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IN THIS ISSUE

Mount Sinai Around the Globe + Vanquishing Disease + Welcoming an Iconoclast + Helping Hands in Haiti

FALL 2011

Mount Sinai SCIENCE & MEDICINE T h e M a g a z i n e o f th e M o u n t S i n a i M e di c a l C e n t e r

Mount Sinai anesthesiologist Irene Osborn, MD greets a young patient during a recent service trip to Haiti

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GLOBAL IMPACT

Our medical programs, research projects, and healthcare outreach extend to every corner of the globe

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Mount Sinai SCIENCE & MEDICINE

21

Volume II, number 3

President and Chief Executive Officer, The Mount Sinai Medical Center

Kenneth L. Davis, MD Anne and Joel Ehrenkranz Dean, Mount Sinai School Of Medicine Executive Vice President For Academic Affairs, The Mount Sinai Medical Center

Dennis S. Charney, MD Senior Vice President, Development, The Mount Sinai Medical Center

Mark Kostegan, FAHP

25

Editor

Celia M. Regan Associate Editor

Travis Adkins Editorial Assistant

Vanesa Sarić Contributors

Philip Berroll Sara Daniels Don Hamerman Andrew Lichtenstein Sima Rabinowitz Katie Quackenbush Spiegel

Healthcare institutions like to use “world-class” to define their quality. Mount Sinai really can. Look at the world. It’s bigger. It’s smaller. It’s more interconnected. It’s more deeply

Design

Taylor Design Mount Sinai Science & Medicine is published three times annually by the Office of Development, The Mount Sinai Medical Center, 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 on the Web at philanthropy.mountsinai.org

divided. It’s safer. It’s at greater risk. Health has never been more openly addressed— and sickness has never been more challenging. According to Mount Sinai’s Global Health Program, the “global village” is coming closer and closer to reality. Rapid air flight and instant communication speed images and ideas to almost every peak and valley of the globe. Right now there are 6.9 billion people on Earth, of whom 2.2 billion are children. By 2050, there will be 9 billion people. For the first time in all of human history, more than half of the world’s population lives in cities. It’s warmer, so diseases such as malaria and dengue that once were seen only in the tropics are now spreading far beyond their traditional boundaries. By United Nations estimates, 500 to 600 million people, or close to 10 percent of the world’s population, are at risk from

ABOUT OUR COVER Mount Sinai neuroanesthesiologist Irene Osborn, MD greets a young patient at Bernard Mevs hospital in Haiti. Dr. Osborn was part of the surgical team that treated the patient, an 18-month-old girl who had sustained a serious skull injury during the 2010 earthquake. This photo was taken the day before the surgery—which was a complete success—and captures the patient’s joy at the chance, as Dr. Osborn says, “to just run around and be a little girl again.” On the back cover, Andrew Abrass, a resident in emergency medicine who also traveled to Haiti, prepares for a procedure. For a portfolio by photojournalist Andrew Lichtenstein chronicling the work of Mount Sinai volunteers in Haiti, see page 28.

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displacement by climate change. Toxic synthetic chemicals and pesticides banned in North America and Western Europe are exported to less developed nations where they cause cancer, birth defects, and sterility. The world is beset by extremes of wealth and poverty. According to the World Bank Development Indicators, almost half of the world’s population lives on a daily income of less than $2.50. This is the world we live in. And this is the world Mount Sinai serves. Read our features to learn how we’re confronting all aspects of disease and illness, both in our New York labs and on almost every continent. It’s a great story, full of hope and real impact. And that is what world-class really means.

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CONTENTS

28 Message 02 Global Impact: Mount Sinai’s reach extends far beyond our borders

News 03 Advancing in the ranks + Commencement hails grads and honorary degree recipients + Dubin Breast Center opens its doors + Greening our children + Fuster honored by France + Celebrating the passage of a 9/11 bill + In Memoriam: Edgar M. Cullman, Sr.

Faculty 07 Eight receive honors and recognition + 14 doctors advance in—and join— Mount Sinai + Research yields new insights into race and genetics, childhood diseases and the environment, heart disease and gene therapy, and fat cells

FEATURES Global Impact 10    Making a World of Difference

Mount Sinai is just about everywhere.

12   Vive la Difference

Drs. Palese and García-Sastre do battle with influenza.

16   Iconoclast Giving 33 Honoring the Cullman family + Cardinale gift goes to key ventures + A season of celebrations include openings of the Dubin Breast Center, The Zweig Center, and a new home for Palliative Care, as well as the Crystal Party, a welcome for Maki, and a salute to scholarship donors and recipients

Alumni 38 A closer look at alumnus Dr. Michael Brodman + Celebrating the 2011 Alumni Weekend and the winners of the Jacobi Medallion + Dr. Nagarsheth is rocking + Why scholarships matter

Dr. Schadt arrives to direct Genomics and Multiscale Biology.

21    Dialogue: Size Matters

Drs. Boffetta and Landrigan examine the epidemiological issues affecting a global population.

25    Passionate Pioneer

Dr. Merad brings brilliance and verve to immunology.

28    Haiti: Revisited A photojournalist follows our volunteers in Port-au-Prince.

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Mg

MESSAGE

Message from

the President      the Dean

&

The work of a major academic medical center like Mount Sinai is felt far beyond its corridors, its neighborhood, and even its country. It has true global impact, whether it takes place on our campus or on another continent. The translational work we do can cure a patient from East Harlem, and lead to treatments in Argentina, Egypt, or South Korea. For centuries, students have chosen a life devoted to medicine and scientific research because they want to touch lives, to make a difference: For the current generation, our ever growing internationalism means that they can touch millions—even billions—through their accomplishments, based in New York City or anywhere across the globe. Just as disease and illness increasingly know no boundaries, the tools we wield to fight them are becoming universally available and effective. This issue of Science & Medicine takes a look at the many ways Mount Sinai is transforming lives on a global scale and the dedicated physicians and scientists who are driving these breakthroughs. Their work dares us to imagine a new world of health and wellness: a world without the devastation of viruses like influenza, a world where tumors can be completely eradicated, a world where an understanding of the human genome leads to the discovery of new diagnostics and therapeutics—and where advances in epidemiology affect everyone, everywhere. Right here, right now, our doctors and surgeons are helping to combat the health

Mount Sinai is transforming lives on a global scale.

crisis in places like Haiti; our programs in global health extend our training and healing further and further to the developing countries whose own health-care systems are challenged, broken down, even nonexistent. We salute the vision of all these professionals, who can see both precisely and with epic scope, and we take pride that they have all made Mount Sinai

Mount Sinai Science & Medicine / FALL 2011

their home.

Kenneth L. Davis, MD President and Chief Executive Officer, The Mount Sinai Medical Center

Dennis S. Charney, MD Anne and Joel Ehrenkranz Dean, Mount Sinai School of Medicine Executive Vice President for Academic Affairs, The Mount Sinai Medical Center

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LEFT: Honorary degree

RIGHT: Dean Charney and Dr. Eva Dubin

recipient Kirsten Gillibrand

present the honorary degree to Nancy G. Brinker,

addresses the graduates

founder of Susan G. Komen for the Cure

NEWS

MSSM’s 42nd Commencement Honors Leaders in Medical Progress Mount Sinai School of Medicine bestowed honorary

the founding CEO and chairman of RainDance

degrees on U.S. Senator Kirsten Gillibrand, Nancy

Technologies, Clarifi Corporation, and CuraGen

G. Brinker, founder of Susan G. Komen for the Cure,

Corporation, each received an honorary Doctor

and three scientific pioneers for their commitment

of Science degree for significant contributions

to advancing medical progress at its 42nd

to their fields.

Commencement, held on May 13 in Avery Fisher

Dean Dennis S. Charney spoke of the

Hall at Lincoln Center.

promising future made possible by discoveries

Keynote speaker Senator Gillibrand (D-New

in genomics and other scientific breakthroughs

York) told the graduating class—a group of 249

and challenged graduates to make that promise

that comprised 123 MD, 53 PhD, 36 MPH, and 37

a reality. “As the next generation of scientists and

MS recipients—that their work as physicians and

clinicians, you must be in the vanguard of such

scientists is critical to America’s success. “We will

an historic transformation in biomedical research

be relying on you to lead this country forward in

and clinical practice,” he said.

biotechnology,” she said. “We need each of you to…

“This graduating class of physicians and

put the knowledge, skills, and talents that you’ve

scientists cannot simply accept things as they

learned at Mount Sinai toward creating a better

are, because deep and profound changes are

future for America.”

already underway,” said the Medical Center’s

Epidemiologist William Foege, MD, MPH, the

president, Kenneth L. Davis. “For the sake of your

former director of the Center for Disease Control and

patients and the vitality of the health care system

Prevention; genomics research expert Leroy Hood,

in America, you must dream things as they can

MD, PhD, the president of the Institute for Systems

be, and ask the necessary questions that will get

Biology; and inventor Jonathan M. Rothberg,

us there, to a bold and brighter future.”

“You must dream things as they can be, and ask the necessary questions that will get us there, to a bold and brighter future.” – President Kenneth L. Davis

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RANKING BY SPECIALTY

Mount Sinai Climbs U.S.News Hospitals Rankings—and Adds to New York magazine “Best Doctors” List The Mount Sinai Medical Center placed 16th out of nearly 5,000 hospitals nationwide in the 2011–2012 “Best Hospitals” issue of U.S.News & World Report, scoring highly in 12 of 16 specialties and improving its position in nine specialties over the 2010 rankings. Mount Sinai ranked in the top 20 in

OF 5000 HOSPITALS

geriatrics (#1), digestive disorders (#5), heart and heart surgery (#11), rehabilitation (#14), diabetes/endocrinology (#15), ear, nose, and throat (#18) and psychiatry

(#18). Heart and heart surgery have enjoyed particular success, rising all the way from #41 in 2007.

2011

2010

Geriatrics

1

1

Gastroenteroloy

5

5

Cardiology & Heart Surgery

11

13

Rehabilitation

14

16

Diabetes & Endocrinology

15

20

Ear, Nose & Throat

18

19

Psychiatry

18

18

Neurology & Neurosurgery

22

24

Nephrology

25

29

Gynecology

26

28

Urology

35

45

Cancer

41

48

“Despite economic and political challenges facing the health care industry, Mount Sinai’s position on the Honor Roll is indicative of our commitment to grow and to treat the patients who require the most sophisticated and complex care,” said Kenneth L. Davis, MD, President and CEO of The Mount Sinai Medical Center. “That enterprising spirit makes us a national leader in this area, and we are proud to be recognized in the rankings.” The 2011 “Best Doctors” issue of New York magazine—another key benchmark in the healthcare industry—includes the largest number of Mount Sinai doctors in the Medical Center’s history. In fact, Mount

Mount Sinai Science & Medicine / FALL 2011

Sinai led all New York area hospitals with 209, representing 18 percent of this year’s list. “The partnership between Mount Sinai School of Medicine and The Mount Sinai Hospital creates a unique synergy between transformative research and excellence in clinical care that fundamentally changes the practice of medicine,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of Mount Sinai School of Medicine and Executive Vice President for Academic Affairs of The Mount Sinai Medical Center. “That legacy of translational research is what put Mount Sinai on the map, and combined with our commitment to comprehensive care, we will continue to rise in the rankings in years to come.”

