New Institute Aims to Advance Science of Women’s Health

Elizabeth A. Howell, MD, MPP, Director of the new Women’s Health Research Institute, right, with Michael Brodman, MD, and Annetine C. Gelijns, PhD, JD.

The Icahn School of Medicine at Mount Sinai has created the Women’s Health Research Institute, with the mission of advancing science in women’s health. The Director of the Institute is a nationally recognized physician-scientist, Elizabeth A. Howell, MD, MPP, System Vice Chair of Research and Professor of Obstetrics, Gynecology and Reproductive Science, and Professor of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai.

“Developing a rigorous research program in women’s health is an essential component of the strategic plan of the Icahn School of Medicine at Mount Sinai, and a natural complement to Mount Sinai’s rapidly growing clinical services and fellowship training programs in this area,” says Eric J. Nestler, MD, PhD, Dean for Academic and Scientific Affairs, Director, The Friedman Brain Institute, and Nash Family Professor of Neuroscience.

Dr. Howell laid the groundwork for the Institute with the close collaboration of Michael Brodman, MD, Ellen and Howard C. Katz Chair and Professor, Obstetrics, Gynecology and Reproductive Science; and Annetine C. Gelijns, PhD, JD, Chair and Edmond A. Guggenheim Professor, Population Health Science and Policy. The two departments are co-sponsors of the new interdisciplinary Institute.

“I think that now is a great time for women’s health research,” says Dr. Howell. “You see a lot of clinical centers of care for women, but you do not see many that are focused on the science of women’s health.”

Two Centers of Excellence will provide the initial platform for achieving the Institute’s goals:

  • The Center for Outcomes and Quality Research in Women’s Health

With particular attention to underserved populations, the Center will build upon Mount Sinai’s strong research portfolio on quality of care and outcomes, with a focus on developing and evaluating interventions to improve women’s health and wellness.

  • The Center for Early Translational Research in Women’s Health

Drawing on the expertise of multiple departments, institutes, and programs, the Center will develop tools and core resources for translational research in genetics and immunology and build new diagnostic and treatment techniques for gynecologic cancers and other conditions in women’s health.

“The idea is that the same topic areas can be studied at both centers,” Dr. Howell says. “Looking at cervical cancer, for example, you can address screening, treatment practices, and patterns in health services. At the same time, you could be doing advanced work on tumor immunology and trying to find ways to diagnose it earlier and treat it more effectively. The centers will be very integrated, but you need both.”

The Institute is now seeking a director for the Center for Early Translational Research and recruiting senior and junior faculty members with expertise in women’s health, health services research, cancer research, and other complementary fields.  The Institute also hopes to establish the Women’s Health Scholars Program, recruiting residents and fellows to spend an additional year learning research methodology for a career in women’s health.

Dr. Howell sees strong potential for working with the centers across the institution, and she is already working closely with Stephanie V. Blank, MD, Director of Women’s Health at Mount Sinai Chelsea.  Dr. Blank will be the clinical lead for the Center for Early Translational Research in Women’s Health, and because she treats many patients with gynecologic cancer, “she will be one of the key people who can bring both our questions and our learning to the bedside,” Dr. Howell says.  Drs. Blank and Howell aim to build a strong ovarian cancer research program as part of this effort.

The Institute is also expanding and building on Dr. Howell’s work. Supported by grants from the National Institutes of Health, she leads research concerning maternal depression, outcomes for very low birth-weight babies, and the effect of hospital quality on severe complications and death in childbirth, which are persistently higher for black women and other ethnic minorities, compared with white women.

In a 2016 study published in the American Journal of Obstetrics & Gynecology, Dr. Howell’s team looked at 353,773 deliveries in 40 New York City hospitals from 2011 through 2013, and found that some of hospitals had rates of serious complications as low as 1 percent, while others had rates up to 6 percent. The study also found that 65 percent of white women delivered at hospitals with the lowest number of complications, and only 23 percent of black women did. “We need to figure out how to address these disparities, and why some hospitals are doing so much better than others,” Dr. Howell says.

“I am very interested in quality of care in general and how we measure it, how we improve it. Those kinds of issues—particularly in maternal and child health—resonate for me,” Dr. Howell says. The interest was present in her earliest days as at Harvard Medical School, when she had a neonatal rotation, caring for infants who were “so small and fragile” and who faced a lifetime of potential complications. Looking at the bigger picture, she also earned a master’s degree in Public Policy at Harvard’s John F. Kennedy School of Government, writing her thesis on infant mortality.

“I always knew that I love patient care,” Dr. Howell says, “but I also knew that I wanted to have a broader impact if I could.”

 

Mount Sinai Researchers Receive $13 Million NIH Grant to Study Impact of Genome Sequencing on Children’s Health Outcomes and Health Care Costs


Researchers at the Icahn School of Medicine at Mount Sinai have been awarded a grant from the National Institutes of Health for a four-year research program, the NYCKidSeq study, that aims to evaluate how genome sequencing can improve health care management by studying the ability to diagnose and treat three areas of childhood disease: inherited neurologic disorders, primary immune deficiencies, and cardiovascular disorders. It is the first clinical study of genome sequencing in children to be supported by a federal grant awarded to Mount Sinai.

“We hope to level the playing field in genomic medicine so that people in Harlem, the Bronx, elsewhere in New York City, and anywhere in the globe can benefit from genomic medicine,” said Eimear Kenny, PhD, Assistant Professor of Genetics and Genomic Sciences at The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, who is the study’s Principal Investigator.

