous donation from 14-year-old twins Joey and Ryder Corleto, who spent considerable time in the NICU at Cedars-Sinai shortly after birth. Wanting to give back to the Cedars-Sinai community, the siblings chose to dedicate their bar and bat mitzvah gifts to help launch the program.

Their mother, Melissa Corleto, vividly remembers the challenges of spending time in a noisy NICU with the twins.

“When they look back at pictures of themselves as babies, it’s hard for them to imagine that this is where they started—at just 2.5 and 3.5 pounds,” Melissa said. “The idea of giving back to the NICU really resonated with them. As a family, we decided this was the meaningful way they wanted to give back.”

Music has always played a major role in the twins’ lives. Ryder is an avid drummer, while Joey is a competitive dancer. The twins said it felt natural to use their funds to help launch a music therapy program, especially one designed to soothe babies and support early brain development.

The bedside therapy sessions are also a welcome change of pace for parents and medical staff.

“The NICU can be a very traumatic and stressful environment, and music therapy helps create a sense of calm for the babies, their families and even the staff,” said Ashley Richardson, RN, assistant nurse manager of the NICU at Guerin Children’s.

For Jason Park, whose son Logan Park has spent more than two months in the NICU, watching his baby remain calm and relaxed as Cellini sang and played music at his bedside brought a sense of much-needed comfort and relief.

“I think the music brings a lot of joy to parents, especially for families like ours who have been here in the NICU for a long time,” Park said. “When the session ended, I was actually sad to hear it stop.”

Read more from Cedars-Sinai Stories and Insights: Strengthening Children’s Health

The rookies made stops throughout Cedars-Sinai Guerin Children’s, the Neonatal Intensive Care Unit (NICU) and Cedars-Sinai Cancer, where they posed for photos, signed autographs and handed out Rams-themed gifts.

Players and cheerleaders were greeted with smiles and posed for selfies with patients, families and staff members across both campuses.

At Guerin Children’s, players spent time talking football with pediatric patients and played a few rounds of Connect Four with patients in the courtyard.

“The fact that the Rams came created a sense of normalcy and it really brightened my son’s day,” said Nadyia Blakemore, whose 6-year-old son is a Guerin Children’s patient. “I appreciate the Rams coming through. It was a blessing to my family”.

In the NICU, rookies met new parents and visited some of the hospital’s smallest patients. At Cedars-Sinai Cancer, patients, physicians and staff joined Rams rookie Chad Lindberg for a football toss game, taking turns throwing passes at an inflatable football target.

“Seeing the Rams players connect with our patients and families in such a genuine and compassionate way means so much to everyone across our hospitals,” said Jill Martin, executive vice president of Cedars-Sinai Medical Network. “These visits create joyful moments, lift spirits and reflect the strong partnership between Cedars-Sinai and the Rams organization.”

The patients were clearly touched by their visits, said Joanne Laguna-Kennedy, MSN, RN, vice president of Hospital Operations and chief operating officer of Cedars-Sinai Marina Hospital.

“The players shared that they felt the same sense of joy,” Laguna-Kennedy said. “We’re incredibly grateful for their time, support and enthusiasm.”

Cedars-Sinai is the official healthcare partner and trusted doctors of the Los Angeles Rams.

Read more from Cedars-Sinai Stories and Insights: Childhood Cancer Survivor Aiden Duong in Rams Spotlight

The at-home monitoring device is designed to track early signs of asthma and provides clinicians with continuous or on-demand remote monitoring of lung sounds. The real-time data enables healthcare professionals to monitor a child’s condition between clinic visits and respond early if a child’s symptoms worsen.

The easy-to-wear device, called AeviceMD, was developed by Aevice Health, a Singaporean digital health company and a graduate of the Cedars-Sinai Accelerator program.

“I saw strong potential in this technology to support how we monitor and manage children with reactive airway issues like asthma outside of the clinical setting,” said Irina Dralyuk, MD, a pediatric pulmonologist at Guerin Children’s. “Being able to assess respiratory symptoms in real time, especially overnight, provides valuable information that can guide earlier intervention and help prevent more serious breathing complications.”

About 4.5 million children in the United States have asthma, making it one of the most common chronic pediatric diseases. Traditionally, doctors have monitored children with asthma through periodic clinic visits and caregiver-reported symptoms such as rapid breathing, chest congestion and breathing difficulties.

However, asthma symptoms often fluctuate widely between visits, and self-reported symptoms are often unreliable. This makes managing worsening symptoms between appointments very difficult.

The wearable stethoscope allows parents to utilize the device at home to record lung sounds and securely share recordings with their doctors. The data enables doctors to build a more complete picture of disease progression, track medication use and assess how patients’ symptoms evolve in response to their treatment plan.

“What we’re trying to do is prevent exacerbations, reduce hospitalizations and emergency department visits, and limit the need for interventions such as systemic steroid use to control asthma symptoms,” Dralyuk said. “Intervening early could decrease chronic inflammation and improve lung function and health over time.”

Children can wear the device, about the size of a half-dollar coin, on the chest for up to 10 hours a day. It is designed for use in children 3 and older.

“We built AeviceMD to make this kind of continuous symptom visibility possible. Having our technology deployed at a large, world-class health system like Cedars-Sinai validates our belief that there is a critical, unmet patient need,” said Adrian Ang, CEO of Aevice Health.

The device is the result of a multiyear collaboration with Cedars-Sinai that began in 2022 and included clinical input from physicians at Guerin Children’s. The collaboration included key regulatory milestones and a pilot program to evaluate the device’s effectiveness in pediatric respiratory monitoring. In 2023, the device received clearance from the U.S. Food and Drug Administration.

“This collaboration demonstrates the importance of providing clinical and operational support to help advance a company’s promising technology toward real-world patient benefit,” said Nirdesh K. Gupta, PhD, managing partner of Cedars-Sinai Intellectual Property Company. “It’s an exciting example of how innovation can directly impact care and improve the way we manage chronic conditions like asthma.”

Read more from Cedars-Sinai Stories and Insights: Common Breathing Problems in Kids and How to Treat Them

Neuro NICU is a specialized program that brings together multidisciplinary pediatric specialists to deliver advanced, coordinated care for newborns with complex neurological conditions. Housed within the Neonatal Intensive Care Unit at Cedars-Sinai, the program is designed to provide timely intervention during the crucial period of early brain development.

The Neuro NICU’s comprehensive, multidisciplinary model of care includes leading experts in neonatology, neurology, neurosurgery, neuroradiology and genomics. The staff also includes specially trained NICU nurses and social workers adept at deploying around-the-clock care tailored to the unique needs of newborns and their families.

“The newborn brain is fundamentally different from that of a child or an adult, which is why neurological care at this stage requires highly specialized expertise,” said David Rowitch, MD, PhD, deputy director for Research at Guerin Children’s. “Understanding how the developing brain responds to injury and how to interpret imaging in this context is critical. The Neuro NICU allows us to bring that expertise together in a coordinated way for each patient.”

The Neuro NICU team, led by co-directors Yolanda Brown-Madan, MD, and Xin Ye, MD, is equipped to treat patients with a wide range of neurological conditions, including neonatal seizures, stroke, severe congenital neurological disorders, brain malformations, as well as birth complications and traumatic injuries to the brain or the nervous system.

A defining feature of the Neuro NICU is the early integration of genomics, which allows the team to deliver precision gene therapies and genetic diagnoses to infants sooner. Guerin Children’s is among the first programs to offer rapid whole‑genome sequencing for babies in a NICU setting, with genetic results delivered in a matter of days.

Research at Guerin Children’s has shown that more than 40% of children seen by pediatric neurologists have an underlying genetic condition. Having genetic information readily available can directly influence clinical decisions and improve the ability to personalize care for vulnerable newborns.

“Our comprehensive approach in the Neuro NICU enables Guerin Children’s to deliver a seamless continuum of care as patients improve and grow beyond their stay,” said Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics and deputy director of Guerin Children’s.

The Neuro NICU also employs state-of-the-art, infant‑specific technologies, including continuous video electroencephalography (EEG) monitoring, which provides real‑time data to help clinicians intervene quickly during critical moments.

That same level of technological capability extends beyond the unit. Designed to function as a regional center for neonatal neurological care, the Neuro NICU extends its reach to affiliated partners and hospitals in the greater Los Angeles area and beyond. Specialized neonatal transport services allow teams to initiate critical therapies before a baby arrives at Guerin Children’s.

“Our goal is to ensure that newborns receive the right care at the right time, regardless of where they begin their medical journey,” said Rangasamy Ramanathan, MD, director of the Division of Neonatology at Guerin Children’s. “Through advanced transport capabilities and virtual collaboration, the Neuro NICU allows us to support community hospitals and families across the region.”

Additionally, the program offers virtual consultations, enabling neurologists to guide care remotely and support physicians at referring hospitals.

“The launch of the Neuro NICU reflects Guerin Children’s’ commitment to advancing research‑driven, specialized, world-class pediatric care for the most vulnerable patients in greater Los Angeles and beyond,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s.

Read more from Cedars-Sinai Stories and Insights: Making Strides in Treating the Smallest Heart Patients

annual meeting, April 24–27 in Boston.

The physician-scientists are available for interviews to discuss new research on improving care in neonatal intensive care units, quality improvement efforts and simulation training for neonatal transport and emergency newborn care.

“As Guerin Children’s continues to evolve as a premier destination for specialty pediatric care in Los Angeles, PAS 2026 is an important opportunity for our pediatricians to share scientific and clinical advances in lifesaving newborn medicine,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s.

Simulation Workshops

Rangasamy Ramanathan, MD, MBBS, director of Neonatology at Guerin Children’s, and Mahmood Ebrahimi, MD, a registered diagnostic cardiac sonographer and clinical instructor in Pediatrics, will co-lead a hands-on simulation workshop on targeted neonatal echocardiography. The training focuses on using echocardiography to assess how patent ductus arteriosus, a congenital heart defect, affects blood flow in preterm infants. The workshop is scheduled for Friday, April 24, 10:30 a.m. to noon.

A second simulation workshop, co-led by Ebrahimi, will train clinicians in the use of point-of-care ultrasound (POCUS) for real-world neonatal emergencies and critical care scenarios. This session is scheduled for Friday, April 24, 6:30-8 p.m.

Guerin Children’s Experts Presenting Research at the Meeting

Manoj Biniwale, MD, director of NICU Clinical Research, Division of Neonatology at Guerin Children’s, will present research across multiple sessions on several topics, including clinical trial data evaluating different approaches to umbilical cord management in premature infants and a simulation training session to improve how healthcare providers learn and retain critical newborn resuscitation skills.

Kurlen Payton, MD, assistant director of Quality and Safety at Guerin Children’s, will present research on a multicenter quality improvement initiative that increased maternal breast milk use at discharge for very low birth weight infants, improving outcomes and health equity.

Kyle Willsey, DO, pediatric intensivist at Guerin Children’s, and Lauren Collins, RN, will present how simulation training and neonatal transport impact workload and outcomes among pediatric transport teams.

To arrange interviews with Guerin Children’s experts, contact Shishira Sreenivas at Shishira.sreenivas@cshs.org or 202-297-0220.

The findings, stemming from two complementary studies published in Nature, could lead to therapies to protect the brain in neurological conditions like multiple sclerosis (MS).

Investigators focused on a group of brain cells called “CUX2 neurons.” Located on the outer layer of the brain, known as the cortex, CUX2 neurons are linked to brain communication, movement, thinking and memory. They are also linked to many neurological conditions, including MS, autism, epilepsy and Alzheimer’s disease.

In the first study, researchers found that CUX2 neurons are especially sensitive to damage caused by inflammation. In diseases like MS, the body’s immune system attacks the brain, leading to long-term damage. While MS has been thought to primarily affect white matter in the brain, this research shows that it could also damage particularly vulnerable CUX2 neurons in the gray matter.

This damage may help explain why people with MS can experience memory problems and cognitive decline as the disease progresses.

“The CUX2 neurons are like a ‘canary in the coal mine’ for the brain affected by MS,” said David Rowitch, MD, PhD, co-corresponding author of both studies, deputy director for Research at Guerin Children’s, and professor of Paediatrics at the University of Cambridge. “They are early warning signs of trouble. If we can protect these cells, we might be able to contain the damage before disease progresses.”

To better understand the workings of CUX2 neurons, investigators performed genetic sequencing of brain tissue from people with MS, and in laboratory mice that can model MS. Their study concluded that these neurons, when under stress, sustain much more DNA damage than neighboring brain cells do. Over time, this damage can lead to cell death.

In the second study, investigators found that CUX2 neurons use the molecule ATF4 to help repair their DNA. ATF4 and the molecules it regulates act like a switch that turns on genes that protect critical brain cells from DNA damage.

Even with these repair tools, the study found, CUX2 neurons remain at risk, especially during long-term inflammation. This may be one reason the condition of people with progressive MS continues to worsen even when treatments reduce inflammation.

“We were excited to find that these brain cells already have natural ways to repair themselves,” said Stephen Fancy, PhD, DVM, co-corresponding author of the study and professor in the departments of Neurology and Pediatrics at UCSF. “By uncovering how certain brain cells protect and repair themselves, we have taken a significant step toward developing treatments that could one day preserve brain function and quality of life.”

Through the studies, researchers found that there are several ways to switch on protective processes in the body that can help prevent damage. Further research is needed to bring the findings into clinical use, but they represent a step toward new approaches to treating brain diseases—one that focuses on limiting DNA damage, enhancing repair and bolstering the resilience of critical brain cells.

“Findings from these two studies represent an important milestone in our understanding of neurological disease pathways,” said Nancy Sicotte, MD, chair of the Department of Neurology and director of Multiple Sclerosis and Neuroimmunology at Cedars-Sinai. “This work is a testament to the dedication and innovation of our investigators, who continue to push the boundaries of science and drive discovery in pursuit of effective therapies for patients.”

Other authors who contributed to the first study include: Laura Morcom, Wenlong Xia, Zhaoyang Xu, Yashika Awasthi, Celine Geywitz, Matthew Ellis, Tomas Noli, Amel Zulji, Daniel Yamamoto, Gemma Girdler, Li Kai, Keying Zhu, Mingming Wei, Xiao-Yan Tang, Kimberly Hoi, Julio Gonzalez, Greg Duncan, Adrien Vaquie, Diana Gold, Riki Kawaguchi, Erdong Liu, Yu Sun, Denny Yang, Gregory Jordan, I-ling Lu, Staffan Holmqvist, Theresa Bartels, Katherine Ridley, Jennifer Choi, Santos Franco, Eric Huang, Ben Emery, Daniel Geschwind, Lucas Schirmer, Gabriel Balmus and Brian Popko.

Funding for the first study: This work was supported by funding from the European Research Council (Advanced Grant 789054 to D.H.R.; DecOmPress ERC StG, 950584 to L.S.), the Wellcome Trust (to D.H.R.), NIH (P01 NS083513 to D.H.R. and S.P.J.F.; R01NS128021 and R21NS133891 to S.P.J.F.; R01 NS124166 to S.J.F.; R01NS120981 to B.E.; 1R35NS137478 to B.P.), NIHR Cambridge Biomedical Research Centre (NIHR203312 to D.H.R.), Dr. Miriam and Sheldon G. Adelson Medical Research Foundation (to D.H.R., D.G. and B.P.), the US Department of Defence (MS230141 to S.P.J.F.), Alex’s Lemonade Stand Foundation (to S.P.J.F.), Race to Erase MS (to S.P.J.F.), the National MS Society (RFA-2203-39300 to L.S.; RG-2001-35775 to B.E.), the German Research Foundation (InCheck GRK 2727, Priority Program SPP 2395, NeuroFlame FOR 5705 to L.S.), the UK Dementia Research Institute (to G.B.), Therapeutic Innovation Networks (PNRR-III-C9-2022-I8 to G.B.), the Hertie Foundation (medMS MyLab, P1180016 to L.S.), an endowment from the Warren family (to B.E.), and a gift from the Spangler Foundation (to S.P.J.F.).

Other authors who contributed to the second study include: Wenlong Xia, Laura Morcom, Zhaoyang Xu, I-Ling Lu, Qing Wang, Kimberly Hoi, Mingming Wei, Keying Zhu, Gregory Jordan, Xiao-Yan Tang, Julio Gonzalez, Vanesa Mattera, Sophia Panigrahi, Riki Kawaguchi, Ben Emery, Santos Franco, Daniel Geschwind and Brian Popko.

Funding for the second study: This work was supported by funding from the European Research Council Advanced Grant (789054 to D.H.R.), the Wellcome Trust (to D.H.R), NIH (P01 NS083513 to D.H.R., S.P.J.F; and R35 NS137478 to B.P.) and Dr. Miriam and Sheldon G. Adelson Medical Research Foundation (to D.H.R., D. G, B. P.), and the NIHR Cambridge Biomedical Research Centre (NIHR203312). This work was supported by the NIH NINDS (R01 NS128021 and R21 NS133891 to S.P.J.F.), the U.S. Department of Defence (MS230141 to S.P.J.F.), Alex’s Lemonade Stand Foundation (to S.P.J.F.), Race to Erase MS (to S.P.J.F.), and a generous gift from the Spangler Foundation (to S.P.J.F.).

