The majority of the research departments/units within the Florida Hospital Research Institute are affiliated with a clinical care department, hospital campus, or represent a stand-alone translational research unit. The following list provides a description of many of the capabilities of the research units or hospital services.
Cancer Institute Translational Research Core
Florida Hospital Cancer Institute Translational Research Core (FHCI-TRC) is a 500 square feet BSL2 cytology and tumor processing/analysis laboratory is equipped with
- molecular biology and cytometric analysis instrumentation for cancer biomarker analysis
- tumor tissue processing/pathological review
- the unique capability for sterile, viable circulating tumor cell capture using advanced high throughput FACS/flow cytometry analysis using a customized aseptic sorting Beckman Coulter MoFlo MDX FACS system
FHCI-TRC has a cooperative agreement with the FH Diagnostic Pathology group for dedicated research Histotechnician services, pathology verification and analysis, as well as access to biomedical specimen/data retrieval and both on- and off-site archive services.
Equipment for biomarker molecular analyses includes 4˚C refrigerator/-20˚C freezers, full-size refrigerator/freezer units, MagPix molecular analyte array analyzer, Class II, Type 2A biological safety cabinet, CO2 Incubator, tabletop autoclave, ultralow -80˚C freezer, high speed refrigerated centrifuge, Gel Logic 4000 pro DNA/protein imaging system; Zeiss Axio Observer 2A microscope and standard and invert Leitz phase contrast microscopes, analytical balance, Smart2Pure Water System, six-color MoFlo XDP Sterile high-speed flow FACS cytometer contained in a dedicated Class II-A laminar flow for aseptic cell sorting and circulating tumor cell isolation, four-color Accuri flow cytometer, BioRad Real Time PCR thermocycler, Stratagene Real Time PCR System, Cytospin centrifuge, LN2, gaseous and dry ice CO2 and 2 EVAC vacuum aspirators and hot plates, heat blocks, vortexes, sonicator, pH meter, and pipettors.
The Florida Hospital Diabetes Institute (FHDI) is a clinical unit of Florida Hospital.
- 8 full-time clinical endocrinologists
- 14 mid-level practitioners
- 8 certified diabetes educators
The FHDI sees more than 38,000 visits, representing over 15,000 unique patients. Approximately 66% of FHDI patients are seen for diabetes and of these, ~20% have T1D
- 27 adult hard-wired beds
- 10 pediatric hard-wired beds
- 51 portable video EEG recording units
- 2 3-T MRIs
- Pre-surgical evaluation includes
- prolonged video-EEG monitoring
- 3T MRI with epilepsy surgery protocol
- Neuropsychological evaluation
- If needed,
- Wada test
- intracranial EEG monitoring and electrical stimulation mapping
Florida Hospital for Children
- 214-bed acute care facility
- Serves 7,500 inpatient children and almost 1200 neonatal admissions
- 35+ pediatric subspecialties including
- Johns Hopkins Children’s Heart Surgery program, a
- Level IV Comprehensive Pediatric Epilepsy Center
- Level III Neonatal Intensive Care Unit (NICU)
- Cancer and Blood Disorder specialty with a pediatric bone marrow transplant program
- Complex Care Clinic for patients with complex diagnoses.
- Excellence in nursing with Magnet status since 2012
- Designated as Best Children's Hospital by US News for 2018-2019
- Designated as a Top Children's Hospital by The LeapFrog Group in 2017
Functional Brain Mapping and Brain Computer Interface (BCI) Laboratory
- The FBM-BCI Lab implements brain imaging techniques to investigate cognitive, sensory, and motor function in epilepsy patients. As part of the pre-surgical evaluation, patients may undergo functional brain mapping with ECoG, EEG and fMRI (language, memory, executive function, attention).