In Memoriam: Edgar M. Cullman, Sr. Trustee Edgar M. Cullman, Sr., whose six decades of service to Mount Sinai were marked by integrity, conviction, and generosity, died on August 28. Mr. Cullman, a lifelong advocate for nursing and patient care, joined the Board of The Mount Sinai Hospital School of Nursing in 1950 and became a Mount Sinai Trustee in 1957. He remained deeply involved throughout his tenure; with his brothers, Lewis B. Cullman and Joseph F. Cullman 3rd, he established The Joseph F. Cullman, Jr. Institute for Patient Care in memory of their father. In October, Mount Sinai will bestow the annual Noble Deeds Society Honorary Award posthumously to Mr. Cullman, and to his family, including his beloved wife, Louise, and their children, Lucy Cullman Danziger and Trustees Edgar M. Cullman, Jr. and Susan R. Cullman. To all of them and their families, Mount Sinai extends our heartfelt condolences. For more about the Cullmans’ long history with Mount Sinai please see page 33.

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Dubin Breast Center Opens The Dubin Breast Center is one of

The April 2011 opening of the Dubin Breast Center of The Tisch Cancer Institute marked an important advance in Mount Sinai’s

the first clinics in the country to offer tomosynthesis, a breakthrough radiology technology.

goal of providing patients the best, most comprehensive breast health care available. Made possible by the support of Trustee Glenn R. Dubin and Eva Andersson-Dubin, MD, the state-of-theart, 15,000 square-foot center features a range of services, from clinical care to psychosocial support, and includes an advanced diagnostic and evaluation center for radiology and diagnostic procedures; an evaluation and treatment center for breast medical oncology; and The Margery Price Infusion Center for chemotherapy. “When you feel that you can walk into a place and you can trust all the people there because they’re fighting this battle with you, it just gives you such a sense of relief,” says Tomomi Arakawa, a patient at the Center. “That’s why the Dubin Breast Center is such a special place for patients.” The Dubin Breast Center is one of the first clinics in the country to offer tomosynthesis, a breakthrough radiology technology that produces sharp 3D images, facilitating earlier and more accurate diagnoses. Mount Sinai celebrated the opening with a gala event that drew more than 250 supporters. Learn more about the Center and take a virtual tour at www.dubinbreastcenter.org. See page 35 for coverage of the event.

“Greening Our Children” Panelists and Expo Focus on Environment The Mount Sinai Children’s Environmental Health Center (CEHC) hosted its fourth annual Greening Our Children benefit luncheon and raised more than $700,000 to support research into the environmental causes of childhood diseases on May 9 in Greenwich, Connecticut. Guests learned how to prevent toxic exposures in the home, browsed through a “green expo” featuring environmentally safe products, and listened to an interactive panel discussion featuring the CEHC’s director Philip J. Landrigan, MD, MSc and his colleague Shanna Swan, PhD alongside actress Jessica Capshaw and children’s health advocate Christopher Gavigan. Co-chaired by Mount Sinai supporters Eunice Burnett and Elisabeth Wolfe, this year’s event was the most successful to date with 700 guests in attendance. TOP: (from left) Shanna Swan, Eunice Burnett, Philip J. Landrigan, Christopher Gavigan, and Elisabeth Wolfe. BELOW: A crowd of 700 attended at this year’s event—the largest yet.

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Valentin Fuster, MD, PhD, Honored by France In June, Valentin Fuster, MD, PhD, the Director of Mount Sinai Heart, the Zena and Michael A. Wiener Cardiovascular Institute, and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, and the Richard Gorlin, MD/Heart Research Foundation Professor, Mount Sinai School of Medicine was awarded the 2011 Grand Prix Scientifique by the Institut de France. Dr. Fuster was chosen for his discoveries in the field of atherothrombosis, or blockage of the arteries. “I feel very proud for what this award represents to my outstanding research colleagues over the years from the Mayo Clinic, Mount Sinai School of Medicine in New York, and the National Center of Cardiovascular Research in Madrid,” said Dr. Fuster, who has served as past President of the American Heart Association and past President of the World Heart Federation. “It is a tremendous honor and I share it with all of them.” Dr. Fuster is the only cardiologist to receive the two highest gold medal awards and all four major research awards from the four major cardiovascular organizations.

Dr. Fuster (right) receives the Grand Prix from Alain Carpentier, MD, of the Institut de France

Mount Sinai Science & Medicine / FALL 2011

Mount Sinai Celebrates Passage of Landmark 9/11 Health Care Bill

PICTURED: (from left) Philip J. Landrigan, MD, MSc; John Howard, MD, director of the National Institute for Occupational Safety and Health; Mayor Michael Bloomberg; Congresswoman Carolyn Maloney; and Jim Melius, MD, administrator of the NYS Laborers Health and Safety Trust Fund

Government, community, and labor leaders gathered at Mount Sinai on July 1 for an event celebrating the passage of the James Zadroga 9/11 Health and Compensation Act, which provides funding for the health care of emergency responders who were affected by the attacks of Sept. 11, 2001. Mount Sinai took the lead in developing the clinical care programs that the bill will support. “Today marks a new milestone in the ongoing efforts to address the health impacts wrought by the September 11th terrorist attacks,” said New York City Mayor Michael Bloomberg.

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Fa

FACULTY

&

Recognition   Awards

Drs. Blander and tenOever Awarded Burroughs Wellcome Fund Grant

The American Psychiatric Association Honors Larry J. Siever

The Burroughs Wellcome Fund recently

Larry J. Siever, MD, professor of psychiatry

awarded Julie Magarian Blander, PhD,

and vice chair of veterans affairs, received

associate professor of medicine, and

the 2011 Judd Marmor Award from the

Benjamin tenOever, PhD, associate

American Psychiatric Association (APA).

professor of microbiology, grants for their

Dr. Siever, honored for his research in

pioneering research in infectious diseases,

biopsychosocial factors involved in mental

supporting study of the intersection of

health, gave a lecture at the APA’s annual

human and microbial biology. Mount

meeting in May.

Sinai was the only research center with two recipients.

Louis M. Aledort Receives Lifetime Achievement Award

APA Honors Margaret Baron and Ethylin Wang Jabs Margaret H. Baron, MD, PhD, professor of medicine in hematology, director of

Louis M. Aledort, MD, Mary Weinfeld

hematology and medical oncology research,

Professor of Clinical Research in

and Ethylin Wang Jabs, MD, vice chair and

Hemophilia, has received the Albert

division chief of the Department of Genetics

Einstein College of Medicine Lifetime

and Genomic Sciences, were among 64

Achievement Award in recognition of

individuals elected to the Association of

his distinguished career in the field of

American Physicians this year.

blood disorders, and his major contributions to the health and welfare of underserved communities.

Alisan Goldfarb Named Physician of Distinction by American Cancer Society

Joanna Fowler Receives Distinguished Women in Chemistry Award Joanna Fowler, PhD, professor of psychiatry and a senior chemist and director of Radiotracer Chemistry, Instrumentation

In May, Alisan B. Goldfarb, MD, FACS,

and Biological Imaging at the U.S.

assistant clinical professor of surgery, was

Department of Energy’s Brookhaven

honored with the Physician of Distinction

National Laboratory, was one of 23 women

Award by the American Cancer Society.

from around the world chosen to receive

Dr. Goldfarb was singled out in particular

a 2011 Distinguished Women in Chemistry/

for her staunch advocacy for patients and

Chemical Engineering Award, sponsored by

improving their quality of life.

the American Chemical Society.

Mount Sinai Faculty Receive New Appointments Michael K. Parides, PhD is now director of the newly established Center for Biostatistics. Dr. Parides, who is also a professor in the Department of Health Evidence and Policy, has served as principal statistician for many large multicenter randomized clinical trials. Yaron Tomer, MD, FACP, who has served as vice chair for research in the Department of Medicine for the past two years and is also the Irene and Arthur M. Fishberg Professor of Medicine, is the new chief of the Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, as well as the acting director of the Mount Sinai Metabolism Institute. Frances R. Wallach, MD has been appointed as Epidemiologist and Infection Control Officer for The Mount Sinai Hospital. Dr. Wallach has served in many capacities during her tenure at Mount Sinai, including as medical director of the Jack Martin Fund Clinic, and is an associate professor of medicine in the Division of Infectious Diseases.

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FACULTY

New RECRUITS Katherine Burdick, PhD recently joined Mount Sinai as chief of neuropsychiatry research in the Department of Psychiatry. Dr. Burdick’s primary research interests are neurocognitive functioning in major psychiatry disorders and cognitive genomics. She was formerly director of the Neurocognitive Assessment Unit in Psychiatry Research at the Zucker Hillside Hospital of the North Shore Long Island Jewish Health System. Carlos Cordon-Cardo, MD, PhD is the new chair of the Department of Pathology. Dr. Cordon-Cardo’s research focuses on analyses of multidrug resistance and alterations of tumor suppressor genes in humans. He comes to Mount Sinai from Columbia University College of Physicians and Surgeons, where he was vice chair of pathology and professor of pathology and urology. Michael Domanski, MD has joined Mount Sinai as director of heart failure research and professor of medicine. Dr. Domanski’s background is in investigating causes of heart failure and in designing and implementing cardiovascular clinical trials. Prior to joining to Mount Sinai, he served as chief of the Atherothrombosis and Coronary Artery Disease Branch at the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Mount Sinai Science & Medicine / FALL 2011

Adolfo Firpo-Betancourt, MD, MPA, FCAP has joined Mount Sinai as director of pathology educational activities in the Department of Pathology. Dr. Firpo-Betancourt has held many highly placed positions throughout his career in health care policy and management, including medical director of Puerto Rico’s Administration of Health Services, and his research contributed significantly to the National Institute of Child Health and Human Development’s groundbreaking Women and Infants Transmission Study. Steven Frucht, MD has joined Mount Sinai as professor of neurology and director of the Robert and John Bendheim Parkinson and Movement Disorders Center. He maintains a clinical practice devoted to Parkinson’s disease, dystonia, tremor, unusual movement disorders, and pediatric movement disorders. Dr. Frucht previously served as associate professor of clinical neurology, Columbia University Medical Center. Carol Levy, MD returns to Mount Sinai as director of the clinical trials office and as a physician in the division of endocrinology, diabetes, and metabolism. As a clinician Dr. Levy specializes in treating diabetes, while as a researcher she concentrates on optimizing clinical trials. Dr. Levy was an assistant professor of

medicine at Mount Sinai earlier in her career; most recently she was an assistant professor of clinical medicine at Weill-Cornell Medical College. Olivier Saidi, PhD has joined Mount Sinai as director of information biology and systems pathology in the Department of Pathology. The co-founder and chief technology officer at Aureon Biosciences Inc., a life science company specializing in personalized cancer treatment, Dr. Saidi has authored numerous publications and holds multiple patents in the fields of tissue-based imaging, machine learning, and neural networks technologies. Jagat Narula, MD, PhD has joined Mount Sinai as director of the cardiovascular imaging program. Dr. Narula, who was also appointed Philip J. and Harriet L. Goodhart Professor of Medicine (Cardiology) and associate dean for global health, has contributed significantly to the development of imaging techniques to identify patients at risk of heart failure. Previously, he was chief of cardiology and associate dean for research at University of California, Irvine’s School of Medicine. Eric Schadt, PhD has joined Mount Sinai as director of the Institute for Genomics and Multiscale Biology and as the Jean C. and James W. Crystal Professor of Genomics, and chair of the Department of Genetics and Genomics Sciences. See page 16 for more about Dr. Schadt. Amir Steinberg, MD, FACP has joined Mount Sinai as an assistant professor in the division of hematology-oncology. Dr. Steinberg’s research focuses on stem cell transplants for acute leukemia and novel therapies for relapsed central nervous system lymphomas; he also has a clinical interest in cancer survivorship. He previously was a clinical assistant professor at UCLA on the staff of Cedars-Sinai Medical Center in Los Angeles. Shanna H. Swan, PhD has joined Mount Sinai as the vice chair for research in the Department of Preventive Medicine and as a member of the Children’s Environmental Health Center. She was previously director of the Center for Reproductive Epidemiology at the University of Rochester School of Medicine and Dentistry; her research focuses on the impact of environmental exposures on male and female reproductive health.

