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IN THIS ISSUE

Clinical Trials & Research in Cancer + Cardiovascular Disease + Neurology + Psychiatry + Diabetes + IBD + Transplantation

FALL 2016

MOUNT SINAI SCIENCE & MEDICINE THE MAGAZINE OF THE

M O U N T S I N A I H E A LT H S Y S T E M

THROUGH THE EYES OF PATIENTS Perspectives on Mount Sinai Care Researchers and clinicians collaborate to provide support

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MOUNT SINAI SCIENCE & MEDICINE VOLUME VII, NUMBER 1

PRESIDENT AND CHIEF EXECUTIVE OFFICER MOUNT SINAI HEALTH SYSTEM

Kenneth L. Davis, MD ANNE AND JOEL EHRENKRANZ DEAN, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI PRESIDENT FOR ACADEMIC AFFAIRS, MOUNT SINAI HEALTH SYSTEM

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Dennis S. Charney, MD CHIEF DEVELOPMENT OFFICER SENIOR VICE PRESIDENT FOR DEVELOPMENT MOUNT SINAI HEALTH SYSTEM

Mark Kostegan, FAHP EDITOR

Celia M. Regan ASSOCIATE EDITOR

Anna Horton CONTRIBUTORS

Travis Adkins Robbie Brenner Julie Briggs Elizabeth Chute Jessica Copen Alison Dalton Sheena K. Fallon Don Hamerman Andrew Lichtenstein Susan McCormick Mario Morgado Rhianna Morris Anna Parini Deborah Schupack Katie Quackenbush Spiegel Veronica Szarejko DESIGN

Taylor Design Mount Sinai Science & Medicine is published twice annually by the Office of Development, Mount Sinai Health System, for an audience of friends and alumni. We welcome your comments; please contact us at magazine@mountsinai.org or call us at (212) 659-8500. Visit us online at philanthropy.mountsinai.org

28 Through the Eyes of Patients: Perspectives on Mount Sinai Care There can be no lens more finely ground, more precise—or more important to us. In a Health System that annually supports more than 152,576 inpatient admissions, more than 3,400,000 non-emergency outpatient visits, and more than 425,000 Emergency Department visits, every patient experience requires a clinical team that can provide outstanding care. But there’s more to the equation. Behind the clinical team is—often— a research team that has helped chart the path to a patient’s diagnosis, treatment, and recovery. The synergy between the teams shapes the outcomes, and it puts Mount Sinai in the top tier of academic medical centers. In this issue, we present ten stories demonstrating how patient outcomes are supported by the strength of Mount Sinai’s clinical and research enterprise, ranging from clinical trials that show immediate results and great promise, to long-term relationships between patients and their caregivers

Correction: We deeply apologize for a photography error in our previous issue, “Medicine 360.” On page 11, our photo of Dr. Paul Greene was incorrect; the new image appears in this issue on page 8. Front cover illustration by Anna Parini Back cover photo by Andrew Lichtenstein

that continue to yield good health. These are stories of strong bonds, the generosity of faith, the expertise of doctors who lead their fields—and the recognition that caring for each patient requires unblinking trust, wide-ranging vision, and keen perspective from everyone involved.

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CONTENTS

40 MESSAGE 02 Strategic Plan Takes Shape 03 Mount Sinai continues to rise in national rankings

NEWS 04 Announcing Mount Sinai Downtown + Ambulatory Pavilion Planned for Mount Sinai St. Luke’s + Continued Expansion of Mount Sinai Queens + Collaboration with Celgene + Bristol-Myers Squibb and Mount Sinai Innovation Partners + Genome sequencing: 600,000 and counting + New app for patients + Recognition from DiversityInc and the Human Rights Campaign Foundation + Undocumented student receives Soros Fellowship + Commencement x 2

FACULTY 08 From Barlogie to Teruya-Feldstein: Spotlight on new recruits + New Deans for the Graduate School and for Academic and Scientific Affairs + More than 175 faculty receive honors and recognition + Mammograms may warn of heart disease, Predicting IBD, Cancer and sepsis, Pre-term birth, Pediatric pneumonia, “Undruggable” cancer genes, Cardiac fibrosis, and Prostate cancer

GIVING 52 Generous gifts throughout the Health System + TEAM ANDI supports NICU + Legacy gifts pledged to Medical Education + A year of celebrations

ALUMNI

60 Profile: Jewel Mullen, MD, MPH, MPA, MSSM ’81 + Scholarship students share their stories + Seven receive Jacobi Medallion + SLR Alumni Association 125th Anniversary Dinner + Sinai Alumni celebrate at Reunion 2016

FEATURES Through the Eyes of Patients 14 How Babies and Mothers May Offer Hope to IBD Patients

 Artificial pancreas trials spotlight a special partnership.

A mother’s pregnancy is a research powerhouse.

18 Keeping the (Heart) Beat

34 Artificial Pancreas Trials Hold Promise

Mitral Valve: A new beat for Max Weinberg.

38 Old Drug, New Use?

Ketamine: New possibility for depression.

20 ‘It’s Simple: Catch It Early’

40 Preserving ‘Who You Are’

 hy early detection is changing W the lung cancer prognosis.

Saving face—and fighting back against HPV.

24 Building Bridges for 44 Partners for Life Patients  When a first transplant fails,

New options for multiple myeloma patients.

a second may succeed.

48 Challenging 28 New Treatments for Convention Phelan-McDermid  Three doctors vs. prostate cancer. Syndrome  Autism treatment supports a family’s journey.

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Mg

MESSAGE Message from

THE CEO      THE DEAN

&

With the involvement of hundreds of faculty and more than 100 national and international experts, the Mount Sinai Health System is nearing completion of our new strategic plan—our first as a seven-hospital Health System, anchored by a top-tier School of Medicine. Our previous strategic plan, created in 2007, brought us to this turning point in our history. A combination of factors helped drive its success: • We anticipated the trajectories of biomedical science and health care, through such decisions as making a major investment in cancer research and clinical care; recognizing the need for high-performance computing and taking a leadership role in big data analytics and genetics as they apply to increasing our understanding of human disease; and committing to advancing personalized medicine, basing treatments on the biology of a patient’s disease. • We remained true to our core values, providing care for all who come to our doors. We are blind to socioeconomic status, race, religion, and ethnicity; everyone gets, to the best of our ability, the same quality of care. We are dedicated to the notion that the grandchildren of our current patients won’t suffer from the same diseases as the grandparents of our current patients; this means a commitment to the creation of new

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

knowledge and to developing new therapeutics and the targets for therapeutics.

We believe we can design and implement a strategy that effectively transforms us from a group of hospitals and ambulatory care centers into a system that truly acts as one—and that captures and energizes the synergistic relationship between our clinical practice and the research and training within our schools.

•  We made educating the next generation of practitioners and scientists the cornerstone of Mount Sinai. Our tradition is one of innovation, and we have crafted curricula and new programs at the Icahn School of Medicine and Graduate School of Biomedical Sciences that reflect this mission, while fitting it into the extraordinary context of a Health System serving the most diverse patient population in the country. As we complete our strategic plan later this fall, we know that no new vision can merely duplicate or simply build on the one that came before it. But because our approaches will follow the principles that shaped our recent results, we believe we can design and implement a strategy that effectively transforms us from a group of hospitals and ambulatory care centers into a system that truly acts as one—and that captures and energizes the synergistic relationship between our clinical practice and the research and training within our schools. We are predicting a new set of exciting ideas that will become pillars of the plan. While the full list is still in formation, here are some highlights: • We will make a commitment to immunology, which has begun to have major implications and yield new therapeutic discoveries across a spectrum of human disease. • We will continue to make major strides in research related to cancer, heart disease, and brain disorders—detecting them at a much earlier stage. • As a world leader in understanding infectious diseases, we must continue to invest heavily in research, especially related to outbreaks such as Ebola and the Zika virus, which present ongoing, ever-evolving challenges.

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• Because diabetes and obesity are epidemic in our community, we

• We will maximize partnerships between the medical school and

have a responsibility to deepen our strong commitment by further

industry, particularly in the life sciences, where our relationship

investments in research designed to discover new therapies.

with pharmaceutical companies will help them to make drugs that

•  Regenerative medicine, involving the ability to regenerate tissue

are safe and effective.

that was destroyed or died, will be a focus, based on new methodol-

Above all, we will ensure our continued leadership in three essential

ogies of understanding cell death and cell growth, and the potential

ways: providing high quality care—care that can take all patients,

of using stem cells to develop tissue.

treat all diseases, offers exceptional access and quality, and provides

•  We will invest in infrastructure that allows us to do early-stage clinical trials, to test therapeutic approaches for the most serious diseases that do not, as yet, have adequate treatment.

the most efficient care possible at the lowest cost; generating new science that is particularly focused on the development of new therapeutics; and training outstanding leaders, both in biomedical research and clinical medicine.

•  Our research will reflect our “for you, for life” approach, supporting the development of new therapies for infants, children, adolescents, adults, and the elderly. •  We will make our care accessible to a much larger territory,

Kenneth L. Davis, MD President and CEO, Mount Sinai Health System

Dennis S. Charney, MD Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai President for Academic Affairs, Mount Sinai Health System

through the most robust health care system in the New York metropolitan area, rivalling any in the United States. This will include a greater ability to make appointments and access your own information, as well a greater emphasis on telemetry software applications and the ability to deliver more care through the Internet and at home.

Mount Sinai Continues to Climb in National Rankings The Mount Sinai Hospital has been recognized as a leading institution in several national surveys by U.S. News & World Report and the Association of American Medical Colleges. The Mount Sinai Hospital is listed on the “Honor Roll” in the U.S. News & World Report “Best Hospitals” rankings for 2016. Seven departments ranked among the top 20 nationally in their specialties, and four other departments at the Hospital were among the top 50. The Hospital ranked third regionally, in both New York City and the New York metropolitan area. New York Eye and Ear Infirmary of Mount Sinai ranked No. 10 nationally for Ophthalmology, one point higher than last year. Mount Sinai Beth Israel, Mount Sinai St. Luke’s, and Mount Sinai West all ranked regionally.

In addition, Kravis Children’s Hospital at Mount Sinai is again ranked among the country’s top children’s hospitals in seven out of ten pediatric specialties as measured by U.S. News & World Report’s “Best Children’s Hospitals” rankings for 2016–2017. Kravis ranked in the Top 25 in two specialties—urology and pulmonology—and returned to the rankings in cardiology after a two-year absence. In a national survey by the American Association of Medical Colleges, Mount Sinai faculty have ranked first in grants per investigator, placing the Icahn School of Medicine at more than double the mean of $282,857. This same survey also shows that Mount Sinai has the third highest research density (grants dollars per square foot) in the country, and is third in growth of sponsored program expenditures.

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DEPARTMENTS RANKED AMONG THE TOP 20 NATIONALLY IN THEIR SPECIALTIES

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NEWS Mount Sinai Invests $500 Million to Create New “Mount Sinai Downtown” Network “Mount Sinai Downtown is a dramatic next step that will enable us to improve access and increase quality by providing care for residents of downtown Manhattan where they live and work.”

In May, the Mount Sinai Heath System announced a

transformation will also include a major investment

plan for the sweeping transformation of Mount Sinai

to support and strengthen behavioral health

Beth Israel, by investing more than $500 million

services, anchored at Beth Israel’s Bernstein Pavilion.

to create the new Mount Sinai Downtown, an

Additionally, New York Eye and Ear Infirmary of

expanded and unified network of innovative facilities

Mount Sinai will be preserved and enhanced.

stretching from the East River to the Hudson River

Mount Sinai Downtown’s facilities will be located

below 34th Street. Much of the existing Beth Israel

throughout the lower Manhattan community,

infrastructure is aging and unable to meet the needs

providing care for each patient in the most appro-

of the modern health care landscape. On average,

priate setting, whether in a traditional hospital bed,

less than 60 percent of the hospital’s licensed beds

an outpatient practice, a surgical facility, or even

are occupied and patient volume at the financially

in the patient’s home. The $500 million investment

troubled hospital has decreased by double digits

represents Mount Sinai’s commitment to develop the

since 2012.

Downtown network into one of the most innovative

Mount Sinai’s investment will create a network of

and accessible health care systems in the country.

greatly expanded primary, specialty, behavioral, and

“For several years, we have been transforming the

outpatient surgery services, including a new, smaller

Mount Sinai Health System toward a new model of

Mount Sinai Downtown Beth Israel Hospital with

care, where we focus on keeping entire communities

approximately 70 beds and a brand-new Emergency

healthy and out of the hospital,” said Kenneth L.

Department with up-to-date technologies; expanded

Davis, MD, President and CEO of the Mount Sinai

and renovated outpatient facilities at three major

Health System. “Mount Sinai Downtown is a dramatic

sites with more than 35 operating and procedure

next step that will enable us to improve access and

rooms; and an extensive network of 16 physician

increase quality by providing care for residents of

practice locations with more than 600 doctors. The

downtown Manhattan where they live and work.”

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Ambulatory Pavilion Planned for Mount Sinai St. Luke’s Renovation is set to begin this fall on a 17-floor ambulatory pavilion at Amsterdam Avenue and 114th Street that will serve as the anchor in a new master plan to transform Mount Sinai St. Luke’s outpatient care. The updated facility will expand the hospital’s primary, preventive, and specialty care, and foster integration with all departments within the Mount Sinai Health System. Located at 1090 Amsterdam Avenue, the new ambulatory pavilion will be financed through the sale of four underutilized properties on the Mount Sinai St. Luke’s campus, a $20 million grant from New York State, and philanthropic support. The new pavilion will help provide a focal point for Mount Sinai St. Luke’s faculty practices to grow and to recruit physicians. The transformation of Mount Sinai St. Luke’s aligns with an industry-wide shift to a more cost-efficient population health model of care that promotes greater access to multidisciplinary health care. “If we implement this vision and create one facility where patients can go to receive all of their care without having to navigate through multiple areas within our hospital, we can really start to make a difference in the community,” says Berthe Erisnor, MBA, Vice President of Ambulatory Services at Mount Sinai St. Luke’s. “We want people to know that health care is really changing uptown.”

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Landmark Research Consortium and Collaborations with Celgene Last month, The Tisch Cancer Institute joined a small, elite consortium receiving a combined $50 million in NIH funds to develop multiple, high-impact research programs that will be presented to Celgene Corporation for consideration over the next 10 years. In addition to The Tisch Cancer

Mount Sinai Queens Continues to Expand Mount Sinai Queens has opened the doors to its new Ambulatory Pavilion, a $175 million facility that allows it to better serve the health needs of its community and significantly expands its medical and surgical capabilities. Located in Astoria, it serves the communities of Western Queens and beyond. The six-floor, 140,000-square-foot Ambulatory Pavilion, which broke ground in October 2013, is one of the largest new medical construction projects in Queens in recent years. While parts of the facility remain under construction, it has been opening in phases since May and is now home to the Stavros Niarchos Foundation Emergency Department, Mount Sinai Doctors multispecialty medical practice, and Mount Sinai Queens Imaging. “As we continue to grow, we are expanding the role we play in all aspects of our neighbors’ health, from providing primary care and imaging tests to surgery and cancer care,” says Caryn A. Schwab, Executive Director of Mount Sinai Queens. “We want to deliver the best care for our community and borough, and in this building, they will get it.”

Institute, The Abramson Cancer Center at the University of Pennsylvania, The Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins will each receive $12.5 million for the option to enter into future agreements to develop and commercialize novel cancer therapeutics arising from the consortium’s efforts. Subject to Celgene’s decision to opt-in and license the resulting technologies, each program has the potential to be valued at hundreds of millions of dollars. “The active and coordinated engagement, creative thinking, and unique perspectives and expertise of each institution have made this collaboration a reality,” said Steven Burakoff, MD, Director of The Tisch Cancer Institute, and the Lillian and Henry M. Stratton Professor of Cancer Medicine, in a shared statement with the directors of the consortium institutions. “Our shared vision and unified approach to biomedical research, discovery, and development, combined with Celgene’s vast research, development, and global commercial expertise, will enable us to accelerate

Strategic Collaboration with Bristol-Myers Squibb in Oncology Dual Therapeutics, LLC, an oncology start-up company developing novel therapeutics for prostate cancer, lung cancer, and acute lymphoblastic leukemia, announced a strategic collaboration with Bristol-Myers Squibb to advance small molecule compounds for the treatment of cancer and other diseases. Dual Therapeutics was founded in 2013, and its technology is based on research developed and exclusively licensed from the Icahn School of Medicine and Case Western Reserve University. This work was made possible in part through Mount Sinai Innovation Partners, which facilitates the real-world application and commercialization of Mount Sinai discoveries and the development of research partnerships with industry. “Mount Sinai Innovation Partners enthusiastically embraces this partnership with Dual Therapeutics and Bristol-Myers Squibb as a seminal next step in translating a discovery made by Mount Sinai researchers into tomorrow’s cancer therapeutics,” said Erik Lium, PhD, Senior Vice President and Executive Director of Mount Sinai Innovation Partners.

the development and delivery of next-generation cancer therapies to patients worldwide.”

Erik Lium, PhD, Senior Vice President of Mount Sinai Innovation Partners; and Steven J. Burakoff, MD, Director of The Tisch Cancer Institute, and the Lillian and Henry M. Stratton Professor of Cancer Medicine.

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NEWS

Largest Genome Study to Date Analyzed Nearly 600,000 Genomes As part of a global collaboration, scientists from the Icahn School of Medicine at Mount Sinai and Sage Bionetworks reported the first systematic search across hundreds of Mendelian disorders in hundreds of thousands of individuals apparently not afflicted with any of these disorders to identify those carrying disease protective factors. The Resilience Project was launched in 2014 with a unique vision: “Characterizing by studying massive the intricacies of numbers of healthy our genomes will adults, scientists might ultimately reveal find rare individuals elements that could who are unaffected by genetic variants that promote health in should induce disease. ways we haven’t Genome analysis of even imagined.” these resilient people could uncover naturally occurring, protective mechanisms that would serve as novel treatments for people affected by these diseases. “We see tremendous opportunity in figuring out what keeps people healthy,” said Eric Schadt, PhD, the Jean C. and James W. Crystal Professor of Genomics, Founding Director of the Icahn Institute for Genomics and Multiscale Biology, and the Project’s co-leader. “Characterizing the intricacies of our genomes will ultimately reveal elements that could promote health in ways we haven’t even imagined.”

Mount Sinai Twice Recognized for Diversity and Health Care Equality This year, Mount Sinai was honored for its leadership in diversity by two different organizations. In April, in recognition of its comprehensive efforts aimed at ensuring a diverse workforce and leadership, the Mount Sinai Health System was ranked No. 3 on DiversityInc’s Top Hospitals and Health Systems list for 2016. DiversityInc Top 10 companies have significantly more diversity than average American corporations, including nearly 50 percent more blacks, Latinos, and Asians, and 49 percent more women than the U.S. corporate average. “We are proud that our leadership efforts continue to be recognized and that the value and positive social impact of a diverse, inclusive, and culturally competent workforce is once again being commended,” said Gary Butts, MD, Chief Diversity and Inclusion Officer for the Mount Sinai Health System and Dean for Diversity Programs, Policy, and Community Affairs at the Icahn School of Medicine. Also in April, six of Mount Sinai’s campuses—The Mount Sinai Hospital, Mount Sinai Beth Israel, Mount Sinai St. Luke’s, Mount Sinai West, Mount Sinai Queens, and New York Eye and Ear Infirmary of Mount Sinai—were recognized as “Leaders in LGBT Healthcare Equality” by the Human Rights Campaign Foundation, the educational arm of the country’s largest lesbian, gay, bisexual, and transgender civil rights organization. Seven years ago, Mount Sinai Beth Israel was the first hospital in New York City to receive this honor; the Health System has now earned top marks in meeting best practice benchmarks that include nondiscrimination; LGBT education, training, and community engagement; and demonstrating a commitment

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Mobile App Connects Patients to Services Mount Sinai’s Department of Information Technology has developed MountSinaiNY, a new mobile application for patients. The app is a one-touch experience, featuring centralized information and services that provide greater access to such health services as appointment scheduling, mobile bill payment, and access to patient medical records; it is available for free in the Apple App Store.

to equitable, inclusive care for LGBT patients and their families. “Mount Sinai has created a diverse organization that understands the unique needs of the many communities we serve,” said Barbara Warren, PsyD, who is the Director of LGBT Programs and Policies in Mount Sinai’s Office of Diversity and Inclusion. “We continue to advance equity and inclusion throughout our health system by creating a culturally and clinically competent environment, training and educating our health workforce and clinicians committed to this goal, and mainstreaming health services for the LGBT community.”