- Specialized equipment for this work includes:
- 128-channel gtech EEG amplifier
- Stimulus presentation software: Presentation, E-Prime, ANT eevoke
- Electromagnetic signal processing software: Curry, BESA, Persyst
- Imaging processing software: Brain Voyager, Analyze
- Gamma Knife Radiosurgery is a non-invasive brain surgery procedure, and despite its name, does not use blades or incisions. Instead, it targets and destroys diseased brain tissue with precisely focused radiation, while leaving surrounding healthy tissue unharmed.
- In fact, this treatment technology allows physicians to treat brain tumors, lesions, vascular malformations and functional disorders that were once considered inoperable.
- Florida Hospital is the only health care provider in Central Florida using this robotic-assisted, state-of-the-art technology.
- The Gamma Knife Center at Florida Hospital Orlando includes a multidisciplinary team of medical experts from neurosurgery and radiation oncology.
- We have one of the largest and most experienced teams in the country, and utilize the Leksell Gamma Knife® Perfexion™—one of the most technologically advanced non-invasive brain surgery techniques available today.
Global Robotics Institute, on the campus of Celebration Health
- Re-known tertiary robotic center under the leadership of Dr. Vipul Patel, performing approximately 1,000 procedures in 2 dedicated operative rooms equipped with:
- da Vinci Xi Robotic System
- Artemis MRI/TRUS Fusion 3D Prostate Biopsy Navigation System
- BK MEDICAL Flex Focus 800 Shared Service Ultrasound- for MRI/TRUS fusion biopsy and intraoperative ultrasonography
i-Discover Data Warehouse
- Integration of multiple systems into a central location for external data transfers, advanced data query, cross-study analysis, and reporting
- utilizes a state-of-the-art dimensional data model that was built specifically to integrate operational, clinical, phenotypic, and genomic data from application systems across Florida Hospital's care operations and research institutes
- i-Discover provides a HIPAA-compliant and IRB-enabled longitudinal view of research subject data enhanced by a semantic layer encompassing clinical and research lexicons and ontologies
- Both scalable and dynamic, i-Discover provides data integration across current and newly installed applications without modification or disruption of the processes and capabilities enabled by those applications.
Institutional Review Board (IRB)
- The Florida Hospital Institutional Review Board (FH IRB) operates to protect the rights and welfare of people who volunteer to participate in human subject research.
- FH IRB has two panels, with each panel meeting once a month (total of 2 meetings per month).
- FH IRB numbers are as follows:
- Federal-Wide Assurance number FWA00002060
- FDA and OHRP Registration numbers
- 00000842 (Panel A)
- 00008071 (Panel B)
- IORG number 0000516
Investigational Drug Service (IDS)
- The IDS provides support to ensure the safety and efficiency of all investigational drug trials at Florida Hospital
- The IDS operates in segregated space with a staff of 2 Investigational Pharmacists and 2 technicians who are specially trained in the research process
- Services provided by IDS include:
- Inventory Control
- Storage of investigational study drugs, separated from regular pharmacy
- Monitored and alarmed freezer and refrigerators for investigational drug storage
- Dispensing and accountability of investigational drugs, including blinding of investigational drugs and treatment randomization capabilities
Magnetoencephalography (MEG) Lab
- Magnetoencephalography (MEG) is a non-invasive, non-surgical brain-mapping procedure that provides the most accurate picture possible of where and when brain activity occurs.
- MEG measures faint magnetic fields produced by electrical neuronal activity, and is capable of tracking moment-to-moment brain activity at the millisecond time scale or better.
- MEG can be used in neurological patients, especially those suffering from epilepsy or who have atypical brain development or brain lesions. Physicians can incorporate MEG technology when planning the best treatment options for each patient, and surgeons use MEG to assist in performing highly targeted operations.
- MEG opens new doors to research in neurodevelopmental disorders, stroke, brain trauma, brain plasticity, aging and memory.
- Florida Hospital has the only MEG in the state of Florida.