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Pediatric interventional cardiology has had meaningful advances over the past decade that are changing how children with congenital heart disease are treated at

Congenital heart defects, which arise from abnormal or incomplete formation of the heart, valves and blood vessels, are among the most common birth defects worldwide. The condition affects approximately 40,000 babies each year in the United States.

From less invasive, catheter-based procedures to improved imaging and emerging technologies, innovations are helping reduce risk, shorten recovery times and expand treatment options for the smallest patients with heart problems.

The Cedars-Sinai Newsroom recently spoke with Stephen Nageotte, MD, MBA, an interventional cardiologist and director of the Congenital Catheterization Laboratory at Cedars-Sinai Guerin Children’s and the Smidt Heart Institute. Nageotte treats children and adults using minimally invasive procedures. He shared what’s new in the field and what families need to know:

What are the most significant advances you’ve seen in pediatric interventional cardiology in recent years?

Over the past five years, there have been major advances in three key areas:

• Premature patent ductus arteriosus [PDA] closure. It’s a congenital heart condition in which a connection between two blood vessels in an infant fails to close after birth. This can cause abnormal blood flow to the lungs and breathing difficulties, particularly in premature infants.
• Transcatheter pulmonary valve replacement, which is a minimally invasive procedure in which we replace a faulty heart valve using a catheter instead of surgery.
• PDA stenting. Sometimes babies have heart problems that limit blood flow to the lungs. We can keep a small vessel called the ductus arteriosus open by placing a tiny tube, or stent, inside it to improve blood flow.

All three procedures have evolved significantly and are allowing us to treat patients in less invasive ways, often replacing or delaying the need for surgery.

How has transcatheter PDA closure changed care for premature infants?

Transcatheter PDA closure has become an important option for premature infants with a hemodynamically significant PDA—meaning the vessel is causing strain on the heart and lungs. In fact, Evan Zahn, MD, of the Smidt Heart Institute, helped develop the device cardiologists use to close a PDA during a transcatheter procedure.

The procedure is quick and can be done at the bedside in the Neonatal Intensive Care Unit [NICU], which helps us avoid transporting fragile infants. Research also suggests many babies show respiratory improvement after closure, which may reduce complications associated with long‑term ventilation.

Who is typically a candidate for the transcatheter PDA closure?

These procedures are generally for premature infants who are showing signs that the PDA is affecting their health, such as needing increased respiratory support or showing enlargement of the heart. There’s no strict minimum weight requirement, and the focus is really on whether the PDA is having a meaningful impact on the baby’s heart and lungs. Transcatheter PDA closure is also performed on older kids and adults.

What impact has new device technology had on how these procedures are performed?

One recent advancement is an improved delivery system for PDA closure devices. The device, known as the Amplatzer Piccolo Delivery System, recently received FDA [Food and Drug Administration] clearance to treat premature infants with PDA, including babies weighing as little as 2 pounds. Previously, the procedure required exchanging multiple catheters during the case, which could introduce instability; the newer system allows physicians to navigate and deliver the device using a single, shorter, softer catheter, potentially improving patient stability and precision.

How has transcatheter pulmonary valve replacement expanded treatment options for patients?

The development of newer self‑expanding valves has significantly increased the number of patients who can receive pulmonary valve replacement through a catheter instead of surgery. These procedures are typically considered from late childhood through adulthood and are used for patients with pulmonary valve disease related to congenital heart conditions. Early outcomes have shown good durability and high success rates.

Imaging plays a big role in heart care. What improvements are making the biggest difference?

There have been significant advances in cardiac CT and MRIs. Imaging is faster, clearer and uses lower radiation doses than in the past. These tools help us better understand heart anatomy, blood flow and timing for interventions. There’s also growing interest in using virtual or augmented reality to create 3D heart models for procedure planning, allowing teams to better visualize anatomy before a procedure.

What should families know as they navigate a congenital heart diagnosis?

Early detection and screening are incredibly important, ideally before birth, so families can meet the care team and understand what to expect. At Cedars-Sinai we can identify a defect while a baby is still in the womb and will continue to care for the baby at birth, during childhood, and all the way through adulthood, so the patient never needs to transfer to another institution.

Congenital heart care is lifelong and truly a team effort. Families aren’t expected to understand every technical detail—our role is to guide them, answer questions and be there every step of the way. Building long‑term relationships with patients and families is one of the most meaningful parts of this work.

Read more from Cedars-Sinai Stories and Insights: Making Strides in Treating the Smallest Heart Patients

Miranda was riding home from school on a motorized minibike when he was hit by a vehicle and then dragged by a semitruck, resulting in catastrophic injuries. Initially rushed to a nearby Level II trauma center to be stabilized, Miranda had injuries so extensive and life-threatening that physicians there decided the best chance to save his life was to transfer him to Cedars-Sinai.  

“As a Level I trauma center, Cedars-Sinai is prepared to deal with highly complex cases like Albert’s,” said Galinos Barmparas, MD, medical director of Trauma in the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai. “Even with our team’s extensive resources and expertise, it’s still a miracle Albert is alive, with the injuries he sustained.”

Major crush injuries to Miranda’s left leg required an amputation up to his hip. He also had a broken pelvis, a damaged urethra, and he battled severe infections from wounds he suffered after he was dragged on the road. Miranda required more than 20 surgeries and the expertise of physicians across multiple specialties, including trauma, orthopedics, plastic and reconstructive surgery, urology, pediatrics, physical therapy, and more.

“I never thought I'd be in a situation like this in my entire life, but here we are,” Miranda said. “But after, like, a long way coming, I've met new people here who've treated me well. And I'm actually glad that they wanted to work with me. ... So it made [Cedars-Sinai] feel like home.”

Barmparas said more than 100 healthcare workers helped Miranda get to this point.

“Patients may survive the initial hit and the initial surgeries,” Barmparas said. “But if they don't have the specialists and the resources, they may not be able to make it.”

Electric and gas-powered bikes that can travel upward of 25 miles per hour, like the one Miranda was riding at the time of his accident, are a safety concern for Barmparas, who oversees trauma surgery at Cedars-Sinai.

“These vehicles are dangerous. I can tell you that I see motorized bike, e-bike and electric scooter injuries in the trauma bay on a regular basis,” he said. “Patients come in all the time with traumatic brain injuries, facial fractures and other life-altering trauma.”

The accident occurred in late September, so Miranda spent the winter holidays, as well as his 17^th birthday, in the hospital. But in that time, he has made tremendous strides in his recovery and has regained some mobility with the assistance of a wheelchair and walker.

“It feels a little surreal, I think, the progress that we have seen from him,” said Romina Kim, MD, a pediatric hospitalist with Cedars-Sinai Guerin Children’s. “From not even being able to get out of bed to now walking with the walker. He’s a completely different kid from the one that we saw six months ago. It’s quite a miracle.”

Now, after more than five months in the hospital, Miranda is finally being discharged from Cedars-Sinai to continue his recovery at a rehabilitation center.

“Next is actually the rehab,” Miranda said. “I don't know how long I'll be there, but I hope it's a short amount of time so I can just get home already.”

The Cedars-Sinai team recently celebrated Miranda’s discharge with a celebration walk and send-off tunnel, waving pompoms and cheering him on as he made his way down the hallway of Cedars-Sinai Guerin Children’s. His physicians are encouraged by his resilience and how far he’s come not only with his physical, but also mental recovery from this traumatic event.

“He has a lot of dreams and aspirations,” Kim said. “And with the kind of attitude that he has, he can really become whatever he wants. I think he's going to do great things.”

As for Miranda, he is looking forward to getting stronger so he can get back to his normal routine and spend time with his friends. Still, he says he’ll miss his Cedars-Sinai care team.  

“Everyone has been so supportive and that's what keeps me positive,” Miranda said. “You know, if they want something good for me, I want something good for me as well.”

Read more from Cedars-Sinai Stories and Insights: Stop the Bleed Courses at Cedars-Sinai

The discovery, published in Cell, has important implications for understanding how a wide variety of intestinal disorders may develop.

“Our research opens the door to treatments that focus on restoring key molecular signals in vulnerable regions of the colon,” said Ophir Klein, MD, PhD, executive director of Cedars-Sinai Guerin Children’s, executive vice dean of Children’s Health, and the David and Meredith Kaplan Distinguished Chair in Children’s Health. Klein is the senior author of the study.

Prior research has shown that the four sections of the colon—ascending, transverse, descending and sigmoid—have different functions and risks for disease, but it wasn’t clear why these variations exist.

In this study, the investigators showed that the identity of distinct regions of the colon are regulated by the gut microbiome. They identified nicotinic acid, a molecule produced by certain bacteria in the gut microbiome, as a main driver of these regional differences in the colon’s sections. Nicotinic acid, also known as niacin, part of the vitamin B3 family, helps the body convert food into energy and supports the health of cells.

The researchers compared laboratory mice with and without a microbiome. They found that production of nicotinic acid by bacteria in the upper colon activates a protective mechanism in colon cells. In mice without a microbiome, minimal nicotinic acid was produced, and cells in the upper colon became more vulnerable to damage and disease.

Investigators also studied human colon tissue samples. They found that the different sections of the human colon showed regional characteristics similar to patterns observed in mice. And in samples from human patients with Crohn’s disease— a type of bowel disease in which abnormal immune system activity causes inflammation—this protective mechanism was reduced.

“Our work highlights the importance of studying host microbiome interactions with careful attention to specific colon regions, rather than treating the colon as a uniform organ,” said Jeremie Rispal, PhD, a postdoctoral scholar at the University of California, San Francisco, and the first author of the study. “We learned that the microbiome controls regional differences and tissue protection.”

Further study will be needed to confirm the precise mechanisms behind this protective effect and to determine how these findings might be used in new therapies for intestinal disorders.

Additional Cedars-Sinai authors include Manasa Vegesna, Dedeepya Vaka, and Dario Boffelli .

Other authors include Jasmine R. Garcia, Brisa Palikuqi, Seung Woo Kang, Coralie Trentesaux, Juan Du, Nicola R. Realini, Paige N. Spencer, James M. Gardner, Annika Hausmann, Michael G. Kattah, and Ken S. Lau.

Funding: This work was funded by NIH U01DK103147 from the Intestinal Stem Cell Consortium (to O.D.K. and D.B.), RC2-DK140862 (to O.D.K. and D.B.), R01DK103831 (to K.S.L.), F31DK127687 (to P.N.S.), T32HD007502 (in support of P.N.S.), T32CA119925 (in support of S.K.), the Leona M. and Harry B. Helmsley Charitable Trust G-1903-03793 (to the VUMC Gut Cell Atlas of which K.S.L. is a member), the Stanley Cohen Innovation Fund (to K.S.L.), the Benioff Center for Microbiome Medicine (to J.R.), and the PZ00P3_223765 SNSF Ambizione grant (to A.H.). Organoid work was supported by funding from the Kenneth Rainin Foundation and NIH R01 DK14167. The Kattah Lab has received research support from Eli Lilly. J.R. was supported by the Bakar Aging Research Institute postdoctoral fellowship and the Bettencourt Schueller foundation.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Continuing a beloved Cedars-Sinai tradition, Santa—a close friend of David Marshall, JD, DNP, RN, Cedars-Sinai’s senior vice president and chief nursing executive—made bedside visits, accompanied by nurses and other health professionals. With Santa dressed in his signature red velvet suit, complete with a snowy beard and a pair of shiny new black boots adorned with jingling bells, his arrival was heralded before he even entered the room, drawing smiles from patients, families and staff alike.

“This visit is something I look forward to every year,” Marshall said. “I even found Santa a new pair of boots for the occasion, because the smallest details can spark the biggest smiles. It’s a reminder that compassion and connection are just as important as the care we provide—especially during the holidays—and it’s worth every jingle.”

In the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s, parents received keepsake ornaments imprinted with their baby’s footprints, a meaningful memento of their child’s first holiday season. Families in Guerin Children’s and the Pediatric Intensive Care Unit were treated to gingerbread house-making kits, diaper-changing mats and cuddly stuffed animals donated by the Owie BowWowie and Friends Foundation, bringing a sense of holiday magic to the day.

For many families, the visit offered reassurance and joy—small but powerful reminders that they are supported not only medically, but emotionally, throughout their hospital journey.

“Our family hasn’t been able to join us yet, since they are traveling from China, so this visit meant a lot to us,” said Yan Wang, father of Wayne Wang, born four days ago. “Being able to take Wayne’s first photo with Santa and celebrate together as a new family made this moment feel even more special.”

Read more on the Cedars-Sinai Blog: Caring for Newborns—Tips for Parents

Suze Lopez, a nurse from Bakersfield, California, was scheduled to finally have a 22-pound ovarian cyst removed; one that had been growing for years. But the results of a routine pregnancy test that was required before the surgery would give her the shock of a lifetime.

“Because of the large ovarian cyst that had been growing for years, it could have been a false positive, even ovarian cancer,” Lopez said. “And I was used to very irregular periods and some abdominal discomfort. I could not believe that after 17 years of praying, and trying, for a second child, that I was actually pregnant.”

Three days after finding out she was pregnant, the 41-year-old emergency room nurse shared the good news with her husband, Andrew, during a date night at a Dodgers baseball game in Los Angeles. But during the trip Lopez started having pain in her abdomen and they headed to Cedars-Sinai.

When they arrived at the medical center, Lopez had dangerously high blood pressure. John Ozimek, DO, medical director of Labor and Delivery, and his team got to work, stabilizing her blood pressure and ordering an MRI, blood work and an ultrasound.

Ozimek was stunned by what the diagnostic images revealed: a very rare abdominal ectopic pregnancy.

“Suze was pregnant, but her uterus was empty, and a giant benign ovarian cyst weighing over 20 pounds was taking up so much space,” Ozimek said. “We then discovered a nearly full-term baby boy in a small space in the abdomen, near the liver, with his butt resting on the uterus. A pregnancy this far outside the uterus that continues to develop is almost unheard of.”

Ozimek said that as the baby grew inside Lopez’s abdomen, behind the mass, it pushed the very large cyst forward. “It makes sense that she just thought the tumor was getting bigger again, not that she could be pregnant.”

What Is an Abdominal Ectopic Pregnancy?

In an abdominal ectopic pregnancy, the fertilized egg implants outside the uterus, often on vital organs or major blood vessels. The placenta cannot safely grow there, creating an exceptionally high risk of catastrophic maternal bleeding and fetal death. A surviving infant is extraordinarily rare and often faces severe medical complications.

“It was profound to see this full-term baby sitting behind a very large ovarian tumor, not in the uterus. In my entire career, I’ve never even heard of one making it this far into the pregnancy,” said gynecological oncologist Michael Manuel, MD, of Providence Cedars-Sinai Tarzana Medical Center, who was called in to remove the giant cyst.

“We had to figure out how to deliver the baby with a placenta and its blood vessels attached in the abdomen, remove the very large ovarian mass and do everything we could to save mom and this child,” Manuel said.

Delivering a Medical Miracle

It took a team of about 30 experts to pull off a highly coordinated, complex delivery and surgery. Maternal-fetal medicine specialists, gynecological oncologists, nurses, anesthesiologists and a host of specially trained surgical technicians filled the operating room to near capacity. 

Manuel lifted the massive dermoid cyst out of the way so Ozimek and team could quickly deliver the baby and hand him off to the Neonatal Intensive Care Unit (NICU) staff. Then they got back to work.

“As soon as the baby was delivered, Lopez started hemorrhaging badly. We were a specially trained team of obstetric anesthesiologists and well prepared, but it was still intense,” said anesthesiologist Michael Sanchez, MD. “I had already powered up a special machine that delivers blood products fast because every second matters. We used 11 units of blood.”

Cedars-Sinai is the only Level IV Maternal Care hospital in California, a designation earned for its ability to provide comprehensive care for mothers before birth, throughout labor and delivery and after childbirth.

“The ability to provide this level of highly trained, coordinated and multidisciplinary care for extremely high-risk patients can make a critical difference in the health of both mother and baby, as we saw in this extraordinary case of Suze and Ryu Lopez,” said Sarah J. Kilpatrick, MD, PhD, chair of the Department of Obstetrics and Gynecology.

The medical team was elated to see that after such a rare and dangerous pregnancy, the little boy the Lopezes named Ryu came into the world with very few health problems, a full head of hair and weighing 8 pounds.

Sara Dayanim, MD, a neonatologist with Cedars-Sinai Guerin Children’s, said a critical concern was whether his lungs had developed properly and if they would be functioning.

“We were very prepared to handle any lung problems the baby might have. But he came out of anesthesia pretty quickly and he was feisty,” Dayanim said. “The following day we were able to remove the breathing tube, and over the course of his two weeks with us, Ryu quickly reached all of the important benchmarks for surviving well. He defied all the odds.”

The Nurse Angel

Like her newborn, Lopez was feisty and focused on recovering quickly so she could spend time in the NICU with Ryu, her husband and teenage daughter, Kaila. She especially remembers Carmen Chavez, MSN, RN, assistant manager of the Maternal-Fetal Care Unit, for coming alongside her before and after the challenging delivery and surgery. Lopez still refers to as her guardian angel through it all.