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Undocumented Student at the Icahn School of Medicine Receives Prestigious Fellowship Denisse Rojas Marquez, a Mexican immigrant and first-year medical student at the Icahn School of Medicine, was awarded a 2016 Paul and Daisy Soros Fellowship for New Americans, the premier graduate school fellowship for immigrants and children of immigrants in the United States. Ms. Marquez became one of the first two undocumented students at the School of Medicine in 2015. This fellowship will support her continued work toward earning her medical degree, and becoming a doctor in underserved immigrant communities and a leader in shaping health care policies. Denisse Rojas Marquez, MD Class of 2019

This was the most competitive year in the Fellowship’s history—just two percent of applicants were chosen. Ms. Marquez was 10 months old when she and her family

left Mexico for the United States. In their new home of Fremont, California, her family found new opportunities that enabled her and her two siblings to attend college. Due to her status, however, Ms. Marquez was ineligible for financial aid and often felt discouraged that no career counselor could offer her guidance on her goals. Remaining steadfast in her aspirations, Ms. Marquez co-founded a national organization called Pre-Health Dreamers (PHD) to provide advising, resources and advocacy for other undocumented students. In just a few years, PHD has reached 652 members in 41 states. Through Ms. Marquez’s leadership, the organization co-sponsored legislation to allow California licensing boards to award professional licenses to undocumented professionals and engaged in institutional advocacy with other academic groups. As a result, more than 50 medical schools will now consider undocumented

Icahn School of Medicine at Mount Sinai Receives Award from Burroughs Wellcome Fund In recognition of its innovative efforts to prepare the next generation of physicians and scientists, the Postdoc Executive Committee at the Icahn School of Medicine at Mount Sinai was recently awarded a grant by the Burroughs Wellcome Fund, a private foundation dedicated to advancing biomedical sciences, to enhance the Postdoctoral Training program. The grant will fund Mount Sinai’s Future Leaders in Science Education and Communication Training Program, and is one of seven programs across the United States to receive this prestigious award. “Effective science communication and education are a gateway to diverse careers in academia, teaching, and science, but practical, hands-on training in these areas can often be difficult to achieve—an obstacle that we look to address through our Future Leaders program,” said Alison P. Sanders, PhD, postdoctoral fellow in the Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, who leads the program along with postdocs Eric S. Sweet, PhD, and Ryan J. Cummings, PhD.

students for admission.

47th Annual Medical Education Commencement Ceremony and Inaugural Master’s Degree Commencement This year’s commencement ceremonies included the first separate commencement ceremony for master’s degree recipients as well as the 47th annual medical education commencement. A total of 327 degrees were conferred to medical and graduate students, including 148 master’s degrees in areas including Public Health, Biomedical Sciences, Clinical Research, Biostatistics, Genetic Counseling, and Health Care Delivery Leadership; 120 MDs; 37 PhDs; and 22 Dual Degrees. Former U.S. Secretary of Health and Human Services Kathleen Sebelius, MPA, and Peabody, Polk, and Pulitzer award-winning journalist Laurie Ann Garrett received honorary Doctor of Humane Letters degrees and delivered the commencement addresses to the medical education and master’s degree graduates, respectively.

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FACULTY

RECENT RECRUITS 1. Bart Barlogie, MD, PhD Professor and Director of Myeloma Research in the Department of Medicine; previously at the Myeloma Institute at the University of Arkansas. 1

2

2. Jane Eisen, MD Professor and Site Chair of the Department of Psychiatry at Mount Sinai St. Luke’s and Mount Sinai West; previously at Brown University. 3

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

6

7

8

9

10

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8. Gregory Stock, PhD Research Professor in the Department of Genetics and Genomic Sciences and Co-Director of the Harris Center for Precision Wellness of the Icahn Institute for Genomics and Multiscale Biology; previously at the University of California, Los Angeles.

4

3. Paul Greene, MD Associate Professor in the Department of Neurology; previously at the Columbia University Medical Center. 5

7. Grant Mitchell, MD Associate Professor and Site Chair in the Department of Psychiatry at Mount Sinai Beth Israel; previously at Columbia University.

12

4. Cynthia Harden, MD Professor and Director of Epilepsy Services in the Department of Neurology; previously at Northwell Health. 5. Ira Jacobson, MD Professor and Site Chair in the Department of Medicine at Mount Sinai Beth Israel; previously at New York Presbyterian/WeillCornell Medical College. 6. Nadia Micali, MD, PhD, MSc Associate Professor in the Department of Psychiatry and Medical Director of the Eating and Weight Disorders Program; previously at University College of London Institute of Child Health.

9. James Sumowski, PhD Associate Professor in the Department of Neurology and Neuropsychologist in the Corinne Goldsmith Dickinson Center for Multiple Sclerosis; previously at the Kessler Foundation. 10. Philip Szeszko, PhD Associate Professor in the Department of Psychiatry; previously at Zucker Hillside Hospital. 11. Emanuela Taioli, MD, PhD Professor in the Department of Population Health Science and Policy and in the Department of Thoracic Surgery, Director of the Institute for Translational Epidemiology, Chief of the Division of Social and Clinical Epidemiology in the Department of Population Health Science and Policy, and Director of the Center for the Study of Thoracic Diseases; previously at Northwell Health. 12. Julie Teruya-Feldstein, MD Professor and Director of Hematopathology in the Department of Pathology; previously at Memorial Sloan Kettering.

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New Dean of the Graduate School of Biomedical Sciences Marta Filizola, PhD has been appointed Dean of the Graduate School of Biomedical Sciences at the Icahn School of Medicine. Recognized as an innovative researcher and a strong adviser and mentor to students and trainees at all levels, Dr. Filizola oversees the academic and administrative functions of all PhD and Master’s programs, as well as the Office of Postdoctoral Affairs. “I am both excited and humbled by the opportunity to serve as a catalyst for innovation in graduate education at Mount Sinai,” said Dr. Filizola. “I believe that we at Mount Sinai are in the best position to train the next generation of great scientists, to prepare them for a wide range of careers in academia, industry, or even finance. Our goal is to empower students with the skills they need to make a difference in today’s world, and I look forward to working with our terrific researchers and educators to achieve this goal.” According to the 2013-2014 report by the Association of American Medical Colleges, only 16 percent of deans in academic medicine are women.

“I am both excited and humbled by the opportunity to serve as a catalyst for innovation in graduate education at Mount Sinai.”

New Dean for Academic and Scientific Affairs Eric J. Nestler, MD, PhD has been appointed Dean for Academic and Scientific Affairs at the Icahn School of Medicine. Dr. Nestler, the Nash Family Professor of Neuroscience, also serves as Chair of the Department of Neuroscience and Director of The Friedman Brain Institute, and as Interim Chair of Psychiatry. He is an internationally renowned neuroscientist and psychiatrist who has made significant contributions to our understanding of the molecular mechanisms of addiction and depression. His research team explores the ways in which long-term exposure to stress or drugs of abuse changes gene expression and chromatin structure within the brain’s reward circuitry, leading to addiction, or depression-like syndromes. As Dean for Academic and Scientific Affairs, Dr. Nestler will oversee the School’s basic research enterprise and all aspects of the Graduate School of Biomedical Sciences, and will provide a bridge for the educational programs of the Graduate School and the Department of Medical Education. His broad scope of responsibilities will include significant involvement in strategic planning and goal attainment, program development, faculty recruitment and retention, research grant portfolio growth, and integration of the scientific enterprise into the larger School and Mount Sinai Health System.

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FACULTY

Research Roundup Cancer Screening Proves Valuable for Assessing Cardiovascular Disease Risk

Cancer Drug Could be Used to Treat Sepsis Tiny doses of a cancer drug may stop the raging, uncontrollable

Routine mammograms used for the early detection of breast cancer

immune response to infection that leads to sepsis and kills

may also provide women with an early warning of cardiovascular

up to 500,000 people a year in the United States, according to

disease, according to a recent study led by Laurie

research led by Ivan Marazzi, PhD, Assistant

Margolies, MD, Associate Professor of Radiology and

Professor of Microbiology. The new drug

Chief of Breast Imaging at the Dubin Breast Center

treatment may also benefit millions of people

of The Tisch Cancer Institute. Dr. Margolies’ research

worldwide who are affected by infections and

showed that nearly 70 percent of mammograms with

pandemics. The study, reported in Science,

breast arterial calcification correlated with the presence

demonstrates in both cells and animals that a

of coronary artery calcium. Calcium deposits in the

small dose of topoisomerase I (Top 1) inhibitor

coronary arteries can narrow arteries and increase the

can dampen an acute inflammatory reaction

risk of heart attack. Heart disease is the leading cause

to infection while still allowing the body’s

of death in women. This type of screening enables

protective defense to take place. The treatment

women to take early steps to improve their health. As Dr. Margolies says, “If we can find out information that’s indicative of heart disease, we can save even more lives.”

Biomarker Discovery Paves Way for Predicting Inflammatory Bowel Disease A multi-institute study has shown that years before inflammatory bowel disease (IBD) is diagnosed and symptoms exist, biomarkers are already circulating that can help predict risk not only of disease development but also of complications. Using clinical data obtained from the main data repository of the U.S. Armed Forces, researchers identified patients with a diagnosis of Crohn’s disease, and then retrieved pre- and postdiagnostic serum samples to assess the presence of antimicrobial antibodies. These markers have previously been shown to circulate in patients’ serum years before

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

The new drug treatment may also benefit millions of people worldwide who are affected.

may help control not only sepsis—deadly infections often acquired in hospital by patients with a weak immune system—but also new and brutal assaults on human immunity such as novel influenza strains and pandemics of Ebola and other singular infections.

Finding Clues to Preterm Birth Preterm birth is a leading cause of infant mortality, but the mechanisms that precede preterm labor remain elusive. Researchers led by Alison Sanders, PhD, a postdoctoral fellow in the Department of Preventive Medicine, found that increased levels of microRNA (miRNA) were directly related to shortened gestational periods. Dr. Sanders and colleagues at Harvard Medical School established a link between

diagnosis and have been associated with more severe

mercury and lead exposure and cervical miRNA

disease when identified at the time of or shortly after

expression. Their studies show the influence

diagnosis. This was the first study demonstrating these

miRNAs have on gestational age at the time of

markers and their progression using multiple samples at

delivery, and environmental contaminants that

different time points before diagnosis. “Acquiring mecha-

factor into miRNA expression. Improvements

nistic information on pre-clinical IBD can potentially

in preterm birth prediction could help to

uncover key pathogenic events, lead to the development of new therapeutic targets and inform predictive algorithms that could

better target therapies for pregnancies at risk for preterm delivery. In addition, novel interventions could

be used to define at-risk populations in whom to test these approaches,”

be designed to interrupt the cascade of molecular events that

said Jean-Frédéric Colombel, MD, co-senior author, and Co-Director of

occur to trigger labor and produce preterm birth.

The Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center and the Helmsley Charitable Trust Director of the Helmsley IBD Center, a hub for basic biomedical IBD research at Mount Sinai.

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A Safe Substitute for Diagnosing Pediatric Pneumonia

The Potential for Reversing Cardiac Fibrosis Through Gene Targeting

Chest X-ray is considered the test of choice for diagnosing

In a study published in the Journal of the American College of

pneumonia—the leading cause of death in children—but the WHO

Cardiology, Roger J. Hajjar, MD, the Arthur and Janet C. Ross Professor

estimates three-quarters of the world’s population

of Medicine and Director of the Cardiovascular

does not have access to radiography. Investigators

Research Center, together with a colleague at Gwangju

led by James Tsung, MD, MPH, Associate Professor

Institute of Science and Technology in South Korea,

of Emergency Medicine and of Pediatrics, have found

have found that the matricellular protein CCN5

that lung ultrasound can be highly effective and

reverses established cardiac fibrosis in heart failure

safe for diagnosing pneumonia in children and a

models. Cardiac fibrosis occurs when healthy cardiac

potential substitute for chest X-ray. By conducting

cells are replaced with fibrous connective tissue,

a randomized controlled trial in the pediatric

causing scarring and a stiffer and less compliant

Emergency Department at The Mount Sinai Hospital

cardiac muscle. It is an independent predictor for the

comparing lung ultrasound to chest X-ray in 191

progression of heart failure, which accounts for approx-

children, they found nearly a 40 percent reduction in

imately 450,000 deaths per year in the United States.

chest X-rays by performing an ultrasound first, with no missed pneumonia cases and no increase in any other adverse events. “Ultrasound is portable, costsaving, and safer for children than an X-ray because it does not expose them to radiation,” says Dr. Tsung. “Our study could have a profound impact in the developing world where access to radiography is limited.”

Going After an “Undruggable” Cancer Gene Genes related to RAS, a family of proteins, are

Our research is the first to demonstrate the ability to reverse cardiac fibrosis in heart failure models.

mutated in more than 30 percent of human cancers and represent one of the most sought-after cancer targets for drug developers. The lack of progress towards developing drugs that systematically target the RAS oncogenes have led many in the field to label

While there currently are no effective cardiac fibrosis therapies available, it is considered a valid target for treatment. “Our research is the first to demonstrate the ability to reverse cardiac fibrosis in heart failure models by targeting a specific gene,” said Dr. Hajjar. “These findings demonstrate that CCN5 may provide a novel platform for the development of targeted anti-cardiac fibrosis therapies, which could benefit many patients with previously untreatable heart failure.”

New Prostate Cancer Study Using Gold Nanoparticles The Mount Sinai Health System is one of only two test centers in the world collaborating with Philips Health Care to help refine fusion biopsy technology and develop applications for guided focal therapy—a

RAS an “undruggable” cancer gene. A study led by E.

treatment option that relies on targeted imaging that

Premkumar Reddy, PhD, Professor of Pharmacological

has been gaining acceptance by urologists to achieve

Sciences and of Oncological Sciences, has identified

cancer control and minimize damage to healthy tissue.

a new mechanism for targeting this important

We are now embarking on a gold nanoparticle directed

cancer gene, and, as Dr. Reddy says, “is a significant

focal therapy trial, the first one of its kind. In preclinical

breakthrough for the cancer field.” Dr. Reddy and a

studies, gold nanoparticles have been shown to provide

multi-institute team of scientists have identified the first small molecule able to inhibit the different signaling pathways

highly selective and rapid tissue destruction with minimal damage to surrounding tissue, enabling a potentially curative

activated by RAS oncogenes simultaneously. The discovered small

treatment of tumors with minimum toxicity. Gold nanoparticles are

molecule acts as a protein-protein interaction inhibitor that prevents

able to actively target and conform to areas associated with abnormal

binding between RAS and signaling proteins that turn a cell into a

tissue growth within the prostate. Ardeshir Rastinehad, MD, Associate

cancer cell. There is now potential to target the mechanism in the

Professor of Urology and of Radiology, is national co-principal

treatment of several RAS-driven cancers.

investigator of this study.

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Fa

FACULTY

&

Recognition   Awards

The Tisch Cancer Institute John Levine, MD, Professor; Chair, Clinical Trials Advisory Committee, Center for International Blood and Marrow Transplant Research Charles Shapiro, MD, Professor; Co-Chair, Osteoporosis in Cancer Guidelines, American Society of Clinical Oncology

The Kimberly and Eric J. Waldman Department of Dermatology Gary Brauner, MD, Associate Clinical Professor; Presidential Citation, American Academy of Dermatology David J. Goldberg, MD, JD, Clinical Professor of Dermatology; Chair, New Frontiers in Cosmetic Medicine Symposium; Co-Chair, Aesthetic Extender Symposium; Co-Chair, Five Continents Cosmetic Meeting; Presidential Citation, American Society for Lasers in Medicine and Surgery; Keynote Speaker, South Carolina Dermatology Meeting

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Emma Guttman, MD, Professor; Co-Chair, Inflammatory Skin Disease Summit; Co-Chair, Joint Symposium, International Psoriasis Council/ International Eczema Council, European Academy of Dermatology and Venereology; President Elect, International Eczema Council; Keynote Speaker, Society for Pediatric Dermatology; Keynote Speaker, California Dermatology Society; Keynote Speaker, Israeli Meeting of Atopic Dermatitis; Presidential Citation, American Academy of Dermatology Cindy Hoffman, DO, Adjunct Assistant Clinical Professor; Koprince Award, American Osteopathic College of Dermatology Mark Kaufmann, MD, Associate Clinical Professor; Chair, Resource-Based Relative Value Scale Committee, American Academy of Dermatology; President’s Award, American Society for Dermatologic Surgery

Faculty from across Mount Sinai have received significant honors in recent months.

Mark G. Lebwohl, MD, Waldman Chair of Dermatology; President, American Academy of Dermatology; Stuart Madden Lecture, Honorary Member, Canadian Dermatology Association; Presidential Lecture, National Medical Association; Honorary Membership, Florida Society of Dermatology and Dermatologic Surgery Jacob O. Levitt, MD, Professor; American Academy of Dermatology Presidential Citation, American Academy of Dermatology

Department of Developmental and Regenerative Biology Ross L. Cagan, PhD, Professor; Keynote Speaker, 20th Annual Scientific Symposium, Wilmot Cancer Institute; Keynote Speaker, 8th Annual Conference, Zebrafish Disease Models Society; Keynote Speaker, Protein Kinase Inhibitor Design and Screening Conference; Keynote Speaker, 2016 Grace Lecture, Center for Integrative Genomics, Switzerland Michael Rendl, MD, Associate Professor; Co-Chair, Skin and Hair Developmental Biology, Annual Meeting; State-of-the-Art Lecture, Annual Meeting, Society of Investigative Dermatology

Department of Emergency Medicine Saadia Akhtar, MD, Associate Professor; President and Chair, Clinical Pathophysiology Competition Committee, Council of Residency Directors Dan Egan, MD, Associate Professor; Chair, Remediation Task Force; Chair, Best Practices Committee, Council of Residency Directors Sigrid Hahn, MD, Associate Professor; Chair, Early Pregnancy Clinical Policy, American College of Emergency Physicians Jennifer Huang, DO, Assistant Professor; Co-Chair, Emergency Ultrasound Simulation Section, American College of Emergency Physicians Ula Hwang, MD, Associate Professor; Chair, Geriatric Committee, American College of Emergency Physicians

Andy Jagoda, MD, System Chair and Professor; Chair, Prehospital Management of Traumatic Brain Injury Task Force, Brain Trauma Foundation; Chair, Emergency Medicine Benchmarking Committee, Association for Academic Chairs; Co-Chair, Airway Credentialing Committee, National Football League; 50 over 50 List, City & State Media Company; Keynote Speaker, International Emergency Medicine Congress, Government of Qatar Stuart Kessler, MD, Associate Professor; Chair, Practice Management Committee, New York American College of Emergency Physicians Michelle Lin, MD, Assistant Professor; Presidential Scholarship for New Health Services Researchers, Academy Health Kevin Munjal, MD, Assistant Professor; Chair, Innovations in Emergency Medical Services Steering Committee, National Highway and Traffic Safety Association; Chair, Community Paramedicine Committee, National Association of EMS Physicians; Physician of Excellence Award, Regional Emergency Medical Services Council of New York City Devorah Nazarian, MD, Assistant Professor; Chair, Clinical Policy on Psychiatric Emergencies Committee, American College of Emergency Physicians Bret Nelson, MD, Associate Professor; Chair, Point of Care Ultrasound Community, American Institute of Ultrasound in Medicine Jeff Rabrich, DO, Assistant Professor; Chair, Emergency Medical Services Committee, New York American College of Emergency Physicians Michael Redlener, MD, Assistant Professor; Mission Lifeline EMS award, American Heart Association Lynne Richardson, MD, Professor; Chair, Advisory Committee to the Director Health Disparities, Centers for Disease Control and Prevention Kaushal Shah, MD, Associate Professor; Chair, Trauma Committee, Society for Academic Emergency Medicine; Chair, Education Committee, New York American College of Emergency Physicians; Co-Chair, Airway Credentialing Committee, National Football League Jason Shapiro, MD, Professor; Chair, Informatics Section, American College of Emergency Physicians Christopher Strother, MD, Associate Professor; President, Simulation Academy, Society for Academic Emergency Medicine James Tsung, MD, Associate Professor; Ultrasound Research Award, Society for Academic Emergency Medicine continued on page 64 »

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Mount Sinai’s patients experience illness, disease, surgery, pain—conditions that can disrupt a family, tear apart a life. When they come to Mount Sinai, they see something else: clinicians and surgeons whose expertise and compassion can provide relief and set patients back on a course of health and hope. But they may not see an equally essential component: the researchers whose science is offering new therapies, innovative tools, insights that transform our knowledge of disease. Mount Sinai’s mission has historically emphasized the collaboration among scientists and clinicians, because our founding leaders knew that the synergy between great minds will not only drive brilliant medicine, but also spark patients’ recovery. Here are 10 stories that show all these components—told through the eyes of our patients, who are at the heart of everything we do.

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hope

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

HOW BABIES AND MOTHERS MAY OFFER

uIBD Patients

Think diapers. If you’re pregnant, you know they’re coming. But could they truly change your life—and perhaps millions of other lives—for the better? For Emily, it’s one of her greatest hopes. BY SHEENA K. FALLON

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Emily, 28 weeks into her pregnancy, laughs easily, resting her hands on her round belly, as she describes how she and her husband are preparing for the arrival of their daughter. But for Emily, the future is more complicated than for other pregnant women. Emily has ulcerative colitis, a type of chronic inflammatory bowel disease (IBD), which causes inflammation, ulcers, and bleeding in the lining of the large intestine. Conception and pregnancy—the health of both mother and baby—can be complicated by the need to manage symptoms, ensuring that the disease is in remission.

Q

And Emily’s thoughts about the future don’t end at childbirth. Her chronic disease must be managed throughout her lifetime, and because genetic predisposition is a factor for IBD, her child has a higher risk of having it as well. For these reasons, she is part of a Mount Sinai program designed to address a full range of such concerns—and her participation is adding a new expectation to her pregnancy: she looks forward to what the future may bring for her and her daughter, a future where, perhaps, the discoveries made in the Mount Sinai studies may change her life. “I think it’s exciting that my daughter’s diapers will be used to potentially find a treatment for me, or— and hopefully this will not be necessary—to treat her,” Emily says. Emily is enrolled in a study whose acronym is based on the first fecal substance produced in utero by a fetus: MECONIUM (Exploring MEChanisms Of disease traNsmission In Utero through the Microbiome). The study’s goal is to explore what role IBD plays in the composition of the microbiome (the complex system of microscopic organisms and bacteria) in newborn babies and mothers, and whether there are particular bacterial strains that may increase the risk of IBD in offspring that could be prevented. Some studies show a higher transmission rate of disease from mothers with IBD as compared to fathers, implying that transmission of IBD from mother to baby starts in utero. The specific types of bacteria, along with the patterns of bacterial transmission between the mother and baby, determine the fetal immune composition as well as immediate and long-lasting health outcomes.

