Mount Sinai Science & Medicine Fall 2011

Please contact us by telephone (212.659.8500) or email ([email protected]) if you wish to have your name removed from our distribution list for fundraising materials.

Our medical programs,

research projects, and

healthcare outreach extend

to every corner of the globe

GLOBAL IMPACTMount Sinai anesthesiologist Irene Osborn, MD greets

a young patient during a recent service trip to Haiti

T H e M a g a z I n e O f T H e M O u n T S I n a I M e D I c a l c e n T e r

Mount SinaiSCiEnCE & MEDiCinE

IN THIS ISSUE Mount Sinai Around the Globe + Vanquishing Disease + Welcoming an Iconoclast + Helping Hands in Haiti FALL 2011

24172 94P Mt Sinai mag-REVISED.indd 2 9/29/11 9:43 AM

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

eDITOr

Celia M. Regan

aSSOcIaTe eDITOr

Travis Adkins

eDITOrIal aSSISTanT

Vanesa Sarić

cOnTrIbuTOrS

Philip BerrollSara DanielsDon HamermanAndrew LichtensteinSima RabinowitzKatie Quackenbush Spiegel

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 [email protected], or call us at (212) 659-8500. Visit us on the Web at philanthropy.mountsinai.org

vOluMe II, nuMber 3

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

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

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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21Mount SinaiSCiEnCE & MEDiCinE

ABOUT OUR COVERMount 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.


MEssAgE02 global Impact: Mount Sinai’s reach extends far beyond our borders

NEws03 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.

FACUlTy07 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

giViNg33 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

FEATURESGlobal 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 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.

CO

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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 under-

standing 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

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

their home.

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

Mount Sinai is transforming lives on a global scale.

Message from ThE PRESidEnT ThE dEAn&

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MSSM’s 42nd Commencement Honors Leaders in Medical Progress

Mount Sinai School of Medicine bestowed honorary

degrees on U.S. Senator Kirsten Gillibrand, Nancy G. Brinker, founder of Susan G. Komen for the Cure,

and three scientific pioneers for their commitment

to advancing medical progress at its 42nd

Commencement, held on May 13 in Avery Fisher

Hall at Lincoln Center.

Keynote speaker Senator Gillibrand (D-New

York) told the graduating class—a group of 249

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

MS recipients—that their work as physicians and

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

be relying on you to lead this country forward in

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

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

learned at Mount Sinai toward creating a better

future for America.”

Epidemiologist William Foege, MD, MPH, the

former director of the Center for Disease Control and

Prevention; genomics research expert Leroy Hood, MD, PhD, the president of the Institute for Systems

Biology; and inventor Jonathan M. Rothberg,

lefT: Honorary degree

recipient kirsten gillibrand

addresses the graduates

the founding CEO and chairman of RainDance

Technologies, Clarifi Corporation, and CuraGen

Corporation, each received an honorary Doctor

of Science degree for significant contributions

to their fields.

Dean Dennis S. Charney spoke of the

promising future made possible by discoveries

in genomics and other scientific breakthroughs

and challenged graduates to make that promise

a reality. “As the next generation of scientists and

clinicians, you must be in the vanguard of such

an historic transformation in biomedical research

and clinical practice,” he said.

“This graduating class of physicians and

scientists cannot simply accept things as they

are, because deep and profound changes are

already underway,” said the Medical Center’s

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

patients and the vitality of the health care system

in America, you must dream things as they can

be, and ask the necessary questions that will get

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

rIgHT: Dean charney and Dr. eva Dubin

present the honorary degree to nancy g. brinker,

founder of Susan g. komen for the cure

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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

geriatrics (#1), digestive disorders (#5),

heart and heart surgery (#11), rehabili-

tation (#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.

“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 recog-

nized 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

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.”

RANKING BY SPECIALTY 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

in Memoriam: Edgar M. Cullman, sr.Trustee Edgar M. Cullman, Sr., whose six decades of service to Mount Sinai were marked by integ-rity, 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 through-out 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 posthu-mously 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.