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Research Roundup Research Suggests Dramatic Shift in Understanding of Personalized Medicine

Safe and Effective Gene Therapy to Treat Severe Heart Failure

Researchers at Mount Sinai and Loyola University Chicago have

In a Phase II trial, researchers found that a gene therapy developed

made a critical discovery in a first-of-its-kind study that may lead

at Mount Sinai stabilized or improved cardiac function in people with

scientists to abandon the use of broad conventional ethnic labels—

severe heart failure. Patients receiving a high dose of the therapy, called

African-American, Hispanic, and Caucasian—to estimate a patient’s

SERCA2a, experienced substantial clinical benefit and significantly

genetic risk for disease. The Mount Sinai Biobank, a program of

reduced cardiovascular hospitalizations, addressing a critical unmet

the Charles R. Bronfman Institute for Personalized

need in this population. The data were published online

Medicine, enrolls consenting patients who confi-

in the June 27 issue of the American Heart Association

dentially provide DNA and plasma samples to aid

journal Circulation.

in genomic and personalized medicine research.

Researchers used genomic technology to determine

safe in this sick patient population, with no increases

Gene therapy with SERCA2a was also found to be

the genetic make-up of nearly 1,000 local Biobank

in adverse events, disease-related events, laboratory

participants and found a continuum in ancestral

abnormalities, or arrhythmias compared to placebo.

genetic heritage at the individual level of self-

“This study establishes a new paradigm for the treat-

identified African-American and Hispanic patients—

ment of heart failure by clinically validating SERCA2a

meaning considerable fractions of their genome came

as a novel target and ushers in a new era for gene

3.5%

from mixed European or African ancestry, respectively—and with it genetic variants that indicate risk for developing disease. Researchers at the Bronfman Institute—directed by Erwin Bottinger, MD, Irene and Dr. Arthur M. Fishberg Professor of Medicine—are now evaluating the clinical use potential of hundreds of genetic markers for diseases of the heart, kidney, and liver, and diabetes, and various drug responses, in all Biobank samples.

Researchers Estimate Environmentally-Induced Childhood Disease Cost at $76.6 Billion

of all direct and indirect US health care costs in 2008 resulted from environmentallyinduced childhood disease.

therapy for the treatment of failing hearts,” said Roger J. Hajjar, MD, research director of Mount Sinai’s Wiener Family Cardiovascular Research Laboratories, and the Arthur and Janet C. Ross Professor of Medicine, and Gene and Cell Medicine.

Researchers Learn How Some Cells Become Fat Cells A new NIH-funded study, published in Developmental Cell, has found that a cellular signaling pathway governs the differentiation of cells into fat tissue or smooth muscle which lines the vascular system. Engaging this signaling pathway and its capacity to govern cell differ-

In three new studies published in the May issue

entiation has important implications in preventing

of Health Affairs, Mount Sinai researchers, led by

obesity and cardiovascular disease. This novel

Leonardo Trasande, MD, associate professor of

study, co-led by Philippe M. Soriano, PhD, professor,

preventive medicine and pediatrics, revealed the

developmental and regenerative biology, and Lorin

staggering economic impact of toxic chemicals and

E. Olson, PhD, previously a postdoctoral fellow in

air pollutants in the environment, and proposed new

the laboratory who is now at the Oklahoma Medical

legislation to mandate testing of both new chemicals

Research Foundation, evaluated the Platelet Derived

and those already on the market. They analyzed

Growth Factor Receptor-beta (PDGFR), using mice that

the costs of conditions—including lead poisoning,

were genetically engineered to have elevated PDGFR

childhood cancer, asthma, autism, and attention

signaling. Findings: The elevated signaling inhibits

deficit hyperactivity disorder—associated with exposure to toxic

differentiation of immature mesenchymal stem cells, which have the

chemicals, and calculated the annual cost for direct medical care

ability to give rise to multiple cell types in the organism, including fat

and the indirect costs, such as parents’ lost work days and lost

cells and vascular smooth muscle. While noting that more research is

economic productivity caring for their children, of these diseases

essential, the researchers believe that the data “indicate that PDGFR

in children. The total: an estimated $76.6 billion, or 3.5 percent of

plays a critical role in determining their cellular fate, providing a new

all US health care costs in 2008.

therapeutic target in preventing the onset of diseases like obesity.”

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North Dakota Spirit Lake Nation: Encouraging local students to enter medicine (Project partners: Cankdeska Cikana Community College/Mailman School of Public Health)

Dominican Republic

Mexico

Conducting mitral valve surgeries and teaching local surgeons techniques of valve repair

Training environmental and occupational health researchers (Project partners: Queens College)

Belize

Haiti

Mental health (See St. Vincent)

International exchange program (See Ireland)

Treating victims of 2010 earthquake

Pediatric environmental health (See Costa Rica)

Grenada Improving cardiovascular health (Project partners: World Heart Federation)

St. Vincent & the Grenadines

Guatemala Distributing birthing kits (See Sierra Leone)

Costa Rica Training Latin American researchers in pediatric environmental health

El Salvador Training healthcare providers to perform cervical cancer screening

Helping to establish national mental health system

Brazil Sao Paolo: Investigating malaria and tropical diseases (Project partners: Cidade Universitaria)

Colombia Heart-healthy habits (See Spain)

Polypill Initiative (See Italy) International exchange program (See Ireland)

Pediatric environmental health (See Costa Rica)

Environmental and occupational health (See Mexico)

Paraguay

Operating on children with cranial and facial conditions

Polypill Initiative (See Italy)

Mount Sinai Science & Medicine / FALL 2011

Peru

Chile Environmental and occupational health (See Mexico)

Argentina Buenos Aires: Collaborating on neonatal and infant health research projects (Project partners: Fundasamin)

Uruguay Pediatric environmental health (See Costa Rica)

Polypill Initiative (See Italy)

International exchange program (See Ireland)

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Ireland Spain

Expanding minority students’ access to international educational opportunities

Italy Determining efficacy of inexpensive pill designed to prevent heart disease

Teaching kids heart-healthy habits (Project partners: Sesame Workshop)

Polypill Initiative (See Italy)

International exchange program (See Ireland)

Israel Egypt

Analyzing risk factors of cardiovascular disease

Introducing state-of-the-art robotic surgery technology

Screening for hepatitis C (Project partners: Harbor Lights)

A

Iran

OF

The sun never sets on Mount Sinai’s commitment to global health. Our physicians, scientists, and students can be found in Colombia, teaching children about heart-healthy habits; in Tanzania, educating local communities about maternal health; in China, leading cancer research projects; in Egypt, combating the spread of hepatitis C; and all around the world, redrawing the map for medical progress.  – Travis Adkins

Nigeria Sierra Leone Distributing birthing kits to caregivers (Project partners: Saving Mothers)

Performing reconstructive surgery on burn victims

Rwanda Cardiovascular disease (See Malawi)

Tanzania Cameroon Educating healthcare workers in AIDS prevention techniques

Ahakishaka Community: Conducting public information campaign targeting malaria and HIV

Cardiovascular disease (See Malawi)

Liberia Mental health (See St. Vincent)

Ethiopia Developing health programs for orphans (Project partners: Worldwide Orphans Foundation)

Malawi Measuring the impact of preventative programs on cardiovascular disease (Project partners: the United Nations Millennium Village Project)

Mozambique Gorongosa National Park: Instructing community health workers and local midwives (Project partners: Carr Foundation)

South Africa International exchange program (See Ireland)

Madagascar Improving malnutrition treatment and family planning programs (Project partners: Maventy Health International)

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Mongolia Performing ocular surgery and other eye care procedures (Project partners: Virtue Foundation)

Thailand Supporting research into children’s environmental health hazards (Project partners: Chulabhorn Research Institute)

China

Vietnam

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Identifying epidemiological risk factors for cancer

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Mitral valve surgeries and valve repair (See Dominican Republic)

Isolating strains of influenza virus

India

Indochina

Launching communitybased healthcare initiatives (Project partners: The Comprehensive Rural Health Project)

Organizing scientific symposiums

Bangladesh Traveling to remote areas to provide basic care (Project partners: Friendship)

Cambodia Performing reconstructive surgery on victims of acid attacks (Project partners: Virtue Foundation)

ICON KEY

MOUNT SINAI CONNECTION Students

Building Capacity In Global Health

Delivering UrgentlyNeeded Care

Researchers Caregivers Administrators

BOX COLOR KEY Promoting Women and Children’s Health

Combating Epidemics

Single Country Program Multi-Country Program

For an interactive feature with information on these and other programs, visit philanthropy.mountsinai.org

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MOUNT SINAI

OUNT SINAI BEGAN LIFE IN 1862 as the Jews’ Hospital, serving the urban poor of New York City who couldn’t receive medical care anywhere else. Even as we tended the health of the community, that community was also our cradle, our nurturer, shaping the facility through every growth phase. And as we grew and diversified, so did the community itself. Mount Sinai in 2011 is a citizen of the world. Every day, we bring the values of our youth to the responsibilities of our adulthood: Our perspective is international; our breakthroughs open paths to new health around the globe. Patients, students, residents, scientists, physicians, and professionals come to us from just about everywhere, and our own medical and educational programs, research projects, and healthcare outreach extend to almost every corner of the globe. Mount Sinai still serves the community. Take a look at what that community has become.

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V i v e l a D i ff e r e n c e 24172 94P Mt Sinai mag-REVISED.indd 12

Their styles differ, but Dr. Peter Palese and Dr. Adolfo GarcĂ­a-Sastre are focused on a common goal: a universal influenza vaccine.

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“What we have in common is that we are PASSIONATE about research.” – Dr. Adolfo García-Sastre

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The two researchers and their teams have already made significant progress. “We have quite good evidence,” says Dr. Garcia-Sastre, “that when used for immunization, some types of influenza virus antigens provide the broader immune response that can protect against multiple strains, unlike the traditional vaccines. We need to come up with better immunogens to make this a reality. But the possibilities are there.” At the same time, the two men and their teams are also researching the possible development of other types of broadspectrum antiviral drugs which could be used against viruses such as dengue, West Nile, and ebola, for which specific drugs do not currently exist. If proven effective, these antivirals could have a dramatic impact on global health not seen since the introduction of broad-spectrum antibiotics to combat bacterial infections. “We now have solid evidence that many different viruses all use particular cellular pathways,” Dr. Garcia-Sastre observes. “And it’s possible that broad-spectrum antivirals could be effective by inhibiting those pathways.” In addition, their work has implications for the fight against other “ever-changing” viruses such as HIV and hepatitis-C. “It’s a slightly different scenario in that these viruses have many different variants coexisting at the same time, whereas with influenza, it is a change from year to year,” says Dr. Palese. “But if we are able to succeed in making better and longer-lasting influenza virus vaccines, we could possibly try to apply that to these others.”

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BY PHILIP BERROLL

It would be hard to find two PhDs who contrast more sharply than Adolfo García-Sastre and Peter Palese. Start with their looks: Dr. Palese is every bit the sober, buttoneddown man of science; Dr. García-Sastre, bearded and long-haired, looks more like a rock musician, and in fact has several shelves of music cassettes — everything from Bach to Meat Loaf — stacked inside his desk. Move on to their hobbies: The Spanish-born Dr. García-Sastre is also an amateur entomologist with an extensive insect collection, while Dr. Palese, a native of Austria, cheerfully admits to having “very few” interests outside of medicine. And go back to the physical and chronological: About two decades in age, and several inches in height, separate the two. But virtually nothing separates them as research colleagues. For nearly 20 years, the two men have joined in a partnership that has made them recognized leaders in their chosen field. Dr. Palese, who is chairman of Mount Sinai’s Department of Microbiology, and Dr. García-Sastre­— a professor of Microbiology and Medicine (Infectious Diseases) who also serves as director of Mount Sinai’s Global Health and Emerging Pathogens Institute (GHEPI) — have both been in the forefront of efforts to understand and combat some of the world’s most deadly viruses. And they are now at work on a project of global import: the development of a universal influenza vaccine that can be used against multiple strains of this persistent and sometimes fatal disease. “We can say that we have different personalities — though it depends how you define ‘personality,’” says Dr. García-Sastre, a smile lighting up his dark eyes. “But motivation-wise, we are very similar. What we have in common is that we are passionate about research.”