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As a researcher herself, Emily appreciates the research focus at Mount Sinai and the effect it has on her care. “I love having good data available so I know what my options are, especially as I’ve learned to become a more sophisticated reader of it, and to see my health in relation to that data.”

RESEARCH-BASED CARE Marla Dubinsky, MD, Co-Director of the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, and the IBD team at Mount Sinai have far-reaching research goals for their patients. “We would like all patients who walk through the front From left: Drs. Marla Dubinsky and Maria Theresa Mella, and patient Emily. door to be involved in research—to be able not only to advance the field on their own behalf, but also help the next generation of Dubinsky. “The footprint in the world of IBD recently diagnosed with IBD are evaluated patients diagnosed with IBD.” By engaging was essentially made here at Mount Sinai.” with the intention of personalizing an patients in behavioral research, clinical tri Mount Sinai manages IBD for approxiapproach to preventing disease progression. als, drug optimization research, microbiome mately 3,000 unique new patients every The goal for Mount Sinai clinicians is to research, or other areas, the IBD team seeks year and provides long-term follow-up for remain nimble in treatment strategies, to approach IBD from all angles. more than 7,000 additional patients at the adjusting treatment accordingly to respond To do so, Mount Sinai has assembled a Feinstein IBD Clinical Center. to disease progression. “We’re able to stratify multidisciplinary team whose collaborations IBD was once viewed as an intermittent patients into what we call ‘high risk of proin research have made the Health System disease, but clinical data have demongression to complication’—for example, a world leader in IBD understandstrated that it is actually a progresprogressing to surgery faster,” continues ing and treating the disease sive disease. Physicians at the Dr. Dubinsky. “We’re able to identify those [see sidebar, page 17]. Feinstein IBD clinic diagnose risk factors very early and because of the BY THE NUMBERS patients as early as possible, wealth of experience we bring to patients, THE HOUSE THAT especially as IBD patients we’re able to quickly assimilate all of their CROHN’S BUILT appear to have a window individualized characteristics and customize Approximate number Mount Sinai’s researchof opportunity early in the our approach to treatment.” of unique new IBD driven treatment of IBD course of the disease when Additionally, the individual approach to patients whom Mount is not a recent phenomtreatment is most effective. treatment at Mount Sinai is augmented by Sinai manages enon. “This is the house To prevent complications and psychosocial support, including behavioral every year. that Crohn’s built,” says Dr. progressive bowel damage, the health, nutrition, and other resources to Dubinsky, gesturing around her paradigm of treatment is shifting to encourage a patient’s self-management in her office. Mount Sinai’s research and early, effective intervention. But knowing and self-efficacy. “The ability to support clinical care in IBD are part of a tradition what therapeutic strategy to employ first and the patients, give them confidence and that dates back to the days of Burrill B. Crohn, at what dosage is not a clear-cut decision. self-management skills is really important,” MD. At Mount Sinai, Dr. Crohn and his adds Dr. Dubinsky. colleagues Leon Ginzburg, MD and Gordon INDIVIDUALIZED CARE Oppenheimer, MD performed research and “In one day we could have a hundred PERSONALIZED TREATMENT published a landmark 1932 article that first patients walking the halls here and each IN PREGNANCY described regional ileitis, which would later would have a different diagnostic approach One of the ways in which Mount Sinai transbecome known as Crohn’s disease. More and treatment approach. That’s what makes lates scientific laboratory discoveries in IBD than 80 years later, Mount Sinai physicians Sinai such a unique platform upon which into therapeutic interventions is through the working in IBD take pride in this history, we change the lives of people with IBD,” IBD Preconception and Pregnancy Planning and Mount Sinai’s renowned position in the Dr. Dubinsky says. Unlike the step-up or Clinic, which was designed for IBD patients field. “When we think about IBD patients, guideline-based approaches that are comwho are pregnant or considering pregnancy. we think about the history of IBD—not only mon treatment strategies for IBD, at the This clinic offers education on planning and Crohn’s but also ulcerative colitis,” says Dr. Feinstein IBD Clinical Center, patients maintaining a flare-free pregnancy as well

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

3,000

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as regular assessments, delivery guidance, and monitoring of therapeutics—and Emily’s experiences there have been welcome. “Part of what’s great about the work these doctors are doing is that pregnancy can sometimes look like ulcerative colitis— like if you have digestive problems,” says Emily. A clinic that understands conditions of pregnancy and of IBD can better manage the treatment of both, as well as any anxieties a patient may feel, which Emily appreciates. “The doctors are good at saying, ‘no, that’s actually a normal expression of pregnancy.’” The clinic has also worked with Emily to modify her treatment schedule for IBD to accommodate the delivery of her baby. “Often when a woman has a medical condition and becomes pregnant, the conditions are treated in isolation and not together,” says Emily’s obstetrician, Maria Teresa Mella, MD, Assistant Professor of Maternal-Fetal Medicine in the Department of Obstetrics, Gynecology and Reproductive Science. “The benefit of the IBD Preconception and Pregnancy Planning Clinic is that patients, especially pre-conception, come to see me once they are pregnant, leading to an open dialogue about IBD issues throughout the pregnancy. We also meet in the patient’s second trimester to discuss options for IBD treatment and what would be safest.” Emily receives Remicade® infusions every two months to keep her ulcerative colitis in remission, and Dr. Dubinsky and

Dr. Mella modifed her schedule to avoid an infusion during the last month of pregnancy, when there is the greatest chance for the medication to be passed to the fetus. Emily will receive an infusion before she leaves the hospital after she gives birth, so she doesn’t have to return after being discharged because, she notes, “It’s very hard to leave the house with an infant.”

THE FUTURE OF IBD “There’s no greater feeling than having someone like Emily come in wanting to get pregnant,” says Dr. Dubinsky, “and then getting her medication perfectly controlled so she could become pregnant, be pregnant, and deliver a healthy baby, contributing to the future of IBD through research.” Which brings us back to those diapers. Like Emily, Dr. Dubinsky is also looking to the future—but to the future of IBD research and prevention, and the results of the MECONIUM study. “Her baby won’t know quite what we’re doing and why. But let’s say that, as the baby gets older, she did have an at-risk microbiome marker. And let’s say that our studies with our other populations were able to create a prevention treatment, to be able to intercept a baby who may be at risk later on. It’s hard to think that could even be possible, but in fact it’s being done—and it’s pretty incredible. “And it’s all based here, in the house that Crohn’s built.”

UPDATE

WORKING TOGETHER IN IBD RESEARCH Multidisciplinary collaboration is the key to research successes at Mount Sinai. Some of the all-star researchers making breakthroughs in IBD include: Judy Cho, MD, Director, The Charles Bronfman Institute for Personalized Medicine, WardColeman Professor of Translational Genetics; Professor, Department of Medicine and Department of Genetics and Genomic Sciences Jose Clemente, PhD, Assistant Professor, Department of Genetics and Genomic Sciences and the Immunology Institute Jean-Frédéric Colombel, MD, Director, Leona M. and Harry B. Helmsley Charitable Trust IBD Center; Professor, Department of Medicine, Gastroenterology Jeremiah Faith, PhD, Assistant Professor, Department of Genetics and Genomic Sciences; Assistant Professor, Department of Medicine, Clinical Immunology Andrew Kasarskis, PhD, Vice Chair, Department of Genetics and Genomic Sciences and Co-Director, Icahn Institute for Genomics and Multiscale Biology Inga Peter, PhD, Assistant Professor, Department of Genetics and Genomic Sciences Bruce E. Sands, MD, Chief of the Henry D. Janowitz Division of Gastroenterology, Dr. Burrill B. Crohn Professor of Gastroenterology

Just before press time, Emily and her husband welcomed a healthy baby girl to their family. All are doing well.

Eric Schadt, PhD, Director of the Icahn Institute for Genomics and Multiscale Biology, Chair of the Department of Genetics and Genomic Sciences, and the Jean C. and James W. Crystal Professor of Genomics

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Keeping the

( HEART ) BEAT BY KATIE QUACKENBUSH SPIEGEL

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Dr. David Adams, a leader in mitral valve repair, heads a surgical team that performs more than 400 repair procedures a year. He is also dedicated to teaching mitral valve reconstructive surgery across the globe, and his research continues to advance the understanding of mitral valve disease. So, when a world-famous rock drummer needed to keep the beat, he turned to Dr. Adams. The mitral valve helps the heart keep its life-sustaining rhythm. Like a metronome... or a drum beat. When the left ventricle contracts, the mitral valve closes, forcing oxygen-rich blood to flow into the aorta and out to the body. Without the mitral valve’s constant opening and closing, the heart wouldn’t beat, and the blood wouldn’t flow. Since 1974, drummer Max Weinberg has done the same job for Bruce Springsteen’s E Street Band. A powerful and spectacularly steady player, Max has delivered thrilling performances that, for decades, kept the beat for The Boss. Known affectionately by fans as “Minister of The Big Beat,” Max was also a late night television personality for 17 years, collaborated with many renowned musicians, and, today, continues to tour the world.

The whole time, though, Max’s heart was failing to maintain the rhythm for his body. Since his mid-30s, his mitral valve had been failing. “I had been diagnosed at thirty-five, but I never really knew my malfunctioning valve was affecting me because of the demands of my particular job—your adrenaline while performing can mask symptoms,” says Max, who says he has always kept himself in top physical shape. “But in my fifties, I noticed that just climbing stairs on the stage to my drums was becoming more challenging.” In 2009, Max saw his longtime cardiologist, who told him the window of opportunity to intervene and take care of his valve problem was closing. He was 57. After an extensive nationwide search

for a valve replacement surgeon, Max was dissatisfied; all of the surgeons he met told him he’d have to lose his own valve. But if he had a tissue valve replacement, a procedure that uses bovine donor tissue, he would likely have to repeat the complex surgery later in life—perhaps even a few times, given his young age. And if he had a mechanical valve replacement, made of plastic, he would need a lifetime of blood thinners, and there was a good chance the valve would click, audibly, and constantly, as it opened and closed. As a drummer, he says, he couldn’t consider this an option. Then Max found David Adams, MD, Mount Sinai’s Marie-Josée and Henry R. Kravis Professor, Chairman of Cardiovascular Surgery, Cardiac Surgeon-inChief, Program Director of the Mitral Valve

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Max Weinberg (left) drumming with Bruce Springsteen’s E Street Band, and (below) with Dr. David Adams. Photo by Danny Clinch Photography

Repair Reference Center, and President of the Mitral Foundation. Dr. Adams told Max he was not going to discuss the possibility of a valve replacement with him as he was an ideal candidate to have his own valve repaired. He explained that the valve not only opens and closes but, as it does so, it squeezes the blood creating a torquelike velocity enabling the valve to work more efficiently. “Dr. Adams was the only physician who explained the importance of the squeezing action,” Max notes. At the end of their consultation, Dr. Adams asked Max what he did for a living. “I told him I am a rock drummer, and he said, ‘You don’t look like a drummer, you look like an accountant,’” says Max. “So I invited him to a show. Afterward, Dr. Adams was flabbergasted; he said, ‘You should not physically be able to do that for more than a few minutes, and you did it for four hours.’” “In Max’s case, having the valve repaired instead of replaced wasn’t only a survival issue but a quality of life issue,” says Dr. Adams. “If he had a mechanical valve replacement, he would have potentially listened to constant clicking while he’s

trying to play music. Having his own valve repaired was fundamentally important to his daily life.” In February 2010, Dr. Adams repaired Max’s valve in an intensive 12-hour surgery. Recovery from open-heart surgery is difficult, but Max says the procedure that saved his life was worth it, and hardly left a scar: “I had the best seamstress on the team!” “Our Mitral Valve Repair Reference Center is one of the highest volume centers in the world, and we have the infrastructure to carry out complex reconstructive procedures, and to follow and study patients after surgery to measure our outcomes and publish long-term data,” says Dr. Adams. “We have helped to establish the basic understanding of the outcomes of mitral valve repair in the current era, setting

benchmarks for which valves are repairable and how durable, safe, and effective repairs are.” Max says he feels lucky to have found Dr. Adams, whom he calls “the Bruce Springsteen of mitral valve surgery.” “I can conclusively tell you that I’m in the best shape of my life; I play four-hour shows, I’m touring the world, I exercise all the time, and my heart valve problem is behind me,” says Max. “Putting myself in the care of Dr. Adams and his team illustrated to me that the mechanics of mitral valve repair can be approached in a very artful fashion. And I can tell you that from the very bottom of my brand new, perfectly working heart, if not for Dr. Adams, Mount Sinai, and this surgery, I would not be standing here today.”

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016


Lung Cancer L

‘It’s Simple: Catch it Early’ BY DEBORAH SCHUPACK

arvey and Faith Edelman travel extensively, regularly walk three or four miles, and have been known to see more than one Broadway show in a day. At age 79, Harvey works full time at his dental practice and golfs when he can. The Philadelphia couple is so active that their daughter Laurie Edelman, who is an associate professor at Mount Sinai, calls them “bionic.” So they were not about to be sidelined when Harvey was diagnosed with lung cancer. “We don’t do sick,” says Faith, Harvey’s wife of 54 years. Shortly after his surgery at Mount Sinai to remove the cancer, the Edelmans were already walking to the park, and, perhaps even more challenging, to an Upper West Side staple. “People said to me, ‘You took him to Fairway?’” Faith recounts. “Whatever comes our

way, we’ll handle it. What’s your choice?” Harvey’s outcome exemplifies Mount Sinai’s pioneering approach to successfully treating lung cancer, which focuses on early detection and minimally invasive surgical treatment, and is making great strides in curing a particularly deadly cancer and preserving quality of life for patients. “He did beautifully,” says Raja Flores, MD, Chairman of the Department of Thoracic Surgery and the Steven and Ann Ames Professor in Thoracic Surgery, who performed the video-assisted thoracoscopic surgery (VATS) lobectomy, which removes the small tumor through three tiny incisions. “He’s cured and immersed back into his productive life.”

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Harvey Edelman and his wife, Faith (right). Harvey sharing a laugh with Dr. Raja Flores (below).

EARLY DETECTION TO COMBAT A DEADLY DISEASE Lung cancer is the leading cause of all cancer deaths in the U.S. and worldwide, and is too often caught once the tumor is too large to successfully resect. A surgery such as VATS lobectomy, which Dr. Flores has made the gold standard in lung cancer surgery, is possible only when the tumor is found at stage one, measuring about 1 to 2 centimeters. “Lung cancer becomes a curable disease when it By the Numbers is found early and treated,” says Claudia Henschke, MD, PhD, Director of the Lung and Cardiac Action Program THE CURABILITY PERCENTAGE OF and Professor of Radiology. CT-DETECTED STAGE ONE TUMORS WHEN “It is critical to find the ANNUAL CT SCREENING IS PERFORMED. cancer early.” Dr. Henschke and David Yankelevitz, MD, Professor of Radiology and Director of the Lung Biopsy Service, are renowned for changing the equation in lung cancer diagnosis. They were the founding investigators of the Early Lung Cancer Action Program (ELCAP), the first study to demonstrate that low-dose computed tomography (CT) scans can reliably diagnose early stage lung cancer in people at high risk for the disease. Before ELCAP, the prevailing methods of screening, such as chest X-rays, could seldom detect stage

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

80–90%

one tumors, which are the earliest and most treatable manifestations of lung cancer. Their groundbreaking work on screening has led to major advances in diagnostic guidelines and nationally and internationally. Among other findings, International (I)-ELCAP (the expanded version of ELCAP, with about 80,000 participants in 10 countries) found that annual CT screening led to more than 80 percent of lung cancers being diagnosed at the earliest stage, stage one, and that the curability of these CT-detected stage one tumors was between 80 to 90 percent, a vast improvement from just five – 10 percent curability today.

NEXT STEP: “HOW DO YOU BEST TREAT IT?” “As technology improves, you see things better,” says Dr. Yankelevitz, explaining that a CT scan can find not only nodules but also reveal information about emphysema, coronary artery disease, and other smoking-related illnesses, as well as breast diseases and osteoporosis. “Once you see things better, you have to figure out what to do with the information. The diagnostic part of our work is mature, but it’s not enough to diagnose. The question becomes, How do you best treat it?” This urgent question has prompted Mount Sinai’s Initiative for Early Lung Cancer Research on Treatment (IELCART), designed to transform the research methodology for identifying the optimal personalized treatments for early stage lung cancer. IELCART aims

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Mount Sinai has recruited a terrific team that has a real passion about early lung cancer work. The surgical team, radiology, pulmonary medicine, radiation oncology, epidemiology, immunology—we have all these pieces in one place that are important for taking the field further.”— Dr. Claudia Henschke

to answer such questions about how much lung should be resected for curative treatment given individual characteristics of both the patient and the cancer; when and to what extent mediastinal lymph node resection should be performed; if sublobar resection is to be performed, the minimal tumornormal tissue margin; and what nodules are best suited for “watchful waiting.” Says Dr. Flores, “For the patient’s sake, we want to be able to answer those questions now rather than waiting another ten years.” IELCART has begun recruiting patients within the Mount Sinai Health System and other institutions throughout the city, with the aim of further expanding to include partners globally. “This is a major initiative,” says Dr. Henschke. “It should revolutionize surgical treatment.” In Harvey Edelman’s case, his doctors at Penn Medicine in Philadelphia discovered several nodules on his lungs in an annual check-up following treatment for a previous cancer, thyroid cancer. The nodules were carefully monitored and no treatment was warranted until 2012, when one began to change. Harvey was referred to Dr. Yankelevitz, who biopsied the nodule and found it cancerous and determined the nodule which was changed was unrelated to the previous thyroid cancer. Dr. Flores then performed the successful VATS lobectomy. “Fortunately, the techniques and the technologies have improved so much in recent years,” says Harvey. Historically, a large thoracotomy incision was used to remove one of the lobes of the lung. This involved cutting major muscle groups in half and frequently removing a rib. But now, surgeons can remove the tumor—if it’s small enough—through a few small incisions and without spreading the ribs apart. Dr. Flores’ work in VATS lobectomy validated its effectiveness by demonstrating equivalent survival and recurrence rates with fewer complications and shorter hospital stays—usually, two days—when compared to standard thoracotomy. And because a person who has had lung cancer is at an elevated risk of getting the disease again, a surgery that removes less lung is key to their long-term survival; the patient is more resilient, able to handle another small resection, if another cancer develops.

THE PROMISE OF A TREATABLE ILLNESS The team believes the progress in lung cancer surgery will follow that of breast cancer, which, with early diagnosis, can be a treatable disease with preserved quality of life. “Treatment for breast cancer used to be radical mastectomy,” says Dr. Yankelevitz. “They would remove the entire musculature of the breast down to the bone. Over time that’s changed. Now, treatment can be a small lumpectomy and radiation, which is much less invasive. A similar approach needs to be done for lung cancer. That’s what we’re doing here, building a solid foundation of data to develop the best way to treat lung cancer. It dovetails completely with our screening program, because we’re finding it earlier and earlier.”

Dr. Flores notes that while 90 percent of prostate and breast cancers are found at a stage where they can be treated, fewer than 20 percent of lung cancers are identified at a curable stage. “If we can bump that up to as high as early detection rates for breast cancer and prostate cancer, you’ll see a lot more cures,” he says. “Lung cancer is the number one killer of men and women. If you really want to make an impact on cancer, make an impact on lung. It’s simple: catch it early.” For the Edelman family, including the couple’s three children and grandchildren, the impact is clear. “He’s my rock,” says Faith. “I can’t have anything happen to him.”

Dr. Claudia Henschke (left) and Dr. David Yankelevitz (right) are founding investigators of the Early Lung Cancer Action Program.

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016


M U LT I P L E M Y E L O M A

BUILDING BRIDGES for Patients BY DEBORAH SCHUPACK

Mount Sinai’s pioneering program in multiple myeloma is finding new treatment options— and helping to extend life. or more than 30 multiple myeloma patients enrolled in a complex clinical trial at Mount Sinai, a crossdisciplinary team of experts is bringing new hope in the face of a disease that is notoriously hard to fight. Multiple myeloma, a cancer of the bone marrow, is a unique shapeshifter that is made up of diverse clones of tumor cells, and, as such, is particularly challenging to treat and cure. Explains Sundar Jagannath, MD, Director of The Tisch Cancer Institute’s Multiple Myeloma Program: “As one clone proliferates and manifests itself as the active disease, you treat it and it goes down, putting the patient in remission. But then another clone, which has not been eradicated, comes up. And so on and so forth. Eventually, new clones emerge, which are much more resistant to chemotherapy.”

Urgent patient need for better therapies in multiple myeloma is coinciding with great promise in science and medicine: the ascendance of precision medicine through genomics and immunotherapy, two of the most exciting and innovative areas in biomedical research today. They are showing extraordinary promise and results in transforming the treatment of cancer through a greater understanding of human biology and disease mechanisms, the discovery of more precise molecular markers, and the development of more sophisticated treatments. Working at the intersection of genomics and immunotherapy, Mount Sinai clinicians and translational researchers are unlocking new treatment options for multiple myeloma patients, who currently face five-year survival rates of 48.5 percent, according to the National Cancer Institute.