“She checked on me so often,” Lopez said. “She sat in on the consults with doctors to make sure we understood everything I was facing at a difficult time. She even helped us tell my daughter about the pregnancy. I’m a nurse myself, but what Carmen did was above and beyond. It meant everything.”

Chavez said she felt Lopez deserved all the support she could get.

“This was an exceptionally high-risk case, and we had to plan every detail,” Chavez said. “It was all hands on deck for our nursing team. Knowing the complexities of Suze’s situation, knowing the challenges she and her baby were about to face, I wanted to stay close.”

Ryu’s parents believe he is the answer to years of praying for a second child. Andrew Lopez said that is why they chose “Jesse” for Ryu’s middle name; it means “gift from God.” 

“He is our gift. And Ryu and Suze are my miracles,” Lopez said. “They let me in the operating room, and it was tough to watch what she was going through, and amazing to see Ryu delivered. So yes, many prayers have been answered.”

“I appreciate every little thing. Everything. Every day is a gift and I’m never going to waste it,” Suze Lopez said. “God gave me this baby so that he could be an example to the world that God exists—that miracles, modern-day miracles, do happen.”

Read more from the Cedars-Sinai Newsroom: Cedars-Sinai Earns Highest Designation for Maternal Care

Pediatric epilepsy affects nearly 470,000 children in the United States, making it the most common childhood brain disorder. There are many types of epilepsy, including Dravet syndrome, a rare and severe form of the condition, caused by a specific genetic mutation that typically begins in the first year of life. It affects 1 in 15,700 children and significantly impacts quality of life.

“Dravet syndrome is the most common genetic epilepsy disorder we see in children that requires specialized care and attention,” said Deborah Holder, MD, program director of Pediatric Epilepsy at Guerin Children’s. “Awareness is critical so families and healthcare providers can recognize the early signs and seek the right interventions.”

With November marking Epilepsy Awareness Month, the Cedars-Sinai Newsroom recently spoke with Holder to learn more about Dravet syndrome, early signs of seizures to watch for, how genetics play a role and why increased awareness and early detection can be life-changing.

What is Dravet Syndrome?

Dravet syndrome is a type of epilepsy that presents in childhood. It's predominantly caused by a mutation in a gene, specifically a sodium channel gene called SCN1A, which is one of the genes that impact how the brain works. It usually starts with seizures in childhood. Most children have their first seizure, usually between one year and 18 months, although it can start as young as six months.

What are the Symptoms of Dravet Syndrome?

Patients with Dravet syndrome typically present with seizures triggered by high fevers, which can be caused by illness, infection or fever occasionally following vaccination. Early seizures are often hemiclonic, meaning they involve rhythmic motor activity on one side of the body. A seizure may occur on the left side of the body the first time and then on the right side of the body the next time. 

A doctor will see a patient come in with these very long, often prolonged seizures, which we call status epilepticus. Such seizures require significant intervention with lots of medications and hospital care.

Children with Dravet syndrome face multiple challenges, including developmental difficulties that may lead to behavioral disorders, delayed language and speech issues, nutrition and sleeping difficulties and abnormalities in gait and walking. Additionally, the condition can affect other parts of the body, such as the heart.

How is Dravet Syndrome Diagnosed?

Because Dravet syndrome is one of the most common genetic epilepsy disorders in children, it’s important to perform genetic testing early. Identifying the underlying mutation allows us to make an accurate diagnosis. Evaluating the child’s seizure patterns and seizure type also helps us gather the information needed to choose the right medications to bring seizures under control.

The challenge with Dravet syndrome lies in the way it affects a child’s genetics. Although patients may appear to have long focal seizures, the medications typically used for focal seizures can actually make their condition worse. This is why it’s really important that we make the genetic diagnosis so we can treat the gene mutation, instead of the seizure type. It’s also important to note that

Is Dravet Syndrome an Inherited Disorder?

Dravet syndrome is not usually inherited from the parents. Many people hear “genetic disorder” and assume it occurs when the gene is passed down from the mother or father, but most genetic epilepsies are what we call “de novo,” meaning the mutation occurs for the first time in the child and is not connected to family history. Even if the parents are completely healthy, a child can be diagnosed with Dravet syndrome. In other words, any baby could potentially be at risk.

How is Genetic Testing Performed for Dravet Syndrome?

Genetic testing now is very easy. We just do a cheek swab. We don't even have to do a blood test. For pediatric patients, we typically do what's called whole exome sequencing, which really sequences all of the genomes we're familiar with today. Instead of doing a panel where we look at the most common genes that cause epilepsy, we really sequence everything. This way, we don't miss any of the genes that we are currently aware of, including SCN1A, the gene that causes Dravet syndrome.

How Do You Treat Dravet Syndrome?

Several anti-seizure medications are specifically approved for Dravet syndrome, including cannabidiol (CBD), which has been formally studied and found effective to manage the condition. However, medications don’t work for everyone, so other approaches can help.

Diet therapy, such as the ketogenic diet—a high-fat, low-carb diet that puts the brain into ketosis—can be very effective. We typically combine medication and diet therapy for the best results.

Additionally, there are several devices and rescue therapies available to help stop prolonged seizures and reduce hospital stays for children with Dravet syndrome. The vagus nerve stimulator is a device commonly used for Dravet syndrome. We place a wire along the vagus nerve, which is a nerve that runs along the neck. The device is designed to continuously monitor the heart rate and, when it detects a rise in heart rate and seizure activity, it sends signals to the brain to both prevent and stop seizures in its tracks.

Currently, there are also a few clinical trials exploring gene-modifying therapies. These approaches aim to directly target the underlying genetic cause, potentially controlling Dravet syndrome more effectively and improving the quality of life for children.

Read more on the Cedars-Sinai Blog: Personalized Epilepsy Treatment for Each Child

Concerned the developmental decline could be signs of a neurological disorder, the family’s pediatrician flagged the issue to Dylan’s parents, Michelle Tang and Ron Sonnenberg. Dylan was admitted to Cedars-Sinai Guerin Children’s, under the care of pediatric neurologist Jeffrey Swarz, MD, and pediatric endocrinologist Bahareh Schweiger, DO, MPH.

A battery of tests revealed two critical diagnoses: Dylan was severely hypoglycemic, and she was experiencing infantile spasms, a form of infantile epilepsy classified as a neurological emergency.

“The brain requires sufficient glucose to function, and hypoglycemia frequently leads to strokes in infants like Dylan,” said Swarz. “It was later determined that she had the ABCC8 mutation, causing congenital hyperinsulinism. The infantile spasms were likely related, but we can’t say for sure.”

Dylan is one of more than 350,000 children and adolescents affected by insulin-related illnesses, including diabetes, in the U.S. November marks National Insulin Awareness Month and World Diabetes Day.

The news from the doctors terrified Tang and Sonnenberg. “We were not very optimistic at that point,” Sonnenberg said. “We were devastated when we first learned her diagnosis.”

Hyperinsulinism occurs when the pancreas produces too much insulin, resulting in potentially life-threatening, low blood sugar levels. The condition can also signal health challenges that extend into adulthood, due to the risk of brain damage from recurrent hypoglycemia.

“If not managed adequately, there can be long-term challenges, including ongoing developmental delays and learning deficiencies,” Schweiger said. “With proper medical intervention, many children achieve reasonable metabolic control and normal functionality.”

Early on in Dylan’s treatment, she had to endure steroid injections, twice a day, to manage her symptoms. “She was in and out of the hospital,” said Tang. “We spent New Year’s Eve in the hospital that first year, because Dylan had to be monitored for adverse reactions to the steroids. But it was a small price to pay for us, as parents.”

Today, Dylan’s glucose levels are carefully managed via her gastrostomy tube feedings. Overnight, continuous feeds help maintain glucose stability. Schweiger said Dylan will still require lifelong multidisciplinary care, due to her medical history, but added, “Her prognosis is great, and her hyperinsulinism is showing signs of becoming less severe, with no recent spasms to report.”

Now, two years after Dylan’s diagnosis, the Tang-Sonnenberg family is celebrating new milestones.

“Dylan’s motor skills are improving—she’s walking with help and pulling herself up,” Tang said. “She’s very social with other children and is showing progress with speech and language skills.”

The family says it has Cedars-Sinai to thank for it all, including a new sense of hope for the future. “We are eternally grateful,” Sonnenberg said.

Read more in Cedars-Sinai Discoveries: Innovation and Collaboration in Pediatrics at Cedars-Sinai Guerin Children’s

To kick-start some Halloween magic, excited parents picked out outfits specially hand-sewn by Cedars-Sinai volunteers to accommodate the hospital’s littlest patients, bringing big smiles and a touch of normalcy in an otherwise stressful time.

“It’s hard to be in the NICU,” said Alva Pantig Gregorio, a clinical social worker who helps parents navigate their child’s stay in the NICU. “Celebrations can be difficult to keep up with when you’re at the hospital with a fragile baby. So, we bring the baby’s first Halloween to them.”

The babies’ costumes, all inspired by children’s books, included pumpkins, a watermelon, a snowman, a caterpillar, an ear of corn and a peanut, complete with a matching hat.  

Lauren Masciarelli’s son, Wesley, surprised everyone by being born two months early, and the doting mom was thrilled to pick out a classic first Halloween costume for her newborn.

“I always liked being a pumpkin as a kid, and I joked with my husband that his first costume next year could be a pumpkin. So, when I saw this, I had to go for it,” Masciarelli said. “This costume is the best quality costume I think he'll ever have in his life.”

Each outfit is lined with Velcro and tailored to accommodate the tubes, wires and other medical equipment. Parents get to take the keepsake costumes home to remember their baby’s first Halloween.

Dana Guerin, director of the Shapell Guerin Family Foundation, stopped by the NICU to join in on the fun celebration.  She was touched by the staff’s and volunteers’ dedication, exceptional care and attention to detail.

“It’s very clear that there is so much hard work and so much love that goes into this event,” Guerin said. “They go the extra mile to bring vulnerable babies, their families and the community together for a day to remember.”

Read more on the Cedars-Sinai Blog: Helmet Safety for Your Kids

The researchers will use stem cells to improve the effectiveness of oral tissue grafting—a procedure thousands of patients undergo each year in which tissue is transplanted from another part of the mouth to improve or repair trauma from significant tissue loss. In about 1 in 4 patients, the grafts fail due to various factors, including lack of blood supply to the graft, infection and poor healing.

The study is funded by a new five-year $5.7 million grant from the National Institutes of Health (NIH) and supports a multidisciplinary team from Guerin Children’s, Virginia Commonwealth University (VCU) and the University of California, San Francisco (UCSF).

"Our goal is to deepen our understanding of the oral mucosa and to learn how to enhance mouth tissue healing,” said Ophir Klein, MD, PhD, co-principal investigator of the study, executive director of Guerin Children’s and executive vice dean of Children’s Health at Cedars-Sinai. “We plan to turn stem cells into personalized oral tissue grafts that we hope will improve outcomes for patients.”

Oral mucosa is the soft tissue lining the inside of the mouth, including the cheeks, gums and tongue. It serves as a protective barrier against bacterial infection and injury, aiding in essential functions like speaking, chewing and swallowing.

For the preclinical research, the team will grow oral tissue in the lab using induced pluripotent stem cells—adult cells that are reprogrammed into cells that can be turned into virtually any cell type—from laboratory mice. The team hopes to be able to produce, in any needed amount, personalized living grafts with blood vessels that closely resemble natural oral tissue.

“Using advanced bioengineering tools, we can create complex tissues with tiny blood vessel networks that build themselves in a short period of time,” said Zev Jordan Gartner, PhD, co-principal investigator on the study and professor of Pharmaceutical Chemistry at the UCSF School of Pharmacy.

This method, Gartner said, will help the team design custom tissue grafts that could potentially be used in any part of the mouth.

Kevin Matthew Byrd, DDS, PhD, co-principal investigator on the study and assistant professor in the Philips Institute for Oral Health Research at the VCU School of Dentistry, said the research could potentially transform reconstructive care for head and mouth injuries.

“By customizing grafts to fit individual patient needs, we are advancing toward more personalized and effective dental treatments,” Byrd said. “This research has the power to notably improve care quality and establish new dental health standards.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

pediatric specialists will join their peers at the American Academy of Pediatrics (AAP) 2025 National Conference & Exhibition Sept. 26-30 in Denver and will be available to comment on breaking news from the conference.

“In just a few short years, Guerin Children’s has assembled a robust roster of world-class pediatric specialists,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s. “In our state-of-the-art facility in the heart of Los Angeles, we’ve created a pioneering healthcare destination with physicians and scientists who deliver exceptional multidisciplinary care and drive innovative research to address childhood diseases—from the womb through adulthood.”

One of these experts, neonatologist Theodora Stavroudis, MD, will serve as chair-elect of the AAP Section on Simulation and Innovative Learning Methods. At the conference, Stavroudis will present original research on neonatal resuscitation.

Guerin Children’s will also have a booth in the exhibit hall—Booth 1738—to showcase the institution’s research, medical education programs and clinical innovations.

Some of the Guerin Children’s experts available for interviews include:

Adolescent Health
Michelle Escovedo, MD, adolescent health specialist

Behavior and Development
Cesar Ochoa-Lubinoff, MD, director of Developmental-Behavioral Pediatrics

Cardiology
Evan Zahn, MD, co-director of the Guerin Family Congenital Heart Program
Richard Kim, MD, director of Pediatric and Congenital Heart Surgery

Ear, Nose and Throat
Gene Liu, MD, director of Academic Otolaryngology at Cedars-Sinai

Epilepsy
Deborah Holder, MD, program director of Pediatric Epilepsy 

Gastroenterology
Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics and associate director of Guerin Children’s

General Surgery
Eugene Kim, MD, pediatric surgeon-in-chief and deputy director of Guerin Children’s

Genetics 
Pedro Sanchez, MD, director of Pediatric Clinical Genetics
Saquib Lakhani, MD, director of Guerin Children's Early Detection Program
Mustafa Khokha, MD, director of Guerin Children's Genetics Research Center
Joyce So, MD, PhD, chief genomics officer at Cedars-Sinai

Infectious Disease
Priya Soni, MD, assistant professor of Pediatrics

Neurology
Jane Tavyev Asher, MD, director of the Division of Pediatric Neurology

Neurosurgery
Moise Danielpour, MD, director of Pediatric Neurosurgery

Oncology
Leo Mascarenhas, MD, director of Pediatric Hematology and Oncology

Orthopedics
David L. Skaggs, MD, director of Pediatric Spine and Pediatric Orthopaedics at Guerin Children’s

Plastic Surgery
Victor Chien, MD, director of Cleft and Craniofacial Surgery

Contact: 
To arrange interviews with Guerin Children’s specialists, contact Shishira Sreenivas at shishira.sreenivas@cshs.org or 202-297-0220.

So brings more than 15 years of leadership experience in research and clinical care to her new role. She will spearhead Cedars-Sinai’s growing genomics initiatives and serve as a strategic leader for the integration of genomics into clinical practice while overseeing genetics and genomics services across the Cedars-Sinai Health System.

“We are excited to welcome Dr. So to Cedars-Sinai, knowing her exceptional expertise and leadership in clinical genetics will be a significant asset to the burgeoning prenatal, pediatric and adult genetics programs,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences and dean of the Medical Faculty at Cedars-Sinai. “Her appointment will ensure Cedars-Sinai remains at the forefront of genomic endeavors, benefiting and transforming the lives of our patients.”

So has joined Cedars-Sinai from the University of California, San Francisco (UCSF), where she was chief of the Division of Medical Genetics and medical director of Adult Genetics. She was also director of the institution’s designation as a National Organization for Rare Disorders Rare Disease Center of Excellence. During her tenure, she developed a comprehensive genetics program that included the launch and rapid growth of UCSF’s Adult Genetics and Preventive Genomics Clinic; the expansion of multidisciplinary specialty services in cardiovascular, neurogenetic and cancer genetics; and the implementation of innovative e-consult and telehealth services to improve access to genetic care.

So earned her bachelor’s degree with high distinction in molecular biology and molecular genetics and her medical degree from the University of Toronto. She completed her medical genetics residency at the university’s Hospital for Sick Children and earned her doctorate in molecular genetics from the Max Planck Institute for Molecular Genetics in Berlin and completed a postdoctoral research fellowship in psychiatric genetics at the Centre for Addiction and Mental Health in Toronto.

“I am honored to join Cedars-Sinai as the inaugural chief genomics officer to advance the fields of genetics and genomics with the goal of enhancing patient care and health outcomes,” So said. “Together with our talented team of investigators and clinicians, we will push the boundaries of what is possible in genomic medicine for the benefit of our patients, their families and the wider community.”

So’s current research focuses on optimizing genetic diagnosis and treatment strategies for adults with complex neurodevelopmental, neuropsychiatric and neurological conditions. She also is deeply committed to quality and continuous improvement in the delivery of genetics and genomics clinical services.

“Dr. So’s appointment reinforces our commitment to advancing precision medicine and making leading-edge genomic care accessible to all our patients through all stages of life,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s. “We are excited to expand our research and clinical capabilities under her leadership.”