This image of an influenza virus cell was captured by Yi-ying Chou, a Mount Sinai School of Medicine

A Vaccine for All Strains

PhD student in the Palese lab.

Their passion is well placed: The impact of a universal flu vaccine would be truly profound. At present, people need to be vaccinated every year at “flu season” because the virus evolves at a much faster rate than many other organisms, and pharmaceutical companies therefore have to keep updating their vaccines. And because evolution has produced multiple strains of influenza, there is always a danger of targeting the wrong strain — resulting in an ineffective vaccine and an outbreak of epidemic proportions. “There is no other vaccine which has to be changed on a yearly basis,” Dr. Palese notes, “in contrast to things like measles or smallpox or mumps, whose vaccine strains from fifty years ago — or in the case of smallpox, two hundred years ago — can still be used. So the hope is that we could get something which would be working and in use as an effective immune response against all strains of influenza.”

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Vive la Difference

“But in the big, overreaching aspects of influenza biology — such as influenza virus vaccines or multivirals — we fully collaborate,” says Dr. García-Sastre, “because these areas require information from multiple, specific research initiatives, resulting in a more comprehensive program. And especially in the last year, the National Institutes of Health (NIH) has put more emphasis on intercollaborative grouping among different researchers, which makes things easier from the point of view of funding.”

1918 Redux: Allaying concern

If proven effective, these antivirals could have a dramatic impact impact  on global health not seen since the introduction of broadspectrum antibiotics.

Mount Sinai Science & Medicine / FALL 2011

Working Separately and in Tandem Their partnership began as a student-teacher relationship. When Dr. García-Sastre came to Mount Sinai in the early 1990s as a post-doctoral fellow, he worked in the laboratory of Dr. Palese — who quickly recognized his younger colleague as “a very able and very effective and successful, imaginative researcher.” After getting his own lab, Dr. García-Sastre continued to collaborate with his mentor on numerous research initiatives while both men also pursued independent projects, an approach which has continued to the present day. For example, Dr. García-Sastre is currently “very focused” on the body’s innate immune responses and their effect on viral replication, while Dr. Palese is researching viral packaging — the ability of a virus to package, transport, and deliver its genome to a host cell, which involves the precise manipulation of DNA throughout the life cycle of the virus.

What was perhaps the pair’s most discussed achievement to date came in 2005, when they led a team that reconstructed the virus responsible for one of history’s most devastating pandemics: the 1918 Spanish flu outbreak, which resulted in at least 40 million deaths worldwide. Their efforts earned them the 2005 Paper of the Year award from the prestigious British medical journal The Lancet. “We decided to focus on that subject in order to understand what made the 1918 virus so destructive — its mechanisms, its characteristics,” explains Dr. García-Sastre, “because by knowing that, we can be better prepared to fight future influenza viruses that may have the same traits.” They began by taking the genetic material of the virus from human samples that were to some extent preserved from victims of the 1918 outbreak — “like Jurassic Park,” says Dr. GarciaSastre, “where they took the dinosaur DNA from mosquitoes.” From there, they recovered the genetic information of the virus, which enabled them to reconstruct and scrutinize it. Comparing the 1918 virus to that of a more recent global pandemic — the H1N1 (swine flu) outbreak of 2009 — they found enough similarities to determine that the vaccine developed to protect against H1N1 vaccine also worked against the 1918 strain. This discovery eliminated a serious concern among public health authorities about the possible use of the older strain in a bioterrorist attack. “It was always one of our fears,” Dr. Garcia-Sastre says, “that if someone had the genetic information that was generated from the 1918 virus, they could reconstruct it for evil purposes. But now we know that everyone who gets vaccinated with the newer vaccine not only becomes protected against the 2009 virus, but also against the 1918 strain. That makes the use of the 1918 strain as a bioterrorist weapon very difficult.”

Between Complacency and Fear Drs. Palese and García-Sastre often venture outside the lab to offer their expertise to a variety of government agencies: Dr. Palese is a member of the National Academy of Sciences (NAS), and Dr. García-Sastre is director of the Center of Excellence in Influenza Research and Surveillance (CEIRS), which is funded by the NIH. In these roles, both men have

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1 9 57   –   1 9 5 8 Asian Flu The Asian Flu claimed 70,000 lives in the United Sates and 2 million worldwide. Unlike the virus that caused the 1918 pandemic, this strain of influenza was quickly identified thanks to advances in scientific technology.

1 9 6 8   –   1 9 6 9 Hong Kong Flu The Hong Kong Flu caused about 34,000 deaths in the United States and one million worldwide—the least-deadly pandemic in the 20th century, but still carrying a powerful wallop.

2 0 0 9   –   2 0 1 0 Swine Flu The Swine Flu resulted in 12,470 deaths in the United States and about 250,000 deaths worldwide. The strain of influenza involved, H1N1, was the very same strain responsible for the Spanish Flu pandemic less than 100 years before—but with a total of 80 million people vaccinated against H1N1 during the 2009 occurrence, the death toll was dramatically lower. Source: www.flu.gov

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The Spanish Flu outbreak, one of the deadliest disease events in human history, caused about 675,000 deaths in the United States and between 40 to 50 million deaths worldwide— approximately 3 percent of the global population.

“There is no other vaccine which has to be changed on a yearly basis.”

1 9 1 8   –   1 9 1 9 Spanish Flu

experienced the tendency of the public and the media to lurch between a false sense of security and an unjustified panic regarding influenza outbreaks. “It’s a very interesting psychology,” says Dr. GarcíaSastre. “When the first deaths from H-5 [avian flu] virus were reported, even though there were very few, it made people afraid to go to countries such as Hong Kong where the flu was found. It���s very difficult to get infected with bird flu; if you go to Hong Kong, you’re more likely to die in a traffic accident than from H-5 infection. But the public has an inherent fear of infectious diseases. The same thing happened with ebola and West Nile virus. It’s the fear of the unknown, with the potential high mortality factor, which makes people very scared.” Dr. Palese speaks of the “hysteria” surrounding the 2009 influenza pandemic, when he was part of a committee reporting to President Obama on best responses. “This report had a possible, non-predictive scenario to help plan for the fall flu season — this number of people infected, that many people symptomatic, etc. And the next thing we know, the headline on page one of USA Today reads ‘Flu Could Infect Half the USA; 90,000 Deaths, 2 Million Patients Possible.’ We made clear that this virus was probably not comparable to 1918, and that we were making vaccines for it — but that information was not on page one of USA Today.” Still, Dr. Palese does take seriously the possible use of viruses in bioterrorism: He has been on several panels advising government officials on dealing with potential bioterrorist threats. “I’m worried about nuclear proliferation and nuclear terrorism as well,” he says, “but I feel that the biological threats are even worse, because of how easily a virus can be developed. At this point, it’s really a catch-up situation where we’re trying to ramp up the production of vaccines and other antibacterial, anti-viral substances.” But both men retain a sense of optimism — based in large part on the progress that has already been made against a number of once-deadly viruses. “The impact that vaccines have had in human health has been enormous,” notes Dr. García-Sastre. “You don’t see kids dying any more from poliomyelitis, except in very rare cases. You don’t see people dying any more from smallpox. And I think that hopefully we can come up with new vaccines against some of the other agents that are still making a big impact on human health, like influenza and HIV and tuberculosis and malaria.” They have also come to see the humor in their odd-couple partnership. Dr. García-Sastre acknowledges with a laugh that compared to his colleague, he appears “relaxed.” And when asked about their differing styles, Dr. Palese responds, “You mean that he never wears a necktie? Well, it’s a free country.”

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Medical advances have helped contain one of history’s worst killers. From 1918 to 2009, the number of deaths from influenza pandemics has significantly decreased — an extraordinary accomplishment — but by its mutating nature, influenza remains a challenging virus. A snapshot:

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Catching the Flu

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I

ERIC SCHADT:

CONOCLAST

Dateline: Manhattan. Here’s where the new director of the Institute for Genomics and Multiscale Biology is taking a leadership role in a global revolution in biology.

By Katie Quackenbush Spiegel

To search for the right name

rately represented what we’re going to be

institute, Eric Schadt did

doing at Mount Sinai. ‘Multiscale biology’

what any world-renowned

is hardly used at all; it’s just beginning to

biomathematics expert, biotech start-up

emerge on Google as something people are

guru, purported “smartest man in the world”

talking about. So we named it the Institute

(yes, he’s actually been called that by more

for Genomics and Multiscale Biology.”

than one science pundit), and global net-

And soon, lots of people are going to talk

work builder would do.

Mount Sinai Science & Medicine / FALL 2011

“We wanted to find a term that more accu-

for Mount Sinai’s newest

He Googled.

about it a lot more. The brand-new concept

“We wanted to find out which terms con-

of multiscale biology, or the study of many

veyed the right meaning and hadn’t been

complex layers of human disease biology —

used a lot, and were posed for an exponen-

from the sub-molecular/genetic level,

tial explosion versus terms like ‘systems

to the molecular, cellular, organ, organism,

biology’ that had already passed through

all the way up to the community scale —

the exponential phase and were now on

is a departure from the prevailing paradigm

the decline,” says Dr. Schadt, director of the

of how the human system was explored in

Institute for Genomics and Multiscale biol-

the past. But it’s just what Dr. Schadt and

ogy, Jean C. and James W. Crystal Professor

his colleagues are going to be doing at

of Genomics, and chair of the Department

Mount Sinai’s new Institute — and they’re

of Genetics and Genomic Sciences.

going to do it differently from anybody.

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to understanding how diseases occur and can be treated, or even prevented. And scientists everywhere have to start working together.

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SCIENCE MUST GLOBALIZE ITS APPROACH

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Eric Schadt: Iconoclast

Embracing complexity

Mount Sinai Science & Medicine / FALL 2011

Dr. Schadt’s new, global perspective on understanding biology is nothing short of a paradigm shift in the scientific world. Years of tradition have laid out the current rules: A scientist discovers a protein, proves its activity in the development of disease in lab experiments, publishes a paper, and careermaking accolades may ensue. But new thinking is resulting in new rules, especially in the bench-to-bedside playing field — or maybe just one new rule: Focus on getting new therapies to patients. Over the last decade, the scientific community has made massive strides in human biologic understanding — and the epicenter of their work has been genomics. Scientists mapped the human genome and conducted high-profile genome-wide association studies of common diseases, like schizophrenia or diabetes, in an effort to identify the root cause of a specific disease among a large population of patients diagnosed with it. Like those of other toptier academic medical centers, Mount Sinai’s labs are bustling with activity that is successfully advancing our insights into diseases. From the genetic screening of large pools of patients with a specific disease, scientists have been able to identify a mutant gene or protein that explained most of the cases. But at the same, scientists can also find that a subset of patients did not have that causative element, yet still had the disease. “Eric Schadt is bringing a whole new mindset to how we connect genes to diseases and to therapeutics,” notes Mount Sinai President and CEO Kenneth L. Davis, MD, “because traditional views have not kept pace with complexity. For example, scientists naively believed that Alzheimer’s disease was caused by the amyloid precursor protein gene, and billions of dollars were spent on Alzheimer’s drug development pursuing the single-gene theory, only to fail to deliver any effective treatments. The Institute of Genomics and Multiscale Biology considers the relationships among all genes in diseased individuals to directly define the biological processes driving disease. This multidimensional view will transform how we diagnose and treat Alzheimer’s and so many others.”