OF 5000HOsPiTAls

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Dubin Breast Center OpensThe April 2011 opening of the Dubin Breast Center of The Tisch

Cancer Institute marked an important advance in Mount Sinai’s

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-the-

art, 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 chemo-

therapy. “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 break-

through 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.

The Dubin breast center is one of

the first clinics in the country to

offer tomosynthesis, a breakthrough

radiology technology.

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.

0505


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 atherothrom-

bosis, 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 Celebrates Passage of landmark 9/11 Health Care BillGovernment, 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 fund-ing for the health care of emergency responders who were affected by the attacks of Sept. 11, 2001. Mount Sinai took the lead in devel-oping 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.

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

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Drs. Blander and tenOever Awarded Burroughs wellcome Fund grant

The Burroughs Wellcome Fund recently

awarded Julie Magarian Blander, PhD,

associate professor of medicine, and

Benjamin tenOever, PhD, associate

professor of microbiology, grants for their

pioneering research in infectious diseases,

supporting study of the intersection of

human and microbial biology. Mount

Sinai was the only research center with

two recipients.

louis M. Aledort Receives lifetime Achievement Award

Louis M. Aledort, MD, Mary Weinfeld

Professor of Clinical Research in

Hemophilia, has received the Albert

Einstein College of Medicine Lifetime

Achievement Award in recognition of

his distinguished career in the field of

blood disorders, and his major contribu-

tions to the health and welfare of under-

served communities.

Alisan goldfarb Named Physician of Distinction by American Cancer society

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

assistant clinical professor of surgery, was

honored with the Physician of Distinction

Award by the American Cancer Society.

Dr. Goldfarb was singled out in particular

for her staunch advocacy for patients and

improving their quality of life.

The American Psychiatric Association Honors larry J. siever

Larry J. Siever, MD, professor of psychiatry

and vice chair of veterans affairs, received

the 2011 Judd Marmor Award from the

American Psychiatric Association (APA).

Dr. Siever, honored for his research in

biopsychosocial factors involved in mental

health, gave a lecture at the APA’s annual

meeting in May.

APA Honors Margaret Baron and Ethylin wang Jabs

Margaret H. Baron, MD, PhD, professor

of medicine in hematology, director of

hematology and medical oncology research,

and Ethylin Wang Jabs, MD, vice chair and

division chief of the Department of Genetics

and Genomic Sciences, were among 64

individuals elected to the Association of

American Physicians this year.

Joanna Fowler Receives Distinguished women in Chemistry Award

Joanna Fowler, PhD, professor of psychiatry

and a senior chemist and director of

Radiotracer Chemistry, Instrumentation

and Biological Imaging at the U.S.

Department of Energy’s Brookhaven

National Laboratory, was one of 23 women

from around the world chosen to receive

a 2011 Distinguished Women in Chemistry/

Chemical Engineering Award, sponsored by

the American Chemical Society.

Recognition Awards&

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.

MOUNT siNAi FACUlTy RECEiVE NEw APPOiNTMENTs

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NEw RECRUITSKatherine 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 investigat-ing 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.

Adolfo Firpo-Betancourt, MD, MPA, FCAP has joined Mount Sinai as director of pathology educa-tional 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 move-

ment 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 suggests Dramatic shift in Understanding of Personalized Medicine

Researchers at Mount Sinai and Loyola University Chicago have

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

scientists to abandon the use of broad conventional ethnic labels—

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

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

the Charles R. Bronfman Institute for Personalized

Medicine, enrolls consenting patients who confi-

dentially provide DNA and plasma samples to aid

in genomic and personalized medicine research.