Read more on the Cedars-Sinai Blog: Do Children Need Genetic Testing?

“We know you’re going to take us to the Super Bowl this year,” Croft said. “We all so appreciate your visit. Now, go out and be awesome.”

Small groups of players then scattered throughout the medical center campus and Cedars-Sinai Marina del Rey Hospital, fully equipped with Rams swag like footballs, hats and pennants.

Several players visited patients at Cedars-Sinai Cancer, taking photos, chatting, and autographing footballs and hats. Other rookies visited patients at the inpatient unit of Cedars-Sinai Guerin Children’s, including a high school football player who smiled widely as he and the pros chatted about different football plays. “You’re one of us now,” a player told the patient.

A highlight: Rampage, the beloved Rams mascot, who posed for pictures with all who asked.

“Everyone wanted a selfie with Rampage,” said Maureen Chin, MSN, RN, associate director of the Department of Pediatrics. “Everyone wanted to hang out with the players and give them high-fives and cheer them on for the season.”

Players also met with new parents and got to make friends with some of the smallest patients in the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s.

“Really, just seeing these kids out here and bringing a smile to their faces with everything they’re going through right now is very special to me,” said Chris Paul Jr., a Rams rookie linebacker.

Rookie Bill Norton echoed the sentiment and said, “It’s cool to bring a light into the day for the patients and I’m excited to come back whenever we can.”

Cedars-Sinai is the Official Healthcare Partner of the Los Angeles Rams.

Read more on the Cedars-Sinai Blog: Safety Tips to Get the Most Out of Exercise and Reduce Injury Risks

The tone was urgent: “Please pick up your child now.” Moments later, Kim, director of the Division of Pediatric Surgery, learned his Pacific Palisades community was on the brink of a wildfire evacuation order. He raced home to help his family pack, but he felt certain, based on past experience, they’d be back soon.

The Kim family is now marking four months in a Santa Monica apartment: The L.A. wildfires, which began Jan. 7, 2025, and also devastated the Altadena community, destroyed their home.

Kim’s daughters, 13 and 16, were uprooted from their home, school and community. In a flash, they were separated from friends and unable to participate in local activities. And now, with summer break approaching, they and many other affected students could experience more disruption in their daily routines.

Connections and Consistency

Suzanne Silverstein, MA, ATR, founding director of Cedars-Sinai’s Share & Care, a program at 30 L.A.-area schools helping at-risk children through trauma, said parents should be prepared to guide children—many of whom are still grieving—through that disruption.

“The Pacific Palisades and Altadena communities were very tight-knit, and they are still suffering,” Silverstein said. “Children and parents have had to deal with losing homes as well as their community connections. It’s a double whammy, and it’s normal to still be grieving.”

Silverstein said children in the Share & Care program have received donated items, and she often hears them say, “I had this in my house that burned down.”

She added, “They’re also struggling because they’ve changed schools—their family moved, or their original school is no longer there—and their friends are at different schools. They’ve had to start over.”

Silverstein emphasized the importance of maintaining connections, especially during the summer break. She encourages parents to set up playdates with friends who have moved to different areas, saying, “Whole families can reconnect, which can be a gift to have everyone together for some positive experiences, and to see that everyone is OK.”

Consistency also is key, Silverstein said. If children have always attended summer camp and their camp is taking place this summer, it could be healing for them to go again, “if it’s something that’s familiar to them and something they can connect to, from before the fire.”

An art therapist, Silverstein also encourages children to express themselves in the ways they are most comfortable.

“Is it writing, is it drawing, is it through poetry or acting? Give them more of those experiences this summer,” she tells parents.

Art is a healing tool in Share & Care—younger children are encouraged to draw what they’re experiencing, while older ones are encouraged to write or draw in a journal, and then share if they’d like.

Also taught are mindfulness, calming breathing techniques, and how to sit quietly together and listen to what others in the group are sharing.

These are activities parents can continue with their children during summer recess, Silverstein said.

“We’ve been teaching parents the breathing techniques we’ve used with their children,” she said. “Parents also can benefit, as this continues to be a stressful and overwhelming time for them, too.”

Silverstein noted that the healing process is different for every child, and a strong parent-child connection can lead the way in best addressing the needs of each individual.

Leaning on Each Other

In the weeks following the fire, Kim’s family stayed in Orange County with relatives. He remembers kindness on full display when his daughters—competitive swimmers—were invited to swim with the local team. His older daughter took them up on the team’s offer.

“That was a huge part of maintaining some semblance of connection, and it helped her recovery,” he said, because she could participate in a routine activity she enjoys while also making new friends.

Kim said both daughters, as well as he and his wife, have benefited from social time with former neighbors and friends who are recovering from the fires.

“Talking about the complete loss we’ve experienced with people who’ve also been through it is a huge help,” he said.

Kim said he hopes to create a “normal” summer experience for his daughters, even though the family is living in a different place—filling it with swim meets and a vacation to the East Coast, a family tradition. His older daughter also will volunteer at Cedars-Sinai, an activity she finds fulfilling.

For the Kim family, time together may prove to have been the most healing.

“My wife and I were quite concerned about the stress of this trauma on the girls,” he said. “Earlier on, there were teary days and sleepless nights, but it’s been a while since we’ve seen emotions bubble up. We continue to watch them closely and make sure they know we’re here for them. I’m in awe of their resilience—it gives me strength to see them get up every morning, go to school and carry on to the next day.”

As the school year ends, these moments are more important than ever.

“We can’t get back the things we lost,” Kim said, “but we can help each other write the next chapter.”

Read more on the Cedars-Sinai Blog: Five Deep Breathing Exercises for Kids and Teens

The Cedars-Sinai Newsroom spoke to two infectious disease specialists—Jonathan Grein, MD, director of Hospital Epidemiology, and Priya Soni, MD, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s—to get the facts about how to protect yourself and your family.

Why is measles so dangerous?

Priya Soni, MD: Many people think that measles is just a rash, but it can be life threatening. One in 5 children who develop measles end up in the hospital. One in 20 children develop pneumonia, and this is the leading cause of measles-related deaths. In addition, 1 in 1,000 children can develop a rare complication of brain swelling—encephalitis—that can cause permanent brain damage.

How does measles spread?

Jonathan Grein, MD: Measles is one of the most infectious diseases that we know of, and it's spread very easily through the air, particularly for people who are not immune or have not received the vaccine. It's so infectious that you don't even need to be in the same room at the same time with someone who has measles to potentially get infected.

What are the telltale signs of measles?

Grein: The symptoms of measles can begin like any other viral illness. You may feel feverish, have muscle aches, headaches, very nonspecific symptoms. Patients may then go on to develop cough, runny nose, sometimes redness of the eyes. That all precedes the classic rash that you may be familiar with that typically starts on the face and spreads throughout the body. I think it’s important to know that it is possible to be infectious several days before that rash begins, which is one of the real challenges with trying to control measles from being spread person to person.

What should you do if you think your child has measles?

Soni: If you think your child has measles, the first thing to do is call your pediatrician, but do not go directly to their offices or the Emergency Department without speaking to someone on the phone first. The virus is extremely contagious, so you want to call ahead to let the healthcare providers know what’s going on. Showing up without calling ahead can cause other children in the waiting room to be infected. In addition, you should immediately isolate your child from other children, especially infants who are less than a year of age, as they may not have protection from the virus. You should also isolate your child from any immunocompromised family members.

How is measles treated?

Grein: The treatment for measles is solely supportive. There is no specific measles treatment, but you want to try to control the fever and make sure the patient is hydrated and resting in isolation.

How do we protect against measles?

Soni: Vaccination is the best protection against measles. The MMR vaccine, which is inclusive of measles, mumps and rubella, is 97% effective after two doses. It's one of the most effective vaccines that we have. And it protects children in outbreak situations and other vulnerable community members as well.

Typically, the first dose of the measles vaccine is given at 12-15 months of age. The second dose is given around 4-6 years of age.

If your child is 6-12 months old, they can receive an early dose of the measles vaccine if they're in a high-risk situation such as an outbreak or if they’ve been exposed to the virus. This additional dose that's given earlier than the recommended schedule does not count toward their two-dose series.

Do adults need to get vaccinated against measles?

Grein: Most adults will not need an additional booster dose if they were previously vaccinated. There is a small number of adults who may have received a different version of the measles vaccine between 1963 and 1967. This vaccine was later found to be less effective, and it doesn't provide as long-lasting immunity as the current vaccine. So if you did receive that vaccine, it is recommended that you receive a booster dose with the current MMR vaccine to achieve appropriate immunity.

Read more on the Cedars-Sinai Blog: Why Some Vaccines Last A Lifetime and Others Don't 

Diego Cruz told his healthcare team that his lifelong dream was to travel to Japan, which got Child Life Specialist Joanne Ordono thinking.

“Because of his physical condition, he can’t travel, but I thought, ‘Why not bring Japan to him?’ And that’s what we did,” Ordono said. “We brought both traditional and contemporary Japan to his hospital room.”

Thanks to the Japanese American Cultural and Community Center in Los Angeles’ Little Tokyo, Cruz had a traditional Japanese experience, starting with a tea ceremony performed by Hirokazu Kosaka, a tea ceremony master. Cruz sipped from a ceremonial bowl filled with matcha tea while Kosaka chanted. 

Next, Kuniharu Yoshida, a calligrapher, brought out his ink and brushes to create a traditional calligraphy scroll that reads, “May your wishes come true.” The calligrapher also helped Cruz write the Japanese character for “strength.” 

Then, musician Chester Ikei played a ukulele and sang traditional Japanese ballads describing the four seasons. 

Cruz, an anime fan, also received gifts from local shop Anime Station. Of course, no cultural experience is complete without food, and Cruz was able to taste mochi and Japanese cheesecake for the first time.

A visibly emotional Cruz took pictures with all his guests and his family members and fought back tears as he expressed his thanks.

“All the years that I’ve had chemotherapy, I missed out on all the things I wanted to do in life,” Cruz said. “While I saw others living a normal life, I’d be here in the hospital. I never thought I’d be able to do these things, so thank you. It means a lot to me.”

Ordono said the afternoon reminded her of the essence of healthcare.

“Obviously, taking care of the patients medically and clinically is super important, but we're treating the whole person,” Ordono said. “It's the emotional and the mental health that is also important, and I believe we got to bring a little bit more joy to this patient today.”

Read more from Discoveries: Innovation and Collaboration in Pediatrics at Cedars-Sinai Guerin Children's

What type of flu activity are we seeing in California this year and what are the symptoms?

As of early January, flu activity in California has been increasing and is comparable to levels observed at this time last year. Influenza (flu) typically presents with sudden onset of high-grade fever, accompanied by body aches, chills, headache, nasal congestion, runny nose and occasionally sore throat or fatigue.

When should you see a doctor?

The course of the flu can vary from person to person, but if you're experiencing prolonged fevers lasting three to five days, worsening cough or shortness of breath, signs of dehydration, or if you have exacerbation of underlying respiratory conditions such as asthma, it may be a good idea to check in with your primary care provider. Additionally, if you develop a new fever after initially recovering from the flu, be aware of the possibility of a secondary bacterial infection, such as a pneumonia, which would require medical attention.

Is it too late to get the flu vaccine?

While getting the flu shot earlier in the season is ideal, vaccination at any point during the flu season can still provide significant protection. The flu vaccine reduces the severity of illness and lowers the risk of complications, especially for high-risk individuals such as young children, pregnant women, the elderly and those with chronic medical conditions.

Each year, the flu vaccine is designed to target the most likely circulating strains. Although the vaccine may not be a perfect match for all strains, it provides partial immunity, which is highly beneficial in preventing severe illness.

What is norovirus and how is it affecting Californians?

Norovirus, often referred to as the “stomach flu,” is a highly contagious virus that causes gastroenteritis. We see symptoms including nausea, vomiting, diarrhea, abdominal cramping and occasionally low-grade fever. Norovirus is one of the leading causes of foodborne illness.

What can people do to stay healthy during virus season?

The advice is always the same. We need to be really mindful of our hand washing and being careful among high-risk individuals. Wearing a mask is of utmost importance because of the fires but also to prevent the spread of respiratory infections in this critical time period during the winter. Additionally, remember to listen to your body and stay home if you’re unwell.

Read more on the Cedars-Sinai Blog: Ask a Doc | What’s Walking Pneumonia?

Santa wheeled a wagon through the Cedars-Sinai Medical Center campus as he brought toys to young patients and their siblings. Santa also sang holiday songs while cuddling the tiny babies in the Neonatal Intensive Care Unit (NICU). And he gifted parents with keepsake ornaments decorated with their baby’s name and footprints.  

“It feels fantastic,” said Christine Silverman, whose one-week-old son, Murray, was in the NICU after being born prematurely.

NICU social worker Alva Gregorio, MSW, said parents were grateful for the opportunity to take a photo of their babies with Santa during their first Christmas, something many were afraid they would miss while being in the hospital.

“It brings a sense of normalcy to the families who have to be in the hospital during the holidays,” said one of the NICU social workers, who dressed as an elf and helped Santa deliver toys as part of the annual holiday tradition. “Some children worry Santa won’t find them because they are in the hospital, so seeing him here handing out gifts brings them great joy.”

David Marshall, JD, DNP, RN, Cedars-Sinai Health System’s chief nursing executive, originated the medical center’s tradition of hosting Santa for an annual visit.

This year, Santa bore a very strong resemblance to Cedars-Sinai’s Gregory Eichelzer, DNP, RN, nursing innovation administrator, and sounded like him too, as he sang holiday standards such as “Santa Claus is Coming to Town,” “Have Yourself a Merry Little Christmas” and “The First Noel.”  

Before he became a nurse, Eichelzer was a professional singer who performed on Broadway and toured the U.S. with productions of “Annie” and “Grease.” While his performances earned high marks from parents, Eichelzer’s baritone had a decidedly different effect on much of his audience as he lulled babies to sleep.

Santa ended his visit to Guerin Children’s with season’s greetings to patients, families and staff. “Merry Christmas, Happy Hanukkah and Happy New Year to all.”

Read more on the Cedars-Sinai Blog: Timely Pediatric Asthma Treatment 

, a longstanding tradition. Parents were invited to select their child’s Halloween outfit from an array of adorable costumes hand-sewn by volunteers and made especially to fit the smallest babies and their medical tubes.

The charming costumes, inspired by children's books, included pumpkins, Supergirl, Bumblebee, Dr. Suess characters, Bluey and Winnie the Pooh. For more than 20 years, Cedars-Sinai volunteers have been crafting the costumes, bringing joy to parents as they bond with their infants during their time in the NICU.

Melissa Burke’s daughter, Billie, has been in the NICU for about a month. The mother of three chose a Supergirl costume to match her family’s superhero theme this Halloween. Billie’s two big brothers are dressing up as Batman and Robin. 

“I love being able to celebrate here in the NICU,” Burke said while rocking Billie. “Halloween is one of our family’s favorite holidays. So, for us to be able to dress her up is incredible.”

The colorful outfits are lined with Velcro to easily fit around the infants without tugging at the tubing or causing any irritation.  

Halloween is always a special time in the NICU, said Bevin Merideth, RN, associate director of the Neonatal Intensive Care Unit. “Parents really love dressing their kids for Halloween,” Merideth said. “It allows them to celebrate their child’s first Halloween, and even if they are in the NICU, it helps to have that little bit of normality. And then they take the costumes home as a keepsake to show their babies how much they’ve grown.”

Read more on the Cedars-Sinai Blog: Making Strides in Treating the Smallest Heart Patients

Khokha and Lakhani, who specialize in rare pediatric genetic diseases and conditions, have published widely in the highest-impact journals and made significant contributions to pediatric development and genetics research.

Khokha will serve as director of the new Guerin Children’s Genetics Research Center, and Lakhani as director of the Guerin Children’s Early Detection Program. Together, they will develop a pediatric genome sequencing program to help identify genetic disorders as early as possible, prompting earlier and more effective screenings and treatments for pediatric diseases.

“The expertise of Dr. Khokha and Dr. Lakhani will help Guerin Children’s detect genetic disorders and inherited diseases earlier, expand our knowledge of these conditions, help parents make more informed healthcare decisions for their children and better tailor treatments,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health at Cedars-Sinai and executive director of Guerin Children’s. “We look forward to them enhancing innovation and medical care for our patients at Guerin Children’s.”

Khokha and Lakhani will collaborate with David Rowitch, MD, PhD, associate director of Research at Guerin Children’s, to establish a birth cohort study that will collect data on genetic sequencing in children to better understand future disease probabilities. This effort will aim initially to introduce informed consent genetic testing.

Khokha and Lakhani join Guerin Children’s from the Yale School of Medicine, where they both were pediatric critical care physicians and led Yale’s Pediatric Genomics Discovery Program, which studies the genetic causes of unknown or undiagnosed diseases in children.

Prior to joining Cedars-Sinai, Khokha was professor of Pediatrics and Genetics at Yale and director of the Pediatric Genomics Discovery Program. His laboratory team studies the developmental biology of congenital malformations, which informs his clinical practice in pediatric intensive care. For more than two decades, Khokha has maintained continuous funding and multiple grants from the National Institutes of Health (NIH). He also has chaired the major NIH grant study section focused on developmental biology.