Management Information Systems (MIS)
- 24/7 computer, local area network (LAN), and internet support
- high speed encrypted wireless
- FH servers complete with hospital grade security and backups
- The Florida Hospital Medical Library is staffed by professional librarians, is available on the Florida Hospital Orlando campus as well as online to all research staff.
- The Library purchases and maintains access to more than 300 online full text journals, over 100 online books, as well as carefully selected print reference and circulating books in an array of clinical disciplines.
- Interlibrary loan requests and literature search services are provided by the librarians and staff.
Neurosurgery OR Suite
- intraoperative 3T MRI
- Stealth Surgical Navigation System®
Neonatal Intensive Care Unit
- 84 licensed beds in Women’s Hospital
- 20 beds in Children’s Hospital
- 2 neonatal transport teams
- 10 neonatologists, 20 nurse practitioners and a dedicated interdisciplinary team specific to the NICU (2 pharmacists, 2 nutritionists, 3 clinical social workers, 3 nurse discharge coordinators, 4 speech therapists, 4 occupational/physical therapists, lactation consultants, and child life specialists)
- The Florida Hospital Nicholson Center FHNC, located on the campus of Celebration Health is
- Designed to educate and train physicians, surgeons and allied health professionals
- An active robotics education and research center with all of the equipment and support to perform both wet and dry lab experiments
- A state-of-the-art 54,000 square foot building housing:
- 25-station minimally invasive and robotic surgical skills lab
- Simulation laboratory with 13 robotic simulators including the Da Vinci, RoSS and Mimic
- Team training surgical suites
- Global videoconferencing and tele-mentoring capabilities
- An innovation and technology accelerator
- Conference center
- Florida Hospital is served by a single radiology group, consisting of nearly 100 radiologists, several dedicated information technology and PACS personnel, as well as 6 in-house board certified medical physicists and 4 physics assistants. The physicists are available for consultation regarding image acquisition and quality.
- Radiology projected volumes are approximately 2 million imaging studies per year, with roughly 38,000 pediatric patients undergoing x-rays imaging (9,500 under 2yrs of age).
- Radiology services are situated on a single centralized picture archiving and communications (PACS) system that is available to researchers from anywhere within the hospitals or via virtual private network outside the hospitals. Radiology facilities include a dedicated pediatric hospital and approximately 100 digital x-ray units. These units are composed of several different makes and models to facilitate impact of acquisition parameters on radiomics values.
- Radiology has dedicated staff to help manage radiology-related research projects and had just created The Division of Advanced Imaging Research to focus on cutting-edge large-scale research projects. The vast support network and large number of radiologists with an interest in education and research ensure that sufficient personnel will be available for research projects
- Montage software is integrated into the radiology enterprise allowing access to advanced data mining techniques.
- The Florida Hospital Center for Thrombosis Research is a 6,200 square foot facility containing separate areas for research and clinical lab services.
- Major equipment and resources for research include:
- 2 flow cytometers
- BD FACS CANTO II
- Coulter Epics XL-MCL
- confocal microscope interfaced with Silicon Graphic computers and an Olympus Cytogenetic Microscope
- analysis of platelet function and coagulation factors
- 3 automated Coagulation Analyzers
- Impedance and Optical Aggregometers
- 2 Thromboelastograph Analyzers
- 2 Sonoclot Analyzers
- molecular biology and protein chemistry
- PCR thermocyclers
- computer controlled gel documentation system
- automated plate washer and plate reader
- fluorescent plate reader
- electropheresis and chromatography equipment
- automatic gamma and beta counters
- high speed ultracentrifuges.
- 2 fully equipped Tissue Culture Laboratories
- 4 CO2 water-jacketed incubators
- laminar flow hoods
- 2 Coulter Cell Counters.