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Robotics Symposium in 3D

Ash Tewari, MBBS, MCh, left, led the audience through a complex robotic surgery in 3D that was streamed live at the AUA Annual Meeting.

Ash Tewari, MBBS, MCh, and Ketan Badani, MD, attracted a standing-room-only audience at the American Urological Association (AUA) Annual Meeting in May, when the Mount Sinai physicians led a 3D satellite symposium on complex robotic prostate, kidney, and bladder cancer surgeries.

Mount Sinai developed some of the key techniques that were shown at the AUA meeting in Boston. U.S. and international physicians—from 15 countries—wore 3D glasses to view the surgeries and then listened to a panel discussion moderated by Dr. Tewari, Chairman, Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, and Dr. Badani, Vice Chair of Urology and Robotic Operations at the Mount Sinai Health System.

Addiction Institute to Explore Effective Therapies

The Icahn School of Medicine at Mount Sinai recently opened a new Addiction Institute that will address one of the nation’s greatest health concerns by exploring effective treatments for patients with substance abuse problems.

“Bringing science to bear on the development of new therapies has reached the top of the national agenda, and that is where Mount Sinai excels,” says Yasmin Hurd, PhD, the Ward-Coleman Chair in Translational Neuroscience and Director of the Addiction Institute at Mount Sinai.

The Institute will manage therapies for all types of substance abuse. By removing the traditional silos that separate research and clinical care, and unifying all areas of addiction under one umbrella, Dr. Hurd says the Institute is “well positioned to meet the challenges of New York City and the nation.” The Institute will leverage Mount Sinai’s considerable body of research and clinical expertise in neuroscience and behavioral health in order to move the field forward.

According to the 2016 U.S. Surgeon General’s Report on Alcohol, Drugs, and Health, more than 20 million Americans have substance abuse disorders and 12.5 million reported misusing prescription painkillers. Despite decades of expense and effort focused on a criminal justice-based model for addressing substance-related problems, the report acknowledged that addiction remains a public health crisis with economic consequences in crime, health, and lost productivity totaling more than $400 billion annually. Dr. Hurd says the Institute’s collaboration with Mount Sinai’s other specialties such as precision medicine, population health, infectious disease, epidemiology, and genomics will help advance treatments and novel discoveries.

“The Institute’s modernized structure across a large, integrated health system will enable us to approach addiction in a cohesive way,” says Dr. Hurd. “In addition to prioritizing our research based on clinical needs, we want to understand the populations at risk and their patterns of behavior. Addiction is complex and one group cannot do it alone.”

Yasmin Hurd, PhD

An important aspect of the Institute’s work will be dispelling the stigma associated with addiction through greater understanding of the biological and behavioral complexities of substance use disorders. Another goal will be encouraging young clinicians to enter residencies and fellowships in the fields of addiction psychiatry and addiction medicine.

“We want to train the best and the brightest through enhanced clinical and research rigor to elevate the field,” says Dr. Hurd. “Clinical treatments for some addictions have not advanced in 50 years. This and other stigmas can deter young physicians from going into this field. Unless we improve the clinical toolkit available for clinicians we will not be able to change the trajectory of care.”

Decades of scientific studies have established that chronic substance misuse leads to profound disruptions of brain circuits involved in pleasure, reward, habit formation, stress, and decision-making. Repeated drug use alters the expression of genes to ultimately increase or decrease their production of proteins, leading to long-term changes in cellular function and even reshaping of the physical structure of neurons.

“Drugs can change the morphology of cells and induce a cascade of adverse events in the brain,” says Dr. Hurd. The Institute plans to move forward with multiple clinical trials that seek to reverse those disruptions. “Most addicts do not want to be addicted,” she adds. “Addiction can be treated. We need medical therapies that partner with behavioral therapies, and we need to be diverse in our treatment portfolio.”

Treating Depression with Software: Technology from Mount Sinai Steps into the Digital Healthcare Universe

A treatment for depression using Emotional Faces Memory Task (EFMT), a technology originally developed by two Mount Sinai researchers, resulted in a significantly greater reduction of major depressive disorder (MDD) symptoms compared to a control group, according to initial clinical results presented at the Society of Biological Psychiatry Annual Scientific Convention.This treatment was developed at the Icahn School of Medicine at Mount Sinai by Brian Iacoviello, PhD, an Assistant Professor of Psychiatry who is Director of Scientific Affairs for Click Therapeutics, and Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean and Professor of Psychiatry, Neuroscience, and Pharmacological Sciences.

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Exposure to Specific Toxins and Nutrients During Late Pregnancy and Early Life Correlated With Autism Risk

Using evidence found in baby teeth, researchers from The Senator Frank R. Lautenberg Environmental Health Sciences Laboratory and The Seaver Autism Center for Research and Treatment at Mount Sinai found that differences in the uptake of multiple toxic and essential elements over the second and third trimesters and early postnatal periods are associated with the risk of developing autism spectrum disorders (ASD), according to a study published June 1 in the journal Nature Communications.

The critical developmental windows for the observed discrepancies varied for each element, suggesting that systemic dysregulation of environmental pollutants and dietary elements may serve an important role in ASD. In addition to identifying specific environmental factors that influence risk, the study also pinpointed developmental time periods when elemental dysregulation poses the biggest risk for autism later in life.

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