Khokha earned his bachelor’s and medical degrees from Northwestern University and completed his internship and residency at St. Louis Children’s Hospital. He completed his clinical fellowship in pediatric critical care at UCSF Medical Center and a postdoctoral fellowship in molecular and cell biology at the University of California, Berkeley.

“Being able to share with parents that we understand the cause of a genetic disorder or birth defect, and that we may have a specific treatment to help, is invaluable,” Khokha said. “Significant strides have been made in the science and technology of genomics. I look forward to building on this momentum at Guerin Children’s.”

Most recently, Lakhani was an associate professor of Pediatrics at Yale and clinical director of the Pediatric Genomics Discovery Program. His lab staff explores the genetics of birth defects, particularly neurodevelopmental disorders and seizures. He has held numerous leadership roles, including director of the pediatric critical care fellowship at Yale.

Lakhani earned his bachelor’s and medical degrees from the University of Virginia. He completed his residency in pediatrics at St. Louis Children’s Hospital, followed by fellowships in pediatric critical care and immunobiology at Yale and integrative medicine at the University of Arizona.

“I’m eager to bring my genomics work to Guerin Children’s and help make genetic testing more available to patients,” Lakhani said. “As we continue to learn more about the genetics of birth defects and rare diseases through research and early detection at Guerin Children’s, the potential to transform treatment and care is very exciting.”

Read more on the Cedars-Sinai Blog: Understanding Prenatal Genetic Testing and Diagnostics

The research project brings together scientists from Cedars-Sinai, Baylor College of Medicine, the University of Michigan and Rutgers University. The investigators will study a process called fetal reversion, also known as developmental reprogramming, in mouse intestines to understand how adult tissues repair themselves, enabling the creation of a detailed map of healing processes.

“Our goal is to explore whether we can use what we learn about fetal reversion to identify a better way to repair and heal organs such as the intestine,” said Ophir Klein, MD, PhD, executive director of Cedars-Sinai Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health.

The research team includes experts in basic science, regenerative medicine, intestinal physiology, virology, drug screening, and genomics and epigenomics. Their endeavor is called the “Consortium on Intestinal Regeneration and Fetal Reversion: from Atlas to Therapy.”

The Cedars-Sinai Newsroom recently spoke with Klein, the project’s coordinating principal investigator, to learn more about the five-year grant, the team’s research goals and how the grant will help advance our understanding of injury repair.

Can you provide a high-level overview of the team’s research interests and how this grant supports its ongoing work?

The fundamental question that we're interested in understanding is how adult tissues repair themselves. We are using the intestine as our model, and we believe that many elements of the repair processes we discover will be more generalizable beyond the intestine and have implications for other organs.

This grant from the NIH will provide the necessary resources for our research team to use this information to study how repair programs work in a mouse model and to find new ways to help the body heal. The data from our research will be shared online in a way that is easy to use, so the research community at large can explore it and come up with new ideas and treatments in the future. The insights we stand to gain could pave the way to a paradigm shift in our understanding of gut repair.

What is fetal reversion, and how will this grant help advance the understanding of injury and repair?

Fetal reversion is a regenerative response in which adult tissues reactivate behaviors from their developmental stage to heal from damage or injury, including those induced by infection, radiation treatment or inflammation.

Sometimes, the body heals perfectly well, while other times it doesn't heal at all. With the support of the NIH grant, we aim to understand how the healing process occurs and whether it involves processes used by the normally developing embryo. This understanding is important to lay a foundation for potential new treatments and drugs for wound healing.

How will the findings from this research potentially impact the development of new treatments for intestinal injuries and gut repair?

The fetal reversion process involves turning off aspects of normal gene expression programs and switching to a more fetal-like state. We don’t yet know if fetal reversion happens in all types of intestinal healing or if it occurs only during certain types of repairs.

It’s still a little bit of a mystery how the gut is able to repair itself after various injuries. One interesting approach is to compare intestinal regeneration across different organisms, and this hasn't been systematically studied. Our aim is to map intestinal injury and repair in mouse and human models, study repair programs and find new therapeutic targets using drug screening. A standardized approach to this study with the latest technologies will hopefully provide further insight into wound healing and fill gaps in our understanding of intestinal regeneration.

This is a historic grant for Cedars-Sinai Guerin Children’s. How will these funds advance the work being done in your laboratory and further advance Guerin Children’s commitment to bench-to-bedside care?

Receiving an NIH grant of this scope allows Guerin Children's to continue conducting leading-edge research, advancing the work of our physician-scientists who merge top-notch clinical care with translational and foundational research. At Guerin Children's, we focus on the entire health span and how pediatric medicine influences health beyond childhood. By learning from children’s health, we aim to improve health outcomes for adults. We are grateful to the NIH and our collaborators for helping us advance this science.

Read more on the Cedars-Sinai Blog: Six Questions With Ophir Klein, MD, PhD

“They noticed that all the long bones were measuring below the 1 percentile. So, he let us know that he suspected some sort of skeletal dysplasia,” said Gould, 42. “This wasn’t on the radar at all.”

Two weeks later, detailed genetic testing confirmed skeletal dysplasia, specifically achondroplasia.

Skeletal dysplasia, also known as dwarfism, is a group of disorders that affect bone, joint and cartilage growth in a child. Achondroplasia is the most common form. The rare genetic disorder occurs in about 1 in 40,000 births. The condition is characterized by birth complications, shorter bones and limbs and delayed developmental milestones. People with skeletal dysplasia typically require long‑term medical follow-up and monitoring.

Navigating Care

With limited access to specialized care in Nevada, Gould and her husband, John, initially flew to Philadelphia to meet with a team of specialists.

As they processed the shock of the diagnosis and the slew of medical challenges that lay ahead, it quickly became apparent that spending extensive time on the East Coast wouldn’t be ideal due to lack of family support.

The couple, who have five children, contacted Moise Danielpour, MD, a pediatric neurosurgeon highly skilled in pediatric skeletal dysplasia treatments and a medical board member at Little People of America.

To the Goulds’ surprise, within 15 minutes, they got a call from Danielpour, director of the Pediatric Neurosurgery Program at Cedars-Sinai Guerin Children’s.

Danielpour looped in a comprehensive team of specialists, including Pedro Sanchez, MD, director of Pediatric Medical Genetics at Guerin Children’s.

“Dr. Sanchez called me 10 minutes later and we probably talked for 90 minutes,” John Gould said. “It was a really personal conversation. I didn't feel like I was speaking to a doctor.”

For Elliot’s birth and long-term care, the Goulds chose Cedars-Sinai, where, coincidentally, John and his twin sister were born in 1976.

On May 6, 2023, Kelly gave birth to Elliot at 35 weeks via cesarean section with more than 20 medical professionals in the delivery room ready in case of an emergency.

“We were prepared for the worst at birth,” Kelly Gould said. “He came out crying, and that was such a big deal because we weren't sure that might happen due to breathing complications associated with achondroplasia.”

Even though Elliot had respiratory and feeding issues due to his small chest size and required continuous oxygen support, the parents were able to take their newborn home to Las Vegas after spending nearly a month at the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s. Unfortunately, at 8 weeks old, Elliot stopped breathing and had to be airlifted back to Cedars-Sinai from Las Vegas for emergency spinal surgery.

The surgery was necessary to treat Elliot for foramen magnum stenosis (FMS), a potentially life-threatening condition commonly associated with achondroplasia that significantly increases the risk of sudden death.

FMS occurs when the opening at the base of the skull through which the spine passes becomes very narrow or kinked, putting pressure on the junction where the brain and the spinal cord meet. Severe FMS in infants under 2, such as in Elliot’s case, can cause breathing problems and delays in crawling and walking.

“To relieve FMS symptoms, we go in and very carefully expand or increase the size of the foramen magnum by taking out the appropriate bone and making that size more normal so there isn't compression of the brain stem and spinal cord due to narrowness or stenosis at the opening of the skull,” said Danielpour, who performed Elliot’s surgery. “This was not a surprise to the parents, but they hadn’t expected it when Elliot was 60 days old. But we helped them deal with the care he needed afterward and have the best outcome possible.”

A New Path to Growth

About 99% of achondroplasia cases stem from a spontaneous mutation in a gene called FGFR3. This mutation disturbs the average pace of bone growth, resulting in short limbs and dwarfism. Doctors said the mutation is unrelated to the age of the mother.

In 2021, the United States Food and Drug Administration (FDA) approved a growth therapy drug called vosoritide (VOXZOGO). This once-daily drug was approved to boost bone growth and improve muscle tone while stabilizing head growth in children 5 and older.

A few months after Elliot’s birth, in October 2023, the FDA expanded the drug’s usage for newborns and children of all ages with achondroplasia.

As the Goulds came to find out, though, getting their hands on this groundbreaking drug in Las Vegas was both tricky and time-consuming. They waited more than 10 weeks for the medication to arrive. It never did.

So the parents contacted Sanchez for help; he arranged for the medication to arrive.

“Dr. Sanchez is the reason Elliot has the drug,” John Gould said. “And we did the first injection at Cedars-Sinai. They walked us through it with the nursing team, and we knew we had come to the right place.”

Now the Goulds, with Elliot in tow, visit Sanchez’s clinic every three months for regular follow-ups, and Elliot is already showing some improvements. 

“Hopefully, the medication will allow Elliot to get the signal to start growing again. Not only should it affect the long bones, but probably all bones and should also allow the rest of his anatomy to adapt appropriately,” Sanchez said.

As for Elliot, John can’t wait to see what his youngest son will bring to the world.

“I know life is going to be really challenging for Elliot,” John Gould said. “We just want him to be in the best position where he goes through life as anybody else would and has those same opportunities without really thinking about achondroplasia, though it will always be a part of him.”

Read more on the Cedars-Sinai Blog: A High-Risk Pregnancy Lifeline

launched in 2022, it sought to build a pioneering children’s health destination that combined multidisciplinary excellence in pediatric care with advanced research to identify and treat the roots of childhood diseases.

Now, as Guerin Children’s marks its two-year anniversary, it is realizing its vision of becoming an internationally recognized children’s health enterprise—with dozens of distinguished faculty members who are elevating and improving children’s healthcare.

“We are thrilled to celebrate this milestone and reflect on the incredible progress we have made,” said Ophir Klein, MD, PhD, executive director of Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health. “Our vision is to continue combining the best clinical care with translational and foundational research to bring the latest advances to our patients and their families.”

Guerin Children’s has recruited a multitude of nationally and internationally renowned physicians and investigators to advance care for children, building a faculty of nearly 130 members.

The team currently offers more than three dozen pediatric subspecialties, taking a multidisciplinary approach to deliver highly specialized care for children in neonatology, oncology, gastroenterology, cardiac services, orthopedics and neurology, among others.

Guerin Children’s was made possible by a generous $100 million gift from the Shapell Guerin Family Foundation—at the time, the largest lifetime gift in Cedars-Sinai’s 122-year history. The foundation’s president, Vera Guerin, along with her husband, Paul, and their children—Dana, Lisa and Michael—are longtime supporters of Cedars-Sinai. 

“We are immensely proud of the progress and accomplishments made by Guerin Children’s over the past two years,” said Vera Guerin, the immediate past chair of the Cedars-Sinai Health System Board of Directors. “Our vision was to provide exceptional clinical care and foster groundbreaking research in pediatric medicine.”

Taking a Multidisciplinary Approach to Medical Care

One of the highlights of Guerin Children’s is the multidisciplinary nature of its clinical care. It pairs expertise in numerous specialties with lifesaving procedures and medications to deliver personalized healthcare to patients as they grow from newborns into adolescence and adulthood.

“The medical team at Cedars-Sinai Guerin Children’s is amazing,” said Krista Hazelwood, mother of 9-month-old Vita Carletti, who was born with a severe case of meconium aspiration syndrome, which led to a critical condition with heart and lung failure.

Guerin Children’s physicians consulted with experts in the Smidt Heart Institute at Cedars-Sinai and the Cedars-Sinai Pediatric Intensive Care Unit and placed the newborn on extracorporeal membrane oxygenation (ECMO) for nearly a month. ECMO is a complex dual-bypass life support machine that performs the functions of the heart and lungs. After a lengthy hospital stay, Vita is now thriving.

“Vita had the best team in the country she could have had working on her and caring for her,” Hazelwood said.

Dana Guerin, director of the Shapell Guerin Family Foundation, said she is gratified to hear such success stories.

“Seeing the impact on the lives of children and their families reaffirms our commitment to this mission,” she said. “We look forward to continuing this journey and making even greater strides in the years to come.”

Notable Appointments to Advance Pediatric Care and Research

Guerin Children’s is building a formidable research enterprise that is attracting internationally distinguished investigators and clinicians to build a robust bench-to-bedside capacity.

Guerin Children’s appointed renowned neuroscientist and stem cell investigator David Rowitch, MD, PhD, to lead research initiatives. Rowitch, a professor in the departments of Pediatrics and Neurosurgery, is expanding the genomic medicine program and translational research, bringing leading-edge advancements and expertise in precision medicine to pediatric care.

Guerin Children’s has recruited or promoted several other high-caliber clinicians and investigators during the last year:

• Leo Mascarenhas, MD, MS, a distinguished pediatric hematologist-oncologist and sarcoma expert, was appointed director of Pediatric Hematology and Oncology at Guerin Children’s and medical director of the Sarcoma Program at Cedars-Sinai Cancer. In this role, Mascarenhas is working to advance innovative clinical trials and investigations and develop novel treatment strategies for children with cancer and blood diseases.
• To bolster specialty surgical services at Guerin Children’s, Eugene Kim, MD, a leading pediatric surgical oncologist and neuroblastoma research expert, was named surgeon-in-chief and associate director of Surgery at Guerin Children’s. In his new role, Kim will collaborate with the leadership of all pediatric surgical subspecialties at Cedars-Sinai to support the Guerin Children’s mission.
• Deborah Holder, MD, a distinguished pediatric neurologist, was named program director of the new Pediatric Epilepsy Program at Guerin Children’s. The clinic offers comprehensive, one-stop care for children with epilepsy and aims to leverage leading-edge advancements and expand treatment access for childhood epileptic seizures.
• Rangasamy Ramanathan, MD, MBBS, an internationally recognized innovator of nasal cannulas for newborns—and the Ruth and Harry Roman Chair in Neonatology in honor of Larry Baum—was named director of Neonatology in the Department of Pediatrics with the goal of significantly enhancing the newly expanded neonatology program.
• David Traver, PhD, a developmental biologist and stem cell investigator, was appointed director of a new developmental biology and regenerative pediatrics center. Traver is recruiting a cohort of investigators to study the cellular processes involved in regenerative medicine, including research into how the body grows, repairs and rebuilds. This could lead to potential discoveries of new therapies for childhood diseases, such as cancer and related disorders.

“We are on a journey toward building an international destination for children’s care that can positively impact the health of our region and the world, and provide children and their families with a comfortable, state-of-the-art environment for the highest level of care,” said Shervin Rabizadeh, MD, MBA, associate director of Guerin Children’s and chair of the Department of Pediatrics.

Training Future Leaders in Pediatrics

In addition to its clinical and research advances, Guerin Children’s also has introduced a pediatric residency program to train future pediatric specialists. An inaugural cohort of eight pediatric residents kick-started the program on July 1. 

The program aims to train the next generation of pediatricians by providing comprehensive education, hands-on experience and mentorship in various pediatric specialties. The residency program is designed to equip pediatric residents with the skills and knowledge needed to excel in various inpatient and outpatient practice settings while caring for diverse patient populations throughout their lifespans.

“As we continue to grow and expand over the coming years, Cedars-Sinai Guerin Children’s will offer a continuum of exceptional and seamless care,” Klein said. “We are committed to our vision of becoming a world-class center for innovative clinical care and impactful research.”

Read More on the Cedars-Sinai Blog: Faces of Cedars-Sinai—Pediatric Plastic Surgeon Victor Chien

The Cedars-Sinai Newsroom sat down with Sabrina Renteria, MD, a child and adolescent psychiatrist in the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, and Romina Kim, MD, a pediatric hospitalist with Cedars-Sinai Guerin Children’s, to discuss stress and burnout symptoms and what parents can do to help.  

What are some of the main causes of stress and burnout in children and teens?

Renteria: Some of the top causes of stress and burnout for this age group stem from academic pressures with high expectations and heavy workloads. High achievers, in particular, tend to overwhelm themselves with extracurricular activities in addition to their schoolwork, leaving insufficient time for rest and relaxation, which can be exhausting both physically and mentally. Additionally, social stress is often a contributing factor, especially in the age of social media where kids are constantly online. Bullying, peer pressure and difficulties navigating social relationships can all lead to severe emotional distress.  

What do stress and burnout look like in this age group?

Renteria: Burnout and stress in children and teens can manifest in various ways. This can look like snappiness or irritability, lack of energy or tearfulness. Depression and withdrawing from friends and family can be common as well. Children might even express frustration or that they feel like giving up.