- separate areas for reagent preparation
- 2 flow cytometers
- Hemostasis and Thrombosis Unit (HTU)
- Clinical laboratory providing diagnostic testing for bleeding and clotting disorders
Translational Research Institute for Metabolism and Diabetes (TRI-MD)
- The Translational Research Institute for Metabolism and Diabetes (TRI-MD) is a joint venture of Florida Hospital and Sanford Burnham Prebys Medical Discovery Institute, focused on translational research in metabolic diseases including obesity, diabetes and the metabolic origins of cardiovascular diseases.
- The TRI-MD occupies a custom designed 54,000 sq. ft. translational research facility located on the Florida Hospital campus.
- First Floor - The Clinical Operations Core has a comfortable waiting area, 9 exam rooms, medical records space, participant check in and consenting areas, an area dedicated to anthropometrics, ECG and vital sign measurements, a phlebotomy room with two phlebotomy chairs, refrigerated centrifuge, -20°C freezer, a recruiting office and study coordinator offices. Immediately adjacent to the clinic are the faculty and administrative offices, the Imaging and Body Composition Core, and 2 conference rooms
- Second Floor - Dedicated to advanced clinical phenotyping, contains the Clinical Research Unit (includes the Metabolic Kitchen), Metabolism and Energy Expenditure Core, the Laboratory - BioRepository Core, and Research Pharmacy.
- Third Floor – The Exercise and Bioenergetics Laboratory includes exercise testing and training equipment, an exercise testing and biopsy suite and a laboratory for biochemical analysis of tissue, including muscle specimens.
- The building is protected from power failure by a 650kW Cat diesel generator which will heat/cool and power the entire second floor for at least 48 hours. Florida Hospital maintains excess diesel supply on 18-wheel trucks on the Orlando campus during hurricane threats.
- Operationally, the TRI-MD consists of separate but interrelated Cores:
- Recruiting Core: The Core has 4 FTEs dedicated to recruitment and screening of prospective research subjects. Additional support for the Recruiting Core comes from the Florida Hospital Marketing Department.
- Clinical Operations Core: The clinic is staffed by full-time clinical research nurses as well as medical assistants and phlebotomists to facilitate patient flow. Equipment within the core includes a Scale-Tronix 5107 Bariatric Stand-On Scale, SECA 242 Digital Stadiometer, and a Philips PageWriter TC50 Cardiograph which interfaces with Florida Hospital Cardiology services for cardiologist 'over-reads.'
- Clinical Research Unit (CRU): The CRU consists of the inpatient testing unit and research kitchen. The unit maintains a 10 bed unit; 6 beds with bathrooms / showers and 4 'flex' rooms which can be used for overnight stays and/or research procedures such as oGTT, FSIVGTT, etc. Additionally, the CRU contains a nurses station, clean storage and linen room, 'soiled' storage room, 2 procedure rooms for invasive procedures (biopsies, tissue oxygenation, endocrine studies, etc.), isotopic turnover studies (e.g. 'clamps') and pharmacokinetics / pharmacodynamics. The Clinical Research Unit is appropriately staffed with ACLS certified Registered Nurses and Advanced LPNs 24 hrs a day 7 days a week. The CRU Core nurses coordinate protocol activities with all other cores respectively.
- Investigational Drug Services (IDS) Research Pharmacy Core: A dedicated, double-locked pharmacy room stores investigational and routine medications. The IDS Research Pharmacy has a USP 797 compliant room for IV preparation. A full-time consultant pharmacist experienced in clinical research manages the Pharmacy Core.
