The Icahn School of Medicine at Mount Sinai now provides an Electronic Lab Notebook service for all researchers through an enterprise license agreement with LabArchives. The service is a secure, cloud-based software designed to replace paper notebooks and to help improve designing and documenting experiments.
“Mount Sinai is moving into the digital age of research record-keeping, and we really need folks to embrace it, to try it out,” says Reginald Miller, DVM, Dean, Research Operations and Infrastructure. “It’s a great way to collaborate with your colleagues, both internally and externally. It’s a resource that has unlimited user capability, and it’s free.”
At a time when science is being encouraged to be more reproducible and rigorous, this type of electronic note keeping is important in being able to show the data to those who request it and to be able to transmit and disseminate the data, according to Talia Swartz, MD, PhD, Assistant Professor, Division of Infectious Diseases.
“This has a huge advantage in providing a platform to make that readily available, and that is of interest to anyone who is trying to disseminate their data and collect it for the purpose of rigorous science,” says Dr. Swartz.
Neanderthals became extinct more than 20,000 years ago, but an innovative study of teeth by an international team, including researchers at the Icahn School of Medicine at Mount Sinai, has uncovered details about their lives that may lead to new insights into human evolution and into chemical exposures that affect health outcomes now.
The study is the first to use teeth to explore in weekly increments the relationship between ancient climate change and the development of hominins—humans and their immediate ancestors. Researchers examined remains recovered from Payre, an archaeological site in the Rhone Valley of Southeastern France, analyzing one tooth each from two Neanderthal children who lived 250,000 years ago, and another tooth from a “modern” human child who lived 5,000 years ago.
“Much like trees, teeth have growth rings that enable us to look at what happened in the life of an individual on a weekly basis,” says co-author Christine Austin, PhD, Assistant Professor of Environmental Medicine and Public Health, Icahn School of Medicine. “For these teeth, we cut a sample approximately 100 microns thick, or the width of a human hair, removed a small amount of material from the surface of the growth rings using a laser, analyzed the elements in that material using inductively coupled plasma mass spectrometry, and then constructed a timeline of exposure to the elements for each individual.”
Analyzing a slice of a Neanderthal child’s tooth, 100 microns thick, provided a timeline of development and chemical exposures. For example, a “stress line” around day 707 of the child’s life indicated a period of severe illness or hunger.
This technology was developed by Manish Arora, PhD, MPH, the Edith J. Baerwald Professor of Environmental Medicine and Public Health, Icahn School of Medicine, and senior author of the study, which was published in Science Advances in October 2018. “Dr. Austin’s work is a game changer for the way we analyze archaeological samples and for our understanding of how environmental stressors have impacted the evolution of modern humans and how they continue to impact our health,” Dr. Arora says. “Her work on the evolution of breastfeeding has direct relevance to understanding the benefits of breast milk in modern medical practice.”
Dr. Austin and her colleagues at institutions in France and Australia noted developmental deformations in the Neanderthal teeth that reflected the stresses of life during harshly cold winters. In addition, both Neanderthals were exposed to lead at least twice during late winter or early spring. Dr. Austin says two mines are located within foraging distance of the recovery site, indicating that food and water from the area may have been contaminated with lead. There were also signs of high, acute exposure, which could have resulted from an event such as inhalation of a cave fire.
“Previously, we thought that lead exposure mainly happened post-industrialization,” Dr. Austin says. “Now we see that is not the case, and that raises questions about the impact of this neurotoxin on their neurodevelopment and ultimately their behavior. That is something we want to explore further.”
Equally of interest were the findings related to breastfeeding. One of the Neanderthals was weaned at about two and a half years of age, which is similar to the norm for early humans. “Compared to other primates, humans wean early, which enables higher reproductive rates and is likely one of the reasons for our species’ success,” Dr. Austin says. “Seeing a human-like weaning pattern in Neanderthals is very interesting and raises questions about when this nursing behavior evolved.”
Dr. Austin says the study could also lead to insights into chemical exposures from breast milk that could impact lifelong health. “There is a growing body of data on the importance of breast milk in the development of an infant’s microbiome,” she says. “By better understanding how the composition of breast milk has evolved, in addition to breastfeeding practices, we can start to propose interventions at critical developmental windows that mitigate exposure to environmental stresses and toxins and thus improve health outcomes.”
Mount Sinai Health System leaders, from left: Kumar Chatani, Executive Vice President, Chief Information Officer, and Dean for Information Technology; Stephen Harvey, Senior Vice President and Chief Financial Officer, Icahn School of Medicine at Mount Sinai; Jane Maksoud, RN, MPA, Senior Vice President of Human Resources and Labor Relations; Karen Badenhorst, Vice President, Enterprise Business Systems, Information Technology; Donald Scanlon, Chief Financial Officer and Chief of Corporate Services; and Phillip Mears, JD, MHA, Senior Vice President, Supply Chain Management.