Kim: Physically, stress can show up as things like headaches, gastrointestinal issues, unintended weight loss due to loss of appetite, tics and other generalized pain. In severe cases, some patients can experience what’s known as functional neurologic disorder, which is characterized by physical symptoms that cause distress and impair function without a structural or neurologic abnormality. In these cases, while nothing seems to be physically wrong with the child, they may experience various physical manifestations, including the inability to walk, muscle weakness or even seizures. With proper treatment, along with time and patience, most of these ailments are reversible.

How do doctors determine if a child’s physical ailment is stress-related, versus physiological?

Kim: It’s our role as doctors to do our due diligence. We always start by obtaining a detailed history from the patient and their family. This subjective information is our first step to piece together the puzzle. We also obtain objective data, such as physical exams, lab work, imaging studies and more to help support a possible diagnosis. Once we narrow things down, we often bring in additional experts, such as our neurology or psychiatry teams to help us confirm the diagnosis and address the problem to get the patient firmly on a path to recovery.

What signs of stress or burnout should parents or guardians look for in their children?

Renteria: Parents know their children best and should look out for significant changes in their behavior and mood. If your child starts to have a drop in grades, is increasingly irritable or constantly in a bad mood, those could all be signs they are under too much stress. Kids may also lose interest in their previously cherished pastimes or hobbies. Another red flag may be sleep issues, like trouble falling or staying asleep, or even sleeping too much.

Kim: When kids are burned out or feeling too much stress, they tend not to be able to cope with their emotions. Often, even the smallest inconvenience can trigger a big reaction. It’s important that parents don’t automatically dismiss what may be an unusual behavior for their child as them just being a “moody teenager,” when there may be much more to it than that.

How can parents or guardians help their kids manage significant stress or burnout?

Renteria: It’s OK for kids to be active and busy, but it’s all about striking a balance. It is important to find the right amount of organized activity and free time to help promote social and emotional growth and development in your child. Parents can help children combat burnout by encouraging them to engage in physical activity, maintain a healthy diet, get enough sleep, establish a daily routine, set realistic goals, practice relaxation techniques, limit screen time and seek professional help if needed.

Kim: By building an open, communicative relationship with their children early on, parents can create a foundation in which a child feels comfortable being able to talk openly about any stress or anxiety they’re experiencing. Another important thing for parents to remember: If they are not modeling good self-care and coping skills themselves, it is that much more difficult for their children to learn these habits. By setting an example of healthy balance for yourself, you can help set your kids up for success as well.

Read more from the Cedars-Sinai Blog: Five Deep Breathing Exercises for Kids and Teens

Safaa, weighing just 1.1 pounds, was in the Neonatal Intensive Care Unit (NICU) at Cedars-Sinai Guerin Children’s.

“Shortly after Safaa was born, pandemic lockdowns were implemented and only one visitor was allowed in the hospital at a time, so we had to take turns visiting her in the NICU,” Cardello said. “We were not only scared of getting germs at the hospital, but we were scared of bringing germs into the hospital and harming Safaa.”

Safaa experienced a number of health challenges in those early days, including bronchopulmonary dysplasia, or premature lung disease, because her lungs were not fully developed. Additionally, her physicians discovered Safaa had an extremely narrow upper airway, making it difficult for her to breathe without medical intervention.

“I would honestly say Safaa had the smallest windpipe I’ve ever seen,” said Irina Dralyuk, MD, a pediatric pulmonologist at Cedars-Sinai Guerin Children’s and one of Safaa’s consistent care providers.

To bypass her narrow airway, Safaa’s doctors performed a tracheostomy, a procedure to create an opening in the neck that extends to the trachea, allowing easier breathing and enabling oxygen to reach the lungs.

Safaa graduated from the Cedars-Sinai Guerin Children’s NICU four months later, in July 2020, but her airway issues were not solved, so she went home with the tracheostomy tube in her neck.

Fixing Safaa’s Airway

“When I first met Safaa, her airway opening was only a couple of millimeters wide,” said Gene Liu, MD, director of Academic Otolaryngology for Cedars-Sinai Medical Center and a pediatric ear, nose and throat specialist for Cedars-Sinai Guerin Children’s. “And even though she was growing, her windpipe needed help to expand.”

Hoping to avoid a major surgical procedure on her neck that would come with additional risks, Safaa’s family and their care team opted for a less invasive approach using a balloon dilation to gradually widen her airway over time.

“Every few months, we would look at Safaa’s airway with a fiberoptic camera, and the balloon dilation procedure would gently push open the airway little by little until it became a very nice, normal-looking airway,” Liu said.

In March 2024, shortly after Safaa’s 4^th birthday, her tracheostomy tube was removed.

Becoming Like Family

Through four years of appointments and procedures, the Cardello family and Safaa’s Cedars-Sinai care team became quite close.

“Safaa got to know us really well and I think that helped when she would come in for her balloon dilation,” Dralyuk said. “I would always meet her and her family in pre-op and either Dr. Liu or I would carry her back to the procedure area. She’s a tough cookie. She and her parents have done an amazing job.”

Dralyuk said she especially loves to hear Safaa say her name. “Early on, we didn’t know what Safaa’s voice might sound like due to her narrow airway and whether there may be any residual damage to her vocal cords. Now when I see her, and I hear, ‘Hi Dr. Dralyuk,’ it is really special.”

Ahmadi Cardello said she and her family are thankful for the care and attention they received.

“The advice Drs. Liu, Dralyuk and all of Safaa’s other doctors gave us always felt like it was something they would recommend for their own child,” Ahmadi Cardello said. “We didn’t feel alone.”

What’s Next for Safaa

Now that her tracheostomy tube has been removed, Safaa and her parents are waiting patiently for the stoma, or the hole where the tube was previously located, to close. That typically happens on its own in a few months.

Prior to the removal, many things that would be normal for a toddler were risky for Safaa as they could cause infection of the stoma.

“I can’t wait to teach her how to swim,” Cardello said, “It’ll be fun to finally take her to the park and let her play in the sand. We haven’t been able to do that until now.”

Ahmadi Cardello is relieved. “Now that Safaa’s tracheostomy has been removed, I feel like we can all breathe a little easier,” she said.

Read more from the Cedars-Sinai Blog: Common Breathing Problems in Kids and How to Treat Them

“Donor milk plays a crucial role in improving the outcomes for our most vulnerable premature infants,” said Bevin Merideth, MSN, RN, associate director of the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s. “A diet comprised of human milk—whether maternal, donor, or a combination of both—has been shown to significantly decrease the incidence of necrotizing enterocolitis [NEC], an inflammation of the intestinal tract, which is the leading cause of death in premature infants,” Merideth said.

To participate in the breast milk drive, donors first register with the milk bank, share their health history and undergo a blood test.  

Wendy De Leon, Cedars-Sinai’s lead lactation consultant, said donors are helping the smallest patients.

“Babies digest human milk better than bovine protein and the antibodies from breast milk are greater than what babies would receive from formula,” De Leon said. “The availability of donor breast milk in our Neonatal Intensive Care Unit [NICU] is made possible through these generous donations of surplus breast milk to milk banks.”

Those who wish to participate in the upcoming milk drive should preregister and bring their frozen milk in a cooler to the drop-off. Frozen breast milk is good for approximately six months.

Mothers Milk Drive
When:       Sunday, Aug. 4, 11 a.m.-2 p.m.
Where:      Cedars-Sinai
Thalians Health Center 
8730 Alden Drive
Los Angeles, California 90048

Read more on the Cedars-Sinai Blog: Support for Nursing Parents 

Kim will continue as director of the Division of Pediatric General Surgery and as vice chair of the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai Medical Center.

Kim succeeds Andrew Freedman, MD, the inaugural associate director of Surgery at Guerin Children’s. Freedman will continue to serve as chief of Pediatric Urology.

“We congratulate Dr. Kim and recognize that with this appointment, our capacity to perform many different kinds of pediatric surgeries within the Guerin Children’s surgery department will greatly expand,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health at Cedars-Sinai and executive director of Guerin Children’s. “We wish Dr. Kim much success as he builds on the legacy of Dr. Freedman, whose leadership shepherded the dramatic growth of the Guerin Children’s surgical enterprise. We express our deep gratitude to Dr. Freedman—our program’s success is largely due to his efforts.”

In Kim’s expanded role, he will collaborate with the leadership of all pediatric surgical subspecialties and work with pediatric and surgery division chiefs to support the Guerin Children’s mission.

“It’s a great honor to step into this new leadership position,” Kim said. “I look forward to continuing to grow our children’s surgery program and strengthening Guerin Children’s as a premier destination for pediatric care.”

Kim is a research expert in neuroblastoma, an aggressive childhood cancer that begins in nerve cells. Among his contributions to the field, he and colleagues have identified a neuroblastoma cancer stem cell population resistant to treatment that may be a cause of recurrent and metastatic disease.

“Dr. Kim is an excellent investigator and surgeon, fully committed and eager to take our pediatric surgical program to the next level,” said Cristina Ferrone, MD, chair of the Department of Surgery. “His expertise will help countless pediatric patients and their families as they navigate critical treatment and surgery.”

Prior to joining Cedars-Sinai in 2022, Kim was a professor of Surgery and Pediatrics at the Keck School of Medicine of the University of Southern California. He also was director of Pediatric Surgical Oncology at Children’s Hospital Los Angeles.

Kim is a past president of the Association for Academic Surgery, president of the Society of Asian Academic Surgeons, associate editor of the journal Frontiers in Pediatrics and the chief editor of pediatric surgical content for Drugs & Diseases.

Read more in Cedars-Sinai Discoveries Magazine: Designing a Lullaby-Friendly MRI

But parents of premature babies often wait weeks or even months before they can do so. This is especially true if infants need a ventilator to help them breathe, a common issue for preemies, because lifesaving ventilator tubes and cords make it difficult to safely move a baby.

Cedars-Sinai joined with other hospitals across the state to find a solution and facilitate earlier skin-to-skin bonding for the tiniest babies and their parents. The project involves neonatal intensive care unit (NICU) specialists, including respiratory therapists, nurses and doctors. They figured out how to carefully move premature babies and respiratory equipment safely out of incubators and into parents’ arms.

“It is a three- to four-person job, and because the baby is so fragile, once the infant is moved, they remain in their parent’s arms for about two hours,” said clinical nurse specialist Amanda Williams, MSN, who led the Cedars-Sinai Guerin Children’s effort.

Emma and Tyler Beckett’s son, Owen, was born the first week of June at Cedars-Sinai at 24 weeks’ gestation, weighing just 1.7 pounds, and he was started on a jet ventilator in the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s.

“It’s so special,” Emma Beckett said. “The day that they told us we could start doing skin-to-skin, it was a surprise for us, and I just started crying immediately because I thought we were going to have to wait a long time—and to be able to do this now, it’s just amazing. Like we feel so much more connected to him.”

Courtney and Steven Fine also are getting an unexpected opportunity to bond with their daughter, Alia, who was born at 26 weeks’ gestation in mid-May and weighed 1.11 pounds.

“It's just nice to have her close to me,” Courtney Fine said. “I just really feel like I'm getting to bond with her more. It really does change my entire day and week.”

The reaction from parents has been universally positive, Williams said.

“We know how important skin-to-skin is for the babies and the parents, both emotionally and physically,” Williams said. “It’s so good for the baby. When they are skin-to-skin, we see their vital signs improving, including their respiratory and heart rates. It also helps mom with producing breast milk, and for both moms and dads, the bonding opportunity is key.”

Rangasamy Ramanathan, MD, MBBS, director of Neonatology and an innovator in neonatal and pediatric respiratory care, pioneered the new technique of nasal high frequency jet ventilation. That technique uses a nose tube called a RAM Cannula that was named for Ramanathan.

“There is so much benefit for the baby and the parents with skin-to-skin care that our approach is to make it possible with the use of jet ventilators as soon as possible in babies with breathing problems,” Ramanathan said.  

Tyler Beckett alternates with his wife, doing skin-to-skin with newborn Owen every other day. “I see his improving health and his improving strength,” Beckett said. “I am happy to think that I might be contributing in a small way, and it makes us feel better too. I am happier and calmer from the contact.”

The same is true for Steven Fine and his baby, Alia. “Skin-to-skin is our happy place,” Fine said. “It lets us not focus on any of the medical issues going on and just be with her and be present.”

Read more from the Cedars-Sinai Blog: Anxious About Breastfeeding? You're Not Alone

The new center brings together investigators studying the cellular processes involved in development and renewal, including how the body grows, repairs and rebuilds. 

“Dr. Traver’s appointment marks an important expansion of our developmental and stem cell biology research program,” said Ophir Klein, MD, PhD, executive director of Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health. “By bringing our talented investigators together, this appointment furthers the potential for new discoveries in regenerative medicine.”

Traver will advance collaboration with research groups across Cedars-Sinai, including the Board of Governors Regenerative Medicine Institute, and with outside partners. He will also serve as professor in the Department of Pediatrics. 

“Through our growing collaborations, Dr. Traver and our other scientists are making discoveries that can lead to new drugs or other therapies for childhood diseases,” said David Rowitch, MD, PhD, associate director of Research at Guerin Children’s and professor in the departments of Pediatrics and Neurosurgery.

Traver joins Cedars-Sinai from the University of California, San Diego (UCSD), where his research team has spent years learning how hematopoietic stem cells—which can become any blood cell in the body—form, differentiate and provide immunity.

Under Traver’s leadership, investigators have developed high-resolution imaging techniques, allowing them to demonstrate that cells comprising the lining of the aorta convert into hematopoietic stem cells. A major goal is to generate patient-specific hematopoietic stem cells to aid recovery for people with cancer and related disorders.

 “I’m very excited to build on the research and clinical care programs at Cedars-Sinai and to work toward translating laboratory discoveries into results that can improve the lives of patients,” Traver said.

Traver earned a bachelor’s degree in cell and molecular biology from the University of Washington and a PhD in immunology from Stanford University. In 2000, while at Stanford, he was awarded the McDevitt Prize for best thesis in immunology. He completed a postdoctoral fellowship in developmental biology at Harvard University and Boston Children’s Hospital.

Traver is the recipient of a Career Development Award from the National Institutes of Health and a New Faculty Award from the California Institute for Regenerative Medicine. He also has received scholar awards from the March of Dimes Foundation, the American Society of Hematology, the Sidney Kimmel Foundation for Cancer Research, and the Leukemia and Lymphoma Society. He was awarded the 2019 Till & McCulloch Award from the International Society of Experimental Hematology for outstanding scientific contributions in the field of hematology and stem cells.

“Dr. Traver has led his laboratory to many research accomplishments,” said Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics at Guerin Children’s. “We look forward to witnessing the innovations that will result from collaborations he will facilitate across our stem cell and regenerative medicine laboratories.”

Read more on the Cedars-Sinai Blog: The Untapped Potential of Stem Cells

The 17-year-old actor, who has starred in popular shows and movies like Ghostbusters: Frozen Empire, The Handmaid’s Tale and Young Sheldon, brought specially designed movie-themed hospital gowns, coloring books and toys for the patients.

“It’s fun for me to be able to bring things and just talk to people and talk to kids and teens,” Grace said.

For the visit, Grace teamed up with nonprofit Starlight Children’s Foundation, a longtime partner of Cedars-Sinai that distributes hospital wear, games and supplies to make the inpatient experience more positive for children and their families.

“Hospitalization can be a scary and lonely experience,” said Richard Jardiolin, the foundation’s spokesperson. “Our goal is to transform hospital experiences so kids can enjoy the best parts of being a kid, no matter what they're going through.”

Grace has been through it herself. She had spine surgery performed by David L. Skaggs, MD, director of Pediatric Orthopaedics at Guerin Children's, to fix severe scoliosis. Now, fully recovered and back in action, she is able to bring joy to other patients still on their healthcare journey.

“Through visits from celebrities like Mckenna, whose sincerity and kindness were apparent throughout her visit, patients and families feel a personal connection with someone they may never have had the opportunity to meet,” said Sandie Sternberg, a certified child life specialist at Guerin Children’s.

During her visit, Grace gleefully swapped pet photos with one of the hospitalized teens and connected with another patient over their mutual love of video games.

“My visit today was great. I got to talk to a lot of kids. I got a new Roblox friend, and I also got invited to a senior prom,” Grace said. “So, I'd say overall, a very successful day.”

Read more on the Cedars-Sinai Blog: Five Deep Breathing Exercises for Kids and Teens

During labor, doctors alerted Hazelwood and her husband, Matteo Carletti, about the presence of meconium—a newborn’s first bowel movement—in the amniotic fluid in the uterus. However, the passing of meconium before birth is a fairly common issue that occurs in up to 22% of deliveries and is typically easy to manage.

But Vita Rose’s birth wasn’t typical.

Moments after Vita Rose’s debut, physicians and nurses rushed the newborn to the Neonatal Intensive Care Unit (NICU) at Cedars-Sinai Guerin Children’s. Soon, she was diagnosed with a severe case of meconium aspiration syndrome.

Unlike regular stool, meconium is a black, tarry and sticky substance. Typically, most babies pass meconium a few hours after birth. However, if ingested in utero or during birth, the viscous fluid could potentially coat the air sacs (alveoli) inside the lungs and block the airways, causing lung and heart problems.