- Energy, Metabolism and Calorimetry Core: The Core is staffed by a Masters level biomedical engineer, and a Masters level Research Associate. The four (4) room calorimeters are supported by a technical/engineering service contract with MEI, Inc., who designed and built the calorimeters. The Core performs the following measures:
- 24 hour energy expenditure by Indirect Room Calorimetry is enabled by a total of four chambers, two full sized (31,000 liters) room calorimeters and two smaller (3,000-5,000 liters) flexible calorimeters. The two larger chambers will allow free living conditions while controlling environmental factors and keeping record of participant activity. They have an intercom, blood ports and pass-throughs for sample collection and meal delivery, respectively and a treadmill or bike for controlled exercise, video cameras and activity monitors for participant activity and core temperature data and a computer, television, bed, curtained restroom and wash station for participant comfort. The two Flexible Calorimeters allow for Resting Metabolic Rates and Pharmacodynamic testing at the lower (3000 L) volume and exercise testing at the higher (5000 L) volume to be performed with increased data integrity and repeatability through greater environmental control, participant comfort and stable highlevel gas analyzers. They have a removable platform that allows for conversion from a resting configuration to an exercise testing configuration, a television for participant comfort and motivation during exercise testing, an intercom and blood ports for sample collection and interventions (glucose/drugs) during pharmacodynamic studies.
- Resting Metabolic Rate (RMR) / Respiratory Quotient (RQ) with two MAX-II Metabolic Carts (AEI Technologies; Pittsburgh, PA) and a TrueOne® 2400 calorimeter (Parvo Medics Sandy, UT). The three carts are setup in a resting configuration with a hood and mixing chamber for signal stability.
- Activity monitoring is performed via tri-axial accelerometry using the BodyMedia SenseWear armband unit (BodyMedia; Pittsburgh, PA); these units have been validated against DLW. Each procedure is governed by a SOP with on-going quality metrics.
- Imaging and Body Composition Core: The Core is staffed by a PhD physicist/biomedical engineer and a MRI/radiology technologist. The 'research only' magnet is a 3T Philips Achieva with multinuclear (31P and 13C) capabilities. In addition to traditional MR imaging, this magnet is used to monitor chemical and metabolic processes within human tissue, noninvasively via MR spectroscopy. This combination of a higher magnetic field strength and multinuclear spectroscopy allows for increased spatial, spectral and temporal resolution, as well as the possibility to replace traditional biopsies with noninvasive/nondestructive measurements. Body composition studies are performed on a GE Lunar iDXA with enCORE software version 13.31 (Note: Table load capacity = 450lbs).
- Laboratory and BioRepository Core: The Laboratory and BioRepository Core performs all blood, urine and tissue specimen collection and processing as well as a large variety of assays.
- The TRI-MD Biorepository specializes in the collection, processing, preservation, and distribution of biomaterials (blood, tissue, cells, and fluids) for use research. For sample processing, the TRI Biorepository is equipped with a Hamilton ChemagicStar system. Incorporating robotic automated sample accessioning technology, the ChemagicStar can accommodate both high and low throughput blood sample processing, as well as provide a standardized and automated nucleic acid extraction method for all sample types including whole blood, tissue, and cells. Integrated with a robust LIMS, this automated system provides a highly efficient and standardized way to process blood and tissue samples into desired components (serum, plasma, buffy coat, DNA, RNA) in preparation for immediate use or for long and short term storage. All samples are labeled with 2D barcodes for easy scanning during storage and retrieval, and a BioMicrolab VolumeCheck is used to measure sample volumes for QC purposes.
- The wet laboratory is equipped with four (4) Oroboros high-resolution oxygraphs (two (2) with fluorometry), a HORIBA Scientific Fluoromax 4 with MicroMax 384, a BioTek Cytation3 mono-fluorescence microplate imaging reader. This equipment allows for real-time high-resolution metabolic measures in both human skeletal muscle fibers, myotubes, adipocytes and isolated mitochondria.
- A ThermoFisher Cryotome FSE and a Nikon Eclipse Ti Fluorescent Microscope support histology and immunochemistry processes. Included among the laboratory's equipment is an Applied Biosystems ViiA™ 7 System, which is a real-time PCR station that is highly suited to quantitative RT-PCR and plate aliquoting is accomplished with the Hamilton ChemagicStar system.