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“IN PROJECTS LIKE OUR SEQUENCING TRIAL, THE WILLINGNESS OF OUR PATIENTS TO PARTICIPATE IS OUR GREATEST STRENGTH.” — Dr. Hearn Jay Cho “By integrating both the genomics and the immunologic analysis, we can take a more global approach—and it’s a more unbiased approach—in understanding what governs the development of multiple myeloma as a disease, what predicts response or resistance to particular types of therapies, and how can we use that information to apply the optimal therapy for a patient,” says Hearn Jay Cho, MD, PhD, Associate Professor of Medicine, Hematology and Medical Oncology, a researcher whose focus includes immunological therapy. FINDING SUCCESS FOR THE PATIENT: “GETTING TO THE NEXT MILESTONE” Mount Sinai recently launched a clinical trial at this intersection, for patients who have been diagnosed with and treated for multiple myeloma but have relapsed many times and are running out of options for further therapies. “Treatment of such patients is very challenging,” says Samir Parekh, MBBS, Associate Professor of Medicine, Hematology and Medical Oncology and of Oncological Sciences. “We ultimately

By the Numbers

48.5%

THE FIVE-YEAR SURVIVAL RATE OF

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

MULTIPLE MYELOMA PATIENTS

Dr. Samir Parekh: “More than half of our patients have gone on to significant milestones.”

hit a wall in terms of FDA-approved treatment options. Given that we have so many patients in this situation, I decided to collaborate with the genomics group and use their computational expertise to help us find treatment options for these patients.” Together with Dr. Jagannath and Eric Schadt, PhD, Director of the Icahn Institute for Genomics and Multiscale Biology and the Jean C. and James W. Crystal Professor of Genomics, Dr. Parekh designed the trial, which takes tumor cells from these patients, sequences their DNA and RNA with highend technology, and analyzes the sequencing data to determine what mutations are at work in the cancer. The doctors then seek to match the mutations to those present in other cancers for which there are FDAapproved treatments. The goal is to connect patients to these particular treatments, using them outside their current purpose. “This individualizes care, personalizes it to a patient’s disease and helps us direct the treatment very rapidly by repurposing the drug for this cancer,” says Dr. Parekh. While many research organizations are

also sequencing DNA material, Mount Sinai is at the forefront in sequencing RNA—valuable because it reveals the gene’s expression patterns and expands the possibility of finding a therapeutic match for the patient. Dr. Parekh’s team works closely with the laboratory of Joel Dudley, PhD, Director of the Institute for Next Generation Healthcare at Mount Sinai, Director of Biomedical Informatics at Mount Sinai’s Icahn Institute of Genomics and Multiscale Biology, Director of the Harris Center for Precision Wellness, and Associate Professor of Genetics and Genomic Sciences. Dr. Dudley is an expert in RNA sequencing and a recognized pathbreaker in the development and use of computational approaches for the repurposing of approved drugs to address unmet clinical needs. For more than half of the 30 or so patients enrolled in the multiple myeloma trial to date, Dr. Parekh and his team found suitable treatment options that would likely have eluded them without the sequencing trial. “These patients have gone on to significant milestones,” says Dr. Parekh, emphasizing that the treatments are not curative but rather buy time until more discoveries can be made. “Most of our approaches take them to the next big event in their lives—like attending a wedding or graduation—or to a clinical breakthrough, such as approval of the next drug or the next line of treatment. We’re really building bridges for them.” As the sequencing trial moves towards its goal of accruing about 50 patients over the next year, Dr. Parekh’s team is further refining researchers’ ability to match the right therapies to each patient. “We are developing software that recalls the treatments that we give and learns from it, in an artificial intelligence-based manner, to help make better and better predictions,” says Dr. Parekh, who was drawn to Mount Sinai because he could combine his background in hematologic malignancies with the Health System’s expertise in genomics.

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Dr. Sundar Jagannath: “It’s important to put the lab and the clinic together.”

“WE HAVE GREAT PATIENTS” None of this research in genomics or immunotherapy could be conducted without patient samples, and no new therapies could be assessed without a group of patients to participate in clinical trials. A world expert in treating multiple myeloma, Dr. Jagannath has built one of the largest and most revered clinical practices in the country. His expertise and reputation have enabled him to lead a practice that admits as many as 400 new patients per year. “In projects like our sequencing trial, the willingness of our patients to participate is our greatest strength,” says Dr. Cho. “We have great patients. They’re very educated, activist, and altruistic, and they understand that their participation in clinical trials now advances the state of the art. It means new drugs might be approved down the road.” Dr. Jagannath agrees, emphasizing that the research begins, literally, with the patient, as researchers use patients’ cancer cells (with each patient’s consent) to learn

Dr. Hearn Jay Cho: “Our patients are very educated, activist, and altruistic.”

what makes them work. Findings from the lab are immediately translated back to the patient, in the form of the right treatment at the right time for their particular cancer. “That’s why it is so important to put the lab and the clinic close together, and to have investigators who bridge both areas,” says Dr. Jagannath, who is also Professor of Medicine, Hematology and Medical Oncology. Together, Mount Sinai researchers are accelerating the development of novel therapies and personalized vaccines for multiple myeloma patients and coalescing a multidisciplinary group of exceptional translational investigators for the simple, but profound, goal of finding a cure. “All these approaches make it an exciting time in myeloma research and treatment,” says Dr. Jagannath. “We are poised to make a big difference in this disease. Patients come here thinking this is a death sentence, and we want to do the best for them. So we are excited that we are at the cusp of trying to find a cure for myeloma.”

Expanding the Team Bart Barlogie, MD, PhD, a world-renowned physician who introduced the first curative therapy for multiple myeloma, has joined The Tisch Cancer Institute as Director of Research in the Multiple Myeloma Program, representing a key next step in becoming a national leader in the field. By collaborating with Dr. Jagannath, he says, “We have a unique opportunity to move the field forward with our understanding of the underlying mechanisms that cause cells to become malignant.”

Why Sequence RNA?

Nucleobases

Base Pair

Helix of SugarPhosphates

RNA

Ribonucleic Acid

DNA

Deoxyribonucleic Acid

DNA contains the genetic instructions used in the development and functioning of every living cell. RNA acts as a messenger that relays genetic information in the cell so that the proteins required for processes needed for tissue to function properly can be correctly generated. Sequencing of DNA and RNA by Mount Sinai researchers captures the widest amount of data for analysis and possible matching of novel therapeutics for myeloma patients.

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NEW TREATMENTS FOR PHELAN-MCDERMID SYNDROME

A Family’s Story . BY ALISON DALTON

PHOTOGRAPHY BY ANDREW LICHTENSTEIN

Phelan-McDermid Syndrome is a genetically linked form of autism with symptoms that are frequently severe, low muscle tone, motor delays, insomnia, and epilepsy.

The Seaver Autism Center at Mount Sinai, which con-

ducts both fundamental laboratory research and clinical treatment, is currently investigating the effects of two drugs, IGF-1 and oxytocin, on patients with Phelan-McDermid Syndrome. Marc and Chardell Buchanan moved their family from Utah to New York so that their son, Ben, could participate in the treatment trials.

This is their story.

Q

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

including intellectual disability, delayed or absent speech,

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The Buchanan family with (center) Alex Kolevzon, MD, Clinical Director, Seaver Center: Marc (at left) with his son, Ben; Chardell, Ben’s mother, flanked by daughters Anna and Kate

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Ben is very sweet, very affectionate. He will walk right up to people in a grocery store and put his hand in theirs. Part of it is scary because he does like to run and he’s not scared of strangers, so he’ll go with anybody. Or he’ll go by himself; he’ll just run into the road. —Chardell Buchanan

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

When he was over two years old, we decided to do some genetic testing and found out that Ben has Phelan-McDermid. That was good and bad: Good, because we had a name for it, so we could find out more about it. Bad, because he was the only one in Utah.—Marc Buchanan

Babies usually smile by the time they’re a month old, and Ben didn’t. So I took him to the doctor, and the doctor kept telling me he was a late bloomer, I was a worrier. This was in Utah.—Chardell

When Ben was three, he started losing his skills. He was signing, but he lost all his signs. He couldn’t set blocks anymore. He wouldn’t go get his shoes. It was because he was having seizures. He would touch his eye and then zone out to where you couldn’t call him back. We didn’t even know that was a seizure.—Chardell

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Ben has never understood cause and effect. He’s never understood, for instance, that something falling down on him could hurt him—which is one of our biggest fears in trying to protect him.—Marc

We are working with families that are really dealing with a heavy burden, especially with the more severely affected individuals. In addition to the day-to-day challenges, the future can be a terrifying thing for the family. What happens when they’re not around?—Joseph Buxbaum, PhD, Director, Seaver Center

The people who are most severely affected need the most help but historically have not been part of research because it’s much harder. So we’ve developed tools, like specialized EEG and observational tools, to assess responses in those who can’t speak, who can’t tell us how they feel. —Dr. Buxbaum

The families are incredibly resilient but they’re living with these problems, every day. You’re thinking about the big outcomes, and of course they’re important, but I think it’s the small things, like being able to sleep, to watch a movie as a family, to have a day out.—Pilar Trelles, MD, Child Psychiatrist, Seaver Center

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Dr. Kolevzon and Ben, with Pilar Trelles, MD, Child Psychiatrist, Seaver Center

One of the things that influenced me to pursue research was to discover new treatments, which can actually affect whole populations of kids. Our work with Ben is a perfect example of the collaboration between our research scientists and our clinicians.—Alex Kolevzon, MD, Clinical Director, Seaver Center

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

We’re hoping for little things with the treatment trials—increasing Ben’s eye contact, maybe, so that we could somehow understand more what he wants, or just getting him to lift his leg so I can get his pants on. —Chardell

I am extraordinarily enthused about the results of the first IGF-1 trial. They exceeded our expectations. The frustration for us is that we want to do a much bigger study, but the costs are prohibitive. We want to do a study that’s big enough to be unequivocal.—Dr. Buxbaum

In the first IGF-1 trial, we saw kids gain skills, including things they’d never done before, like brushing their teeth, riding a scooter, holding a TV remote. In terms of functional outcomes, those are very meaningful. When I see those kinds of things, I get really, really excited.—Dr. Kolevzon

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At the Seaver Autism Center, clinicians get excited about the basic research science we do because they know it may lead to an effective treatment. And our basic research scientists, they’ll meet a family and hear about the challenges they face in day-to-day life. The family will walk up to them and shake their hand and say, “Thank you for what you’re doing.” And I can tell you, that is a strong motivation.—Dr. Buxbaum

I think the success of our clinical trials, the fact that these families stick with these studies—that speaks to the dedication of the families, but also to the effectiveness of our team in helping families feel supported through the process. We’re all very excited and passionate about the work that we do, and I think that comes across.—Paige Siper, PhD, Chief Psychologist, Seaver Center

One day Pilar was sick, and she called us at home from her bed because she was worried about Ben and she wanted to check on him. And Dr. Kolevzon gave us his cell phone number and told us we could call any time, even at night. —Marc

Everyone at Seaver has been phenomenal. Ben gets very happy when he knows he’s coming to Seaver. When we walk in it feels like a second home. We know they’re going to take good care of us. They go above and beyond. We know they care about us. —Chardell

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016


Promise ARTIFICIAL PANCREAS TRIALS HOLD

BY JESSICA COPEN

When doctor and patient share a disease, faith, trust, and enthusiasm can result. And a life-changing device may be transformational for millions.

t’s a bond forged, tested, and strengthened over nearly two decades, and not for the reason you might expect: Alecia Wesner and her doctor, Carol Levy, MD, both have type 1 diabetes. But ask Alecia if their shared diagnosis is at the heart of that bond, and she will shake her head. “At the end of the day, your doctor has to be someone you trust. Dr. Levy is both an incredible person and amazing doctor—and she also happens to have type one diabetes.” A veteran of two Artificial Pancreas (AP) system trials led by Dr. Levy, who is Director of the Mount Sinai Diabetes Center and Associate Professor of Medicine, Endocrinology, Diabetes and Bone Disease at the Icahn School of Medicine, Alecia lights up when she talks about the two trials; she is equally excited about future opportunities. For years she heard about research for the development of different kinds of devices

for people with diabetes, but none of them was based in New York City. “I think it’s really exciting they’re finally happening at Mount Sinai,” she says. “It’s something to celebrate.” There’s good reason for her enthusiasm. The AP system could be life changing because it takes a lot of the management onus off the shoulders of patients with the disease. Dr. Levy refers to the device as a “relief of burden” for patients. “The challenge for people with diabetes is that they need to check their blood sugar throughout the day to see what’s affecting their glucose levels,” Dr. Levy says. The attention required to calculate insulin doses based on food, physical activity, blood glucose levels, and other factors, such as menstrual cycles and stress, requires a great deal of physical, mental, and emotional stamina. Even the most meticulous person can’t perfectly match insulin doses to the body’s needs

all the time. And failure to maintain proper blood glucose levels can lead to life-threatening hypoglycemia, or low blood sugar, as well as other complications that can arise from elevated glucose levels. The AP device changes the game by becoming, in effect, the decision maker. For almost all patients, it provides improved blood glucose control with minimum effort, helping people avoid the perpetual tightrope they’ve teetered on for most of their lives. Combined with a tiny sensor and wearable insulin pump, a smartphone (with an algorithm acting like a mini computer), can stand in for a pancreas, automatically monitoring blood sugar levels and delivering insulin as needed. In fact, the smartphone-loaded program adjusts the dose, communicating with the pump via Bluetooth—using real-time data. “The system is user-friendly and that makes it likely to be widely used,” Dr. Levy says.

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Readings from the artificial pancreas are transmitted to a Control Algorithm Device.

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

DIY There’s a community of patients and their families, however, who are unwilling to wait for the FDA’s blessing. The movement has even spawned groups on Facebook and Twitter with the hashtag #Wearenotwaiting. Dr. Levy acknowledges that some tech-savvy people have been able to create AP devices that work well for them and their families, but the trend toward open-sourcing homemade devices and sharing algorithms makes her uncomfortable. “It’s great to be able to hack into a system to do all these things. But it’s not a one-size-fits-all. What works for one person with diabetes may not work for another. Besides,” she adds, “they haven’t gone through the hundreds of thousands of patient-hours of testing” that the InControl AP system has. For instance, in the trial that began in July, each person will participate for six months, and the entire study is expected to last through 2019. “Homemade devices have not been vetted in the same way,” Dr. Levy says.

It’s not a cure but it may be the next best thing. Alecia had “a renewed sense of hope,” she says, during the first trial because the device monitored and adjusted her nighttime basal insulin to maintain target glucose levels, which can dip dangerously. “I had five nights of testing a device that could make adjustments predictively in a way I cannot, especially while sleeping. I would have stolen the device if I could.” But like so many others with the disease, she must wait for the FDA’s final seal of approval. According to the U.S. Centers for Disease Control and Prevention, 1.25 million Americans have type 1 diabetes. Usually diagnosed in children and young adults, the disease is increasing worldwide, with an estimated 80,000 children around the globe diagnosed each year.

THE CLINICAL TRIALS This first AP study at Mount Sinai in 2014 was done in collaboration with the University of Virginia and the Mayo Clinic. It followed ten patients with type 1 diabetes for five days and was the first outside of the hospital study of an AP system in New York State. The second

study was conducted in partnership with the Rensselaer Polytechnic Institute, Stanford University, and the Barbara Davis Center for Diabetes at the University of Colorado; it observed participants over three days while they wore the AP system. Both studies were completed in controlled outpatient settings. Dr. Levy notes that though there was never a shortage of trial participants, for both volunteers and staff these are labor-intensive studies. Yet patients and the study team are still willing to contribute whatever is needed to keep the research moving forward. The study that just opened will be one of the largest long-term clinical trials of an artificial pancreas in the U.S. Mount Sinai is one of ten sites throughout the world participating and sharing a $12.7 million grant from the National Institutes of Health. The trial, which began in July 2016, will evaluate the system over a longer term for people on the device at home, going about their normal daily routines. Dr. Levy says the ultimate goal of the two-part study will be to establish the safety and efficacy of the InControl AP system for FDA approval and accelerate its introduction to the market.

“This is something that could benefit the quality and longevity of my life, and the lives of my peers. The impact the device could have for everyone touched by type one diabetes is momentous.” – ALECIA WESNER

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HOW DOES AN ARTIFICIAL PANCREAS SYSTEM WORK?

1

CGM Censor

Continuous glucose monitoring (CGM) sensor is inserted under the skin to continuously measure blood glucose levels in the patient’s body fluids.

2 CGM Receiver CGM receiver displays the updated readings as graphs and trends minute by minute, and translates readings from USB to Bluetooth.

Deliveri ng 180 IU

A SPECIAL RELATIONSHIP For Alecia, like so many others, FDA approval for the InControl AP system can’t come soon enough. “This is something that could benefit the quality and longevity of my life, and the lives of my peers. The impact the device could have for everyone touched by type one diabetes is momentous.” An activist for finding a cure, she’s a New York City board member for the JDRF, the leading charitable funder of type 1 diabetes research, and a well-known public speaker. Alecia also participates in the JDRF’s 100-mile bike rides. “I’ve had type one diabetes for thirty-seven years and I feel strongly that my life is a gift. Participating in clinical trials is a way of giving back, with the hope of helping provide a better a future for all of us living with type one.” Alecia cites her trust and faith in Dr. Levy as the core of their connection; for the doctor, it’s her patient’s enthusiasm that stands out. “Without patients like Alecia, these studies couldn’t be done. She’s lovely, hardworking, and a straight shooter who will tell you when she’s not happy and when she is.” They became even closer during the first two AP trials. “During one of our studies, it was three in the morning and I had to wake up Alecia to check her blood sugar. Both of us were in our pajamas, no makeup with our hair pulled back,” she recalls with a smile. “It was an experience.” Alecia agrees. “It was shocking for a second or two when Dr. Levy woke me in the middle of the night to check my blood glucose level. Then I remembered where I actually was—and why—and I laughed, as these are unique moments in pushing medical technology forward.”

4

Insulin Pump

The CAD communicates with a body worn insulin pump that automatically administers the correct insulin dose via a cannula inserted in the skin.

Insulin 180 IU

3

Control Algorithm Device (CAD)

Readings are sent to a control algorithm device (CAD)—e.g., a smartphone, tablet, or PC— where an algorithm analyzes them and calculates the correct insulin dose, if required.

Patient Alecia Wesner (far left), and Dr. Carol Levy (center), with her team: (standing, from left) Y. Sally Xie, MD; Selassie Ogyaadu, MD, MPH; David Lam, MD; Georgia Kulina, MD; (seated, from left) Elizabeth Burtman, MD; Camilla Levister, NP, CDE.

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OLD DRUG, NEW USE? The possibility of ketamine

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

BY ELIZABETH CHUTE

ew clinical research that points to a potential at the Yale School of Medicine, resulted in the first U.S. patent—held breakthrough in treating depression is occurring at jointly by Mount Sinai, Yale University, and the NIH—based on the Mount Sinai, where researchers at the Icahn School anti-depressant effects of ketamine in treatment-resistant depression. of Medicine are paving the way for a new treatment Securing a patent led to the next step in researching the drug’s that could provide hope for a significant number of use as a treatment: a license to develop it, granted to pharmaceutical people suffering from the oftencompany Janssen, which is conducting large-scale crippling mood disorder. clinical trials and developing the drug for FDA The discovery that the drug ketamine—first approval. Now in phase three of the trials, the drug synthesized in 1962 and used widely since could be approved as a treatment for depression and then for anesthesia—may relieve the symptoms ready for use with patients as early as 2018 or 2019 if of serious depression has been described successful. by many as potentially the most significant As a drug long approved for use in humans, advance in depression research in decades. ketamine is well known to medical practitioners. It Still to be approved by the U.S. Food and Drug is a quick and effective anesthetic for surgery, and Administration for this new purpose, it is the focus is commonly used in veterinary medicine. It lives of ongoing clinical research that will ultimately in another marketplace as well: known colloquially determine its safety and efficacy for treating as “special K,” it is a drug of abuse, taken for its Dr. Dennis S. Charney depression or other serious mood disorders. hallucinogenic effect in larger doses. Ketamine affects glutamate, a neurotransmitter PATH TO DISCOVERY in the brain, by blocking a receptor called the NMDA receptor. In Mount Sinai researchers have played an instrumental role in this way, it works differently from traditional anti-depressants, such discovering that ketamine can treat depression that is otherwise as SSRIs (selective serotonin reuptake inhibitors), according to Dr. resistant to medication and therapy. Research led by Dennis S. Charney. All currently available antidepressants work primarily Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School via actions on serotonin and norepinephrine and require regular, of Medicine at Mount Sinai, and John Krystal, Chair of Psychiatry repeated doses before they begin to have an effect on symptoms.

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There is often a delay of several weeks or even several months before a standard antidepressant medication begins to reduce depression symptoms in patients. In stark contrast, ketamine has been shown to start to reduce depressive symptoms within a few hours or days. It is this dramatic departure of ketamine from standard antidepressants that has both researchers and patients taking notice. Originally interested in the studying the role of glutamate, Dr. Charney and researchers decided nearly two decades ago to probe its function in patients with serious depression by looking at the patients’ response to ketamine. “We were not expecting that it would be a treatment for depression,” he says. “When we conducted the study, we found to our surprise that a single dose of ketamine produced a rapid antidepressant effect—within hours—in patients with serious depression.”