“In a lot of cases, meconium aspiration is very mild because there's maybe not very much that gets deposited into the lungs. But in Vita Rose’s case, there was a significant amount, to the point that it caused significant lung damage,” said David Epstein, MD, director of Pediatric and Congenital Cardiac Intensive Care at Cedars-Sinai Guerin Children’s.

By next morning, Vita Rose’s complications had snowballed quickly, and her health had taken a turn for the worse.

ECMO to the Rescue 

Vita Rose was in respiratory lung and heart failure. With her life in jeopardy, the newborn was placed on a ventilator to help her breathe, and Guerin Children's physicians consulted with experts in the Smidt Heart Institute to devise a plan to strengthen the baby's heart and lungs. 

“In the initial chest X-rays that were taken within one hour [of birth], her lungs were already very opaque, which tells us that her lungs didn't have the ability to oxygenate her blood or to remove some of the carbon dioxide that all babies have,” said Richard W. Kim, MD, director of Pediatric and Congenital Heart Surgery and surgical director of the Guerin Family Congenital Heart Program in the Smidt Heart Institute and Cedars-Sinai Guerin Children’s.

“Gradually over the course of the next few hours, it became apparent that even our typical forms of invasive support, like a ventilator or a machine that can breathe for her, weren't going to be sufficient,” Kim said.

Time was of the essence. So, in addition to the ventilator, the doctors decided to put her on extracorporeal membrane oxygenation (ECMO). ECMO is a dual bypass life support machine that performs the function of the heart and lungs.  

Generally, patients are on ECMO for only three to five days to reduce the risk of blood clots, neurological issues, seizures and potential infections.

But Vita Rose’s condition was extremely critical. In order to keep her stable, doctors kept her on ECMO support for nearly a month and monitored her condition closely.

So did Vita Rose’s parents. The lifesaving machine and complex web of cords and tubes prevented the parents touching or holding their baby girl. All they could do was show up, pull up a chair next to the machine and talk to her. 

“We just prayed and showed up and showed up, and it was like really early on in the situation that we had to ask ourselves … is our kid going to live?” Hazelwood said.

It Takes a Village

Vita Rose was in the Guerin Children’s Pediatric Intensive Care Unit for more than 100 days, including nearly a month on ECMO.

Over the course of her stay in Guerin Children’s, Vita Rose required round-the-clock care and underwent multiple medical procedures to get her heart and lungs functioning without machines. Healthcare workers from numerous departments and specialties pitched in to meet Vita Rose’s changing needs.

“I think she's met every unit at the hospital except maybe dermatology,” Hazelwood said.

Epstein credits the hospital-wide team. “It's really like this cadre of individuals from all areas who are working with her to get her through this. So, it was a huge team effort, and it was one that I was just proud to be a part of because everybody just worked so well together,” Epstein said.

Kim agrees. “There were many dark days, but I think we never gave up. We were always very optimistic for her. And sure enough, that's the way it worked out in the end,” he said.

While the recovery was slow and steady, Vita Rose is already thriving, babbling and fixating on her favorite stuffed toys hanging over her crib, just like any other child her age.

“She's come a very, very long way,” Hazelwood said. “She is the strongest, most joyous, bravest little fighter we know. And we're just so, so grateful that God said she can stay.”

Read more on the Cedars-Sinai Blog: A High-Risk Pregnancy Lifeline

The S. Mark Taper Foundation Rabbit Garden is one of four gardens that make up a 5,000-square-foot outdoor area. The garden features rabbit-shaped seating and fresh greenery, providing a relaxing environment for inpatients and their families to enjoy.

“The impact of childlike touches at Guerin Children’s, like the S. Mark Taper Foundation Rabbit Garden, should not be underestimated,” said Arthur J. Ochoa, JD, senior vice president of Advancement and chief advancement officer for Cedars-Sinai. “The garden delights and uplifts the spirits of young patients every day—such a significant part of what we strive to do at Cedars-Sinai.”

Guerin Children’s is full of other whimsical touches, from a video wall and vibrant artwork to an interactive playroom.

Ophir Klein, MD, PhD, executive director of Guerin Children’s and executive vice dean of Children’s Services, said the garden is an example of the importance of balancing treatment with emotional support.

“Successfully caring for patients medically is just part of what we work so hard to achieve at Guerin Children’s,” said Klein, the David and Meredith Kaplan Distinguished Chair in Children’s Health. “We want children to be well physically, but also to be happy and hopeful, as they receive the best-quality, most compassionate care.”

Read more on the Cedars-Sinai Blog: How to Choose a Pediatrician

The findings, published in Cell, could help scientists develop interventions that repair damaged intestines.

“This study moves forward our knowledge about how the villi, the long and narrow microscopic protrusions that line the small intestine, are first formed,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health at Cedars-Sinai, executive director of Guerin Children’s and co-corresponding author of the study.

“Understanding villi creation in detail could lead to new treatments for digestive disorders,” said Klein, who is also the David and Meredith Kaplan Distinguished Chair in Children’s Health.

Villi help the body absorb nutrients. They can become damaged by autoimmune disorders, such as celiac disease, or as a result of radiation or chemotherapy to treat cancer.

This study involved a collaboration between scientists working with Klein at Guerin Children’s and with Zev Gartner, PhD, at UCSF. Investigators at the California Institute of Technology and University of Michigan also contributed to the study.

The research teams used high-resolution microscopic techniques to observe how fetal intestines form in laboratory mice, which build their villi similarly to how humans create villi.

The investigators grew intestinal tissue from mouse embryos in laboratory dishes to see in real time how cells began constructing villi. The researchers labeled cell populations with fluorescent proteins to observe which ones were involved in building tissue.

By doing so, they discovered that fibroblasts, a type of connective tissue cell, behave like a sheet of water that breaks up into droplets. They describe this mechanism, which under a microscope looks like rain on a windshield, as “dewetting.” Using a mathematical model, the investigators found that cells follow the same physical principles as water to form droplet-like cellular aggregates that fold tissue into villi.

“Some people have atrophied villi that are blunted or completely flattened due to disease or damage, causing malabsorption and other digestive disorders,” said Tyler Huycke, PhD, a postdoctoral scholar in the School of Pharmacy at UCSF and one of the three co-first authors of the study. “If we can induce cells to undergo this aggregation and tissue-folding behavior that we observe during normal development, we might be able to create more villi and more absorptive surface area for people with digestive disease.”

The investigators plan to study additional steps involved in villi creation, including learning how the tissues continue to elongate into their final form and the cell signaling involved.

“The mechanism we describe in this paper is used by cells to create a patterned curvature in tissues that eventually form villi,” said Gartner, a professor in the Department of Pharmaceutical Chemistry at UCSF and co-corresponding author of the study. “We seek to understand if this mechanism forms other parts of the body. This work lays the foundation for engineering functional human tissues for applications ranging from regenerative medicine to disease modeling and drug testing.”

Cedars-Sinai investigators Emilie Barruet, Dedeepya Vaka and Dario Boffelli also worked on the study. Other investigators include Teemu Häkkinen, Hikaru Miyazaki, Vasudha Srivastava, Emilie Barruet, Christopher McGinnis, Ali Kalantari, Jake Cornwall-Scoones, Qin Zhu, Hyunil Jo, Roger Oria, Valerie Weaver, William DeGrado, Matt Thomson and Krishna Garikipati.

Funding: The study was funded by R01DK126376, R35DE026602, F32DK128949, U01CA244109, R01GM135462, and U01DK103147 from the Intestinal Stem Cell Consortium, a collaborative research project funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Allergy and Infectious Diseases. This work was further supported by funding for the UCSF Center for Cellular Construction by the National Science Foundation.

Read more on the Cedars-Sinai Blog: New Organ-Chip Can Re-Create the Cells of Your Intestines

“It’s an honor to continue to serve COG, a research network that has contributed significantly to most children surviving cancer today,” said Mascarenhas, director of Pediatric Hematology and Oncology and a professor of Pediatrics. “I look forward to even more progress in the next five years and beyond, thanks to the research and therapeutic advancements from healthcare professionals at research institutions that are part of COG.”

COG is a National Cancer Institute-funded clinical trials network comprising more than 200 leading hospitals and cancer centers across North America, Australia and New Zealand. All members work to advance progress in treating pediatric and adolescent cancer patients. As such, it is the largest clinical trials group in the world.

COG notes that patient participation in clinical research from member institutions, including Cedars-Sinai, has led to a combined five-year survival rate of 85% for children with cancer.

Mascarenhas has been a member of COG for more than 25 years and a member of the COG voting body, composed of principal investigators from each member institution, for 17 years. As voting body chair, Mascarenhas appoints leaders, coordinates and oversees elections within COG, and serves as a liaison between various COG scientific and administrative committees advocating for and facilitating smooth and efficient conduct of COG trials at each member site.

“Dr. Mascarenhas’ reelection to voting body chair for Children’s Oncology Group is a testament to his outstanding leadership in the pediatric and adolescent cancer field,” said Ophir Klein, MD, PhD, executive director of Cedars-Sinai Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health. “His service and that of his fellow clinicians and scientists is what will lead to more benefits for patients locally and globally.”

Mascarenhas is known for his expertise in treating sarcomas and pediatric solid tumors. Sarcomas are rare cancers that occur in bone or soft tissue. Mascarenhas has led and collaborated on several clinical trials that have resulted in key insights and improvements in treatments for these cancers.   

“Dr. Mascarenhas’ research is fueling critical learnings that continue to give new hope to pediatric cancer patients and their families,” said Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics at Guerin Children’s. “His yearslong involvement with Children’s Oncology Group underscores that the most robust science often stems from dedicated experts around the world working together to answer the most challenging questions.”

 In addition to his roles with Guerin Children’s, Mascarenhas is a senior investigator in the Samuel Oschin Comprehensive Cancer Institute Cancer Therapeutics Program at Cedars-Sinai and medical director of the Sarcoma Program at Cedars-Sinai Cancer.

“We congratulate Dr. Mascarenhas on his reelection to Children’s Oncology Group voting body chair and commend him on his longtime commitment to the cancer field,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Foundation Distinguished Chair. “Patients treated at Cedars-Sinai and beyond will continue to benefit as a result of Dr. Mascarenhas and all the physician-investigators in COG who are determined to save more lives.”

Mascarenhas’ second term as voting body chair began in April 2024 and will continue through March 2029.

Read more on the Cedars-Sinai Blog: When Your Child Has Cancer | Tips for Parents

“Dr. Pruetz is known for exemplary treatment and care in the high-tech, high-risk world of fetal and pediatric cardiology,” said Evan Zahn, MD, director of the Pediatric Congenital Heart Program at Guerin Children’s and in the Department of Cardiology at the Smidt Heart Institute. “In welcoming Dr. Pruetz, we give more families the opportunity to benefit from the latest innovations in fetal and pediatric heart interventions at Cedars-Sinai.”

Pruetz is an expert in using prenatal ultrasound to diagnose congenital heart defects in the fetus. He has also advocated for the use of risk stratification systems to create individualized care plans for babies born with a heart defect. He created a classification system known as Emergent Neonatal Cardiac Intervention for newborns with congenital heart disease diagnosed as critical.

In addition to his clinical work, Pruetz studies devices and procedures to treat life-threatening heart conditions in the womb. He was part of a multidisciplinary team that in 2015 developed the first pacemaker for fetuses with congenital complete heart block, a defect that affects the heart rate. This device is implanted in utero on the outer surface of the heart. In 2016, Pruetz helped perform the first fetal heart intervention in Southern California, which involved the successful opening of a blocked heart valve. He continues to study ways to improve the success of these fetal interventions.

Pruetz also studies disparities in the detection and care of congenital heart disease to uncover the social determinants that might account for these differences. He aims to increase the detection rate of congenital heart disease in the community.

“We’re thrilled to leverage Dr. Pruetz’s expertise, reputation and leadership in treating the most complex heart abnormalities in fetuses and newborns,” said Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics at Guerin Children’s. “This allows us to expand state-of-the-art treatments for babies with congenital heart defects before they are born and well into childhood.”

Prior to joining Cedars-Sinai, Pruetz was medical director of the Fetal Cardiology Program at Children’s Hospital Los Angeles, and associate professor of Clinical Pediatrics and Clinical Obstetrics and Gynecology at the Keck School of Medicine of USC. He was also a pediatric cardiologist at Hollywood Presbyterian Medical Center in Los Angeles, Adventist Health in Glendale, and Huntington Health, an affiliate of Cedars-Sinai, in Pasadena.  

“Dr. Pruetz is a superb addition to the experienced pediatrics and cardiology teams at Cedars-Sinai,” said Ophir Klein, MD, PhD, executive director of Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health. “I’m confident that the research efforts he is undertaking are going to lead to breakthroughs that further improve the lives of children born with heart abnormalities.” 

Pruetz earned a bachelor of science in microbiology and molecular genetics from UCLA. He earned his medical degree from Tufts University School of Medicine in Boston and completed his pediatric internship and residency in pediatrics at Cedars-Sinai. He completed his fellowship in pediatric cardiology at Children’s Hospital Los Angeles.

Pruetz is a member of numerous professional societies, including the American Society of Echocardiography, American Heart Association, American Institute of Ultrasound in Medicine, Society of Pediatric Echocardiography, and Fetal Heart Society, and he has received multiple medical awards. His research findings have been published and cited in more than 40 peer-reviewed medical journals, and he has presented his work at various national conferences, scientific sessions and symposiums.

Read more on the Cedars-Sinai Blog: How Congenital Heart Patients Can Move From Pediatric to Adult Care

The findings were published in Nature Cell Biology.

“By understanding how an embryo forms organs, we can start to ask questions about what goes wrong in children born with congenital malformations,” said Ophir Klein, MD, PhD, executive director of Guerin Children’s, the David and Meredith Kaplan Distinguished Chair in Children’s Health, and co-corresponding author of the study. “This work may lead to additional research into how birth defects are formed and can be prevented.”

Incisors are the sharp teeth at the front of the mouth that bite into food and cut it into smaller pieces.

Scientists know that during development, proteins called morphogens send signals to cells that coordinate tissue growth. This study showed how a signaling center—a cluster of specialized cells that regulate organ development by producing morphogens—is created.

The study is a collaboration between the laboratories of Klein at Cedars-Sinai Guerin Children’s and the University of California, San Francisco (UCSF), and professor Otger Campàs at the Physics of Life Excellence Cluster of TU Dresden in Germany and the University of California, Santa Barbara (UCSB).

“Using techniques that our lab developed to measure the mechanical changes that occur during embryonic development, we were able to understand how a pressure buildup in the tissue establishes the main signaling center of the developing tooth,” said professor Campàs, the managing director and chair of Tissue Dynamics at the Physics of Life Excellence Cluster of TU Dresden, and former associate professor of Mechanical Engineering at UCSB.

A human fetus starts to form gums at about six weeks of pregnancy. By roughly nine weeks, a fetus develops buds that will eventually sprout teeth. Investigators studied these processes in a laboratory mouse fetus, which develops similarly to a human fetus but in 21 days rather than nine months.

Investigators studied tissue samples containing the tooth bud of a laboratory mouse fetus over the period in which it develops an enamel knot, a signaling center specific to tooth formation.

The group performed several experiments to study the orientation of the cells within the tooth bud and what signals the cells send. They found the cells in the tooth bud start to grow and divide, which puts a mechanical pressure at the center of the tissue. The pressure causes the cells in the center to stop dividing and form the enamel knot.

“It’s like those toys that absorb water and grow in size,” said Neha Pincha Shroff, PhD, a postdoctoral scholar in the School of Dentistry at UCSF and co-first author of the study. “Just imagine that happening in a confined space. What happens in the incisor knot is that the cells multiply in number in a fixed space, and this causes pressure to build up at the center, which then becomes a cluster of specialized cells.”

This study builds upon the findings of another study by Klein and colleagues published in Nature Communications in 2016. The study found that a protein called YAP, which is involved in sensing mechanical signals, is required for formation of the enamel knot.

“What this latest work shows is that both mechanical pressure and molecular signaling play a role in organ development,” Klein said.

The investigators said future studies should investigate communication between molecular signals and mechanical pressure and how mechanical pressure may regulate the development of other organs.

Investigators Pengfei Xu (co-first author), Sangwoo Kim, Elijah Shelton, Ben Gross, Yucen Liu, Carlos Gomez, Qianlin Ye, Tingsheng Yu Drennon, Jimmy Hu and Jeremy Green also worked on the study.

Funding: The study was funded by the National Institute of Dental and Craniofacial Research, the Deutsche Forschungsgemeinschaft under Germany’s Excellence Strategy, and Physics of Life Excellence Cluster of TU Dresden.

Read more on the Cedars-Sinai Blog: Six Questions With Ophir Klein, MD, PhD

When Grace was 12, her father, an orthopedic surgeon, gave her a hug and noticed that something wasn’t quite right.

“I remember my dad hugged me and was feeling my back and said, ‘you have scoliosis,’ I didn’t even know what that was,” said Grace. “I didn’t think it was a big deal, I thought I was fine and thought he was just being weird, but it turns out I had scoliosis.”