Scientists have now come to understand that one errant gene does not cause all cases of schizophrenia; one wayward protein does not cause all cases of type 2 diabetes. It’s more complicated than that: There are many more elements at play. Layers and layers of elements, from the proteins that package the outside of a gene and make it behave differently from the way it should, to the over-productive cells that can’t stop dividing. And for the first time in scientific history, scientists have the deep sequencing and magnification technologies that allow them to “see” many of these complex layers — all at the same time.

“What I’ve come to realize is that biology is just too big for one pharmaceutical company or one academic research center to master. The scale of the data, and the pure scope of everything that needs to be understood — there is no single group that is going to solve this,” Dr. Schadt says. “The biology of disease is not going to be figured out inside of the pharmaceutical industry; it’s going to be the purview of academic medical centers and large health care providers that have the collaborative spirit to join forces and do what’s necessary to understand these hard diseases.” Which is why Dr. Schadt came to New York.

Making it matter

FOR THE FIRST TIME IN SCIENTIFIC HISTORY,

scientists have the deep sequencing and magnification technologies that allow them to “see” many complex layers — all at the same time.

“You can imagine back in the day of Louis Pasteur, when the microscope came to be, it opened up a whole new world of investigation and exploration for understanding living systems,” says Dr. Schadt. “That’s sort of what we have in these new technologies. It’s as if we are developing this finer and finer grained picture of how things are put together.” So now, Dr. Schadt thinks the scientific community needs to broaden its approach to exploring biology, to complicate it. Science must globalize its approach to understanding how diseases occur and can be treated, or even prevented. A place like Mount Sinai, where collaborative and interdisciplinary work is the name of the game, is the perfect setting for scientific game-changing.

“I won’t say that the biggest thing in life I wanted to do was move from the west coast to New York,” said Dr. Schadt in a recent phone interview from his house in Palo Alto, California. “I love it out here, the weather and the geography, the laidback vibe. I’m from Michigan, so I know all about the hard winters and hot summers. The west coast has always really clicked for me.” Dr. Schadt, 46, says his motivation to pack up his family — wife, five young kids — and leave Palo Alto was really mission-driven. “Life is short. The mission I’m on is to take all of this amazing information being generated on living systems today, and actually make it matter to everyday life.” He decided that he would go wherever he needed to go to see this vision through. “That could have been South Dakota, and I’d be there. Although obviously New York is a great city, so we’re quite thankful that it’s New York and not South Dakota,” Dr. Schadt says. “Most of the puzzle pieces to accomplish this mission already exist at Mount Sinai. This is unique. There aren’t any other such opportunities, in my opinion, in the United States.” Dr. Schadt, who has been recently profiled in Esquire, Bio-IT World, and The New York Times, wasn’t supposed to be a scientist. He grew up in an evangelical Christian family in Michigan that didn’t exactly embrace science, and after graduating from high school, he enlisted in the Air Force and volunteered for the Special Forces — parachute rescue. He was plucked from the ranks after acing a mathematics aptitude test and given a

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military scholarship to California Polytechnic State University, where he received a BS in applied mathematics. He went on to earn a Master’s in pure mathematics from the University of California-Davis, and a PhD in biomathematics at the University of California-Los Angeles before his career took off and he became something of a scienA L I M PA

tific iconoclast. Dr. Schadt worked in executive positions

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on the scientific side of companies like

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Roche, Rosetta Inpharmatics, and Merck

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before co-founding the non-profit Sage Bionetworks, developer of an open-source platform for multiscale biologists like himself, to share the new models of disease biology gleaned from their high-tech explorations. He then co-founded and assumed the role of chief scientific officer at Pacific Biosciences, producer of the world’s best and most up to the minute genomic sequencing technologies. As part of his arrival at Mount Sinai, Dr. Schadt has brought two of Pac-Bio’s cutting-edge prototype machines, which can map the structure of DNA and other biological molecules, such as RNA, as well as a new DNA sequencer that just recently hit the market. The equipment

Mount Sinai’s Center for Science

will be used by a team of some two dozen

and Medicine, the future home of the Institute for Genomics and

multiscale biologists who will be recruited

Multiscale Biology, will open in 2012.

to Mount Sinai’s new Institute in collaboration with disease-focused institutes and other departments. Ultimately, their goal is simple: to solve problems and improve human health. But they’ll do so by catalyzing innovation in the application of genomics technologies through collaborations with the scientists in Mount Sinai’s existing disease- and technology-based institutes. Even as he directs Mount Sinai’s new Institute for Genomics and Multiscale Biology, Dr. Schadt will remain CSO at Pac-Bio. This

4 Recent Genomic Advances that Demand an Informatics Revolution According to Eric Schadt, several genomics discoveries that occurred in the early 2000s will set the stage for massive challenges—and tremendous advances—in the future. Among them:

1

T he discovery that environmental stress can induce heritable DNA-based changes

2

T he maturation of highly parallel sequencing and genotyping technologies that have revolutionized our ability to associate changes in DNA with disease

3

T he discovery of whole new classes of RNA that do not carry out instructions from genes, yet are still critical to cellular and higher order biological processes

4

T he development of third-generation DNA sequencing that will lead to greater insights about underlying biology

type of deep academia-industry collaboration is highly unusual — another paradigm shift. Dr. Schadt says that this collaboration will equip the Institute’s scientists with the latest technologies, and move biology out of intellectual property-protective industry and into the pre-competitive space of academia, where the ultimate goal is to learn about biology and not market blockbuster drugs — while also ensuring that the scientists in Mount Sinai’s institute remain focused on the translation of biological knowledge into patient therapies for the market.

“As our ability to capture data from entire genomes increases exponentially, we are facing a huge software and computing challenge. Life sciences and biomedical researchers will need novel solutions in the future if we hope to translate all of the knowledge from these discoveries into understanding. The big challenge we will take on at Mount Sinai? It’s the translation of the deluge of data coming from the new discoveries and technologies into actionable results that can have an impact on human wellbeing.”

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Eric Schadt: Iconoclast

“MOST OF THE PUZZLE

pieces to accomplish this mission already exist at Mount Sinai. This is unique. There aren’t any other such opportunities, in my opinion, in the United States.” – Eric Schadt

to have all of the pieces and the vision, but it also requires the resources to make that vision come together. Mount Sinai has the big drive and capacity to take all of the available information and make it matter to the patients.” So now that Dr. Schadt has bridged this gap and joined the two traditionally disparate worlds of academia and industry, and his team is going to embrace the complexity of human biology, what are they going to do with all of the priceless knowledge they generate? Why, give it away, of course.

Mount Sinai Science & Medicine / FALL 2011

Information-driven medicine

“My whole professional life has been built around trying to span the divide between industry and academic research,” Dr. Schadt says. “My thought has always been that we can do more successful science, science with greater impact, if we are blurring that line.” Ultimately, the goal is to apply sequencing findings immediately to the practice of real-life medicine, not just at Mount Sinai, but everywhere. Mount Sinai, Dr. Schadt says, is the right place for this to happen now. Hospitals are typically separate corporations from their medical schools and research centers, which can make them difficult to navigate, and which can cause internal competition for resources and the attention of institutional leadership. “What I love and find refreshing about Mount Sinai is that it’s a large medical center and school, but they’re not separate entities,” Dr. Schadt says. “It’s not complicated; there is this very simple, focused mission. There’s a huge and diverse patient population, and there’s a more entrepreneurial spirit. And it’s great

“This isn’t unlike the revolution that swept through Wall Street in the days when the mathematicians first arrived on the scene to give rise to quantitative trading: They took us from making decisions about which stocks to buy based on gut feeling to taking in all available information and integrating it to make better decisions about what to buy and when,” Dr. Schadt says. “Those who won the game were those who could make better and more accurate predictions about what would pay off. This is the type of shake-up that is coming for medical sciences.” But the stakes are higher in medicine, he notes. This is the business of saving lives, of making better and more accurate predictions about disease. So everyone working on disease has to share. “The only way we are going to figure out disease biology is to enable communities of life sciences researchers to collaborate, to leverage the knowledge and understanding that emerges from their individual groups,” Dr. Schadt says. “Of course we will be working to develop diagnostics and therapeutics ourselves at Mount Sinai, generating intellectual property. But sharing the data will help validate models others have put forth, and get better and more refined pictures of disease biology. And people will think of ways to use your data that you never would have thought of.”

So in the new institute at Mount Sinai, Dr. Schadt and his team are going to create the open-access network for multiscale biologists around the world, based on the technology he helped develop at Sage Bionetworks. Scientists everywhere who are exploring the many scales of biology can use this global platform to reflect their disease models off the data produced by scientists elsewhere, leveraging different resolutions of the system, ultimately using them to create the most accurate view of human biology. The platform will manage governance and intellectual property rights so that no single group develops an advantage over the others, in terms of access to data or results. “Let the world figure out the biology of disease. The sooner we can get that information generated, the sooner we’ll be able to impact a huge number of diseases. With better models of disease, we’ll go forward with higher confidence,” Dr. Schadt says. “Those who win this game will be those who are better masters of the information, making better predictions, better diagnoses, better assignments of the treatments patients should receive. This is a huge paradigm shift for biomedical sciences, to become a more information-driven, quantitative science.” So Eric Schadt, the iconoclast and paradigm transformer, is going forward with total confidence in his uncompromising vision for the Institute for Genomics and Multiscale Biology at Mount Sinai, and for biomedical science in general. In this move from industry to academia, from traditional to revolutionary, from making slow progress to figuring things out quickly, from the west coast to the east coast, Dr. Schadt may have to compromise on one point: riding his motorcycle to work, something he did every day in California. Maybe. “When the weather gets chilly, I’ll have to park the bike and take the train. But my commute into the city is a bit longer than my commute in California,” he says. “If the bike ends up being faster than the train, then the bike it will be.”

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ometimes smaller is bigger. Framingham, Massachusetts— population 68,000—was the site of a monumental epidemiological study that has followed three generations of the town’s residents from 1948 until the present day, a study whose researchers first proved links between cigarette smoking and heart disease; elevated blood pressure and strokes; and high levels of HDL cholesterol and cardiovascular benefits, among many other major findings. Estimated impact? 3,200,000 lives saved—and counting.

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Epidemiology can involve thousands of individual study participants and span multiple generations, and yield insights into human health that affect entire populations, and the general public may never even notice it. Because epidemiological breakthroughs prevent disease from happening in the first place, such work goes unacknowledged, according to epidemiologists Philip Landrigan, MD, MSc, Dean for Global Health and Director of the Children’s Health Environmental Center, and Paolo Boffetta, MD, Director of the Institute for Translational Epidemiology. Or as Dr. Landrigan puts it: “Our most grateful patients are the ones who don’t even know we exist.” Dr. Landrigan’s seminal research into the effect of environmental hazards on child development formed the basis for Congressional legislation regulating the use of lead and pesticides, while Dr. Boffetta has investigated the spread of cancer and other diseases in Iran, China, and countries across the globe. We recently sat down with Drs. Landrigan and Boffetta to get a closer look at the almost invisible, but enormously influential, field of epidemiology.

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“It’s the largest study of its kind ever conducted in the U.S. and its findings could have a global effect.” – Philip Landrigan

Science and Medicine asks:

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hen most people think of medical breakthroughs, they might think of drugs or treatments, developed in a lab and delivered in a clinic, that cure disease. How do the breakthroughs that come from epidemiology differ from that common definition?