- Robust protein quantitation and analysis assays are performed by ELISA with a BioTek Synergy plate reader as well as the MesoScale Discovery platform, which allows for multiplexing and a high dynamic range and Western Blotting with the BioRad Criterion gel electrophoresis system and quantified with Li-Cor Odyssey Clx imaging system.
- The laboratory performs radiolabeled functional assays by way of a PerkinElmer TriCarb 2810TR Liquid Scintillation Counter in a controlled room with dedicated hood.
- A cell culture room with three LabConco Biosafety Cabinets is routinely used for myoblast and adipocyte cultures from primary tissues.
- A Fluorescence Activated Cell Sorting (FACS) with a BD FACSAria cell sorter supports well designed protocols for blood and adipose cell separation.
- Nutrition Core: The Nutrition Core is capable of providing a wide variety of dietary interventions, from standard meal cycles to protocol-specific diets. ProNutra, the gold standard software for metabolic feeding studies, facilitates the menu planning process, and its complementary application, ProNESSy, collects and analyzes food data for accurate, streamlined reporting to TRI-MD’s faculty biostatisticians. The TRI-MD’s Metabolic Kitchen is a state-of-the-art facility supervised by a Masters level Registered Dietitian. Daily operations are coordinated by a dedicated team of (9) nutrition professionals, who are actively involved in the design and implementation of research proposals, protocols, and procedures at the TRI-MD. This team works in conjunction with the Clinical Research Unit and Calorimetry Cores to provide precise dietary interventions for research studies with nutritional factors under investigation. The Metabolic Kitchen serves as a centralized location for the preparation and storage of research-specific meal components, with a wide variety of commercial-grade stainless steel cooking equipment and walk-in cooler and freezer space.
- Exercise & Bioenergetics Laboratory (EBL) The Exercise and Bioenergetics Laboratory houses:
- an exercise training facility
- an exercise testing laboratory
- a wet laboratory
The EBL is staffed by 4 full-time faculty, 2 full-time exercise physiologists and 8 post docs. One full-time exercise research assistant is also available in the exercise training facility. The TRI-MD exercise training facility has 5 Vision Fitness treadmills, 4 Vision Fitness upright bicycles, 2 Vision Fitness recumbent bicycles, 1 Proteus rower, 1 Physio-Step, 1 Life Fitness Fit 3 Multi Gym for resistance exercise, and a BIODEX Quick Set System 3 Dynamometer to assess dynamic muscle strength across various major muscle groups. The exercise training facility is fully equipped with men’s and women’s showers, lockers and changing rooms. This facility has the capability to monitor participants’ blood pressure, blood glucose, and urine ketones as well as heart rate (via heart rate monitor wrist watches and chest straps) and Ratings of Perceived Exertion (RPE) at specific time intervals. The exercise testing laboratory is equipped with a Track Master TMX625C treadmill, Lode Excalibur cycle ergometer, Lode Corival cycle ergometer, Phillips Stress Vue wireless ECG system, and a Parvo Medics TrueOne 2400 Metabolic Cart. This equipment allows for VO2max tests on a cycle or treadmill, as well as acute bouts of exercise or strength testing.
- Data Management and Biolnformatics Core: An interoperable Electronic Data Capture (EDC) system that incorporates an Electronic Health Record (EHR), Clinical Trial Management System (CTMS), Clinical Data Management System (CDMS) underwent a phased launch through 4Q 2012. The Cerner Millennium HER provides TRI-MD study team members with restricted-access to electronic study visit management and source documentation as well as access to a participant's full Florida Hospital medical record. In February 2012, the TRIMD launched Cerner Power Trials, an electronic CTMS that supports study screening and enrollment/management, as well as Cerner Discovere, a 21CFR Part 11 compliant CDMS that features, as currently configured, Retrieve Form Data-capture (RFD); manual data validation and query generation; and CDASH formatted output. Florida Hospital MIS also supports i-Discover, a Florida Hospital enterprise core data trust that supports high throughput data management; cross-study data aggregation and analysis; and cohort identification and analysis.