Grace, who grew up appearing in popular shows and movies like The Handmaid’s Tale, Young Sheldon, I, Tonya and Ghostbusters: Afterlife, began to notice her physical appearance gradually morphing into someone else.

By the time Grace turned 16, her scoliosis began to affect her work. For red carpet events, she would have her dresses altered so that one side was longer than the other to camouflage her scoliosis. On stage and in front of the cameras, Grace would stand as straight as she could, but by the end of the day, she would be tired and in pain.

“I had started to notice just how crooked I was standing and so were people around me,” said Grace. “I'd get in trouble on set all the time. They'd always be telling me, ‘Stand up straight,’ ‘Stop slouching,’ ‘Mckenna, you're on your mark, but you're all the way over here,’ ‘We need you to stand up,’ and so on.”

As Grace's quality of life declined, her parents could not watch their daughter in pain and knew that if her career was to continue, surgical intervention would need to be considered. Grace’s father heard of the right surgeon for the job: David Skaggs, MD, director of Pediatric Spine and Pediatric Orthopaedics at Cedars-Sinai Guerin Children’s. 

When Grace met with Skaggs, her spine was at a 50-degree curve.

“What was unique about Mckenna is that her waist really looked asymmetrical, the layperson could see from across the room that something was going on,” said Skaggs. “When she bent forward she had a big hump on her back and she was becoming increasingly aware of it.”

With her rapidly deteriorating spine, Skaggs agreed that spinal surgery was the best option. The catch—she would need to heal and recover ahead of filming for the second Ghostbusters film.  

“She asked me, ‘is there any way I could have surgery and carry a 40-pound pack?’ I said, Of course you can. We'll get you back to filming.”

Skaggs and his multidisciplinary team got to work and performed spinal surgery, inserting metal rods, also known as spinal instrumentation, and screws across six vertebrates to straighten her spine.

“The reason we have surgery and care for these kids is so they can return to a normal life,” said Skaggs. “Now when we look at Mckenna, you can almost not tell that she ever had scoliosis or surgery. Mckenna’s body looks perfectly symmetrical and she’s over an inch-and-a-half taller.”

Following her successful surgery Grace took to social media to share her journey and encourage others.

“Mckenna was a rockstar,” said Elaine Butterworth, RN, pediatric nurse navigator and the director of Patient Experience and Education for the Pediatric Spine Program. “I remember her videotaping herself getting out of bed for the first time, when she was at her most vulnerable time and she not only recorded it but later posted it to help other kids.”

Back in the spotlight, Grace was standing tall and straight—just in time to walk the Ghostbusters carpet.

Read more on the Cedars-Sinai Blog: Supporting the Spine From Adolescence to Adulthood.

“She had all the odds stacked against her,” said Seth Langston, MD, a neonatologist at Cedars-Sinai Guerin Children’s who spoke at Ellyannah’s “graduation ceremony” to mark her progress.

“She needed help breathing with the ventilator. She needed antibiotics to treat infections. And she had challenges with feeding. But Elly knew she had the most caring and loving parents supporting her and rooting for her. And she could not and did not disappoint them,” Langston said. “Ellyannah has been mighty, and she has been courageous. She has overcome obstacle after obstacle and ignored the odds to get to this moment and has shown us all the true strength of a preterm baby.”

Ellyannah’s parents, Cecia and Boris Lopez of Gardena, spent every hour they could in the hospital with their baby, most of that time in the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s.

“I don’t think Elly would be going home if Cecia and Boris hadn’t been here every single day,” said nurse Joshua De Roboam, RN, who calculated that he personally spent 720 hours over the last year with Ellyannah. “She sometimes wouldn’t even settle down unless her parents were there to talk to her, hold her, care for her. It’s led to her development and being who she is today.”

Dressed in a pink graduation cap and gown, Ellyannah nestled calmly in her parents’ arms as they flipped the tassel on her cap to signify her graduating from the hospital. 

“Seeing Ellyannah so small was very traumatic, but also very miraculous,” said Cecia Lopez. “We had the opportunity to see her finish developing with the help of these amazing doctors and nurses. The NICU has been like family to us; we love them and respect them.” 

The feeling is mutual for the many healthcare workers who cared for Ellyannah over her journey.  “She’s a miracle and the strongest baby I’ve ever met,” De Roboam said. “She reminds us that miracles can happen every day and that we’re so lucky to do what we do.” 

Ellyannah is going home weighing 17 pounds. She has a feeding tube and needs extra oxygen, but her parents are confident of a full recovery.  

As they waved goodbye to their Cedars-Sinai Guerin Children's family, Cecia and Boris said this graduation will be the first of many for their baby, and they will teach her, “If you can graduate from the NICU, you can do anything in your life.”

 Read more on the Cedars-Sinai Blog: A High-Risk Pregnancy Lifeline 

, has an important message for parents whose children have been diagnosed with sarcoma, a type of cancer that develops in the bones or soft tissues.

“For many children, there are treatment options and even a cure,” said Mascarenhas, recently appointed as director of Pediatric Hematology & Oncology at Cedars-Sinai Guerin Children’s and as medical director of the Sarcoma Program at Cedars-Sinai Cancer.

He recently spoke with the Cedars-Sinai Newsroom about the clinical care and research he will lead at Cedars-Sinai.

When a child is diagnosed, what is the most important thing for parents to know?

It’s critical patients receive care from an expert team with extensive knowledge in diagnosing and treating sarcomas. A multidisciplinary team is crucial to a patient’s outcome because these diseases are complex. A typical sarcoma diagnosis requires expertise from an oncologist, surgeon, radiation oncologist, pathologist, radiologist, and, nowadays, a molecular geneticist.  All that information is used to make the best possible treatment plan.

These patients also need expert nurses, physical therapists and occupational therapists. Treatment for these conditions can be hard on patients and their families, so psychological support every step of the way and connection to a support peer group are really important.

What progress has been made in the diagnosis and treatment of pediatric sarcomas in recent years?

Treatment for sarcomas generally involves a combination of surgery, chemotherapy and/or radiation. However, we typically don't need to use all three modalities to treat pediatric patients. At Cedars-Sinai Guerin Children’s, we create a custom treatment plan for each patient, depending on the stage of their disease and how much tumor was removed during surgery.  

With the expanding knowledge of genetics and molecular genetics, we have learned that many sarcomas are actually driven by mistakes that occur with genes. Understanding the biology of how sarcomas grow and spread is an important aspect of how we can further advance new treatment approaches.

What have scientists learned from studying the genetics of sarcomas?

There is a unique sarcoma that primarily occurs in very young children, called NTRK fusion sarcomas. This is a type of sarcoma that occurs during development, when a gene called NTRK fuses with another gene. When we detect a fusion, it tells us what the exact diagnosis is—allowing us to recommend the best possible treatment combination for the patient to experience the best outcomes.

Today we utilize a drug called larotrectinib, which shrinks NTRK fusion sarcomas that are not responsive to chemotherapy. I was very fortunate to be involved with the development of that drug.

What will your research at Cedars-Sinai Guerin Children's focus on?

I’m looking forward to working with a large group of scientists here to see how to translate discoveries in the lab directly to the care of patients. I will lead clinical trials for sarcomas and certain pediatric solid tumors to see if potential new treatments are actually helpful. Since sarcomas are rare, we are collaborating with other researchers and scientists here at Cedars-Sinai, around the country and around the world to improve outcomes.

What progress is being made in treating sarcomas?

Sarcomas are tough cancers. If the disease has not spread, children have the best possible outcomes. For children whose sarcoma has spread to other organs, there are still treatment options.

Our treatment arsenal has improved greatly. We have techniques such as liquid biopsy, a simple blood test that may be able to tell us if your cancer is under control or not. Our hope in the future is that rather than waiting for scans to tell us how you are doing, perhaps a blood test will also tell us. Treating the cancer when it's still at a very low level in the body may allow the patient to actually be cured before the cancer manifests itself with symptoms that cause trouble.

We are also utilizing genomic medicine and immunotherapy to improve treatment options. I’m very hopeful—through collaborations at Cedars-Sinai, nationally and internationally—that we will be able to continue to fight this illness and improve outcomes for patients.

Read more on the Cedars-Sinai Blog: When Your Child Has Cancer | Tips for Parents

Globally, measles cases increased by 79% in 2023, according to the World Health Organization. In 2022, WHO estimated that measles killed more than 130,000—most of them children. 

In the U.S., during the first two months of 2024, nearly two dozen cases have been reported in California, Arizona and nine other states.

“Measles is a huge concern and directly related to declining measles vaccination rates,” said Priya Soni, MD, a pediatric infectious disease specialist with Cedars-Sinai Guerin Children’s. “Vaccine hesitancy, fueled during the pandemic by the anti-vaccine movement, has affected vaccination rates nationwide. In addition, because children were quarantined during the pandemic, many missed out on well-child visits and didn’t catch up on their vaccines. That has meant 61 million fewer doses distributed nationwide between 2020 and 2022.”

Measles is a contagious infection—even more infectious than COVID-19. While one person with COVID-19 can infect one to three others, one person with measles can infect as many as 18 other susceptible individuals. This airborne virus remains infectious for up to two hours after an infected individual leaves an area.  

“The big danger with measles is that it is one of the most unpredictable infections,” Soni said. “There is a very real risk of hospitalization, death or serious damage to the immune system. Even after you’ve recovered from measles, your immune system can be altered for up to three years and you become at risk for many other infections.”

Other potential complications include bacterial pneumonia and encephalitis, an inflammation of the brain. Measles carries the highest risk of complications in children 5 and younger and in adults 30 and older.

The measles vaccine, given as part of the MMR (measles, mumps and rubella) vaccine, is extremely effective, giving those vaccinated with just one dose up to 93% protection. The second dose confers up to a 97% lifetime protection rate.  

Although the first dose of the MMR vaccine is traditionally given to infants 12-15 months of age, and the second around a child’s fifth or sixth birthday, Soni said infants as young as 6 months can receive the first vaccine if they are traveling to areas where the measles infection rate is high.

For parents worried their child may have been exposed to measles, there are several telltale signs. One of the first is small white spots that appear inside the cheeks. Those spots—called Koplik spots—are unique to measles. Children also can develop a diffuse rash of small, red bumps that erupt on the face but then spread down the rest of the body, along with a high fever.

“Unfortunately, there are no antivirals or treatments for measles other than rest, staying hydrated and fighting the fever with cool baths and fever-reducing medications,” Soni said.

The good news about measles is that it is preventable with the vaccine, Soni said. But when collective MMR vaccination rates drop below 95% in a population, our “herd immunity” diminishes and this can lead to pockets of outbreaks with measles in certain communities and populations.  

“There is no scenario where getting the actual measles infection is somehow better for your child then getting the vaccine,” Soni said. “You are doing an incredible thing for your child and your family by getting them vaccinated.”

Read more on the Cedars-Sinai Blog: COVID-19 and Flu Shots Provide a Double Dose of Protection

opened a clinic today to provide specialized multidisciplinary care for children with Angelman syndrome, a rare and severe neurodevelopmental condition.

“Children with Angelman syndrome present significant difficulties in their communication, motor and overall development. They have a sensitive and loving temperament but struggle regulating their emotions and behavior,” said Cesar Ochoa-Lubinoff, MD, director of Developmental-Behavioral Pediatrics at Guerin Children’s, who will head the new clinic. “Our team of experts aims to help parents access the best interventions for their children and navigate the challenges of this syndrome the best way possible.”

Angelman syndrome occurs in 1 in 15,000 births. It is caused by the lack of expression of the mother’s UBE3A gene. (The father’s UBE3A gene is silenced at birth in the human brain.) This condition causes developmental delays and behavioral and emotional regulation problems.

The Angelman Syndrome Foundation, a nationwide parent advocacy organization, is providing a grant to support the Angelman Syndrome Clinic at Cedars-Sinai Guerin Children’s.

Caring for children with Angelman syndrome is complex. Children typically need to be seen by different specialists to meet their medical needs: gastroenterology, neurology, epilepsy, genetics, developmental medicine, diet and nutrition, speech therapy, and occupational and physical therapy. The Angelman Syndrome Clinic at Cedars-Sinai Guerin Children’s will make it possible for children and their families to consult with multiple experts in one place.

“We look forward to supporting families with the top-notch expertise we’re able to provide,” said Shervin Rabizadeh, MD, MBA, associate director of Cedars-Sinai Guerin Children’s and chair of the Department of Pediatrics.

In addition to providing care, the clinic will collect data to help investigators understand the trajectory of the disease. The data will eventually be used for clinical trials comparing the efficacy of new drugs designed to treat Angelman syndrome.

“This clinic is a prime example of how Cedars-Sinai melds clinical care with research,” said Ophir Klein, MD, PhD, executive director of Cedars-Sinai Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health. “This work is promising not only for the specialized care and medical advances it will bring to Angelman syndrome patients but also because discoveries related to rare diseases can lead to advances for more common diseases and conditions.”

The Angelman Syndrome Clinic at Cedars-Sinai Guerin Children’s is located in the Cedars-Sinai Steven Spielberg Building at 8723 Alden Drive, Los Angeles, CA 90048.

Families may make an appointment with the clinic by calling 310-423-7779.

Read more on the Cedars-Sinai Blog: Understanding Rare Diseases

Follow Cedars-Sinai Guerin Children’s on X (formerly known as Twitter) for the latest pediatric news from Cedars-Sinai.

“Cedars-Sinai Guerin Children’s continues to build its roster of talented physicians,” said Ophir Klein, MD, PhD, executive director of Cedars-Sinai Guerin Children’s and the David and Meredith Kaplan Distinguished Chair in Children’s Health. “The addition of these specialists expands the care options and expertise we can offer patients and their families.” 

The new specialists are:

• Pediatric neurosurgeon David Bonda, MD. Bonda completed a neurosurgery residency at The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and a fellowship in pediatric neurosurgery at Seattle Children’s Hospital/University of Washington. During residency, he completed a postdoctoral research fellowship at Cold Spring Harbor Laboratory investigating the neural circuitry of executive control in mice. This work serves as the foundation for his current research, which utilizes intracranial recordings from children with epilepsy to better understand executive control circuitry.
• Pediatric orthopaedic surgeon Amelia Lindgren, MD. Lindgren completed an orthopaedic surgery residency at the University of California, San Diego, and a fellowship in pediatric orthopaedic surgery at Nemours Children’s Hospital. She also completed a research fellowship within the Department of Pediatric Orthopaedic Surgery in Rady Children’s Hospital. 
• Pediatric neurologist and epileptologist Jeffrey Swarz, MD. Swarz completed a residency in pediatrics and a fellowship in pediatric neurology at Tufts Medical Center and a fellowship in pediatric clinical neurophysiology at UCLA Mattel Children’s Hospital. He has coauthored several published studies and is currently investigating how brain recordings in children with epilepsy can predict how well brain surgery will control their seizures.
• Diagnostic radiologist Christopher (Travis) Watterson, MD. Watterson completed a residency in diagnostic radiology at Cedars-Sinai where he was also chief resident. He also completed a fellowship in pediatric radiology at Boston Children’s Hospital/Harvard University and a fellowship in neuroradiology at Emory University. Watterson is an active member of the Society for Pediatric Radiology where he sits on the Fetal Imaging Committee and ER & Trauma Committee.

Cedars-Sinai Guerin Children’s was established in December 2021. The pediatric enterprise includes state-of-the-art inpatient facilities, infant and newborn care, multidisciplinary treatment programs, specialized care for complex cases, and a network of pediatricians based throughout the Los Angeles region.

“The concentration of pediatric primary and specialty providers available through Cedars-Sinai Guerin Children’s makes it possible for children to receive the care they need throughout their lives, all in one network,” said Shervin Rabizadeh, MD, MBA, associate director of Cedars-Sinai Guerin Children’s and chair of the Department of Pediatrics.

Read more on the Cedars-Sinai Blog: Early Diagnosis of Autism and ADHD

Continuing a heartwarming tradition, Santa—who bears a striking resemblance to David Marshall, JD, DNP, RN, senior vice president and chief nursing executive at Cedars-Sinai—made a spirited visit to pediatric patients in Cedars-Sinai Guerin Children’s.

Santa sported a snowy beard and was adorned in his signature red suit, glossy black boots and hat topped with a festive pom-pom. Accompanied by nurses and healthcare professionals, he spread holiday cheer by gifting young patients a cuddly stuffed animal from the Owie BowWowie Foundation. Parents of newborns received keepsake ornaments imprinted with their baby’s footprints.

First-time mother Ashley Kaslove told Santa about her newborn daughter, Harley, currently a patient in the Neonatal Intensive Care Unit. “Even though she's not at home, thank you for finding my daughter, your presence means the world to us,” Kaslove said.

Santa’s eyes misted up when he told Kaslove that visiting the medical center was one of the highlights of his year. “To be able to provide that feeling to a family is something special,” he said.

Receiving a visit during a baby's first Christmas in the hospital added a special touch for many families—and made Santa’s day.

“It brings a piece of familiar tradition into what can be a challenging time for families with a loved one in the hospital,” Santa said. “The moment I witness the joy and smiles on their faces is priceless and brings me instant joy.”

Read more in Discoveries: Six Questions With Ophir Klein, MD, PhD