DR. BOFFETTA: The idea of a major breakthrough as something that happens at a particular moment in time is less applicable, because epidemiological breakthroughs happen through a steady accumulation of evidence. It’s not usually one single epidemiology study that makes a difference in clinical practice or preventive practice; it’s the consistency of the data across many different studies. Many important aspects of modern medicine, though, such as tobacco control, depend on epidemiological findings. Epidemiologists have been extremely successful in identifying environmental causes, dietary habits, and other significant risk factors for major diseases. That work has made a big difference in terms of preventing disease. When we make a discovery through an epidemiologic

study of a risk factor that causes a disease, and then we translate that to the population, we can save hundreds of thousands of lives. The paradox of prevention is that obviously people, individually, don’t know if they’ve been prevented from dying or developing disease. If a doctor makes a great discovery in cancer or chemotherapy, or develops a new drug, and the patient who is given the drug doesn’t die, that patient has an individual feeling of being saved. The same doesn’t apply in prevention. Dr. Landrigan: To illustrate Paolo’s point, just after World War II in 1948, rates of heart disease and stroke in this country were skyrocketing. People, and especially men, were dying of heart disease in their forties and fifties. It was epidemic. There were suspicions and rumors of what was causing it, but we didn’t really know. So the U.S. Public Health Service along with some researchers in Boston went to a town called Framingham, Massachusetts just outside of Boston and set up what is now known as the Framingham Heart Study. They enrolled the whole adult population of the city of Framingham, and within five or ten years they had identified most of the major risk factors for heart disease — cigarette smoking, hypertension, obesity, diabetes, sedentary lifestyle, cholesterol, and triglycerides — and translated the discoveries into programs for prevention. It’s an amazing success story. Yet when I speak about the Framingham story to a public audience and ask if they think the rates of heart disease have gone up, stayed the same, or gone down, the majority think there’s been

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either no change or a change for the worse — and that includes audiences of medical professionals. In fact we have driven down the death rate from heart disease in this country by something like sixty percent since 1948. It’s one of the best kept secrets in American medicine. Epidemiology is a powerful engine of discovery. Studies [like Framingham] take a long time to do and they’re expensive, but very significant.

You have different backgrounds and, at least on the surface, very different research interests from one another [cancer for Dr. Boffetta and children’s health for Dr. Landrigan]. How does your work intersect? DR. BOFFETTA: One of the major trends that I’m investigating is the rapid change in the living conditions for many low-income countries as they move from a traditional lifestyle to a Western lifestyle. The path of habits and risk factors that influence health — things like environmental exposures and diet — have changed completely. Within one generation, in countries like India, Pakistan, and Indonesia, there has been a doubling of the risk of breast cancer in women. And if you move from a rural area to an urban area, there is another doubling. We think this is due probably to multiple factors — including an increase in obesity, a more

sedentary life, postponing the first pregnancy, fewer children, and less breast feeding. But to really advance to a level where we can identify the epidemiological factors of cancer, we need a new generation of studies that are even larger in scope than the Framingham study. We need to track individuals across their entire lifespan because many diseases, including cancer, begin to take root early in life through risk factors that might affect the individual’s health forty or fifty years later. Phil’s research into early childhood health has the potential to give us new insights into the causes of cancer, among many other diseases. I’m particularly excited about the National Children’s Study and Phil’s role as one of the principal investigators. It’s the largest study of its kind ever conducted in the U.S. and its findings could have a global effect. It’s establishing a new paradigm for epidemiology. Dr. Landrigan: The way the National Children’s Study will work is just amazing. The study will enroll 100,000 pregnant women in one hundred and five counties across the U.S. over the next five years and we will track the health of their children from the prenatal stage all the way up until the age of twentyone, and possibly further. We’ll analyze blood and urine samples from the mothers to screen them for their exposure to more than two hundred synthetic chemicals, and we’ll collect the DNA of every child so we can look at their genetic makeup. As soon as we’ve got a few thousand babies born into the study, we’re going to be able to say intelligent things about the causes

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“Our most grateful patients are the ones who don’t even know we exist.” – Philip Landrigan

Mount Sinai Science & Medicine / FALL 2011

MSSM is the First Fully Designated PAHO/ WHO Collaborating Centre In Children’s Environmental Health In The U.S. As a Collaborating Centre, Mount Sinai will partner with the World Health Organization in building global capacity in children’s environmental health through conducting conferences, developing training modules, and providing mentorship, internships, and training fellowships to health professionals from the region of the Americas, especially Latin America, and also in Southeast Asia and the Western Pacific. Additionally, it will assist WHO in establishing prospective epidemiological studies researching the effects of the environment on children’s health while also developing estimates of the economic cost of pediatric diseases of environmental origin, which ultimately will guide WHO in the development of country-specific blueprints for disease prevention and health promotion.

of prematurity, low birth weight, and certain birth defects. A couple of years after that, we will begin to better understand risk factors for autism and asthma. And then a few years after that, we’ll get into early childhood diseases. By the time the children have become adults, we’ll be able to see the factors that underlie heart disease, cancer, schizophrenia, infertility, and a host of other health problems. The range of possible outcomes is as broad as all medicine. We’ve been actively collaborating with the World Health Organization to create partnerships with similar studies that are underway or in the process of getting started in Japan, Denmark, Britain, China, Taiwan, and Korea (see sidebar). Together with our international peers, we’re pooling our data because we realized it will give us much more statistical power to look at connections between environmental exposure and diseases in children. The scientific findings from the National Children’s Study will be applicable throughout the world, but just as importantly, the study will also become a model for joint international research efforts.

What do you find most challenging about epidemiology? Dr. Landrigan: Early in my career I was involved in studies that demonstrated that lead caused brain damage in children at low levels of exposure. The results of those studies persuaded the EPA to ban lead from gasoline, which drove down average lead levels in this country by ninety percent, and then the United Nations followed with encouraging similar policies around the world. Now there are only five or six countries in the world that still use leaded gasoline.

So for me, the great challenge of epidemiology is the prospect of discovering the preventable causes of disease and then turning those discoveries into disease prevention. Right now in the U.S., the epidemic of obesity among children is having dire consequences. Obesity is associated with diabetes, heart disease, and certain forms of cancer. Some experts who specialize in population projections have forecast that today’s generation of American kids will be the first generation of children in the last one hundred years to have a shorter lifespan than their parents, and that terrible statistic reflects obesity. Dr. Boffetta: I enjoy epidemiology because on the one hand you have the challenge of scientific discovery and trying to find something new about the causes of disease. But the other aspect which is equally rewarding to me is that epidemiology is not just discovery per se — finding a gene that developed twenty million years ago — but discovering something that may lead to preventive action on the individual and societal levels. Epidemiology leads to a better understanding of the nature of disease, and how it works, but it also leads to something that is translatable immediately into prevention. That, to me, that is the goal. I was with the World Health Organization for twenty years, so I’m used to considering epidemiology and prevention strategies from a high-level, international perspective; but since joining Mount Sinai and collaborating with Phil and his team, I’ve also seen how important it is to anchor research in specific areas and populations, like the work Phil is doing in the National Children’s Study and with minority populations in New York City. Local research holds the key to global results, and I’m excited about the new projects that we’ll be working on together.

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Miriam Merad, MD, PhD doesn’t do her father’s — or anyone’s — medicine. Her passion for discovery has the potential to touch millions of lives across the globe.

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Passionate Pioneer

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By Sima Rabinowitz The little girl rushed to the hospital in the middle of the night was neither ill nor injured. During her childhood in Algeria, Miriam Merad often accompanied her father and mother — a cardiologist and a toxicologist, respectively — to work when they responded, at all hours, to emergencies.

“I came to think of the hospital as my second home,” says Dr. Merad, who grew up to be professor of sciences, medicine, hematology, and medical oncology, and director of the Cancer Immunology Program at Mount Sinai’s Tisch Cancer Institute. “And I was passionate about medicine from a young age. As a heart doctor, my father was always on call, and my mother was developing the first center of toxicology in Algeria. There was endless talk in our house about science and medicine.” She recalls with great appreciation her parents’ work and commitment to their profession and to improving health in what was then, and remains, a country with enormous unmet medical needs. At the same time, she insists, “We can’t do our fathers’ medicine. They did everything by the book. That is probably what was appropriate in that time and place. But now, we need to constantly innovate. We must do ‘crazy things.’ And we have the capacity to do that here at Mount Sinai.”

Driven to cure Doing “crazy things,” Dr. Merad explains, means embracing the unexpected and acting on novel ideas and new ways of approaching complex problems. By “we,” she is referring to physician scientists in academic medicine who are not constrained by the limitations and preoccupations of the pharmaceutical industry, where drug

discovery often happened in the past. “We are driven by one principal concern,” she adds, “To cure disease.” “Driven” captures Dr. Merad’s nature and career perfectly. Trained as a physician (she received her medical degree in oncology from the University of Algiers and then specialized in hematapoetic cell-blood stem cell-transplantation at a hospital in France) and as a scientist (she received her PhD in immunology through a joint program at Stanford University and the University of Paris VII), she is dynamic and enthusiastic, enormously productive, and intensely dedicated to understanding some of the most complex questions of human biology. Great innovation and creativity will continue to arise, she is convinced, from the collaboration of researchers and physicians from diverse disciplines who bring distinct knowledge, expertise, and perspectives to their common work. Clinicians must identify patients’ unmet medical needs, help researchers understand what diseases and disorders require attention, and share information about how existing treatments affect their patients, and basic scientists must help decipher the biological mechanisms underlying disease. The process of understanding and treating disease depends, much like the body itself, on intricate networks and support systems. Together, scientists and doctors must strive to translate breakthroughs in the laboratory to effective therapies with the potential to prevent, diagnose, treat, and cure disease.

Support systems The complex support systems and networks that both sustain healthy cells and contribute to their injury and subsequently to disease is precisely the focus of Dr. Merad’s work. For a long time scientists believed, she explains, that cancer resulted solely from cell proliferation (uncontrolled growth). We now know that all cells need “to be fed.” They require the right niche to grow, an environment provided by stromal cells that consist of numerous cell types, including immune cells, which exist in high number in tumor lesions. Indeed, patients who die from their cancer always die of tumor relapse: No matter how efficient conventional therapies — such as chemotherapy and radiation therapy — can be at eliminating big tumor masses, they always fail to eliminate all of the tumor cells. Studying the support systems that help remaining tumor cells to grow and develop can lead to the cure of tumors, explains Dr. Merad.

“In the lab, we are working to learn more about the tumor-associated immune network and how it could be used synergistically with conventional therapy to cure cancer,” she says. “We focus on the biology of dendritic cells [DC] and macrophages (which are white blood cells present in every tissue). Dendritic cells are a bridge to the outside world, uniquely equipped to sense and inform the immune system when injuries occur and induce immune response to eliminate the injury. DC sense tumor cell proliferation as a tissue injury and can lead to the induction of specific immunity to cancerous cells. It is this unique ability to promote immunity against tumors that could be used as a novel and specific arm against the remaining cancer cells. Macrophages are cells related to the DC family; their main role is to promote tissue repair and growth and thus in contrast to DC can help tumors grow.”

Collaborative study “My lab consists of a mix of basic immunologists, physician scientists, and clinicians. Together we are intent on learning to decipher the processes that regulate DC and macrophage ability to modulate tumor growth and progression and come up with novel therapeutic strategies that will synergize with conventional antitumor therapies. Because dendritic cells and macrophages regulate tissue response to all kind of injuries, our work on cancer has implications and potential for a much broader impact on disease: many immune disorders, infectious diseases, autoimmune diseases — including inflammatory bowel disease, which is a focus of many investigators at the Mount Sinai Immunology Institute, and brain immune disease.” Over and over, Dr. Merad has successfully demonstrated the importance of the translational approach and the power of collaborating across disciplines. Last year, she published a study in Science reporting unanticipated and “amazing” findings that resolve a long-standing controversy about the origin of microglia, macrophages of the brain thought to play a key role in the development of many neurodegenerative diseases, such as Alzheimer’s disease, as well as immune diseases, including multiple sclerosis. While much study remains to be done, this result could represent a critical first step toward the eventual discovery of the cause of devastating brain immune and degenerative disease.