Researchers used genomic technology to determine

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

participants and found a continuum in ancestral

genetic heritage at the individual level of self-

identified African-American and Hispanic patients—

meaning considerable fractions of their genome came

from mixed European or African ancestry, respec-

tively—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 Environ- mentally-induced Childhood Disease Cost at $76.6 Billion

In three new studies published in the May issue

of Health Affairs, Mount Sinai researchers, led by

Leonardo Trasande, MD, associate professor of

preventive medicine and pediatrics, revealed the

staggering economic impact of toxic chemicals and

air pollutants in the environment, and proposed new

legislation to mandate testing of both new chemicals

and those already on the market. They analyzed

the costs of conditions—including lead poisoning,

childhood cancer, asthma, autism, and attention

deficit hyperactivity disorder—associated with exposure to toxic

chemicals, and calculated the annual cost for direct medical care

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

economic productivity caring for their children, of these diseases

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

all US health care costs in 2008.

safe and Effective gene Therapy to Treat severe Heart Failure

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

at Mount Sinai stabilized or improved cardiac function in people with

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

SERCA2a, experienced substantial clinical benefit and significantly

reduced cardiovascular hospitalizations, addressing a critical unmet

need in this population. The data were published online

in the June 27 issue of the American Heart Association

journal Circulation.

Gene therapy with SERCA2a was also found to be

safe in this sick patient population, with no increases

in adverse events, disease-related events, laboratory

abnormalities, or arrhythmias compared to placebo.

“This study establishes a new paradigm for the treat-

ment of heart failure by clinically validating SERCA2a

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

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 gov-

erns 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-

entiation has important implications in preventing

obesity and cardiovascular disease. This novel

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

developmental and regenerative biology, and Lorin

E. Olson, PhD, previously a postdoctoral fellow in

the laboratory who is now at the Oklahoma Medical

Research Foundation, evaluated the Platelet Derived

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

were genetically engineered to have elevated PDGFR

signaling. Findings: The elevated signaling inhibits

differentiation of immature mesenchymal stem cells, which have the

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

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

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

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

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

Research Roundup

3.5% of all direct and indirect

US health care costs in 2008 resulted from

environmentally-induced

childhood disease.

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Dominican Republic

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

North DakotaSpirit Lake Nation: Encouraging

local students to enter medicine (Project partners: Cankdeska Cikana Community College/Mailman School of Public Health)

ChileEnvironmental

and occupational health (See Mexico)

International exchange program (See Ireland)

ArgentinaBuenos Aires:

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

Polypill Initiative (See Italy)

BrazilSao Paolo: Investigating malaria

and tropical diseases (Project partners: Cidade Universitaria)

Polypill Initiative (See Italy)


Environmental and occupational health (See Mexico)

MexicoTraining environmental

and occupational health researchers (Project partners: Queens College)

Pediatric

environmental health (See Costa Rica)


ColombiaHeart-healthy

habits (See Spain)

Pediatric environmental health (See Costa Rica)

BelizeMental health

(See St. Vincent)Haiti

Treating victims of 2010 earthquake

St. Vincent & the Grenadines

Helping to establish national mental health system

PeruOperating on children

with cranial and facial conditions

El SalvadorTraining healthcare

providers to perform cervical cancer screening

GuatemalaDistributing birthing

kits (See Sierra Leone) Costa RicaTraining Latin American

researchers in pediatric environmental health

UruguayPediatric environmental

health (See Costa Rica)

GrenadaImproving cardiovascular

health (Project partners: World Heart Federation)

ParaguayPolypill Initiative

(See Italy)

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TanzaniaAhakishaka

Community: Conducting public information campaign targeting malaria and HIV

Cardiovascular disease (See Malawi)

SpainTeaching kids

heart-healthy habits (Project partners: Sesame Workshop)

Polypill Initiative

(See Italy)

MozambiqueGorongosa National Park:

Instructing community health workers and local midwives (Project partners: Carr Foundation)

MadagascarImproving malnutrition

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

CameroonEducating

healthcare workers in AIDS prevention techniques

IrelandExpanding minority

students’ access to international educational opportunities

South AfricaInternational exchange

program (See Ireland)

LiberiaMental health

(See St. Vincent)

IsraelIntroducing

state-of-the-art robotic surgery technology

NigeriaPerforming

reconstructive surgery on burn victims

EthiopiaDeveloping health

programs for orphans (Project partners: Worldwide Orphans Foundation)

Sierra LeoneDistributing

birthing kits to caregivers (Project partners: Saving Mothers)

EgyptScreening for hepatitis C

(Project partners: Harbor Lights)

IranAnalyzing risk

factors of cardio-vascular disease

MalawiMeasuring the impact

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

RwandaCardiovascular

disease (See Malawi)