THE SINAI TRIALS

Extending the effects of ketamine is critical for treating patients, says Dr. Murrough. He points out that ketamine is not necessarily a cure for depression, which is a chronic disorder similar to conditions like diabetes, hypertension, and Alzheimer’s and requires ongoing treatment. “Ketamine may become an important part of a patient’s treatment if it gains approval for this indication [depression],” says Dr. Murrough. “For patients with serious and persistent depression, a combination treatment strategy that includes psychotherapy and other medications will likely yield the most durable benefit.” Translational research focused on new mechanisms of action is key to developing the drug as a treatment for depression, he says. “We know a lot about ketamine, but we don’t know yet how the story ends, what a treatment regimen will look like. Taking the scientific discoveries from basic neuroscience research to new treatments for patients is our ultimate goal.” Researchers have extended the original findings to studies in four areas: combining lithium with ketamine to extend the antidepressant effect; studying its effect on suicidal thinking; evaluating it as a treatment for post-traumatic stress disorder; and giving ketamine via an intranasal route—rather than by intravenous infusion, as all previous studies had done.

Ketamine’s quick and positive effect on depression symptoms is the focus of the ongoing clinical trials at Mount Sinai, led by Dr. James Murrough, Director of the Mood and Anxiety Disorders Program at the School. In one active study, which includes a testing protocol lasting eight to 12 weeks, patients are selected to participate because they have not responded to other types of antidepressant treatment; they are given weekly infusions of ketamine for the first few weeks. Trial participants are also screened SEEKING APPROVAL for any history of drug abuse, given ketamine’s TO OFFER HOPE history as a recreational drug. Ketamine may have appeal to potential patients “Patients who respond to ketamine report for two outstanding reasons: it works quickly, and a profound lifting of negative thoughts and it may be effective where other treatments have feelings, and a marked increase in their ability failed. Clinicians are also hopeful that, if approved to experience positive emotions,” Dr. Murrough by the FDA, the drug may bring long-term relief explains. The effects can be seen almost for some of their patients. immediately following treatment, and can last “Depression is set to be the leading cause of days, weeks, or even months in some cases. disability world-wide—it is critical that science and Perhaps most striking, patients who suffer medicine catch up with this massive public health suicidal thinking may experience rapid relief need, and do so quickly,” says Dr. Murrough. from these thoughts, according to Murrough. This is the first hope for a truly novel treatment – DR. JAMES MURROUGH A member of the current Mount Sinai research for depression that the field has seen in years, team, Drew Kiraly, MD, PhD, who is Chief the team believes. Right now several companies Resident for Research in the Department of are making significant investments in order to Psychiatry Residency Program, notes, “After twenty-four hours, a lot study ketamine or ”ketamine-like” drugs as potential new, more of patients say this is the best they’ve felt in years…Finally, there is a effective treatments. sense of relief and of feeling free of the symptoms.” “While the regulatory process has yet to be completed, there is As part of the study, lithium is combined with ketamine in good reason for optimism,” says Dr. Murrough. “Delivering ketamine order to study how these two drugs work together—with hope of or related medications to patients in the clinic will represent a true extending ketamine’s antidepressant effects, which tend to wear off breakthrough in depression treatment, and will represent a milestone after about two weeks. in drug discovery for psychiatry and behavioral health.”

“Patients who respond to ketamine report a profound lifting of negative thoughts and feelings, and a marked increase in their ability to experience positive emotions.”

Note: Dr. Dennis Charney is a named co-inventor on a patent for the use of ketamine as a treatment for depression. Icahn School of Medicine at Mount Sinai licensed this patent and will receive payments related to the use of ketamine for the treatment of depression. Dr. Charney is entitled to a portion of these payments. Dr. Murrough is not named on this patent and will not receive any royalties related to ketamine for the treatment of depression. Dr. Murrough is a co-inventor on a patent application pending for the combination of ketamine and lithium to extend the antidepressant effect of ketamine and for the treatment of suicidal ideation.

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PRESERVING

‘WhoYou Are’ New Treatment Paradigm for Cancer of the Throat

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

BY DEBORAH SCHUPACK

E

ugene Bryant’s perspective on life is hard won. The longtime construction worker and contractor has seen New York from 60 stories in the air and, working on tunnels under Grand Central Station, from 250 feet below ground. His recent treatment for throat cancer and his subsequent good health are integral to that perspective. “Life is good,” says Eugene, 54, enumerating his day-to-day pleasures—golfing, mowing his lawn, visiting with his grown daughters, and playing with his young grandson. “I’m on the right side of the grass.” In July 2014, he went to the doctor for flulike symptoms and swollen glands, one of which remained swollen even after a course of antibiotics. After several months, and visits to “every doctor in the world,” he received a diagnosis: oropharyngeal (throat) cancer. “It was like someone stabbed me. My heart

stopped,” he recalls. “Then I decided, Okay, how do I fix this?” Eugene was referred to Eric Genden, MD, MHCA, FACS, the Isidore Friesner Professor and Chairman of OtolaryngologyHead and Neck Surgery and Professor of Neurosurgery and of Immunology, who found him to be an excellent candidate for a pioneering clinical trial involving TransOral Robotic Surgery (TORS) and a lowered dose of radiation treatment, designed to preserve quality of life for people with his particular cancer. “Because this cancer affects the head and neck, it affects speech, taste, cosmetic appearance, ability to socialize,” says Dr. Genden. “It affects the very core of who you are. Many of the therapies traditionally used to treat these patients may achieve cure but decimate quality of life and function. We have an epidemic of younger patients, who are going to live a long time, so we are faced with the question, What is the best approach for them?”

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’

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Patient Eugene Bryant (center), with the doctors: (from left) Thomas Kraus, Eric Genden, Brett Miles, Krzysztof J. Misiukiewicz, Vishal Gupta, and Marshall Posner.

SKYROCKETING EPIDEMIC The incidence of throat cancers associated with the Human Papilloma Virus (HPV), which also causes cervical cancer in women, has skyrocketed to epidemic proportions in recent years among men in their 40s and 50s, says Dr. Genden; previously, the typical patient with throat cancer was age 70 or older and likely to be a smoker and heavy drinker. The current standard of care for HPV-related oropharyngeal cancer is chemoradiation, which can be extremely toxic. It can cause significant health, cosmetic, and quality-of-life side effects, can elevate the risk of subsequent radiationinduced cancer, and can eventually leave a patient dependent on tubes for feeding or breathing. At Mount Sinai, surgeons perform an innovative minimally invasive robotic surgery that allows them to tailor therapy and reduce the dose of radiation in selected cases, improving function and quality of life. The surgery also spares the lip and jaw by entering the mouth robotically and removing the tumor with a laser, which is much quicker and less disfiguring than invasive

surgeries of the past. In fact, patients can operative treatment and reduce toxicity for return home and resume eating normally the better long-term outcomes. next day. “This is a young population who can live This surgery and another twenty to forty subsequent treatment years after their cancer. are at the heart of a Although radiation proves BY THE NUMBERS pioneering clinical trial curative, the long-term that aims to change consequences can be the equation for HPVsevere,” says Dr. Posner, Number of robotic associated throat cancer. citing several: scarring, surgeries performed Developed by two noted fibrosis, disintegration of at Mount Sinai for oncologists—Marshall teeth, bone destruction, oropharyngeal cancer. Posner, MD, Professor of and even carotid stenosis, Medicine, Medical Director which can increase risk of the Head and Neck of stroke. “These effects Number of patients to Oncology Center, and are essentially dependent date who have entered Associate Director of the on the dose of radiation the SIRS trial. Center for Personalized delivered. The primary Cancer Therapeutics, purpose of the SIRS Trial and Brett Miles, DDS, is to demonstrate the MD, Associate Professor feasibility of giving no Likely cure rates for of Otolaryngology and radiation in some cases, early stage HPV-related oropharyngeal cancer. Assistant Professor of or reducing the dose.” He Dentistry—the Sinai emphasizes that patients Robotic Surgery Trial in are carefully screened and HPV Positive Oropharyngeal Squamous Cell observed, to make sure they are appropriate Carcinoma, or SIRS Trial, uses information for the trial and are getting the right reduced gleaned from surgery to improve postor eliminated dosage.

500 32

85–90%

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“One of the things that makes Mount Sinai a terrific place to innovate is its creative progressive approach to taking care of patients—dating back to the advent of many surgeries developed here at the turn of the century. These kinds of trials, which require that we engage many different disciplines, push medicine forward.” – Dr. Eric Genden

PUTTING THE PATIENTS FIRST Vishal Gupta, MD, Associate Professor of Radiation Oncology, a key part of the clinical team, explains that the patients’ needs have been at the heart of the trial from its very inception. “When I would follow up with patients who’d been treated traditionally, many of them would have these symptoms—difficultly eating, dry mouth, bone destruction,” he says. “That’s what prompted this, the belief that we should try to do something better for our patients.” For Eugene, the surgery and subsequent therapy—25 courses of radiation instead of 32, as well as five courses of chemotherapy— mean that he not only is facing a better long-term prognosis but also could work while undergoing treatment. “Work in the morning, hospital in the afternoon, then home to bed,” he recounts. “I was tired, but I didn’t lose any work.” Preliminary data for the trial, which is still enrolling patients, show promising results: reduced side effects, excellent quality of life, and cure rates comparable to standard-ofcare therapy. The team has performed more than 500 robotic surgeries for this cancer, and 32 patients to date have entered the SIRS Trial. This preliminary analysis of the enrolled patients leads the investigators to believe that in early stage HPV-related oropharyngeal cancer, cure rates are likely to approach 80 to 90 percent.

for HPV-associated head and neck cancer. Monoclonal antibodies are natural and manmade proteins that can bind to substances in the body, such as cancer cells, and be used to deliver therapeutic or diagnostic matter directly to these cells. Mount Sinai is well positioned to develop monoclonal antibodies more rapidly and efficiently than ever. “We have very sophisticated, highly automated facilities,” says Dr. Moran, Director of the Center for Therapeutic Antibody Development and Professor of Microbiology and of Immunology. “We can make monoclonal antibodies twice as fast as it used to be done, and that’s no exaggeration. Coupling the technology that we have developed with the available clinical samples and the expertise of our clinical staff here at Mount Sinai—it’s just a great team effort.” Dr. Kraus, Assistant Professor in the Experimental Therapeutics Institute, agrees. “It’s crucial that we’re all here together at Sinai—our high-level antibody facility, the clinicians, the pathologists, and the patients. It starts with the patient. With the patient’s consent, we can use the excised tumor as an immunogen to generate antibodies. The pathologists verify the specificity of the antibodies for binding to tumors. The validated antibodies may then be used by the clinical team in the diagnosis and treatment of their patients.”

ADVANCING RESEARCH TO ADVANCE TREATMENT At Mount Sinai’s Experimental Therapeutics Institute, a team of pioneering scientists led by Thomas Moran, PhD and Thomas Kraus, PhD is developing monoclonal antibodies to advance noninvasive diagnostic methods and highly targeted therapies

HELPING PATIENTS NOW There is an urgency to Mount Sinai’s advancing the frontiers against HPVrelated head and neck cancer because the numbers continue to rise; the National Cancer Institute expects that, if current trends continue, the number of men with HPV-associated head and neck cancer will

exceed the cases of cervical cancer in women by 2025. “You’ve got this new disease with this new treatment and this innovative trial all coming together at one time, early in the disease process,” says Dr. Genden. “That’s very exciting. We’re not waiting twenty years to see how we can help these patients. We’re helping them now.” Says Dr. Miles, Principal Investigator of the SIRS trial, “It’s very gratifying to give patients not only a cure but also a good quality of life, the ability to continue working, socializing, living their life.” Eugene, for one, is happy with the results. “Cancer treatment is so much less invasive now,” he says, noting that his father and grandmother died of cancer. “I mean, I went to work every day. Even five, six years ago, people weren’t doing that. I feel lucky that I wound up in this program.” Formerly an avid cook, he does mourn the loss of his acute sense of taste, but he has little difficulty eating, swallowing—or maintaining his sense of humor. “I’ve told my children I’m going to live long enough to be a burden on them,” he says with a smile.

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016


PARTNERS vLIFE Investigating solutions to transplantation failure— and preventing it—requires partnership. BY RHIANNA MORRIS

llen Skolnick has her sights set on a vacation in the Galápagos Islands with her husband, Rob, and daughter, Rebecca. As a seasoned traveler and an animal lover, Ellen has dreamed of visiting the equatorial islands and seeing the unique species that inspired the theories of Charles Darwin. But planning a trip there is not as simple as arranging a hotel, booking flights, and checking on Rob’s and Rebecca’s work schedules. Ellen has the additional tasks of researching the hospital facilities available in Ecuador and convincing her team of doctors at Mount Sinai that her body can handle the adventure. “One of my doctors said I couldn’t go. But I want to go. He said I should go to Europe; that I should go to Italy because it tastes better. I would just love to see the animals.”

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TWO TRANSPLANTS Ellen enjoys bantering with her doctors, but after 30 years, she knows to heed their advice. Starting in the mid-1980s with a diagnosis of diffuse scleroderma, a connective tissue disease, Ellen has developed a close, strong relationship with Mount Sinai. Her health concerns required it: The scleroderma ravaged her kidneys, requiring her first graft (organ) transplant in 1992 and because of that graft’s failure, a second one in 2000. Prior to each transplant, Ellen was at Mount Sinai multiple times per week to receive life-saving kidney dialysis. BY THE NUMBERS Post-transplant follow-up and care require regular visits as well, so the halls of Mount Sinai have become as familiar as those of her home; her doctors have become extended family. “Love” and “amazing” are words that come up often when she talks about the doctors who have cared of all transplanted for her and who she remains connected to. grafts fail within But there is more than familiarity to the 11 YEARS. relationships. “I work with them as my partners,” Ellen says. “My doctors want me to be there for them as much as they are there for me. They want me to understand patients are what’s going on with my health, and when I don’t understand, they answer all my added to the questions. There is no question too small national wait list or ridiculous, and there is always someone, EACH MONTH. sometime, somewhere, who’s going to answer me.” This partnership for life enabled Ellen to finally take Rebecca to Disney World after the second transplant; it has allowed her to watch Rebecca grow up and become an accomplished clinical psychologist; it has allowed her and Rob to become typical New Yorkers, enjoying the City’s dining scene and regular trips to the symphony; and it has given her an independent life—a gift transplant patients do not always have.

50%

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

3,000

WHEN TRANSPLANTS FAIL For although nearly 100 percent of transplant patients and their grafts survive after one year, half of all transplanted grafts fail within 11 years. Second transplants are generally considered risky and call for much higher doses of immunosuppressant drugs. The demand for transplants is also always very high—3,000 patients are added to the national wait list each month, and the average wait for a first transplant is nearly four years. Improving the long-term survival of the first graft is a top priority for those in the transplant community. “Ellen demonstrates how the success of transplantation transforms lives. She also reminds us that we could do better. If we had better research tools at our disposal, then our hope is that she would not have had to lose the first kidney,” explains Barbara Murphy, MD, Chair of the Department of Medicine and Murray M. Rosenberg Professor of Medicine at the Icahn School of Medicine. Dr. Murphy was also Ellen’s transplant nephrologist during the period of her second transplant. PERSONALIZED MEDICINE AND RESEARCH Progress in research tools has been limited by the fact that organ transplantation has not yet benefited from the discovery and application of personalized medicine. Currently, treatment regimens for transplant patients still largely follow a one-size-fits-all approach, rather than a precise, individualized one. There is great potential for personalization in assessing which patients might be at risk for graft failure and for tailoring the heavy doses of immunosuppressants that a transplant patient receives after surgery. This potential drives the work of Dr. Murphy and her colleague Peter S. Heeger, MD, Director of Transplant Research. Their combined research efforts constitute one of the best-funded National Institutes of Health transplant research groups in the country. “The goals of the research that Barbara and I undertake are to define and identify graft-failure risk factors and testing strategies for transplant patients,” Dr. Heeger says. “We want to be able to change the

“My doctors want me to be there for them as much as they are there for me. They want me to understand what’s going on with my health, and when I don’t understand, they answer all my questions.” — ELLEN SKOLNICK

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DR. BARBARA MURPHY

“Ellen demonstrates how the success of transplantation transforms lives. She also reminds us that we could do better.” — DR. BARBARA MURPHY

therapies for individual patients to make it such that their one kidney transplant will last for their lifetime.” Using genetic and genomic techniques, Dr. Murphy has recently made headway with a study that has the ability to predict the development of kidney fibrosis—a common cause for graft loss—through a gene expression profile. The hope, Dr. Murphy points out, is that before damage even begins, patients “would have their immunosuppression and treatment modified, even using some new therapies, to prevent the development of fibrosis so that we can slow or prevent the graft loss.” This first-of-its kind finding was published in July in the prestigious medical journal The Lancet, and it has the potential to change how all kidney transplant patients are monitored and managed. An opportunity for early intervention would mark a significant breakthrough in transplant research and care, as doctors might eventually be able to change the treatment approach in order to prevent fibrosis from progressing.

“We have an outstanding clinical transplant program, a center of excellence, which performs two hundred kidney transplants a year,” Dr. Heeger notes. “And we also have investigators who are committed to identifying those individuals who are likely to have good outcomes over the long run, and to identify those people who are at risk for losing their grafts. It’s a very interactive, cross-disciplinary system. We start off in animal models, we define mechanisms, and we work directly with our clinician partners to translate our discoveries into clinical trials. We are better than anyone else in country at doing this sort of translational work.” Ellen’s first transplant fell within the expected window of failure. But thanks to a strong living-donor match for her second transplant, her younger brother David, Ellen has overcome the statistics at 16 years and counting and takes pride in the partnership she has formed with her Mount Sinai caregivers, such as Dr. Murphy. It’s what has allowed her to dream of seeing the blue-footed boobies and magnificent frigatebirds just like Darwin. “You have to be able to get back into the swing of things and do something that makes you happy,” Ellen says. “I know that my Mount Sinai partners will do all that they can to help me with that.” DR. PETER HEEGER

ANOTHER PARTNERSHIP: RESEARCH AND CARE That connection—that partnership—between research and care defines the success that Drs. Murphy and Heeger have had at Mount Sinai and inspires their research that aims to save lives.

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Challenging

CON VE

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When Mount Sinai urologist Howard Schiff, MD (center) was diagnosed with a lifethreatening case of prostate cancer, he and his colleagues William Oh, MD (right) and Ashutosh Tewari, MD (left) decided to do something unconventional. Their approach could help change the way we think about treating the disease. It wasn’t what he expected. BY TRAVIS ADKINS

E NT IO N 49

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W BY THE NUMBERS

1 in 7 Prostate cancer is the most common men’s cancer in America, affecting 1 in 7 men.

2.3 min A new case of prostate cancer occurs every 2.3 minutes.

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

Source: American Cancer Society and Prostate Cancer Foundation

hen Howard Schiff, MD went to his doctor in 2013 to be examined for back pain, the last thing he thought he’d hear was a diagnosis of metastatic prostate cancer. A urologist at the Mount Sinai Health System for more than 36 years, Dr. Schiff is a firm believer in practicing what he prescribes: he’s vigilant about having his levels of PSA—the telltale protein that, when elevated, often indicates prostate cancer— checked every year. But when an MRI scan showed evidence of metastatic cancer on his spine, Dr. Schiff understood immediately what he was up against. “Because I’m a urologist, and because of the location and description of the tumor, I knew right away that this was most likely metastatic prostate cancer, even though my PSA levels had been normal up until that time,” says Dr. Schiff. “So I went back to my office and had someone draw a PSA test on me.” Many doctors consider any PSA level above 4 to be possible evidence of cancer; in one year, Dr. Schiff’s levels had gone from 2.5 to 76. Out of the blue, Dr. Schiff found himself diagnosed with an advanced stage of the very disease that he has spent much of his life preventing. Subsequent CAT and bone scans showed the cancer had spread to his pelvis, right hip and leg bone, spine, and ribs. The long-term survival rate for metastatic prostate cancer this aggressive, Dr. Schiff knew all too well, was extremely low—but that’s where his case took another unexpected turn. Thanks to a highly personalized and unorthodox treatment plan he devised with his Mount Sinai colleagues William Oh, MD and Ashutosh Tewari, MBBS, MCh, Dr. Schiff’s cancer is in remission, and he’s back to doing what he does best: keeping his patients—including himself—healthy and cancer-free. The most surprising part? His treatment didn’t involve an experimental drug or untested therapy—just the willingness to do things differently with the techniques at hand, the expertise to make it work, and the courage to take a chance.

BREAKING WITH THE STATUS QUO Immediately after his diagnosis, Dr. Schiff went on a course of hormone therapy—the standard first line of defense for advanced prostate cancer—that succeeded in lowering his PSA count to an undetectable level within six weeks. According to the usual standard of care, Dr. Schiff should have continued with nothing but hormone therapy until the treatments stopped working—on average, a year or two—then moved on to chemotherapy. It’s the course he himself would have taken if he were treating a patient with his same prognosis; physicians are bound ethically and legally to take the tested and proven approach, even if the proven approach is flawed. Ever the physician, though, Dr. Schiff decided that he would look at his prostate cancer as a chance to take action on something that had long bothered him about the way urologists treat the disease. “Up until recently, oncologists and urologists have thought about prostate cancer reactively,” Dr. Schiff says. “Something would happen, and we would treat patients with one thing; something else would happen, and then we’d treat them with something else. Why are we reactive instead of proactive?” Dr. Schiff didn’t have to look far to find a leading prostate cancer researcher who agreed with him on this point and was eager to find a better way. Dr. Oh, Chief of the Division of Hematology and Medical Oncology, Ezra M. Greenspan Professor in Clinical Cancer Therapeutics, and Associate Director for Clinical Research at The Tisch Cancer Institute, oversaw his treatment. “The standard of care is to do one treatment at a time, and to wait for that treatment to stop working before adding the next treatment,” says Dr. Oh. “The problem with this approach is that for men with advanced disease, we know with almost one hundred percent certainty that the cancer will progress. By using one treatment at a time, we’re very concerned about the fact that we’re just letting the cancer develop resistance.”