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“Dendritic cells are a bridge to the outside world, uniquely equipped to sense and inform the immune system when injuries occur.” – Miriam Merad

The big picture — and the small With focus on — and success in — identifying some of the key causes of illness and disease, Dr. Merad’s research can have a critical impact, influencing the understanding of multiple diseases and conditions affecting countless patients around the world. Nonetheless, she is committed to the plight of patients with rare diseases, as well. She is currently engaged in identifying the cause of a rare disease called Langerhans cell histiocytosis, characterized by the accumulation of abnormal dendritic cells in tissues. This disease affects mainly children. Dr. Merad serves on the board of a consortium organized by the parents of a child who suffers from this disease. Once a year the consortium organizes a workshop where basic scientists, clinicians, and patients meet. A child afflicted with Langerhans histiocytosis speaks to the group and clinicians introduce patients with difficult or refractory cases. “Basic scientists are always very touched and inspired by

the patient session,” Dr. Merad notes, “because no matter how basic or clinically oriented scientists are, we all strive to have an impact on human disease.” It is this concept of deep and continuous interactions among basic scientists, physician scientists, and clinicians that Dr. Merad enjoys and wants to expand further at Mount Sinai. She initiated a cancer immunotherapy focus group where basic immunologists and oncologists meet monthly to discuss how promising data on animal models can be translated into cancer patients. She also serves as an assistant director of the MD/PhD program and continuously preaches the importance of translational research. Dr. Merad and Ross L. Cagan, PhD, Mount Sinai’s vice dean of graduate studies, are collaborating to start a new graduate course for first-year PhD students called “Translational Science”; the goal of the course is to expose students to the clinical world and teach them principles of translating basic research into medicine.

At a time of great uncertainty in the world in so many regards, when obtaining funding for even the most worthwhile projects can be a challenge, Dr. Merad is optimistic about the prospects for success and achievement in academic medicine in general and at Mount Sinai in particular. Her colleagues clearly agree. It’s hard to find an investigator or an MD/PhD student at Mount Sinai who, in the course of talking about translational research, does not mention the importance and influence of Dr. Merad’s work. “It’s a wonderful time to be in academic medicine, a pioneering time,” she affirms. Mount Sinai’s Institutes model is a productive and effective one, she says, and the medical center’s history, support, and appreciation for the “crazy” and creative work of collaboration, and the innovation that ensues, have the potential for the great and lasting impact that is every scientist’s, physician’s — and patient’s — dream.

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HAiTiREViSiTED Photography by Andrew Lichtenstein

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he earthquake that struck

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Haiti in January 2010 took a

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grave toll, but the devastation that it wrought upon the country’s health-care infrastructure has proven to be a disaster almost as serious, preventing victims from receiving urgently needed care and contributing to the spread of diseases such as cholera. As reported earlier in these pages, Mount Sinai was quick to respond in the earthquake’s immediate aftermath, coordinating relief efforts in some of the hardest-hit areas, and that work continues today through ongoing service trips. In conjunction with the University of Miami-based Project Medishare, a team of Mount Sinai physicians, nurses, and other caregivers volunteered at a hospital in Port-au-Prince in March 2011, and photojournalist Andrew Lichtenstein documented their work. The photos portray a deep and abiding commitment summed up by neuroanesthesiologist Irene Osborn, MD, one of the volunteers: “This is why I went into medicine.” – Travis Adkins

Top to bottom: Andrew Abrass, a resident in emergency medicine, and Theresa Madaline, a resident in internal medicine, prepare to drain fluids from a patient’s abdominal cavity    Waiting at the hospital’s front gate    A tent city at what used to be a soccer stadium

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Right column, top to bottom: Neuroanesthesiologist Irene Osborn, MD monitors an operation    A morning church service at the hospital’s chapel    On the street in front of the hospital    Opposite page: Andrew Abrass with a patient

Mount Sinai Science & Medicine / FALL 2011

Left column, top to bottom: Maya Barghash, a resident in internal medicine, examines a patient    Hospital laundry, washed by hand and laid out on the roof to dry    Andrew Abrass, with his Haitian translator, checks in on an ER patient

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Sleep was a luxury for the hardworking volunteers, as this sign on a dorm room door attests    Brushing her hair in the mirror, a patient gives herself a smile

Mount Sinai Science & Medicine / FALL 2011

Top, then bottom left to right: Micah Nite, a resident in emergency medicine, removes a match from a young girl’s ear in triage    Theresa Madaline at work in the ER 

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GIVING Noble Deeds Society to Honor the Cullman Family Mount Sinai will pay tribute to the Cullman family— supporters of the medical center whose Mount Sinai ties date to its founding nearly 160 years ago—at the annual Noble Deeds Society Dinner on October 19th. To be held at the New York Public Library, the event will posthumously honor Edgar M. Cullman, Sr., who died at age 93 in August 2011, his wife, Louise, and his children and grandchildren: Collectively, they represent an unsurpassed multigenerational legacy of philanthropic leadership and involvement at Mount Sinai. “I am deeply saddened by Edgar’s loss,” said Peter W. May, Chairman of the Mount Sinai Boards of Trustees. “When we

Trustees Susan Cullman,

decided this spring to present him and his family with the

the late Edgar Cullman,

Noble Deeds Award at the annual fall event, we knew we were

and Edgar Cullman, Jr.

honoring a man of vitality who inspired us all, and a family who shared his passionate commitment. I cannot think of a better way to remember him than to honor the Cullman family’s extraordinary relationship with Mount Sinai. No one has had a greater impact on the patient experience.”

Mr. and Mrs. Cullman’s generosity and commitment

Mr. Cullman’s great-grandfather, Benjamin Nathan,

inspired the involvement of their children—Lucy Cullman

co-founded what is now The Mount Sinai Hospital—then

Danziger, Edgar M. Cullman, Jr. and Susan R. Cullman—

called the Jews’ Hospital—in 1852. Inspired by his grand-

who have been dedicated Mount Sinai supporters since

father’s and father’s service on The Mount Sinai Board of

the early 1970s. Mr. Cullman, Jr. and Ms. Cullman joined

Trustees, Mr. Cullman joined the Board in 1957, after serving

their father as Trustees in 1986 and 2001, respectively.

for seven years on the Board of The Mount Sinai Hospital

“My family and I proudly continue the legacy of

School of Nursing. His appreciation for nursing and innate

highlighting the importance of patient care and vigilantly

sensitivity to the difficulties patients face has motivated his

trying to make it better,” Ms. Cullman said.

efforts to improve the patient experience.

The Cullmans’ most recent gift to The Campaign

“I’ve always wanted to make the hospital a happier place for

for Mount Sinai will help recruit world-class physician

the patient going through whatever they’re going through,”

scientists in cardiovascular research, cancer, genetics,

Mr. Cullman said shortly before his death. “That’s where I’m

neurology, and other critical fields, as well as fund

needed. To me that’s the most important thing that I’ve done.”

other vital patient care-related objectives throughout

The Cullman family has committed more than $30 million

Mount Sinai.

to advance medical education, nursing, and patient care initia-

“Edgar’s vision was central to Mount Sinai’s success

tives throughout the institution. Their most transformative

in so many ways, and his influence and that of the entire

gifts to date—engineered by Mr. Cullman and his brothers

Cullman family has ensured that the quality of care

Lewis B. Cullman and the late Joseph Cullman 3rd in memory

that patients receive at Mount Sinai rivals that of any

of their father—resulted in the creation of The Joseph F.

other institution in the world,” said president and CEO

Cullman, Jr. Institute for Patient Care in 2001.

Kenneth L. Davis, MD. “One evening is not long enough

“Having the Cullman Institute in a large academic medical

to remember the many contributions of this remarkable

center is a visual reminder that we are here to serve patients

leader, nor to express our gratitude for the Cullman

and their families, to reduce their fear and anxiety, and

family’s six generations of service and to celebrate the

to make their experience a better one,” said the Institute’s

achievements their partnership and generosity have

director, Dr. Mary Dee McEvoy.

made possible.”  – Sara Daniels

Benjamin Nathan

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Cardinale Pledge Strengthens Genomics Research A $1 million pledge from Gerald J. Cardinale will

and take a leap forward in medical

support genomics-focused translational research

progress.”

programs at Mount Sinai and promote multidisci-

plinary collaboration across the medical center.

at the forefront of gen-

Mr. Cardinale’s pledge will fund a variety of efforts

omics research,” said

“Mount Sinai is already

“Interpreting the human genome is the new frontier in medicine.”

led by the Center for Discovery and Innovation and

Mr. Cardinale, noting the

the Institute for Genomics and Multiscale Biology,

medical center’s recent

two of the medical center’s most important ventures.

recruitment of Eric E.

Allocated to the President’s Strategic Initiative Fund,

Schadt as the Jean C. and

the pledge will enable Mount Sinai’s leadership

James W. Crystal Professor

to direct its resources to areas of strategic priority

of Genomics and director

such as recruiting investigators and other faculty;

of the Institute for Genomics

equipping the medical center with next-generation

and Multiscale Biology. “I look

sequencing technology; and expanding genomic

forward to continuing to support

– Dennis S. Charney

research initiatives in cancer, heart, and brain diseases,

its growth and trailblazing initiatives

immunology, metabolism and endocrinology, and

under Eric’s leadership.”

ABOVE: An image

infectious diseases.

The pledge by Mr. Cardinale, a partner at Goldman

of intracellular protein

Sachs, adds another chapter to the firm’s long tradition

“Interpreting the human genome is the new

frontier in medicine,” said Dr. Dennis S. Charney,

of support for Mount Sinai. Goldman Sachs’s close

the Anne and Joel Ehrenkranz Dean, Mount Sinai

relationship with Mount Sinai dates all the way back to

School of Medicine. “Philanthropic pioneers such as

the 1850s and more than 15 of the firm’s employees have

Mr. Cardinale are helping us explore that frontier

served as Trustees over the years.

and DNA content from Dr. Schadt’s research

MOUNT SINAI SCIENCE & MEDICINE / FALL 2011

Top Chef Dishes $100,000 to Young Scientist Cancer Research Fund

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Chef Floyd Cardoz (left) with Goutham Narla, MD, PhD

Floyd Cardoz, a well-known chef featured in the most recent season of the hit show "Top Chef," won the show’s 2011 competition and a grand prize of $100,000 on behalf of The Tisch Cancer Institute’s Young Scientist Cancer Research Fund at Mount Sinai School of Medicine. “I’ve seen the passion this work ignites in young researchers and it’s an honor for me to be able to support it,” said Chef Cardoz, former executive chef/partner of Tabla and soon-to-be executive chef/partner of a new Danny Meyer restaurant. The co-directors of the fund, Goutham Narla, MD, PhD, assistant professor of genetics and genomic sciences, and Analisa DiFeo, PhD, instructor in genetics and genomic sciences, thanked Chef Cardoz for his generous donation. "Chef Cardoz’s support for the Young Scientist Cancer Research Fund will be invaluable to the mission and vision of The Tisch Cancer Institute," said Dr. Narla.


