About

Meagan S. Allen is a historian of alchemy, specializing in the medical alchemy of the later Middle Ages. Her research interests lie at the intersection of alchemy, pharmacology, and theology, with a particular focus on the writings of the 13th century Franciscan polymath Roger Bacon. Her first book, "Roger Bacon and the Incorruptible Human: Alchemy, Pharmacology, and the Desire to Prolong Life" (2023), examines Bacon’s alchemical theories and how he believed that the key to extending life was rooted in alchemy rather than traditional medical curricula. Allen’s work explores how 12th and 13th-century alchemy, which was generally concerned with transmutation of metals, encompassed a broader understanding of the generation and corruption of all material things in the sublunary world, and how this understanding related to humoral medicine and the prolongation of life. Her second major work, "The Sciences of Roger Bacon’s Opus Maius" (2025), is an edited volume that investigates Bacon’s plans for educational and ecclesiastical reform through the study of arts and sciences, emphasizing the importance Bacon placed on sciences as a foundation for theology and societal improvement. Currently, Allen is working on a new edition and translation of Bacon’s "Epistola de secretis operibus artis et naturae et de nullitate magiae," which describes how human art can perfect nature. Prior to her position at Johns Hopkins University, she was the 2021-2023 Cain Postdoctoral Fellow at the Science History Institute in Philadelphia. She earned her PhD in the History of Science from Indiana University in 2021 and has held visiting fellowships at the Max Planck Institute for the History of Science and Corpus Christi College, Oxford.

Research topics

• Medicine
• Pediatrics
• Internal medicine
• Surgery
• Pathology
• Anesthesia

Selected publications

• Updated recommendations for the design of therapeutic trials for neonatal seizures

  Pediatric Research · 2026-01-21

  articleOpen access

  The International Neonatal Consortium Seizure Working Group of the Critical Path Institute provides an update to the original recommendations for design of clinical trials to treat neonatal seizures based on recent experiences from several trials and developments in the field. Although there aren't sufficient new data to inform definitions of optimal efficacy endpoints, the Working Group recommended inclusion of alternate measures of seizure burden reduction as secondary or exploratory endpoints, to elucidate clinically meaningful efficacy endpoints for future trials. It was recommended to include additional key covariates, such as timing of seizure onset/cessation, randomization, and ASM administration. There are new recommendations regarding potential for unmasked or single-masked trials, and reporting of concomitant medications and adverse events, and genetic testing. Importantly, specific recommendations were added regarding improved strategies for recruitment and consent, including the use of novel technologies and the involvement of patient advocacy groups. Recommendations regarding trial infrastructure and operational feasibility were included to facilitate trial initiation and conduct, given the many logistical challenges of conducting neonatal seizure treatment trials. Finally, the recommendations consider accommodations for local or national regulations and resources, to ensure that trials are conducted as appropriate to the setting in which the patients are treated. IMPACT: This review provides an update to the initial recommendations for neonatal seizure treatment trial design, with recommendations regarding: (1) exploratory endpoints to inform future trials, (2) additional key covariates to include, (3) considerations regarding masking of investigators, (3) inclusion of concomitant medications and adverse events, (4) genetic testing, (5) strategies for recruitment and consent, and (6) infrastructure and operational feasibility.

  PublisherOA PDFDOI

• Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants

  UNC Libraries · 2026-03-18

  articleOpen access

  Importance: The management of patent ductus arteriosus (PDA) in preterm infants is controversial. Objective: To determine whether expectant management compared with active treatment of a protocol-defined PDA in preterm infants decreases the incidence of death or bronchopulmonary dysplasia (BPD). Design, Setting, and Participants: A randomized clinical trial including infants born at 22 to 28 weeks' gestation and diagnosed with a protocol-defined PDA between the age of 48 hours and 21 days at screening. The trial was conducted from December 2018 to December 2024 at 33 hospitals within the National Institute of Child Health and Human Development Neonatal Research Network. The final date of follow-up was June 2025. Interventions: Infants with PDA were randomized to expectant management (n = 242) or active treatment (n = 240; acetaminophen, ibuprofen, or indomethacin) to close the PDA. Main Outcomes and Measures: The primary outcome was death or BPD at 36 weeks' postmenstrual age. The secondary outcomes included the components of the primary outcome and other morbidities of prematurity. Results: A total of 482 infants were randomized (median gestational age, 25 weeks [IQR, 24 to 27 weeks]; median birth weight, 760 g [IQR, 620 to 935 g]). The trial was stopped for futility and safety after the 50% interim analysis for the primary outcome due to higher survival in the expectant management group. The incidence of death or BPD was 80.9% (195/241) of infants in the expectant management group vs 79.6% (191/240) of infants in the active treatment group (adjusted risk difference, 1.2% [95% CI, -5.7% to 8.1%]; P = .73). The incidence of death before 36 weeks' postmenstrual age was 4.1% (10/241) of infants in the expectant management group vs 9.6% (23/240) of infants in the active treatment group (adjusted risk difference, -5.6% [95% CI, -10.1% to -1.2%]; P = .01). Infections resulting in death occurred in 0.8% (2/241) of infants in the expectant management group vs 3.8% (9/240) of infants in the active treatment group. Conclusions and Relevance: In extremely preterm infants with a protocol-defined PDA, death or BPD did not differ between the expectant management group and the active treatment group. Survival was substantially higher with expectant management. Trial Registration: ClinicalTrials.gov Identifier: NCT03456336.