“WHEN I NEEDED THE BEST PEOPLE, I went to my colleagues at Mount Sinai. I want to offer the same thing to my patients.” — DR. HOWARD SCHIFF

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One year into Dr. Schiff’s treatment, the hormone therapy seemed to be containing his tumor’s spread. Yet going by the statistics for a case such as his, Dr. Schiff knew that in all likelihood it was only a matter of time before he’d need chemotherapy. A new study had just been presented that suggested that the chemotherapy agent docetaxel, when used early in conjunction with hormone therapy, had shown promising results for prostate cancer. He’d also read a number of recent papers which suggested that a prostatectomy—even when performed after the cancer has metastasized beyond the prostate— could extend life span significantly. What if, instead of waiting for the tumor to make its next move, he beat it to the punch? RISK AND REWARD With Dr. Oh’s approval, Dr. Schiff decided to have his prostate removed immediately and, as soon as he recovered, to skip straight to chemotherapy. It was a daring choice. Many doctors would hesitate to recommend that a patient choose surgery based on promising but inconclusive studies, and then follow that with a course of chemotherapy that was not yet a common practice. It took an extraordinary convergence of circumstances to make such an aggressive approach feasible, according to Dr. Tewari, who holds the Kyung Hyun Kim, MD

Chair in Urology and is Chairman of the Milton and Carroll Petrie Department of Urology; Dr. Tewari performed Dr. Schiff’s prostatectomy. “There was a medical oncologist, Dr. Oh, who was very much up-to-date on understanding how to control the distant metastasis; a patient who happened to be a urologist and was highly aware of the literature; and a surgeon who had done the surgery thousands of times,” says Dr. Tewari, who has performed more than 5,000 robotic radical prostatectomy procedures. “The stars aligned at that exact same time.” The results of the stars aligning are— well, pretty stellar. Dr. Schiff completed a series of three different treatments in January 2016; as of April, the most advanced scanning technology currently available could find no evidence of disease. His PSA levels are undetectable. Drs. Oh and Tewari, meanwhile, are expanding clinical studies to determine if the approach that worked so well for Dr. Schiff could be beneficial for more patients. This type of approach is also being investigated in major cancer centers around the world as it represents a new and more aggressive way of treating an otherwise lethal malignancy. “I feel terrific,” says Dr. Schiff. He has resumed seeing patients and has shared his personal story with those with comparable stages of prostate cancer to let them know what a difference new therapies can make. “When I needed the best people, I went to my colleagues at Mount Sinai. I want to offer the same thing to my patients.”

(Above left) Dr. Ashutosh Tewari and his patient, Dr. Howard Schiff; the two with Dr. William Oh and Dr. Daniel Gainsburg (left); and Drs. Oh and Schiff (above); Dr. Tewari (opposite)

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Gv

GIVING Mount Sinai Receives Significant Gifts Supporting Key Priorities Since our last issue, several donors have provided critical support for some of the Health System’s most pressing priorities. Their philanthropy has helped advance many key initiatives, including these: Arnhold Support for Adolescent and Global Health

underserved youth in New York City for more

Two transformational gifts facilitated by Jody and

to the Arnholds’ support, the Center will expand

John Arnhold are having a significant impact on

the breadth and depth of its supportive services,

endeavors central to Mount Sinai’s core mission.

including mental health, trauma support, suicide

than 45 years and is the largest free-standing health center of its kind in the country. Thanks

The Arnhold

prevention, and eating disorder treatment and

Foundation and the

counseling.

Mulago Foundation have committed an additional $15

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

million to support

Cohen Foundation Spurs Research in Lyme Disease

the expansion and

The Steven and Alexandra Cohen Foundation is

impact of The Arnhold

supporting Mount Sinai’s Multiscale Integrated

Institute for Global

Network model of Lyme Disease (LymeMIND)

Health, which was

project with an $8 million grant. LymeMIND

established in 2014.

represents a unified, predictive network model

Under the leadership

of Lyme disease that enables systems medicine

of Prabhjot Singh, MD,

approaches to identify biomarkers and therapies.

PhD, the Institute is

The Icahn Institute of Genomics and Multiscale

poised to take a fresh approach that will allow our

Biology is at the forefront of applying integrative

researchers to discern where a population’s problems

network biology approaches to understanding

run deepest, develop programs that address these

complex disease; however, multiscale network

issues, and provide care that offers new hope for

biology approaches have never before been

patients and the communities they live in, both at

applied to address the complexity of Lyme disease.

home and throughout the world.

Thanks to this support, Mount Sinai expects to

A new $5 million commitment from the Arnholds

make a significant impact on the landscape of

will support an expansion of the programs at the

Lyme disease research.

Mount Sinai Adolescent Health Center for the

Joel Dudley, PhD and Brian Kidd, PhD in the

thousands of young patients who seek integrated

Genetics and Genomic Sciences department will

medical and mental health services and prevention

lead this initiative. Dr. Dudley is Assistant Professor

education each year. The Center, led by Angela Diaz,

of Genetics and Genomic Sciences and Director of

MD, MPH, Jean C. and James W. Crystal Professor

Biomedical Informatics, and also directs the Harris

in Adolescent Health, has served the needs of

Center for Precision Wellness. His team is focused

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To Support the NICU, TEAM ANDI is Born

Dr. Neil Calman, Gail Engelberg, and Alfred Engelberg

on developing and applying methods

outpatient and inpatient settings,

to integrate the digital universe of

using a family practice model. The

information to build better predictive

Department is led by Neil Calman, MD,

models of disease, drug response,

who also serves as President and CEO

and wellness. Dr. Kidd is Assistant

of the Institute for Family Health.

Professor of Genetics and Genomic

“Mount Sinai is the only academic

Sciences, and his research is focused

medical center in Manhattan to

on solving key problems in systems

recognize that training family physi-

immunology, translational bioinfor-

cians who are capable of providing

matics, and precision medicine.

high quality and low cost care in urban neighborhoods is essential to

The Alfred and Gail Engelberg Department of Family Medicine and Community Health Alfred and Gail Engelberg have made a $4 million gift to the Icahn School of Medicine at Mount Sinai to support the

the health and well-being of New York City,” said Alfred Engelberg. “Gail and I are proud to support this effort.”

Honoring Bernard and Josephine Chaus for Legacy of Giving

expansion of Mount Sinai’s residency

As founding supporters of Mount Sinai

program and help the next generation

Heart, the late Bernard and Josephine

of family medicine. Located at the

Chaus were loyal to our mission: to

Icahn School of Medicine, the Alfred

provide the best research and clinical

and Gail Engelberg Department of

care for the community we serve. The

Family Medicine and Community

family’s long legacy of philanthropy

Health is dedicated to education,

to Mount Sinai has made it possible

research, and patient care for medically

for Mount Sinai Heart, under the

underserved communities. As a collab-

leadership of Valentín Fuster, MD, PhD,

oration between the Icahn School of

to further its mission of improving

Medicine and the Institute for Family

health for whole populations and

Health, the Department’s mission is

reflects Dr. Fuster’s longstanding

to ensure outstanding primary care

dedication to health through preven­

educational experiences for students,

tative medicine and lifestyle changes.

residents, and other trainees in both

Their most recent generous gift

“I brought Andi into this world, but the Mount Sinai NICU staff brought her to life,” says Amy Knepper, whose daughter was born 10 weeks early in mid2012, weighing just two pounds, 12 ounces. “I truly believe how newborns enter this world and how they are cared for lays the blueprint for their future,” she says. “I will forever be grateful to the nurses and staff.” Amy and her husband, Jonathan, came to consider the NICU staff part of the family: Andi spent nine weeks in The Mount Sinai Hospital’s NICU (Neonatal Intensive Care Unit), and Amy visited her every day. When the Kneppers were finally able to take Andi home, no longer a newborn but an infant, Amy’s only wish was that she could have spent not just days at the NICU, but nights with her daughter as well. Learning that Mount Sinai was planning to create private NICU suites where families could stay overnight with their newborns, Amy created TEAM ANDI as an Official Charity Partner of the New York City Marathon in order to raise funds to support this effort. She ran the Marathon by herself for TEAM ANDI in 2013, raising $67,000 and then the effort grew quickly: from eight runners in 2014 to 10 runners in 2015, raising more than $270,000 in three years. And Amy hasn’t stopped there: now 17 runners are slated to fundraise and run in the 2016 Marathon. “I don’t think it’s a coincidence that at mile twenty-three, on an uphill portion of the race, sits The Mount Sinai Hospital’s NICU,” says Amy. “All at-risk newborns face personal uphill obstacles to survival.” – Robbie Brenner

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GIVING

includes an endowment to establish the Chaus

The Fraga’s second gift will establish the Stroke and

Family Fund for Cardiovascular Research to ensure

Cerebrovascular Disease Program Fund within the

continued support of innovative cardiovascular

Department of Neurosurgery to advance the mission

research from bench to bedside.

of improving global stroke care through the development of a comprehensive stroke program across

Gilinskis Support Global Women’s Health Program in Colombia Thanks to a $2.5 million gift from Jaime and Raquel Gilinski and the Fundacion Vida Raquel K. Gilinski, the Mount Sinai Global Women’s Health Program is extending its reach into Cartagena, Colombia. Major gaps in maternal and fetal care exist in this region due to a lack of updated equipment and training;

“Mount Sinai Heart is dedicated to transforming the diagnosis, prevention, and treatment of cardiovascular disease, but we could not achieve this mission without philanthropy.”

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

- Valentín Fuster, MD, PhD

the Mount Sinai Health System, under the direction of J Mocco, MD, MS. Dr. Mocco is an expert in treating blood vessel diseases of the brain, neck, and spine and his research focuses on translational efforts to treat ischemic and hemorrhagic strokes.

Moise and Chella Safra: Support for Mount Sinai Heart

with the Gilinskis’ support, ultrasound and electronic fetal monitors have been purchased and workshops on the use of this equipment have begun. Additional initiatives in Cartagena funded by this gift include educational programs for pregnant teens and the introduction of anesthesia for women in labor. The Global Women’s Health Program was founded by Michael Brodman, MD, Professor and Ellen and Howard C. Katz Chair of Obstetrics, Gynecology, and Reproductive Science at the Mount Sinai Health System, and is led by Annmarie Beddoe, MD, who is also Director of Chemotherapy Services at Mount Sinai. The program is funded entirely through philanthropy and is strengthening women’s health care in Botswana, Colombia, Dominican Republic, Honduras,

Supported by a $2 million gift from philanthropist Chella Safra, Mount Sinai Heart continues its

Jamaica, Liberia, Niger, and South Africa.

mission to provide compassionate clinical care and

Lucyna and Arminio Fraga: Advancing Research for Fibromuscular Dysplasia and Stroke

York and around the globe. “Mount Sinai Heart is

Lucyna and Arminio Fraga are supporting two signif-

says Valentín Fuster, MD, PhD, Director, Mount Sinai

icant research priorities at Mount Sinai with gifts

Heart; Director, The Zena and Michael A. Wiener

totaling $2.4 million. First, they are providing funding

Cardiovascular Institute; Richard Gorlin, MD/Heart

for the research of Jeffrey W. Olin, DO, FACC, FAHA,

Research Foundation Professor; Physician-in-Chief,

MSVM that will allow his team at Mount Sinai Heart

The Mount Sinai Hospital. In recognition of

to advance their critical research investigating the

Mrs. Safra’s gift, a section of the reception area in

cellular and genetic basis of Fibromuscular Dysplasia,

the Lauder Family Cardiovascular Center has

a rare vascular disease that causes abnormal cellular

been named the Moise and Chella Safra Patient

growth in the walls of medium and large arteries

Engagement Area, honoring Mrs. Safra and her

throughout the body. Through careful review and

late husband, Brazilian banker and philanthropist

assessment of Fibromuscular Dysplasia patient data

Moise Safra. The area provides a relaxed setting for

gathered from across the country and around the

patients and their families. – Susan McCormick

offer patients access to innovative research, in New dedicated to transforming the diagnosis, prevention, and treatment of cardiovascular disease, but we could not achieve this mission without philanthropy,”

world, physicians and scientists hope to discover the physical and/or genetic factors that contribute to this condition.

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Leaving a Legacy Mount Sinai’s efforts in medical education have been strengthened by two notable and significant planned gifts this year—from donors who recognize the need for supporting future generations through a legacy pledged right now. In the spring, Vera and Donald Blinken made a

Kenneth L. Edelson, MD has

historic and transformational bequest to name the

also been moved to include

Donald and Vera Blinken FlexMed Program at the

Mount Sinai in his estate plans.

Icahn School of Medicine. For each of them, the inspi-

In July, he committed to fund

ration to contribute to the future of health care stems

scholarship support and endow

from their past. A native New Yorker, Donald Blinken

a professorship in the Kimberly

has been treated by Mount Sinai doctors for more

and Eric J. Waldman Department

than 50 years. He co-founded the investment firm of

of Dermatology. “Mount Sinai

Warburg Pincus, chaired the State University of New

gave me my life and I want to

York Board of Trustees, and served as Ambassador to

give back,” said Dr. Edelson, an

Hungary in the 1990s. While in Hungary, Vera founded

Associate Clinical Professor of

Primavera, the first mobile breast cancer screening

Dermatology at the Icahn School

program in Central Europe. “With a planned gift, we

of Medicine who was one of 42

can do much more with our legacy,” said Ambassador

graduates of the School’s inaugural

Blinken, “and we hope that this gift will inspire others

Class of 1972. “Receiving a schol-

to do the same.”

arship meant the world to me

The Blinkens’ generosity will expand the

and was the reason I was able to

innovative FlexMed program at the Icahn School of

graduate from medical school.”

Medicine, the first program in the country to offer

Dr. Edelson noted that he

early acceptance to college sophomores, including

trained with giants in the field of

those studying the humanities. “Buildings are

medicine—Hans Popper, Lou Aledort, Richard and

important, but we feel that doctors are a critical

Mortimer Bader, and Henry Janowitz, among others—

element in the quality of medicine,” said the Blinkens.

who inspired him to pursue a career in dermatology.

“Intellectual curiosity is as important as a stethoscope,

“My legacy is Mount Sinai,” he said with pride.

and we’re pleased to support young people who are

Kenneth L. Edelson, MD (left) with Mark Lebwohl, MD, Waldman Chair of Dermatology and Chair of the Kimberly and Eric J. Waldman Department of Dermatology

And for Mount Sinai, bequest intentions like these

interested in the world and have broadened their

are essential to providing outstanding education,

horizons through the study

research, and clinical care for future generations.

of literature, history, and

“Making a philanthropic commitment is a deeply

philosophy. It gives these

personal decision, and there are different ways to

students a real edge in their

make gifts that are long lasting and meaningful,”

medical careers.”

according to Mark Kostegan, FAHP, who is Chief Development Officer and Senior Vice President for Development at Mount Sinai. “Planned gifts help to sustain the mission of Mount Sinai and ensure our institution’s success for many generations to come. “We are deeply grateful for the vision and thought that moved the Blinkens and Dr. Edelson to make such generous commitments,” Mr. Kostegan added.

LEARN MORE

To learn more about the impact of scholarships, see our student profiles on page 61.

– Susan McCormick

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GIVING

Celebrations Over the past year, Mount Sinai hosted nearly 50 events in New York City and around the country, attended by more than 6,000 guests.  We are honored to celebrate our philanthropic community.

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The 31st Annual Mount Sinai Crystal Party WHEN: May 5, 2016 WHERE: Central Park Conservatory Garden, New York City WHO: 1. Jonathan Dixon; Mohammad Malik; Joshua S. Friedman; Joshua B. Friedman; Erica Friedman; Caroline Heyer; Harris Heyer; Harris Mufson; Tyler Friedman. 2. Jonathan Crystal; Meredith Grossman, MD; Judd Grossman; Jean Crystal, Trustee; James Crystal, Trustee. 3. Crystal Party Honorary Co-Chairs Glenn August (Trustee) and Debbie August flanked by Leni and Peter May (Trustee). 4. Kyle Owens; Zibby Schwarzman, Trustee.

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Celebration and Naming of the Alfred and Gail Engelberg Department of Family Medicine and Community Health WHEN: May 24, 2016 WHERE: The Mount Sinai Hospital WHO: Gail Engelberg; Alfred Engelberg; Neil Calman, MD; Kenneth L. Davis, MD; Robert “Red” Schiller, MD.

The 10th Annual “What a Wonderful World” Gala WHEN: October 5, 2015 WHERE: The Gramercy Theatre, New York City WHO: Louis Armstrong Center for Music and Medicine award recipients Bernie Williams; Gabriel A. Sara, MD; Roy Haynes; Kaley Clavell.

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Dubin Breast Center Fourth Annual Fact vs. Fiction Luncheon and Symposium WHEN: September 30, 2015 WHERE: 320 Park WHO: 1. Jessica Sliwerski; Eva Andersson-Dubin, MD, Trustee. 2. Sandra Lee.

Margaret Loeb Kempner Humanitarian Award WHEN: November 5, 2015

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WHERE: The Colony Club, New York City WHO: James Tsai, MD; Thomas L. Kempner, Jr.; Douglas Buxton, MD.

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GIVING

Dubin Breast Center Fifth Annual Gala WHEN: December 7, 2015 WHERE: Mandarin Oriental Hotel, New York City WHO: 1. Len and Emily Blavatnik; Michael Brodman, MD. 2. Eva Andersson-Dubin, MD, Trustee; Chloe Moussazadeh; Elisa Port, MD. 3. Michele Barakett; Timothy Barakett, Trustee; Wendy Hakim.

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Opening of the Jo Carole and Ronald S. Lauder Newborn Intensive Care Unit WHEN: April 11, 2016 WHERE: The Mount Sinai Hospital

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WHO: 1. Adam Azrak; Ian Holzman, MD; Freda Azrak. 2. Kristina Burke; Vanessa Morris-Burke; Thomas Burke. 3. Daniel Brodsky; Estrellita Brodsky; Alexander Brodsky; Kate Brodsky.

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Mount Sinai Women’s Health Day of Learning and Luncheon WHEN: November 12, 2015 WHERE: The Plaza Hotel, New York City WHO: Jennifer Gersten Price; Judy Gersten; Carol Lowenthal; Lisa Lowenthal Pruzan; Leni May; Leslie May Blauner; Jane G. Rittmaster.

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Celebration and Ribbon Cutting for the Stavros Niarchos Foundation Emergency Department WHEN: June 9, 2016 WHERE: Mount Sinai Queens WHO: Michael Minikes, Trustee; Judith O. Rubin, Trustee; David Reich, MD; Roula Siklas; Caryn Schwab; Vasili Tsamis; Costas Constantinides.

Dedication of the Richard and Cynthia Zirinsky Center for Bipolar Disorder WHEN: November 11, 2015 WHERE: The Mount Sinai Hospital WHO: Cynthia Zirinsky; Igor Galynker, MD, PhD.

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Innovations in Cardiovascular Medicine at Mount Sinai WHEN: March 10, 2016 WHERE: Palm Beach Country Club WHO: 1. ValentĂ­n Fuster, MD; Rhonda Starr; Gerald Starr; Eileen Grunther. 2. Jaime and Racquel Gilinski; Bonnie M. Davis, MD, Trustee.

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ALUMNI Meeting Patients Where They Are How Jewel Mullen, MD, MPH, MPA, MSSM ’81, Principal Deputy Assistant Secretary for Health in the U.S. Department of Health and Human Services, leverages her Mount Sinai medical education to improve public health

“I used to write on my school applications

building community-based prevention and

“It’s important to meet people where they

that I wanted to help people, but I didn’t

care programs, strengthening coordination

are to partner with them for their health,”

know from the start that I wanted to work

between communities and public health

she explains. And she means that literally

in public health,” says Dr. Jewel Mullen,

and health care systems, and removing

and figuratively. “My experience allows me

physician, epidemiologist, Principal Deputy

barriers to high-quality care.

to offer the best public health assets of the

Assistant Secretary for Health in the U.S.

“I grew up in the suburbs of New York

federal government to the people of Puerto

Department of Health and Human Services

City, in an environment where I observed

(HHS), and Icahn School of Medicine at

demographic differences in health from a

Mount Sinai graduate. “I’m one of those

young age. I learned that the factors that

people who like a lot of different things, and

contribute to a community’s health, like race,

I’m very stimulated by education—which is

social status, access to quality care, weren’t

why I have so many degrees, I guess.”

always equitable,” says Dr. Mullen. “It has

Dr. Mullen holds multiple degrees—

always been clear to me that a guiding

her Bachelor’s and Master’s in Public

interest in medicine was equity—ensuring

Health from Yale, her Master’s in Public

people have access to what they needed to

Administration from Harvard, and her

be healthy.”