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Opening Night On April 6, Mount Sinai celebrated the opening of the Dubin Breast Center with more than 250 guests in attendance. Pictured: 1. (from left) Glenn and Eva Dubin, Tracy Pollan and Michael J. Fox, and Kenneth L. Davis. 2. Gary and Nina Wexler. 3. (from left) Steven Farbman and Eileen Price-Farbman, Robert Price, Benjamin Shapiro, and Alexandra Farbman. 4. Pat Battle, WNBC-TV anchor and cancer survivor, hosted the evening. 5. (from left) Howard and Allison Lutnick and Marcy and Michael Lehrman. 6. (from left) Steven J. Burakoff, President Davis, Glenn and Eva Dubin, Elisa Port, and George Raptis. 7. Dara Richardson-Heron, MD, CEO of Susan G. Komen For the Cure’s Greater New York City chapter.

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A New Home for Palliative Care The official dedication of the Wiener Family Palliative Care Unit on May 24 signaled a new advance in Mount Sinai’s leadership in palliative care. Made possible through the generous support of the Wiener family, the new unit offers a comprehensive array of palliative care resources, from pain management to emotional support, to bring better quality of life to seriously ill patients and their families.

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Pictured: 1. (from left) Diane E. Meier, director of the Wiener Family Palliative Care Unit, with Susan West, Zena Wiener, and Tommy Hess. 2. (from left) President Davis, Dr. Meier, Mrs. Wiener, and Albert Siu.

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Crystal Party in the Park The 26th annual Crystal Party was held on May 5, welcoming approximately 1,300 Mount Sinai leaders, friends, and staff under an enormous tent in the Central Park Conservancy Garden. The event raised more than $3 million for Mount Sinai. Pictured: 1. Friends of Mount Sinai: Andrew and Zibby Right, Alexander Silverman and Lauren Hochfelder Silverman, Kasra and Sarina Sanandaji. 2. Elizabeth Greenstein and Mark Babyatsky. 3. Kenneth L. and Bonnie M. Davis, Lisa and Jeff T. Blau, Leni and Peter W. May 4. Anne Ehrenkranz and Dennis S. Charney. 5. New York Times photojournalist Bill Cunningham. 6. Beverly Riddick, Victor Franklin, and Carla Harris.

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Zweig Center Opens An intimate dinner held April 13 at the home of Barbara and Martin Zweig marked the occasion of the opening of the Zweig Family Center for Living Donation, a key part of the Recanati/Miller Transplantation Institute. The Zweigs’ gift also established the Sidney J. Zweig Professor of Medicine to advance the knowledge and practice of transplantation, held by Leona Kim-Schluger, MD. Pictured: (from left) Michael L. Marin, Martin Zweig, Leona Kim-Schluger, President Davis, Barbara Zweig, and Sander S. Florman.

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A Warm Welcome Mount Sinai welcomed Robert G. Maki, PhD, a renowned sarcoma cancer researcher, to his new role as the Steven Ravitch Chair in Pediatric Hematology/Oncology on May 11—the birthday of Steven Ravitch, who died at age 2½ from leukemia. Trustee Richard Ravitch, Steven’s father, expressed the hopes that the work done by Dr. Maki will one day mean no more families will lose loved ones to leukemia. “It brings us great joy to have Steven’s name linked with the hope for a brighter future,” he said. 1

Pictured: 1. Richard Ravitch. 2. Robert G. Maki

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Scholarship Dinner Toasts Supporters Scholarship donors met some of the students who have benefited from their generosity during an April 14 dinner event.

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Pictured: 1. (from left) Judy Kase, Andrew Ellis, Judith Segal, Emily Segal, Sam Benjamin, Charles Segal, and Nathan Kase. 2. Pat and Robert Levinson with Bryan Carter.

great doctors. grateful patients. Join us in celebrating the physicians who uphold Mount Sinai’s standard of excellence, create lasting and meaningful connections with patients, and deliver unparalleled care. Mount Sinai observes National Doctor’s Day by recognizing our outstanding physicians throughout the year. Make a gift in honor of your Mount Sinai physician today at philanthropy.mountsinai.org/honor or by calling 212.659.8500.

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Al

Al ALUMNI

ALUMNI Equal to the Task Michael Brodman, MD is a man on a mission: advancing women’s health. When asked if there’s any piece of sage

patients brought him to Mount Sinai,

advice he likes to impart to the medical

where he received his MD, completed his resi-

students and residents in his charge,

dency, and has served on the faculty ever since.

Michael Brodman MD ’82 leans back, purses both ways before crossing the street,” he

Overcoming inequality in women’s health

says finally, “and don’t text while driving.”

His amiability disappears when Dr. Brodman

Dr. Brodman laughs good-naturedly; true

talks about the persistent inequities in how

his lips, and considers the question. “Look

to his down to earth style, he seems to find

the medical field treats men and women.

the image of himself waxing philosophical

He points to cardiovascular studies

to be particularly funny.

as an example. “A lot of studies that

In fact, he laughs often during the course

look at heart disease and drug use

of a conversation about the career path

are done mostly on men,” he says.

that has brought him to his current role as

“Women and men don’t respond to

chairman of Mount Sinai’s Department of

treatments and drugs the same way;

Obstetrics, Gynecology, and Reproductive

women have different symptoms

Science, chuckling about the math classes

when they have chest pain. So more

he once taught to freshmen engineers as a

women have delayed diagnoses of

graduate student (“I had no idea what I was

myocardial infarction than men,

talking about,” he says) and the hobbies

because women don’t have the same

that he enjoys (woodworking, cooking, and

symptoms, and all the symptoms

golf, “though not necessarily in that order.”)

that everybody is tuned into are

A self-described “happy person,” he left a

male symptoms.”

career in bioelectrical engineering in large

Giving women’s health equal

part, he says, “because it was just too much

footing is Dr. Brodman’s vision for

being in a lab and not enough spending

the department he leads, which

time with people.” The desire to treat actual

has grown dramatically since

LEFT: Patients in Liberia—a country with only six OB-GYNs and a female mortality of 180 in 1,000 births—wait to see physicians and caregivers from the Global Women’s Health Initiative. The program sends residents and faculty members from the Department of Obstetrics, Gynecology, and Reproductive Science and other Mount Sinai departments to countries such as Liberia, where they perform complicated surgical procedures and teach local healthcare providers essential knowledge such as how to detect early warning signs during labor. RIGHT: Dr. Brodman, the chairman of the OB-GYN department, was inspired to create the program when he took a surgical mission to Niger.

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he became chairman eight years ago. Under his

Caribbean. The Global Women’s Health Initiative

leadership, the department has gone from 10 to 45

is fully integrated with the department’s residency

full-time faculty members; added family planning

program; this integration distinguishes it from

and urogynecology services; significantly expanded

global health efforts at most other medical centers,

services in minimally invasive surgery, oncology,

which tend to consist of residents and physicians

infertility, and both high-risk and generalist

undertaking their own individual trips to devel-

OB-GYN; and added a global health program.

oping countries with little institutional support.

A program as big as the world

Dr. Brodman hopes to see the program adopted as a model for other academic medical centers. “Our

Dr. Brodman harbors particularly large ambitions

ultimate goal is to have governing bodies of OB-GYN

for the global health program. His interest in

departments across the country recognize global

global health took hold when he was recruited by

health as a positive educational program,” he says.

the International Organization for Women and

It’s all part of his larger goal of promoting

Development to go on a surgical mission to Niger,

women’s health. “The medical community needs to

where he performed surgical procedures on women

do more to see that enough research and studies are

who had developed complications during child-

done on women so that we can actually determine

birth. The trip inspired him to create the depart-

how women respond to different treatment and

ment’s Global Women’s Health Initiative, which

strategies,” he says. “Most people who dole out

gives residents in their third year the opportunity to

research money are men, and that influences how

spend a three-week rotation, taking part in a faculty-

the money gets doled out. We need to effect a

led medical mission in one of the initiative’s partner

culture change in medicine to ensure that women

countries in West Africa, Central America, and the

get treated as equals.”  – Travis Adkins

“We need to effect a culture change in medicine to ensure that women get treated as equals.” – Dr. Michael Brodman

Doc of Rock Nimesh P. Nagarsheth, MD ‘97 (center) marches to the beat of his own drum—literally. Dr. Nagarsheth—a gynecological oncology surgeon and an assistant professor of obstetrics, gynecology, and reproductive science at Mount Sinai—plays drums, guitars, and keyboard for the rock band N.E.D. (No Evidence of Disease), which creates and performs music to raise awareness about gynecologic cancer. The band includes five other gynecological oncology surgeons from Alaska, Louisiana, North Carolina, and Oregon. N.E.D. has released two albums so far (No Evidence of Disease and their second album, Six Degrees) and will be featured in a forthcoming documentary. “Music reflects life,” says Dr. Nagarsheth, who is also the author of Music and Cancer: A Prescription for Healing. “There’s a lot we can learn through music about the healing process.” For more information, visit their Web site: www.nedtheband.com

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Al

ALUMNI

ALUMNI Scenes from Alumni Weekend 2011 MSSM & MSH alumni reconnected with each other and with their alma mater at this year’s Alumni Weekend, held April 1–3. More than 500 gathered for three days of activities and celebration headlined by a dinner event at which the Jacobi Medallion—one of Mount Sinai’s highest honors—was presented to Eric M. Genden, MD, MSSM ’92, David S. Mendelson, MD, MSH ’81, David Muller, MD,  MSH ’95, Pedro Pasik, MD, MSH ’56,  and Anthony Squire, MD, MSSM ’78. During the dinner event, outgoing Alumni Association President Martin Goldstein, MD, MSH ’73 presented

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President Davis and Dean Charney with a check for $100,000 raised by alumni to support scholarships. “As alumni, we understand the critical need for scholarship funds, and it is our great pleasure to help meet that need through this gift,” said Dr. Goldstein. The weekend also raised another $50,000 in contributions from alumni. “Mount Sinai is one of the top medical schools in the country today in large part because

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of its alumni,” said Jeffrey T. Laitman, PhD, the new president of the Mount Sinai Alumni Association. “I look forward to working closely with them to continue that success.” Pictured: 1. Alumni from classes for years ending in 1 and 6 were honored at a special dinner reception. 2. (from left) Iris Reyes, MD , Jill Baron, MD, and Nadine Keegan, MD, celebrated their 25th anniversary reunion along with other members of the class of 1986. 3. Outgoing alumni president Martin Goldstein presented Dean Charney with a $100,000 check raised by alumni for scholarship support. 4. 2011 Jacobi Medallion recipients (from left) Eric M. Genden, David S. Mendelson, Pedro Pasik, Anthony Squire, and David Muller.

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Mount Sinai Science & Medicine / FALL 2011

When medical students are overburdened by debt, we all pay the price. The world urgently needs more primary care physicians, global health specialists, and translational researchers, yet the financial realities of medical education often discourage students from entering these vital fields. That’s why Mount Sinai is embarking on a Scholarship Initiative that will give our students the resources they need to put aside financial concerns and pursue careers in primary care, global health, and translational research. With your help, we can make an investment in the future of healthcare.

For more information, please contact: Lisa Harper Director of Development 212.731.7492 lisa.harper@mountsinai.org philanthropy.mountsinai.org

Please consider making a gift to scholarships at Mount Sinai School of Medicine.

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Are you part of

THE CIRCLE?

If you are not, now is the time to join the Mount Sinai Leadership Circle and be part of our exclusive membership events. Members of the Mount Sinai Leadership Circle advance Mount Sinai’s mission: patient care, research, and medical education. Circle members receive invitations to special events during the year—such as a lecture series featuring noted experts discussing the latest medical breakthroughs, and other opportunities keyed to your level of giving. For more information on the Mount Sinai Leadership Circle, please contact Al Seminsky at (212) 731-7428 or albert.seminsky@mountsinai.org

www.philanthropy.mountsinai.org

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Non Profit Org. U.S. Postage

PAID The Mount Sinai Medical Center 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 (philanthropy@mountsinai.org) if you wish to have your name removed from our distribution list for fundraising materials.

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Mount Sinai Science & Medicine Fall 2011