  PublisherDOI

• Developmental Progression of Inhibitory Control and Flexible Problem-solving Among Infants with Histories of Preterm Birth

  Developmental Neuroscience · 2025-06-10 · 1 citations

  articleOpen access

  INTRODUCTION: Inhibitory control during visually guided reaching allows for the development of flexible problem-solving in healthy infants born at term. Inhibitory control is often impaired among older children born preterm, but the developmental trajectory of inhibitory control in infants born preterm is not well understood. The objective of this study was to evaluate the developmental trajectory of inhibitory control on the Object Retrieval Task in infants born preterm. METHODS: This was a cross-sectional study including a convenience sample of infants born preterm (less than 37 weeks), who were evaluated at corrected ages 5-6, 7-8, 9-10, 11-12, 13-15, and 16-18 months. Children born preterm with additional diagnoses of congenital anomalies, known genetic disorders, focal stroke, neoplasm, or maternal HIV exposure or children in the care of the state were excluded. Children in each of the age-groups were asked to retrieve a toy from a Plexiglas box with an opening on one side. The orientation of the opening was rotated over three trials, and the visually guided reach patterns were scored based on methods used by Diamond. Visually guided reach patterns ranged from perseverative hitting of the box to immediately reaching through the box opening. Analysis consisted of Fischer's exact tests to compare categorical measures, Jonckheere-Terpstra tests to compare ordinal measures, F test from general linear models to compare continuous measures and ordinal logistic regression to assess the association between brain injury and reach patterns. RESULTS: The majority of infants born preterm in corrected age-groups of 5-6, 7-8, and 9-10 months perseveratively hit the box regardless of the orientation of the opening. This pattern of predominant immature visually guided reaching persisted at 12 months corrected age in this cohort of infants born preterm, with 75% participants demonstrating an immature reach with the box opening at the front and to the left and 88% demonstrating this with the box opening to the right. CONCLUSIONS: In this cohort of preterm infants, developmental progression of inhibitory control and progression of visually guided reaching did not follow the same developmental trajectory observed in full term typically developing infants previously documented by Diamond (1994). While 100% of typically developing infants born at term in Diamond's cohort demonstrated inhibitory control and mature visually guided reach patterns by age 12 months, 75% of participants in our cohort of infants born preterm continued to demonstrate a predominance of immature visually guided reach patterns. This study demonstrates identification of early impairments in inhibitory control using a resource-conscious, low-cost, and brief neurobehavioral assessment tool. This provides a window for early interventions to limit problems in executive dysfunction at school age and beyond.

  PublisherOA PDFDOI

• Proceedings of the 15 ^th International Newborn Brain Conference: Long-term outcome studies, developmental care, palliative care, ethical dilemmas, and challenging clinical scenarios in neonatal neurology