The Mount Sinai Health System is undertaking a massive business-operations project that will affect 39,000 staff and consultants in the system. The Enterprise Business Process Transformation (eBPT) Program will integrate the computer systems now used for human resources, financial operations, payroll, budgeting, and purchasing into a single, cloud-based system using Oracle software. It will roll out gradually, with the first functions going live by January 2020.
“This is a transformative opportunity,” says Karen Badenhorst, Vice President, Enterprise Business Systems, Information Technology, Mount Sinai Health System. “Standardizing our disparate systems and processes will harmonize how we work, increase our productivity, and strengthen the foundation of our business operations.” Staff will be able to view and update their personal information and data about their skills and qualifications. It will be easy to review paystubs, benefits, available PTO days, and performance appraisals, as well as apply for new positions and add certifications and other educational information.
The effort will encompass the Health System’s hospitals and ambulatory offices, Corporate Services, and the Icahn School of Medicine at Mount Sinai. This new approach will offer staff quicker access to data and easier ways to update it. There will be only one set of processes and procedures, which will eliminate the need for cross training on multiple software systems. Once it is implemented, all Mount Sinai staff members will be able to access information relevant to their positions anytime and anywhere, using desktop computers, laptops, tablets, and mobile phones.
“Many of the modules are intuitive,” says Jane Maksoud, RN, MPA, Chief Human Resources Officer and Senior Vice President of Human Resources and Labor Relations. Mount Sinai will provide online tools and reference guides, and additional training resources for areas that are more complex. The program will be integrated in stages, which will be complete by the end of 2020. To start the process, payroll will go live by January 2020 for The Mount Sinai Hospital, Mount Sinai Queens, the Icahn School of Medicine, and Corporate Services, followed in later months by payroll for Mount Sinai Beth Israel, Mount Sinai Brooklyn, Mount Sinai St. Luke’s, Mount Sinai West, and the New York Eye and Ear Infirmary ofMount Sinai. The timeline for integrating South Nassau Communities Hospital will be determined at a later time.
The new eBPT Program will tie together human resources, finance, and supply-chain computer systems. Its increased and more unified automation will make it faster and easier for managers and supervisors to process transactions, requests, and approvals, and to review employees’ attendance, continuing education, and professional accomplishments. With a few clicks, all staff can create and read real-time data and reports with greater efficiency and control. Within the School of Medicine, it will be easier to manage research grants and expedite workflow. In addition, basing the system in the cloud will make it easier to continually update and improve. All of this should lead to increased efficiency and cost savings, Ms. Badenhorst says.
Working committees, small group meetings and town halls across the Health System will be used to communicate the project’s progress and to gain valuable input from everyone who will be using the new systems, says Stephen Harvey, Senior Vice President and Chief Financial Officer, Icahn School of Medicine at Mount Sinai. “The large-scale transformation of our business operations will require some changes in the way we manage our work and control operations,” Mr. Harvey says. “Given the size and complexity of this project, we will need everyone’s help to ensure success.”
The Mount Sinai Health System recently received the HealthCare Partnership Award at the 39th annual gala for One Hundred Black Men, Inc. of New York held at the Sheraton New York Times Square. The award acknowledged the burgeoning partnership between the organization and Mount Sinai to advance solutions for health and economic issues that impact communities of color. Health System leadership, including members of the Mount Sinai Boards of Trustees, and black male medical students were among the attendees. Eric J. Nestler, MD, PhD, Dean for Academic and Scientific Affairs, Icahn School of Medicine at Mount Sinai, accepted the award on behalf of the institution.
The organization is the founding chapter of the national nonprofit that dedicates itself to supporting and empowering the black community. Most recently, the Health System sponsored the organization’s Citywide Hunger Relief Program, which provided healthy nutritious food to needy New Yorkers during the holiday season. Along with ongoing support for long-standing projects, new collaborations are also being planned, including a potential relationship with Mount Sinai Innovation Partners.
Mount Sinai Health System representatives at the gala included, from left, Gary C. Butts, MD, Chief Diversity and Inclusion Officer; William A. Brown, Associate Director, Information Technology, Enterprise Infrastructure; and Reginald W. Miller, DVM, DACLAM, Dean for Research Operations and Infrastructure.
“One Hundred Black Men, Inc. of New York has a proven track record of innovative entrepreneurship within communities of color throughout the New York metropolitan area,” says Reginald W. Miller, DVM, DACLAM, Dean for Research Operations and Infrastructure, Icahn School of Medicine at Mount Sinai. “Its mission dovetails seamlessly with the Health System’s own.”