Doctor of Medicine from Mount Sinai—

She was asked to come to Washington

and has spent more than three decades

to take on her newest role at HHS, where

in leadership roles at state and federal

her goal is to foster collaboration across

health agencies tackling chronic disease by

its programs to advance public health,

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

including women’s health, disease

“The ability to go from the Annenberg building to the Bronx VA, or Elmhurst, or down to Beth Israel, even in the 1970s, presented more of a mosaic experience in terms of the patients I met and the medical problems  I was exposed to.” – Dr.Jewel Mullen

prevention, and the federal government’s response to the Zika virus. Recently, she has traveled a great deal between Puerto Rico and the U.S. as part of that effort, and says her public health experience coupled with her medical knowledge—her Icahn School of Medicine education—have been indispensable.

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SPOTLIGHT ON SCHOLARSHIPS At Mount Sinai, our conviction that “medicine is service” informs everything we do, and our primary mission is to enable students to serve patients with compassion, dedication, and skill. What begins here becomes a lifelong journey of service and scientific discovery. Thanks to scholarship support, many students who might not otherwise be able to afford a medical education can pursue their passions without facing a future of debt. Meet two of our students:

Dr. Donald Bergman, President of the Mount Sinai Alumni Association, presents Dr. Mullen with a 2016 Jacobi Medallion (left); with her husband, Dr. Herbert Knight

Rico, where they live, while under-

prestigious Jacobi Medallion.

standing the challenges they’re facing

“Hearing about the spectrum of

in face of their current economic crisis.

their interests gave me an appreciation

The ways you engage with people and

for how much more broadly medical

really learn about their experiences—

students today think about how they

those are social and cultural bridges we

might leverage their medical education,”

have to cross to do this work effectively.”

she says. “Mount Sinai has grown

Although she was a student who had

exponentially as a research institution,

her pick of many medical schools, she

and its partnerships with different

knew Mount Sinai was the right place

sectors and organizations have grown

for her, Dr. Mullen says.

as well. It is clear to me that students

“Mount Sinai has always had a

today are better positioned to go into

reputation for academic excellence,

a range of careers, shaped by their

but I knew that academic rigor was

medical education, while at the same

backed by the long history of Sinai as

time there is a core group of students

a teaching hospital even before the

who are focused on patient care and

medical school was founded. That told

community health. Some schools have

me that it was a great place to get an

a reputation for producing one type of

education,” says Dr. Mullen. “The ability

doctor or the other; I hope Mount Sinai

to go from the Annenberg building

continues to do well at producing both.”

to the Bronx VA, or Elmhurst, or

When she is on campus again in the

down to Beth Israel, even in the 1970s,

fall to speak at the annual White Coat

presented more of a mosaic experience

Ceremony, Dr. Mullen wants to commu-

in terms of the patients I met and the

nicate to incoming medical students

medical problems I was exposed to.

the vast range of possibilities that their

My experience there informed my

Icahn School of Medicine degree will

desire to think about patients in a

afford them.

community context.”

“I want them to know that you’re

Dr. Mullen says she enjoys meeting

never locked in—don’t limit your

current medical students to learn about

thinking to what your opportunities

their diverse interests—something

might be in the moment,” she says.

she had the opportunity to do in

“There are so many different ways that

March 2016, when she was in New

we can express the art and science of

York to receive Mount Sinai Alumni’s

medicine.” – Katie Quackenbush Spiegel

Alexandra Dembar, MD Class of 2019, was born and raised in Indianapolis, Indiana. She graduated from Indiana University with a BA in Spanish, focusing specifically on linguistics. In college she was involved in increasing access to financial capital via microfinance in rural communities in Honduras; she worked there for a summer and led several trips of her fellow students during which they partnered with community leaders to create micro-lending institutions and set up community financial infrastructure. She is a member of the Icahn School of Medicine’s Primary Care Scholars Program, which is designed to prepare the next generation of primary care physicians to meet the rising needs of local and global communities through core training, mentorship, and experiences. “I am especially passionate about working to increase access to care for underserved populations, particularly in areas of women’s health and mental health, and hope to use medicine as a platform to fight for equal access to health care both in the United States and abroad.” Khameer Kidia, MD Class of 2017, earned a BA in French Literature from Princeton University and an MPhil in Medical Anthropology from Oxford University, where he studied as a Rhodes Scholar. He was drawn to the medical field after working with a team of physicians on a project targeting the treatment of HIV-positive teenagers in his native Harare, Zimbabwe. Shortly thereafter, Khameer applied to the recently named Donald and Vera Blinken FlexMed Program [editor’s note: for more about the Blinkens’ gift, see page 55], which encourages college sophomores in any major to apply for early assurance of acceptance to the School. He is a global health scholar in The Arnhold Institute for Global Health and recently published a personal narrative about his family’s history of cardiac disease entitled “Disheartening Disparities” in The New England Journal of Medicine. “Coming from Zimbabwe and having studied in the United States and United Kingdom makes me think critically about the disparities in the distribution of health care internationally; I am interested in closing those gaps.”

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ALUMNI

Mount Sinai Honors 2016 Jacobi Medallion Recipients More than 325 guests gathered at The Plaza Hotel on March 16, to celebrate and honor the 2016 Jacobi Medallion recipients. Seven leaders received the Jacobi Medallion, the highest award bestowed by Mount Sinai, in recognition of their commitment to compassionate care and to the advancement of medicine. PICTURED: Standing, from left: Kenneth L. Davis, MD, President and Chief Executive Officer, Mount Sinai Health System; recipient Adolfo García-Sastre, PhD; Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine; recipient Alexander Kirschenbaum, MD, MSSM ’80, MSH ’87; Donald Bergman, MD, MSH ’77, President, The Mount Sinai Alumni Association, and Clinical Professor of Medicine; recipient Albert L. Siu, MD, MSPH; and recipient William Lawson, MD, DDS, MSH ’73. Seated from left: recipient Jean C. Crystal, Trustee; recipient Jewel Mullen, MD, MPH, MPA, FACP, MSSM ’81; Sandra K. Masur, PhD, Chair, Jacobi Medallion Selection Committee, and Professor of Ophthalmology; and recipient Rosanne M. Leipzig, MD, PhD.

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MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

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St. Luke’s-Roosevelt Hospital Alumni Association 125th Anniversary Dinner The St. Luke’s–Roosevelt Hospital Alumni Association celebrated its 125th anniversary on April 14, 2016 with dinner and a reception recognizing the accomplishments of a group whose careers

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exemplify the highest standards of medical practice. Since 1881, the St. Luke’s–Roosevelt Hospital Alumni Association has built a strong sense of community and enhanced its recognition as a center for excellence in research, education, and patient care.

PICTURED: 1. Honorees: Barbara Edwards Dennis, BS, RN; George Unis, MD; Annetta J. Kimball, MD; Grace J. Kim, MD, FACS. 2. John T. Barnard, MD; Arnold Phillips, MD; Jeffrey Dermksian MD; George Dermksian, MD. 3. Carl Braun, MD; Farrokh Shahrivar, MD. 4. Norma M.T. Braun, MD; Hon. Sharon M.J. Gianelli; Arthur Gianelli, President, Mount Sinai St. Luke’s.

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2016 MOUNT SINAI ALUMNI REUNION AND ALUMNI AWARDS CEREMONY

RETURN, RECONNECT, REDISCOVER

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More than 100 alumni and guests gathered on May 13 to reconnect and reminisce with classmates, colleagues, and friends at the 2016 Alumni Reunion and Alumni Awards Ceremony. Attendees were welcomed by David Muller, MD, MSH ’95, Dean for Medical Education, Marietta and Charles C. Morchand Chair in Medical Education, who reflected on the extraordinary growth and reach of the Mount Sinai Health System, and attended campus lectures by faculty members on topics that included the Visiting Doctors Program, medical education today, and the East Harlem Health Outreach Partnership.

SAVE THE DATE

REUNION 2017 Friday, May 19, 2017

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We hope to see you there!

Guests moved on to the New York Academy of Medicine for the ceremony, where Theodore Christopher, MD, MSSM ’81 delivered the keynote address; Mount Sinai Alumni Association President Donald Bergman, MD, MSH ‘77 and Vice President and Chairman of the Alumni Awards Committee, along with Burton A. Cohen, MD, MSSM ‘79, Vice President and Chairman of the Alumni Awards Committee, presented awards to the following alumni for their service to the Mount Sinai community: Theodore Christopher, MD, FACEP, MSSM ’81 Carine Davila, MD, ISMMS ’16 Leslie Dubin Kerr, MD, MSSM ’85 Marvin Gilbert, MD, MSSM ’69 Eric J. Nestler, MD, PhD Ilana Ramer Bass, MD, ISMMS ’16 Lester Silver, MD, MSSM ’69

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PICTURED: 1. Members of the MSSM Class of 1986 celebrate their 30th reunion. 2. Marvin Gilbert, MD, MSSM ’69, recipient of The Mount Sinai Alumni Special Recognition Award, and Donald Bergman, MD, MSH ’77. 3. Members of the MSSM Class of 1981 celebrate their 35th reunion. 4. (L-R) Jose Baez, MD, MSSM ’86; Melinda Miller-Thrasher, MD, MSSM ’86; Susana Escalante-Glorsky, MD, MSSM ’86; Gregory Tino, MD, MSSM ’86, Ariel Glorsky. 5. (L-R) David Hiltzik, MD, MSSM ’02; Sharon Singh, MD, MSSM ’01; Jeremy Schiller, MD, MSSM ’01; Ezra Cohen, MD, MSSM ’01; David Lewis, MD, MSSM ’01. 6. Members of the MSSM Class of 1996: (L-R) Christina Tan, MD; Keri Peterson, MD; Samantha Feder, MD; Tara Timmerman, MD; Karen Goldberg, MD; Beth Joseph, MD.

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Jay Horton, PhD, Clinical Instructor; Keynote Speaker, Central Committee to Promote Palliative Care Conference, Hospital Authority/Institute of Health Care

In Memoriam Mount Sinai Science & Medicine salutes two Trustees who have died since the publication of our last issue. We extend our deepest condolences to their families and friends. Steven Ames served as a member of the Mount Sinai Boards of Trustees from 1973 to 1987, following in the footsteps of his late mother, Harriett Annenberg Ames. With his spirt of philanthropy, he generously endowed programs including cardiology, scholarship, pediatric, fellowships, and pulmonary care. His family’s tradition of support is commemorated with the naming of the Annenberg Building of the Icahn School of Medicine at Mount Sinai. Betty Yarmon was a Trustee of the former Beth Israel Medical Center and Continuum Health Partners for nearly 20 years. She and her late husband, Morton, showed their support by naming the Betty and Morton Yarmon Center for Parkinson’s Disease, the Betty and Morton Yarmon Neurobehavior and Alzheimer’s Disease Center, the Betty and Morton Yarmon Center for Healthy Aging, and the Betty and Morton Yarmon Stroke Center at Mount Sinai Beth Israel.

continued from page 12

&

Recognition   Awards

MOUNT SINAI SCIENCE & MEDICINE / FALL 2016

The Alfred and Gail Engelberg Department of Family Medicine and Community Health Neil S. Calman, MD, System Chair and Professor; President, American Association of Teaching Health Centers; Lewis and Jack Rudin Prize in Medicine and Health, New York Academy of Medicine and the Greater New York Hospital Association; Champion of Diversity Award, Manhattan Staten Island Area Health Education Center; Commencement Speaker, College of Optometry, State University of New York Eric Gayle, MD, FAAFP, Assistant Professor; Jack Geiger Award, Community Health Centers Association of New York Raymond Teets, MD, Assistant Professor; Education Working Chair, Academic Consortium of Integrative Medicine and Health

Brookdale Department of Geriatrics and Palliative Medicine Patricia Bloom, MD, Associate Clinical Professor; Keynote Speaker, Loraine Halis Family Caregiver Conversation Series, Alzheimer’s Association Jeffrey Farber, MD, MBA, Associate Professor; Keynote Speaker, Hospital Acquired Conditions Conference, Global Healthcare Professional Network Nathan Goldstein, MD, Professor; Keynote Speaker, Central Committee to Promote Palliative Care Conference, Hospital Authority/Institute of Health Care Cameron R. Hernandez, MD, Associate Professor; House Call Physician of the Year, American Academy of Home Care Medicine Gregory Hinrichsen, PhD, Assistant Professor; M. Powell Lawton Award for Distinguished Contributions to Clinical Geropsychology, Society of Clinical Geropsychology

Rosanne M. Leipzig, MD, PhD, Gerald and May Ellen Ritter Professor of Geriatrics and Adult Development; Robert S. Gordon Lectureship, Yale University School of Medicine Elizabeth Lindenberger, MD, Associate Professor; Keynote Speaker, United Jewish Appeal Federation Janeen Marshall, MD, Assistant Professor; Distinguished Young Alumni Award, Chowan University Jacqueline Yuen, MD, Assistant Professor; Keynote Speaker, United Jewish Appeal-Federation

Mount Sinai Heart Valentín Fuster, MD, PhD, Director and Physician-in-Chief; The Great Cross, Ministry of Health, Spain; First Cardiovascular Fellow in Recognition of Excellence in Scientific and/or Educational Contributions to Respiratory Medicine, European Respiratory Society, Netherlands; Award for Leadership in Global Population Health Education, Research, Science, American College of Cardiology; Doctor Honoris Causa, Instituto Universitario Escuela de Medicina del Hospital Italiano, Argentina; Award for Valuable Support in the Progress to Prevent Cardiac Diseases, Ecuadorian Society of Cardiology; Honorary Guest Award, City of Córdoba, Argentina; Doctor Honoris Causa, University of Córdoba, Argentina; Honorary Member, Argentinian Federation of Cardiology; Honorary Acknowledgement Award, Ministry of Health, Government of Córdoba, Argentina; National Award “Caja Rural”, City of Granada, Spain; Ignacio Chavez Award, World Congress of Cardiology and Cardiovascular Health, Mexico City, Mexico; Biomedical Research Award, Fundación Ferrer Investigación; Opening Lecture, World Congress of Cardiology, World Heart Federation; Opening Lecture, National Congress of Cardiology, Argentina; Opening Lecture, Cardiovascular Symposium, University of Rome; Keynote Speaker, 80th Annual Scientific Meeting, Japanese Circulation Society; Keynote Speaker, 15th Annual Controversies Course, Cedars Sinai & California American College of Cardiology Chapter; Opening Lecture, Argentine Congress of Cardiology; Keynote Speaker, Imaging Institute, University of Oxford; Keynote Speaker, The Royal College of Physicians, United Kingdom

Department of Medical Education Gary C. Butts, MD, Dean for Diversity Programs, Policy, and Community Affairs; Professor; National Medical Fellowships Lifetime Achievement Award, Institute for InterGroup Understanding; Member, Alpha Omega Alpha Medical Honors Society; Champion Award, Building the Next Generation of Academic Physicians

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Reena Karani, MD, MHPE, Senior Associate Dean for Curricular Affairs and Undergraduate Medical Education; Professor; Board Member; Chair, Step 2CS Test Materials Development Committee, National Board of Medical Examiners; Edward Beacham Lectureship, Johns Hopkins University School of Medicine; Davidoff Lectureship, Albert Einstein College of Medicine

Andrew Dunn, MD, Professor; Chair, Board of Governors; Chair, Health and Public Policy Committee, American College of Physicians

Shirsh Huprikar MD, Associate Professor; Chair, Infectious Diseases Community of Practice, American Society of Transplantation

Janice Gabrilove, MD, Professor; Program Chair, Translational Science 2016 Conference, Association for Clinical and Translational Science, American Federation for Medical Research

Harish Jasti, MD, Associate Professor; Award for Leadership, Society of General Internal Medicine, Mid-Atlantic Region

Jeffrey T. Laitman, PhD, Distinguished Professor; Creation of the “Professor Jeffrey T. Laitman Award” to Recognize Outstanding Scientists and Educators Who Establish Bonds Between Nations, Brazilian Society of Anatomy; Keynote Speaker, Santa Casa Medical School, Brazil; Board of Directors Certificate of Appreciation for Leadership Service, American Association of Anatomists; University Lecture, Federal University of Rio de Janiero, Brazil; University Lecture, University of Sao Paulo, Brazil

Adolfo García-Ocaña, PhD, Professor; Session Chair, 76th Scientific Sessions, American Diabetes Association; Session Chair, 5th Annual NYC Regional Diabetes Meeting

David Muller, MD, Dean; Marietta and Charles C. Morchand Chair in Medical Education; Professor; Robert J. Glaser Distinguished Teacher Award, Alpha Omega Alpha Society and Association of American Medical Colleges

Scott L. Friedman, MD, Dean for Therapeutic Discovery; Irene and Dr. Arthur M. Fishberg Professor of Medicine; Burton Combes Memorial Lecture, University of Texas Southwestern Medical School; Charles S. Lieber Memorial Lecture, American Gastroenterologic Association; Maud Menten Honorary Lecture, University of Pittsburgh School of Medicine; Emmet B. Keefe Mentorship Award, National Liver Conference; Visiting Professor, Earl A. Chiles Research Institute; Distinguished Achievement Award; State of the Art Hans Popper Lecture, American Association for the Study of Liver Diseases; Member, Board of Directors, American Friends of the US Israel Binational Science Foundation; Keynote Speaker, Catalan Association for Gastroenterology, Spain

Samuel Bronfman Department of Medicine Julio Aguirre-Ghiso, PhD, Professor; Distinguished Speaker, Seminar Series, Wistar Institute; Distinguished Speaker, Seminar Series, Albert Einstein College of Medicine Indu Ayappa, PhD, Associate Professor; Chair, Planning Committee, Sleep and Respiratory Neurobiology Assembly, American Thoracic Society Nina Bhardwaj, MD, PhD, Ward-Coleman Chair in Cancer Research; Professor; Frederick W. Alt Award for New Discoveries in Immunology, Cancer Research Institute Paolo Boffetta, MD, MPH, Professor; Honorary Member, Italian Society of Occupational Medicine and Industrial Hygiene Nicole M. Bouvier, MD, Assistant Professor; Sir William Osler Young Investigator Award, Interurban Clinical Club Alfred Burger, MD, Associate Professor; Chair, Annual Meeting, American Board of Internal Medicine, Self-Evaluation Process, Program Committee, Society of General Internal Medicine; 2016 Award for Excellence in Clinician Education, Society of General Internal Medicine, Mid-Atlantic Region Daniel Caplivski, MD, Associate Professor; Keynote Speaker, Centre for Tropical Medicine and Global Health, Oxford University; Keynote Speaker, John Radcliffe Hospital, United Kingdom; Keynote Speaker, National Center for Global Health, Japan; Keynote Speaker, Peruvian American Medical Society

Sacha Gnjatic, PhD, Associate Professor; Chair, Biomarker Task Force Working Group 4, University of Texas Southwestern Medical School; Lloyd J. Old, MD Award for Excellence in Cancer Immunology, Cancer Vaccine Cancer Immunotherapy Foundation

Donald Gardenier, DNP, Assistant Professor; Edge Runner, American Academy of Nursing Erica Grabscheid, MD, Associate Professor; Winner, Presidential Poster Competition, American Geriatrics Society David Greenwald, MD, Professor (Pending); Chairman, Citywide Colon Cancer Control Coalition; Trustee, American College of Gastroenterology; Educational Director, New York Society for Gastrointestinal Endoscopy Percio Gulko, MD, Lillian and Henry M. Stratton Professor of Medicine (Rheumatology); Visiting Professor, Universidade Federal do Rio Grande do Sul, Brazil Yujin Hoshida, MD, PhD, Assistant Professor; Member, Tisch Cancer Institute; Keynote Speaker, University of Strasbourg, France; Keynote Speaker, Seoul National University; Keynote Speaker, Japan Association of Molecular Targeted Therapy for Hepatocellular Carcinoma; Keynote Speaker, Kumamoto University, Japan; Keynote Speaker, International Workshop on NASH Biomarkers; Keynote Speaker, Paris NASH Symposium; Keynote Speaker, National Cancer Institute

Minal Kale, MD, MPH, Assistant Professor; Co-Chair, Scientific Abstracts Committee, Society of General Internal Medicine; Mid-Atlantic Award for Excellence in Clinician Investigation, Society of General Internal Medicine, Mid-Atlantic Region Laurie Keefer, PhD, Associate Professor; Chair, Psychosocial Patient Education Sub Committee, Crohn’s and Colitis Foundation of America; Co-Chair, Centrally Mediated Disorders of GI Pain Committee, Rome Foundation; Commissioner for the Recognition of Specialties and Proficiencies in Psychology, American Psychological Association Boe-Hyun Kim, PhD, Instructor; Kamel Khalili, Pioneer in NeuroVirology Lectureship Award, International Society for NeuroVirology Paula Klein, MD, Assistant Professor; Alumni Achievement Award, State University of New York Downstate Medical Center Josep M. Llovet, MD, Professor; Chair and Invited Speaker, 6th Asia-Pacific Primary Liver Cancer Expert Meeting; Chair and Keynote Speaker, Annual Conference, International Liver Cancer Association; Fellow and Best Oral Presentation on Liver Cancer, American Association for the Study of Liver Diseases; Educational Counsellor, International Liver Cancer Association; Senior Editor, Clinical Cancer Research, American Association of Cancer Research; Chair and Keynote Speaker, 17th World Congress on Gastrointestinal Cancer, European Society for Medical Oncology; Keynote Speaker, 11th International Meeting on Therapy in Liver Diseases; Keynote Speaker, 10th International Symposium on Alcoholic Liver and Pancreatic Diseases and Cirrhosis; Keynote Speaker, Session VII Symposia, Falk Foundation; Keynote Speaker, American Association for the Study of Liver Diseases; Keynote Speaker, International Liver Congress 2016-European Association for the Study of Liver Diseases; Keynote Speaker, European Conference on Interventional Oncology Paul J. Maglione, MD, PhD, Assistant Professor; Editorial Board, Clinical and Experimental Medicine Aniwaa Owusu Obeng, PharmD, Assistant Professor; Chair, Provider Adoption Barriers Interest Group, The Implementing GeNomics In PracTicE (IGNITE) Network, National Institute of Health, National Human Genome Research Institute