ItalyDetermining efficacy

of inexpensive pill designed to prevent heart disease

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

OFA

i


IndochinaOrganizing scientific

symposiums

CambodiaPerforming reconstructive

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

ThailandSupporting research

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

IndiaLaunching community-

based healthcare initiatives (Project partners: The Comprehensive Rural Health Project)

BangladeshTraveling to remote

areas to provide basic care (Project partners: Friendship)

MongoliaPerforming ocular surgery and

other eye care procedures (Project partners: Virtue Foundation)

VietnamIsolating strains

of influenza virus

ChinaIdentifying epidemiological

risk factors for cancer

Building Capacity In Global Health

Promoting Women and Children’s Health

Delivering Urgently-Needed Care

Combating Epidemics

MOUNT SINAI CONNECTION

Students

Researchers

Caregivers

Administrators

Single Country Program

Multi-Country Program

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

Mitral valve surgeries and valve repair (See Dominican Republic)

ICON KEY

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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 profes-sionals come to us from just about everywhere, and our own medical and educational pro-grams, 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.

MOUNT SINAI


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

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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, buttoned-down 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 col-leagues. 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 passion-ate about research.”

A VACCINE FOR ALL STRAINS Their passion is well placed: The impact of a universal flu vac-cine 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 phar-maceutical 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.”

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 immuno-gens 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 broad-spectrum 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 effec-tive 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.”

“What We haVe in common is that We are about research.” – Dr. Adolfo García-Sastre

Passionate

BY PHILIP BERROLL

This image of an influenza virus

cell was captured by Yi-ying chou,

a Mount Sinai School of Medicine

PhD student in the Palese lab.

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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, imagin- ative researcher.” After getting his own lab, Dr. García-Sastre continued to col-laborate 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.

“But in the big, overreaching aspects of influenza biol-ogy — 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 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 know-ing 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 vic-tims of the 1918 outbreak — “like Jurassic Park,” says Dr. Garcia-Sastre, “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 devel-oped 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 gener-ated from the 1918 virus, they could reconstruct it for evil pur-poses. 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

if ProVen effectiVe, these antiVirals coulD haVe a Dramatic imPact on global health not seen since the introDuction of broaD-sPectrum antibiotics.

Dramatic imPact

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Vive la Difference


Catching the Flu

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:

1918 – 1919 Spanish Flu

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.

1957 – 1958 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.

19 68 – 1969 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.

2009 – 2010 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

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. García-Sastre. “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 acci-dent 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 terror-ism 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 anti-bacterial, 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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BY KATIE QUACKENBUSH SPIEGEL

ERIC SCHADT:

CONOCLASTDateline: 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.ITo search for the right name for Mount Sinai’s newest institute, Eric Schadt did what any world-renowned

biomathematics expert, biotech start-up guru, purported “smartest man in the world” (yes, he’s actually been called that by more than one science pundit), and global net-work builder would do. He Googled. “We wanted to find out which terms con-veyed the right meaning and hadn’t been used a lot, and were posed for an exponen-tial explosion versus terms like ‘systems biology’ that had already passed through the exponential phase and were now on the decline,” says Dr. Schadt, director of the Institute for Genomics and Multiscale biol-ogy, Jean C. and James W. Crystal Professor of Genomics, and chair of the Department of Genetics and Genomic Sciences.

“We wanted to find a term that more accu-rately represented what we’re going to be doing at Mount Sinai. ‘Multiscale biology’ is hardly used at all; it’s just beginning to emerge on Google as something people are talking about. So we named it the Institute for Genomics and Multiscale Biology.” And soon, lots of people are going to talk about it a lot more. The brand-new concept of multiscale biology, or the study of many complex layers of human disease biology — from the sub-molecular/genetic level, to the molecular, cellular, organ, organism, all the way up to the community scale — is a departure from the prevailing paradigm of how the human system was explored in the past. But it’s just what Dr. Schadt and his colleagues are going to be doing at Mount Sinai’s new Institute — and they’re going to do it differently from anybody.