  Journal of Neonatal-Perinatal Medicine · 2024-08-05

  articleOpen access

  BACKGROUND: Preterm birth is associated with significant risks for long-term impairments in brain structure and cognitive functions (1). At the microscopic level, the transient inflammatory and hypoxic-ischemic events occurring during premature birth disrupt the development of subplate neurons and pre-oligodendrocytes, both of which play a crucial role in the establishment of thalamo-cortical connections and the maturation of the claustrum (2,3). Altered thalamo-cortical connectivity and claustrum microstructure have previously been reported in preterm-born infants (4,5). This study combines findings from two investigations aiming at exploring the long-term consequences of prematurity on these subplate and pre-oligodendrocyte-dependent systems (6).
\nMETHODOLOGY: Thalamo-cortical (TC) and claustro-cortical (CC) connections were reconstructed from diffusion-weighted imaging data using probabilistic tractography. Streamlines were generated between bilateral thalami or claustra and cortical regions of interest (see Figure 1A and 2A-C). Connection probability was chosen as metric of TC structural connectivity in a sample of 67 very preterm (PT) and 70 full-term (FT) born adults while CC connectivity was measured as connection density in 65 PT and 81 FT born adults of the BLS at 26 years. In both studies, cognitive performance was assessed by full-scale intelligence quotient (IQ) using the Wechsler Adult Intelligence Scale. Additionally, a verbal comprehension subtest score was computed in the first study. Neonatal medical complications were assessed using a standardized optimality scoring system (OPTI). Differences between groups and their associations with prematurity or cognitive variables were performed via ANCOVAs and linear regressions (study 1) or Pearson correlations (study 2) respectively.
\nRESULTS: Findings revealed increased connectivity between the left thalamus and left prefrontal cortex in very preterm-born adults, which was associated with both lower birth weight and a lower verbal comprehension score (Figure 1A-B). Furthermore, decreased connectivity between bilateral thalami and temporal cortices in PT born adults positively correlated with the duration of ventilation during the neonatal period (Figure 1A). Finally, lower connectivity between bilateral claustra and parieto-occipital cortices in PT born adults was associated with lower gestational age, birth weight and a higher degree of neonatal complications (Figure 3A-B). Lower left claustro-occipital connectivity was also associated with lower IQ.
\n
\nCONCLUSION: Together, these findings suggest that prematurity has a lasting impact on cortico-subcortical white matter connectivity, particularly in subplate/pre-oligodendrocytes-derived systems. Furthermore, these alterations are linked to the degree of prematurity and have implications for the persistence of cognitive impairments into adulthood.

  PublisherOA PDFDOI

• Correspondence on “Recognition and Management of Delirium in the Neonatal Intensive Care Unit: Case Series From a Single-Center Level IV Intensive Care Unit”

  Journal of Child Neurology · 2024-05-31

  letterOpen access
  PublisherOA PDFDOI

• Influence of Eat, Sleep, and Console on Infants Pharmacologically Treated for Opioid Withdrawal

  JAMA Pediatrics · 2024-04-15 · 20 citations

  articleOpen access

  Importance: The function-based eat, sleep, console (ESC) care approach substantially reduces the proportion of infants who receive pharmacologic treatment for neonatal opioid withdrawal syndrome (NOWS). This reduction has led to concerns for increased postnatal opioid exposure in infants who receive pharmacologic treatment. However, the effect of the ESC care approach on hospital outcomes for infants pharmacologically treated for NOWS is currently unknown. Objective: To evaluate differences in opioid exposure and total length of hospital stay (LOS) for pharmacologically treated infants managed with the ESC care approach vs usual care with the Finnegan tool. Design, Setting, and Participants: This post hoc subgroup analysis involved infants pharmacologically treated in ESC-NOW, a stepped-wedge cluster randomized clinical trial conducted at 26 US hospitals. Hospitals maintained pretrial practices for pharmacologic treatment, including opioid type, scheduled opioid dosing, and use of adjuvant medications. Infants were born at 36 weeks' gestation or later, had evidence of antenatal opioid exposure, and received opioid treatment for NOWS between September 2020 and March 2022. Data were analyzed from November 2022 to January 2024. Exposure: Opioid treatment for NOWS and the ESC care approach. Main Outcomes and Measures: For each outcome (total opioid exposure, peak opioid dose, time from birth to initiation of first opioid dose, length of opioid treatment, and LOS), we used generalized linear mixed models to adjust for the stepped-wedge design and maternal and infant characteristics. Results: In the ESC-NOW trial, 463 of 1305 infants were pharmacologically treated (143/603 [23.7%] in the ESC care approach group and 320/702 [45.6%] in the usual care group). Mean total opioid exposure was lower in the ESC care approach group with an absolute difference of 4.1 morphine milligram equivalents per kilogram (MME/kg) (95% CI, 1.3-7.0) when compared with usual care (4.8 MME/kg vs 8.9 MME/kg, respectively; P = .001). Mean time from birth to initiation of pharmacologic treatment was 22.4 hours (95% CI, 7.1-37.7) longer with the ESC care approach vs usual care (75.4 vs 53.0 hours, respectively; P = .002). No significant difference in mean peak opioid dose was observed between groups (ESC care approach, 0.147 MME/kg, vs usual care, 0.126 MME/kg). The mean length of treatment was 6.3 days shorter (95% CI, 3.0-9.6) in the ESC care approach group vs usual care group (11.8 vs 18.1 days, respectively; P < .001), and mean LOS was 6.2 days shorter (95% CI, 3.0-9.4) with the ESC care approach than with usual care (16.7 vs 22.9 days, respectively; P < .001). Conclusion and Relevance: When compared with usual care, the ESC care approach was associated with less opioid exposure and shorter LOS for infants pharmacologically treated for NOWS. The ESC care approach was not associated with a higher peak opioid dose, although pharmacologic treatment was typically initiated later. Trial Registration: ClinicalTrials.gov Identifier: NCT04057820.