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Charles A. Powell, MD, Professor; Service Award and Chair, Nominating Committee, Assembly for Thoratic Oncology, American Thoracic Society; Service Award, Chair, Assembly for Thoracic Oncology of the American Thoracic Society; President Elect, Fleischner Society Neil Schachter, MD, Professor; Chairman, Grants Committee, American Lung Association of the Northeast; Co-Chair, American Thoracic Society’s Sleep and Respiratory Neurobiology’s Journal Club Committee, American Thoracic Society; Will Ross Award, American Lung Association Gwen Skloot, MD, Chair, Program Committee, Respiratory Structure and Function Assembly; Chair, Evaluation and Management of Asthma in the Elderly Workshop, American Thoracic Society Dan Steinberg, MD, Associate Professor; Chapter President, New York Special Interest Group, Association of Program Directors in Internal Medicine Talia H. Swartz, MD, PhD, Assistant Professor; Young Investigator Award, Conference on Retroviruses and Opportunistic Infections, Medscape David C. Thomas, MD, MHPE, Associate Dean for Graduate Medical Education and Professor; Our Town Thanks You Award, Straus News, “Our Town” newspaper Surafel Tsega, MD, Instructor; Audience Choice Award for Best Research Abstract, Lown Research Day, Lown Institute for High-Value Care

MOUNT SINAI SCIENCE & MEDICINE / FALL 2015

David J. Volsky, PhD, Professor; Distinguished Fellow, Collegium of Eminent Scientists, Kosciuszko Foundation; Plenary Speaker, 13th International Symposium on NeuroVirology and Conference on HIV in the Nervous System; Keynote Speaker, Annual NeuroHIV Symposium, Johns Hopkins University/ National Institute of Mental Health Center for Novel Therapeutics of HIV-associated Cognitive Disorders; Professor Emeritus in Pathology and Cell Biology, Columbia University Christopher Walsh, MD, Associate Professor; Leadership in Research Award, National Hemophilia Foundation Jeffrey Weiss, PhD, MS, Associate Professor; Edge Runner, American Academy of Nursing Juan P. Wisnivesky, MD, DrPH, Irene and Dr. Arthur M. Fishberg Professor of Medicine; Elected Member, American Society of Clinical Investigation

Department of Microbiology Dusan Bogunovic, PhD, Assistant Professor; Milstein Award for Young Investigators, International Cytokines and Interferon Society; Young Investigator Award, American Society for Microbiology Benhur Lee, MD, Ward-Coleman Chair in Microbiology; Keynote Speaker, 4th Measles-Rubella Mini Symposium, Sabin Vaccine Institute Peter Palese, PhD, Chair and Professor, Horace W. Goldsmith Professor of Medicine; Member, Committee on International Security and Arms Control; Member, Standing Committee on Medical and Public Health Research During Large-Scale Emergency Events, National Academies of Sciences, Engineering, and Medicine; Honorary Doctorate, McMaster University; Maurice Hilleman Award, American Society for Microbiology Benjamin tenOever, PhD, Irene and Arthur Fishberg Professor of Medicine; Professor; Keynote Speaker, Keystone Symposia; Keynote Speaker, International Society for Influenza and Other Respiratory Virus Diseases Domenico Tortorella, PhD, Professor; Chair, Immunology Study Section, American Heart Association

Estelle and Daniel Maggin Department of Neurology Susan B. Bressman, MD, Site Chair, Mount Sinai Beth Israel, Mount Sinai West and Mount Sinai St. Luke’s; Professor; Movement Disorders Research Award, American Academy of Neurology and Parkinson’s Disease Foundation Uraina Clark, PhD, Assistant Professor; Suffrage Science Award, MRC Clinical Sciences Centre, Imperial College, United Kingdom Mark W. Green, MD, Professor; Lifetime Achievement Award, National Headache Foundation Cynthia Harden, MD, Professor; Chair-Elect, Epilepsy Section, American Academy of Neurology; Keynote Speaker, Australian and New Zealand Association of Neurology; Lecturer, 2nd Foro de Epilepsia, Spain Fred D. Lublin, MD, Saunders Family Professor of Neurology; John F. Kurtzke Memorial Lecture, Consortium of Multiple Sclerosis Centers Aaron Miller, MD, Professor; Secretary, American Academy of Neurology Lawrence C. Newman, MD, Professor; President and John Graham Lecture Award Recipient, American Headache Society David M. Simpson, MD, Professor; Chair, Quality Standards Subcommittee on Botulinum Toxins, American Academy of Neurology; Co-Chair, Clinical Science Subcommittee, International Neurotoxin Association

Barbara G. Vickrey, MD, MPH, System Chair, Estelle and Daniel Maggin Department of Neurology; Henry P. and Georgette Goldschmidt Professor of Neurology; President, American Neurological Association Ruth Walker, MB, ChB, PhD, Associate Professor; Plenary Lecture, International Parkinson and Movement Disorder Society

Fishberg Department of Neuroscience Mark Baxter, PhD, Professor; Pavlovian Research Award, Pavlovian Society Patrizia Casaccia, MD, PhD, Professor; Chair, Congressionally Directed Medical Programs on Multiple Sclerosis Research; Vice Chair, Myelin Conference, Gordon Research Conference; Keynote Speaker, Virginia Symposium on Brain Immunology and Glia Paul Kenny, PhD, Chair and Professor; NARSAD Distinguished Investigator Award, Brain & Behavior Research Foundation Eric Nestler, MD, PhD, Dean for Academic and Scientific Affairs; Director, Friedman Brain Institute; Nash Family Professor; Lifetime Achievement Award, PATH Foundation, New York

Department of Neurosurgery Johanna T. Fifi, MD, Assistant Professor; Fellow; Chair, Annual Meeting, Society of Vascular and Interventional Neurology

Ellen and Howard C. Katz Department of Obstetrics, Gynecology, and Reproductive Services Michael Brodman, MD, Chairman’s Chair; System Chair and Professor; First Vice President, New York Obstetrical Society

Department of Oncological Sciences Amaia Lujambio, PhD, Assistant Professor; Pinnacle Research Award in Liver Disease, American Association for the Study of Liver Diseases Miriam Merad, MD, PhD, Professor; Keynote Speaker, Dendritic Cell International Meeting; Keynote Speaker, European Neuroimmunology Meeting; Keynote Speaker, European Academy of Tumor Immunology; Keynote Speaker, French Society of Immunology Eirini Papapetrou, MD, PhD, Associate Professor; New Investigator Award, American Society of Gene and Cell Therapy

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Ramon Parsons, MD, PhD, Chair and Professor; Chair, Special Conference Committee, American Association of Cancer Research; Keynote Speaker, Department of Pathology Retreat, Yale University; Keynote Speaker, Breast Cancer Research Retreat, Johns Hopkins University

Department of Ophthalmology Rudrani Banik, MD, Associate Professor; Chair, Patient Information Committee, North American Neuro-Ophthalmology Society Ronald C. Gentile, MD, Professor; Rhett Buckler Award, American Society of Retina Specialists, Austria; Keynote Speaker, Annual Vitrectomy Course, Massachusetts Eye and Ear Infirmary, Harvard Medical School; Richard C. Troutman, MD Award in Ophthalmology, State University of New York-Downstate Medical Center Alumni Association Michelle Rhee, MD, Assistant Professor; Chair, Scientific Program Committee, Contact Lens Association of Ophthalmologists; Vice Chair, Scientific Program Committee, Eye Bank Association of America; Leadership Development Program, American Academy of Ophthalmology Paul A. Sidoti, MD, Professor; Induction, Doheny Society of Scholars, Doheny Eye Institute James C. Tsai, MD, MBA, President, New York Eye and Ear Infirmary of Mount Sinai; Chair, Department of Ophthalmology; Dealfied-Rogers Professor of Ophthalmology; Physician Scientist Award, Fight for Sight; Secretariat Award, American Academy of Ophthalmology; Elected Fellow, New York Academy of Medicine Albert Wu, MD, PhD, Assistant Professor; Romanian Association of Plastic Surgery, Honorary Member

Leni and Peter W. May Department of Orthopaedics Alexis Colvin, MD, Associate Professor; Segal Talk, U.S. Food and Drug Administration Arthritis Foundation Leesa M. Galatz, MD, System Chair, Mount Sinai Chair in Orthopaedics; Professor; Chair, Fellowship Match Committee, American Shoulder and Elbow Surgeons; Spotlight Speaker, Rotator Cuff Disease Session, Orthopaedic Research Society; Presidential Guest Speaker, New Zealand Shoulder and Elbow Society William Hamilton, MD, Associate Professor; Forty Years of Service in the Field of Dance Medicine, New York City Ballet James C. Latridis, PhD, Mount Sinai Chair in Orthopaedic Research; Professor; Chair, Spine Section, Orthopeadic Research Society; Chair, New Investigator Research Funding Workshop,

Orthopaedic Research Education Foundation; Inducted Fellow, American Institute for Medical and Biological Engineering; Henry Farfan Award, North American Spine Society

Lillian and Henry M. StrattonHans Popper Department of Pathology Carlos Cordon-Cardo, MD, PhD, System Chair and Irene Heinz Given and John LaPorte Given Professor of Pathology; “Thought Leader” Award, Agilent Technologies; Keynote Speaker and Certificate of Honor, Museo de Historia de la Medicina y Ciencias de la Salud, University of Puerto Rico; Keynote Speaker, European Association of Urology; Keynote Speaker, American Association of Pathologists’ Assistants; Keynote Speaker, International Society for the Study and Exchange of Evidence from Clinical Research and Medical Experience; Keynote Speaker, Asociación Española de Urologia, Spain

Jack and Lucy Clark Department of Pediatrics Edward E. Conway, MD, Professor and Mount Sinai Beth Israel Site Chair; Chairman, Executive Section on Critical Care, American Academy of Pediatrics; Board of Regents, American College of Critical Care Medicine; Nominee for the Distinguished Career Award, Section on Critical Care, American Academy of Pediatrics Bruce D. Gelb, MD, Professor; President, International Pediatric Research Foundation; Featured Speaker, Annual Meeting, Congenital Heart Surgeons Society; James C. Hunt Visiting Professor, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center Maria New, MD, Professor; Elected Member, and Guest Lecturer, Interurban Club; Guest Editor, Journal of Steroid Biochemistry and Molecular Biology; Lead Guest Editor, International Journal of Reproduction, Fertility and Sexual Health; Selected Abstract Reviewer, European Society of Pediatric Endocrinology Lawrence Noble, MD, Associate Professor; Policy Chair, Section on Breast Feeding, American Academy of Pediatrics; Secretary, Academy of Breastfeeding Medicine Anna Nowak-Wegrzyn, MD, Associate Professor; Chair, Medical Advisory Board, International Food Protein Induced Enterocolitis Syndrome Association; Gail Shapiro Memorial Lectureship, American Academy of Allergy Asthma and Immunology Hugh A. Sampson, MD, Professor; Stephen D. Lockey, Jr. MD Lectureship, American Academy of Allergy Asthma and Immunology

Lisa M. Satlin, MD, System Chair, Herbert H. Lehman Professor of Pediatrics; Chair, Hepatorenal Fibrocystic Disease Center External Advisory Committee, University of Alabama; Annual Alan B. Gruskin, MD Lecture, Children’s Hospital of Michigan Annemarie Stroustrup, MD, MPH, Associate Professor; Co-Chair, Communications Committee, Society for Pediatric Research Julie Wang, MD, Associate Professor; Physician Chair, Allied Health Professionals Assembly; Chair, Anaphylaxis Committee, American Academy of Allergy, Asthma and Immunology Amy Woolover, MD, Assistant Professor; Literacy Champion Award, Reach Out and Read of Greater New York Steven Yung, MD, Assistant Professor; Chair, New York State Solutions for Patient Safety

Charles R. Bronfman Institute for Personalized Medicine Judy Cho, MD, Director; Keynote Speaker, Department of Medicine Research Retreat, Johns Hopkins University Eimear Kenny, PhD, Assistant Professor; Keynote Speaker, Consortium on Asthma among African-Ancestry Populations in the Americas; Keynote Speaker, Pharmacogenomics Research Network; Keynote Speaker, Human Heredity and Health in Africa Girish Nadkarni, MD, Instructor; Best Abstract, American College of Cardiology

Dorothy H. and Lewis Rosenstiel Department of Pharmacology and Systems Therapeutics Ravi Iyengar, PhD, Professor; Keynote Speaker, Drug Safety, Gordon Conference; Jeffrey Michel Innovations in Systems Biology Award, Department of Bioengineering; Lectureship, Rice University

Department of Preventative Medicine Manish Arora, PhD, MPH, Associate Professor; 2015 Joan Daisey Award, International Society of Exposure Sciences Jia Chen, ScD, Professor; Chair, American Association of Cancer Research Maida Galvez, MD, Associate Professor; Environmental Champion Award, U.S. Environmental Protection Agency Region 2; Award for Outstanding Dedication and Service to the Members and Children of NY Chapter 3 AAP, American Academy of Pediatrics

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Luca Lambertini, PhD, Assistant Professor; Co-Chair, Advisory Council on Children’s Environmental Health, New York State Department of Health Philip J. Landrigan, MD, Dean for Global Health; Professor, Department of Preventive Medicine; Dr. Irving Selikoff Lifetime Achievement Award, Asbestos Disease Awareness Association; Araki Foundation Award for Social Medicine Promotion, Juntendo University, Japan; Outstanding Leadership in Children’s Environmental Health, Grassroots Environmental Education

Department of Psychiatry Cindy J. Aaronson, MSW, PhD, Assistant Clinical Professor; Secretary, Board of Directors, Anxiety and Depression Association of America Hansel Arroyo, MD, Assistant Professor; Dorfman Journal Paper Award for Best Article for Original Research, Academy of Psychosomatic Medicine Joseph Buxbaum, PhD, G. Harold and Leila Y. Mathers Research Professor of Geriatrics and Adult Development (Molecular Biology of Aging); Professor; Elected Member, National Academy of Medicine; Keynote Speaker, Meeting of the Minds Symposium, Neurosciences Institute, State University of New York at Stony Brook Barbara Coffey, MD, Professor; Co-Chairman, Risk Symposium, American Academy of Child and Adolescent Psychiatry; Named Lecturer, San Antonio County Psychiatric Society Don Des Jarlais, PhD, Professor; Co-Chair, Expert Committee to Update Science of HIV and Drug Use; Presenter, UN General Assembly Special Session on Drugs, United Nations Office on Drugs and Crime Rita Goldstein, PhD, Professor; Symposium Chair, Society for Neuroscience

MOUNT SINAI SCIENCE & MEDICINE / FALL 2015

Iliyan Ivanov, MD, Associate Professor; Best Poster Presentation, Annual Meeting, American Professional Society of Attention Deficit Hyperactivity Disorder and Related Disorders Harold Koenigsberg, MD, Professor; Fellow, American College of Neuropsychopharmacology Alexander Kolevzon, MD, Associate Professor; Chair, National Medical Student Training Program; Outstanding Mentor Award for the Summer Medical Student Fellowship, American Academy of Child and Adolescent Psychiatry Glenn Martin, MD, DFAPA, CIP, Senior Associate Dean for Human Subjects Research; Assistant Professor; Speaker of the Assembly, American Psychiatric Association Nadia Micali, MD, PhD, MSc, Associate Professor; President, Eating Disorders Research Society

Jeffrey Newcorn, MD, Associate Professor; Chair of Advisory Board, Klingenstein Third Generation Foundation Mercedes Perez, MD, PhD, Assistant Professor; Keynote Speaker, Psychiatry Resident and Fellow Graduation Ceremony, Bergen Regional Hospital, New Jersey

Department of Rehabilitation Medicine Kristjan T. Ragnarsson, MD, Professor; Distinguished Public Service Award, American Scandinavian Foundation; Distinguished Rusk Alumni Award, Rusk Rehabilitation of New York University School of Medicine

Panagiotis Roussos, MD, PhD, Assistant Professor; New Vision Award, Charleston Conference on Alzheimer’s Disease; Presidential Early Career Award for Scientists and Engineers, Office of Science and Technology Policy, The White House

Ruth J. & Maxwell Hauser and Harriet & Arthur H. Aufses, Jr., MD Department of Surgery

Akhil Shenoy, MD, MPH, Assistant Professor; Dorfman Award, Academy of Psychosomatic Medicine

Susan K. Boolbol, MD, FACS, Associate Professor; Chair, Breast Fellows Program Director Committee, Society of Surgical Oncology; Chair, Vendor Relations Committee, American Society of Breast Surgeons

Pamela Sklar, MD, PhD, Mount Sinai Chair in Psychiatric Genomics; Professor; Fellow, American College of Neuropsychopharmacology; Keynote Speaker, National MD/PhD Student Conference, University of Colorado; Keynote Speaker, Mental Health Research Conference, Society of Mental Health Research; Keynote Speaker, Department of Neuroscience Annual Retreat, University of Connecticut James J. Strain, MD, Professor; Frits Huyse Award, European Psychosomatic and Consultation-Liaison Society Talia Wiesel, PhD, Assistant Professor; Diplomate, Academy of Cognitive Therapy

Department of Radiation Oncology Manjeet Chadha, MD, Professor; Fellow, American Society of Radiation Oncology Ronald Ennis, MD, Associate Professor; Chairman, Government Relations Committee, Government Relations Council, American Society of Radiation Oncology

Department of Radiology Burton Drayer, MD, Dean for Clinical Affairs; System Chair, Department of Radiology; Charles M. and Marilyn Newman Professor; Chairman, Research and Education Foundation, Radiological Society of North America

Celia M. Divino, MD, Professor of Surgery; Associate Examiner, American Board of Surgery; Advisory Council for General Surgery, American College of Surgeons Daniel M. Herron, MD, Professor; Chair, Communications Committee, American Society of Metabolic and Bariatric Surgery; Chair, Executive Committee for Video-Based Education, American College of Surgeons James C. Jeng, MD, Associate Professor; Chairman, Disaster Preparedness Committee, International Society for Burn Injuries; Chairman, Disaster Subcommittee, American Burn Association; Invited International Speaker; Delivery of Murray Clarke Oration, Australian New Zealand Burn Association; Study Section Reviewer, Orphan Diseases Program, Food and Drug Administration; Keynote Speaker, National Consolidated Operations Plan, Health and Human Services Sung Yup Kim, MD, Assistant Professor; President, Korean American Physicians Association of New York Barry Salky, MD, FACS, Professor; Keynote Speaker, Institut de Recherche contre les Cancers de l’Appareil Digestif, France; Keynote Speaker, Invasive Digestive Surgery Seminar for Next Generations; Keynote Speaker, Annual Congress of the Indian Association of Gastrointestinal Endo-Surgeons, India

Adam Jacobi, MD, Assistant Professor of Radiology; Keynote Speaker and Certificate of Merit for Abstract, Annual Meeting, Society of Thoracic Radiology

Mark Sultan, MD, FACS, Professor; The Eugene Courtiss Annual Lecture, Northeastern Society of Plastic Surgeons

Alexander Kagen, MD, Associate Professor; Chair, Pathology Working Group, American College of Radiology

Patricia Sylla, MD, Associate Professor; Chair, Conflict of Interest Task Force, Society of the American Gastrointestinal and Endoscopic Surgeons

William L. Simpson, Jr., MD, Associate Professor; Fellow; Fellowship, American College of Radiology

Ageliki Vouyouka, MD, Associate Professor; President, New York Society for Vascular Surgery

Bachir Taouli, MD, Professor; Honorary Membership, Iranian Society of Radiology

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2015–2016

SNAPSHOT Scholarships change lives AVERAGE STUDENT DEBT UPON GRADUATION

National

$181,000 Icahn School of Medicine at Mount Sinai

$144,000 Our goal is to reduce student debt to less than

$100,000

612 52% 466 Women

MD

$61,649

19%

92

$22,049

Students

Underrepresented minorities

43%

match to top 20 academic medical centers

MD/PhD

54

MD/Masters

Average annual cost of tuition, room, and board

Average per-student scholarship

$190,235

Awarded to 34 FlexMed students

Reducing student debt begins with YOU philanthropy. mountsinai.org/ scholarships

$4,428,915 Total scholarship funds distributed for academic year 2015–2016

For more information on the power of scholarships at the Icahn School of Medicine at Mount Sinai, contact Anastasia Hagan, Director of Development for Medical Education and Alumni Relations, at anastasia.hagan@mountsinai.org or 646-605-8773.

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Non Profit Org. U.S. Postage

PAID Mount Sinai Health System Office of Development One Gustave L. Levy Place, Box 1049 New York, NY 10029-6574

S. Hackensack, NJ Permit No. 897

Please contact us by telephone (212.659.8500) or email (PhilanthropyOptOut@mountsinai.org) if you wish to have your name removed from our distribution list for fundraising materials.

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