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SCIENCE MUST GLOBALIZE ITS APPROACH

to understanding how diseases occur and can be treated, or even

prevented. And scientists everywhere have to start

working together.

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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 technolo-gies that allow them to “see” many of these 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 inves-tigation and exploration for understanding living systems,” says Dr. Schadt. “That’s sort of what we have in these new tech-nologies. 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.

EMBRACING COMPLEXITYDr. 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 career-making 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 com-munity 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 top-tier academic medical centers, Mount Sinai’s labs are bustling with activity that is success-fully advancing our insights into diseases. From the genetic screen-ing 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 multidimen-sional view will transform how we diagnose and treat Alzheimer’s and so many others.”

“What I’ve come to realize is that biol-ogy 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 under-stand these hard diseases.” Which is why Dr. Schadt came to New York.

MAKING IT MATTER“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 laid-back 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 motiva-tion 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 amaz-ing 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 sci-ence, 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

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.

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Eric Schadt: Iconoclast


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:

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 scientific iconoclast. Dr. Schadt worked in executive positions on the scientific side of companies like Roche, Rosetta Inpharmatics, and Merck 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 will be used by a team of some two dozen multiscale biologists who will be recruited to Mount Sinai’s new Institute in collabora-tion 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 catalyz-ing innovation in the application of genomics technologies through collaborations with the scientists in Mount Sinai’s existing dis-ease- 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 type of deep academia-industry collabora-tion 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.”

1 The discovery that environmental stress can induce heritable DNA-based changes

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

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

Mount Sinai’s center for Science

and Medicine, the future home

of the Institute for genomics and

Multiscale biology, will open in 2012.

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“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 dispa-rate 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.

INFORMATION-DRIVEN MEDICINE“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 under-standing that emerges from their individual groups,” Dr. Schadt says. “Of course we will be working to develop diagnostics and therapeutics ourselves at Mount Sinai, gen-erating 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 advan-tage 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 infor-mation 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 diagno-ses, better assignments of the treatments patients should receive. This is a huge paradigm shift for biomedical sciences, to become a more information-driven, quanti-tative 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.”

“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 sequenc-ing 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 cor-porations 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 sepa-rate 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

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Eric Schadt: Iconoclast


SIZEometimes 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.

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 unac-knowledged, 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 envi-ronmental 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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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 sky- rocketing. 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, hyperten-sion, 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

science and medicine asks:

When most people think of medical break-throughs, they

might think of drugs or treat-ments, developed in a lab and delivered in a clinic, that cure disease. How do the break-throughs that come from epidemiology differ from that common definition?

DR. BOFFETTA: The idea of a major break-through 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 epidemiol-ogy 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 suc-cessful 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

“It’s the largest study of its kind ever

conducted in the U.S. and its findings

could have a global effect.” – Philip Landrigan

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“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.”

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

You have different back-grounds 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 can-cer, 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 find-ings 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 twenty-one, 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

– Paolo Boffetta

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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.

MSSM is the First Fully Designated PAHO/WHO Collaborating Centre In Children’s Environmental Health In The U.S.

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 partner-ships 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 real-ized it will give us much more statistical power to look at connections between environmental exposure and diseases in children. The scien-tific 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 epidemiol-ogy is the prospect of discovering the prevent-able 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 fore-cast 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.

– Philip Landrigan

“Our most grateful patients are the

ones who don’t even know we exist.”

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Size Matters


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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“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 can-cer 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 immunolo-gists, physician scientists, and clinicians. Together we are intent on learning to decipher the processes that regulate DC and mac-rophage 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 inflamma-tory 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 success-fully demonstrated the importance of the translational approach and the power of col-laborating across disciplines. Last year, she published a study in Science reporting unan-ticipated 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 devastat-ing brain immune and degenerative disease.

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 sci-ence 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 CUREDoing “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 preoccupa-tions 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-trans-plantation 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 collabora-tion 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 treat-ments affect their patients, and basic scientists must help decipher the biological mechanisms underlying disease. The process of understand-ing 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 labora-tory 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 prolifera-tion (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 radia-tion 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.