  PublisherOA PDFDOI

• Factors affecting early childhood growth in hypoxic-ischemic encephalopathy treated with hypothermia

  Journal of Perinatology · 2024-02-07 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

• Early brain injury

  Elsevier eBooks · 2024-11-29

  book-chapterSenior author
  PublisherDOI

• Infant Feeding and Weight Trajectories in the Eat, Sleep, Console Trial

  JAMA Pediatrics · 2024-08-12 · 7 citations

  articleOpen access

  Importance: Infants with neonatal opioid withdrawal syndrome (NOWS) cared for with the Eat, Sleep, Console (ESC) care approach receive less pharmacologic treatment and have shorter hospital stays compared to usual care with the Finnegan Neonatal Abstinence Scoring Tool, but the effects of these approaches on feeding and weight are unknown. Objective: To evaluate feeding practices and weight trajectories in infants cared for with ESC vs usual care. Design, Setting, and Participants: ESC-NOW is a cluster randomized trial of infants with NOWS born at 36 weeks' gestation or later at 26 US hospitals from September 2020 to March 2022. Each site transitioned from usual care to ESC (the study intervention) at a randomized time. Feeding was per site practice and not specified by the intervention. Feeding and weight outcomes were assessed at hospital discharge. Intervention: ESC vs usual care. Main Outcomes and Measures: Outcomes include prospectively identified secondary end points related to feeding and weight. z Scores were used for growth to account for corrected gestational age at the time of measurement. All analyses were intention to treat and adjusted for study design. Maternal/infant characteristics were included in adjusted models. Results: The analyses included 1305 infants (702 in usual care and 603 in ESC; mean [SD] gestational age, 38.6 [1.3] weeks; 655 [50.2%] male and 650 [49.8%] female). Baseline demographic characteristics were similar between groups. The proportion of breastfed infants was higher in the ESC group (52.7% vs 41.7%; absolute difference, 11%; 95% CI, 1.0-20.9). A higher proportion of infants cared for with ESC received exclusive breast milk (15.1% vs 6.7%; absolute difference, 8.4%; 95% CI, 0.9-5.8) or any breast milk (38.8% vs 27.4%; absolute difference, 11.4%; 95% CI, 0.2-23.1) and were directly breastfeeding at discharge (35.2% vs 19.5%; absolute difference, 15.7%; 95% CI, 4.1-27.3). There was no difference in proportion of infants with weight loss greater than 10% or maximum percentage weight loss, although infants cared for with ESC had a lower weight z score on day of life 3 (-1.08 vs -1.01; absolute difference, 0.07; 95% CI, 0.02-0.12). When pharmacologic treatment was added into the model, no breastfeeding outcomes were statistically significant. Conclusions and Relevance: In this study, infants cared for with ESC were more likely to initiate and continue breastfeeding and had no difference in percentage weight loss. The improvement in breastfeeding with ESC may be driven by reduction in pharmacologic treatment and provision of effective nonpharmacologic care. Trial Registration: ClinicalTrials.gov Identifier: NCT04057820.

  PublisherOA PDFDOI

• List of contributors

  Elsevier eBooks · 2024-11-29

  book-chapterOpen access
  PublisherDOI

Frequent coauthors

• Pamela Donohue

  Johns Hopkins University

  100 shared

• Elizabeth Cristofalo

  Calvert Memorial Hospital

  66 shared

• Renée F Wilson

  Johns Hopkins University

  52 shared

• Maureen Gilmore

  Johns Hopkins Medicine

  52 shared

• Jonathan Z Weiner

  Kaiser Permanente

  52 shared

• Karen Robinson

  42 shared

• Greg R. Alexander

  Central University of Technology

  26 shared

• Mitchell S. Cairo

  New York Medical College

  22 shared

Awards & honors

• 2021-2023 Cain Postdoctoral Fellow at the Science History In…