“Mount Sinai is one of the largest economic producers in East Harlem,” says Gary C. Butts, MD, Chief Diversity and Inclusion Officer, Mount Sinai Health System, who is also a member of the organization. “We are positioned to authentically partner with One Hundred Black Men. The collaboration will serve them, us, and the community in ways that have not been realized in the past.”
From left: Noam Harpaz, MD, Professor of Pathology, and Medicine (Gastroenterology); Sanford J. Grossman, PhD; Judy H. Cho, MD; and Asher A. Kornbluth, MD, Clinical Professor of Medicine (Gastroenterology).
The Sanford J. Grossman Charitable Trust has committed $3 million to a center at the Icahn School of Medicine at Mount Sinai that is focused on advancing the understanding of Crohn’s disease and creating personalized medicine for its treatment.
“Mount Sinai has a large and unique data set on patients: clinical symptoms, pathology reports, genomics, family history, and radiology,” says the founder of the trust, the economist Sanford J. Grossman. “My hope is that the integration and analysis of this data will enable a better understanding of Crohn’s disease, and with that knowledge, therapies will be developed to alter the natural course of the disease.”
Crohn’s is a chronic inflammatory bowel disease that affects nearly 700,000 people in the United States. Over time it can damage the bowel and create complications such as strictures, a narrowing section of the intestine that can lead to loss of function and reduce the quality of a patient’s life.
“Our main goal is to develop treatments that specifically deal with stricture in Crohn’s disease, and that aren’t the usual anti-inflammatory treatments,” says Judy H. Cho, MD, Director of the Center, and the Ward-Coleman Chair in Translational Genetics at the Icahn School of Medicine at Mount Sinai.
One new effort is a small clinical trial led by Robert Hirten, MD, Assistant Professor of Medicine (Gastroenterology) at the Icahn School of Medicine, that is exploring whether steroids are beneficial for Crohn’s patients hospitalized with a bowel obstruction caused by stricturing. Dr. Cho is conducting genetic and molecular projects involving pluripotent stem cells that might someday be engineered to repair the defects that cause Crohn’s disease. She says, “We are very grateful for Dr. Grossman’s donation, which will fund our unique, integrative team and catalyze new research.”
Students celebrated the 15th anniversary of EHHOP. From left: Rebecca Choi, Saloni Agrawal, Rachel Levantovsky, Derek Kao, Michelle Tran, Mimi Chung, and Anna Stacy.
For 15 years, students at the Icahn School of Medicine at Mount Sinai have been providing free, confidential medical services to uninsured residents of East Harlem at a campus-based clinic at 102nd Street. Supported entirely by donors and volunteers, and supervised by physicians, the East Harlem Health Outreach Partnership, or EHHOP, serves more than 300 patients annually in more than 1,000 clinic visits.
On Wednesday, April 10, 150 Mount Sinai students, faculty, staff, alumni, donors, and friends gathered to celebrate EHHOP’s long-standing success and commitment to providing health services to the East Harlem community at a fundraising gala held at the Museum of the City of New York. The event helped move EHHOP closer to its goal of raising $100,000, which will enable it to continue supporting underserved patients.
Over the years, EHHOP has expanded beyond its primary care clinic and now operates ancillary clinics that provide care in mental health, women’s health, and ophthalmology, as well as in-house podiatry and cardiology care. EHHOP’s eye clinic distributes free prescription glasses to patients, and all prescription medications are free. The clinic recently began offering free legal services to its patients, as well.
“Beyond its dual mission of service and education, EHHOP brings together a community of students, staff, and faculty who believe that health is a human right,” said medical student and EHHOP gala co-chair James Blum.
Mitchell Katz, MD, President and Chief Executive Officer of NYC Health + Hospitals, the largest municipal health system in the United States, was the event’s keynote speaker. Dr. Katz commended EHHOP on its emphasis on primary care and mission to deliver high-quality care to all New Yorkers. EHHOP Program Director Yasmin S. Meah, MD, Associate Professor, Medicine (General Internal Medicine), Medical Education, and Geriatrics and Palliative Medicine, said the show of support at the event was “energizing and moving.” Dr. Meah oversees the clinic with Medical Director David C. Thomas, MD, Professor, Medicine (General Internal Medicine), Medical Education, and Rehabilitation Medicine.
Medical student and gala co-chair Denisse Rojas-Marquez told the crowd, “What may not have been so obvious is the outpouring of support for EHHOP from Mount Sinai alumni who live in different parts of the country.” For example, she added, “An alumnus from the class of ’73 who lives in California donated the wine at tonight’s event. Everything was given with so much love to contribute to our successful event.”
Ari Bar-Mashiah, a medical student who serves as EHHOP co-chair with fellow student Pepe Muniz Rodriguez, said, “It is an honor to be able to serve patients in our own backyard, and know that we can truly make a difference in the health care landscape of our local community and New York City at large.”