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Passionate Pioneer


THE BIG PICTURE — AND THE SMALLWith 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 consor-tium 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 scien-tists are always very touched and inspired by

the patient session,” Dr. Merad notes, “because no matter how basic or clinically oriented scien-tists 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 influ-ence 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 collabora-tion, 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.

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

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Photography by Andrew Lichtenstein


Top to bottom: Andrew Abrass, a resident in emergency medicine, and Theresa Madaline, a resi-dent 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

he earthquake that struck

Haiti in January 2010 took a

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

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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

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

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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

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

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Mr. and Mrs. Cullman’s generosity and commitment

inspired the involvement of their children—Lucy Cullman

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

who have been dedicated Mount Sinai supporters since

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

their father as Trustees in 1986 and 2001, respectively.

“My family and I proudly continue the legacy of

highlighting the importance of patient care and vigilantly

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

The Cullmans’ most recent gift to The Campaign

for Mount Sinai will help recruit world-class physician

scientists in cardiovascular research, cancer, genetics,

neurology, and other critical fields, as well as fund

other vital patient care-related objectives throughout

Mount Sinai.

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

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

Cullman family has ensured that the quality of care

that patients receive at Mount Sinai rivals that of any

other institution in the world,” said president and CEO

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

to remember the many contributions of this remarkable

leader, nor to express our gratitude for the Cullman

family’s six generations of service and to celebrate the

achievements their partnership and generosity have

made possible.” – Sara Daniels

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 philan-

thropic 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

decided this spring to present him and his family with the

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

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. Cullman’s great-grandfather, Benjamin Nathan,

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

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

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

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

for seven years on the Board of The Mount Sinai Hospital

School of Nursing. His appreciation for nursing and innate

sensitivity to the difficulties patients face has motivated his

efforts to improve the patient experience.

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

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

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

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

The Cullman family has committed more than $30 million

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

tives throughout the institution. Their most transformative

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

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

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

Cullman, Jr. Institute for Patient Care in 2001.

“Having the Cullman Institute in a large academic medical

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

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

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

director, Dr. Mary Dee McEvoy.

Noble Deeds Society to Honor the Cullman Family

Trustees Susan cullman,

the late edgar cullman,

and edgar cullman, Jr.

benjamin nathan

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GIVINGGv


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 execu-tive chef/partner of a new Danny Meyer restaurant. The co-directors of the fund, Goutham Narla, MD, PhD, assistant professor of genetics and genomic sci-ences, 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 invalu-able to the mission and vision of The Tisch Cancer Institute," said Dr. Narla.

A $1 million pledge from Gerald J. Cardinale will

support genomics-focused translational research

programs at Mount Sinai and promote multidisci-

plinary collaboration across the medical center.

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

led by the Center for Discovery and Innovation and

the Institute for Genomics and Multiscale Biology,

two of the medical center’s most important ventures.

Allocated to the President’s Strategic Initiative Fund,

the pledge will enable Mount Sinai’s leadership

to direct its resources to areas of strategic priority

such as recruiting investigators and other faculty;

equipping the medical center with next-generation

sequencing technology; and expanding genomic

research initiatives in cancer, heart, and brain diseases,

immunology, metabolism and endocrinology, and

infectious diseases.

“Interpreting the human genome is the new

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

the Anne and Joel Ehrenkranz Dean, Mount Sinai

School of Medicine. “Philanthropic pioneers such as

Mr. Cardinale are helping us explore that frontier

Cardinale Pledge Strengthens Genomics Research

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

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

“ Interpreting the human genome is the new frontier in medicine.” – Dennis S. Charney

and take a leap forward in medical

progress.”

“Mount Sinai is already

at the forefront of gen-

omics research,” said

Mr. Cardinale, noting the

medical center’s recent

recruitment of Eric E.

Schadt as the Jean C. and

James W. Crystal Professor

of Genomics and director

of the Institute for Genomics

and Multiscale Biology. “I look

forward to continuing to support

its growth and trailblazing initiatives

under Eric’s leadership.”

The pledge by Mr. Cardinale, a partner at Goldman

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

of support for Mount Sinai. Goldman Sachs’s close

relationship with Mount Sinai dates all the way back to

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

served as Trustees over the years.

ABOVE: An image

of intracellular protein

and DNA content from

Dr. Schadt’s research

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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 leader-ship in palliative care. Made possible through the generous support of the Wiener family, the new unit offers a comprehen-sive array of palliative care resources, from pain management to emotional support, to bring better quality of life to seriously ill patients and their families.

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.

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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scholarship Dinner Toasts supporters

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

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. 1

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.

PICTURED: 1. richard ravitch. 2. robert g. Maki 1 2

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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.


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

advice he likes to impart to the medical

students and residents in his charge,

Michael Brodman MD ’82 leans back, purses

his lips, and considers the question. “Look

both ways before crossing the street,” he

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

Dr. Brodman laughs good-naturedly; true

to his down to earth style, he seems to find

the image of himself waxing philosophical

to be particularly funny.

In fact, he laughs often during the course

of a conversation about the career path

that has brought him to his current role as

chairman of Mount Sinai’s Department of

Obstetrics, Gynecology, and Reproductive

Science, chuckling about the math classes

he once taught to freshmen engineers as a

graduate student (“I had no idea what I was

talking about,” he says) and the hobbies

that he enjoys (woodworking, cooking, and

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

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

career in bioelectrical engineering in large

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

being in a lab and not enough spending

time with people.” The desire to treat actual

patients brought him to Mount Sinai,

where he received his MD, completed his resi-

dency, and has served on the faculty ever since.

OVERCOMiNG iNEquALiTy iN WOMEN’S HEALTH

His amiability disappears when Dr. Brodman

talks about the persistent inequities in how

the medical field treats men and women.

He points to cardiovascular studies

as an example. “A lot of studies that

look at heart disease and drug use

are done mostly on men,” he says.

“Women and men don’t respond to

treatments and drugs the same way;

women have different symptoms

when they have chest pain. So more

women have delayed diagnoses of

myocardial infarction than men,

because women don’t have the same

symptoms, and all the symptoms

that everybody is tuned into are

male symptoms.”

Giving women’s health equal

footing is Dr. Brodman’s vision for

the department he leads, which

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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“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—liter-ally. Dr. Nagarsheth—a gynecological oncol-ogy 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

he became chairman eight years ago. Under his

leadership, the department has gone from 10 to 45

full-time faculty members; added family planning

and urogynecology services; significantly expanded

services in minimally invasive surgery, oncology,

infertility, and both high-risk and generalist

OB-GYN; and added a global health program.

A PROGRAM AS BiG AS THE WORLD

Dr. Brodman harbors particularly large ambitions

for the global health program. His interest in

global health took hold when he was recruited by

the International Organization for Women and

Development to go on a surgical mission to Niger,

where he performed surgical procedures on women

who had developed complications during child-

birth. The trip inspired him to create the depart-

ment’s Global Women’s Health Initiative, which

gives residents in their third year the opportunity to

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

led medical mission in one of the initiative’s partner

countries in West Africa, Central America, and the

Caribbean. The Global Women’s Health Initiative

is fully integrated with the department’s residency

program; this integration distinguishes it from

global health efforts at most other medical centers,

which tend to consist of residents and physicians

undertaking their own individual trips to devel-

oping countries with little institutional support.

Dr. Brodman hopes to see the program adopted as

a model for other academic medical centers. “Our

ultimate goal is to have governing bodies of OB-GYN

departments across the country recognize global

health as a positive educational program,” he says.

It’s all part of his larger goal of promoting

women’s health. “The medical community needs to

do more to see that enough research and studies are

done on women so that we can actually determine

how women respond to different treatment and

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

research money are men, and that influences how

the money gets doled out. We need to effect a

culture change in medicine to ensure that women

get treated as equals.” – Travis Adkins

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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

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 schol-

arship 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

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.

Scenes from Alumni Weekend 2011

when medical students are overburdened by debt, we all pay the price.

For more information, please contact:

Lisa Harper Director of Development 212.731.7492 [email protected] philanthropy.mountsinai.org

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.

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

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www.philanthropy.mountsinai.org

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 [email protected]

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Documents

Mount Sinai Science & Medicine Fall 2011