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Medicine Research Day Celebrates Discovery,
The Steven Lamm, MD Master Clinician Award,
Awards & Accolades, Flashback Photo
May 2019

It’s Not About the Aviary

A message from the chair, Dr. Steve Abramson

On rounds one recent morning I asked the team about a patient’s occupation before she became ill. As is frequently the case, amidst the pressures of a busy admitting night, the question had not been raised. Understandably, since the patient had a clear diagnosis of atherosclerotic heart disease with acute MI, the patient’s employment mattered little in making the correct diagnosis and choosing the most effective treatment. We have come to think of occupational history in the context of job-related exposures, for example aiding in the diagnosis of psittacosis from work in an aviary or pulmonary fibrosis in first responders following exposure to World Trade Center “dust.” But especially for hospitalized patients, social context is vitally important, as it creates the opportunity to connect with the patient as an individual apart from their disease.

In our daily work we underestimate the depersonalizing impact of hospitalization. Immediately upon admission, people give up their private clothing and are handed a hospital gown, a symbol of the institution. Vulnerable from illness, bare-butted and clothed in institutional garb, they lose their identity as unique individuals, transforming into patients, literally defined as “a person who suffers patiently.”

In our brief interactions, the simple question of “What do (or did) you do for a living?” changes the physician-patient relationship and creates a connection. The patient is no longer a “vessel of disease” but rather a person with a meaningful life interrupted by the admission that now defines them. On recent rounds, a homeless alcoholic revealed that he was a former paratrooper in Vietnam, a woman with heart failure and depression glowed with stories of her life as an illustrator of raunchy magazines. These individuals were able to emerge from behind their hospital gowns; the relationship with their physicians changed, to the benefit of both the patient and the doctor.

It is surprising how often the social and occupational history – the life the person lives – is ignored when patients are admitted to the hospital. We need to keep in mind the ancient admonition that “The physician should not treat the disease but the patient who is suffering from it.” Taking brief moments to inquire about life separate from disease will allow the person to emerge, brighten the encounter and enable us to connect, even if we never make the diagnosis of psittacosis.

Department of Medicine Research Day

On Monday, April 29, members of the NYU Langone Health research community gathered to attend the 18th annual Department of Medicine Research Day. The event, showcasing the impressive research breadth of the department and its collaborators, consisted of 9 scientific talks and 173 poster presentations. Featured projects at the full-day event touched on many facets of medicine, from basic science to clinical and population health.
          “This was a fantastic day of science, with wonderful presentations from faculty and trainees in the Department of Medicine and colleagues from throughout the School of Medicine. Medicine Research Day reaffirms my enthusiasm for the physician-scientist model and the key role these individuals play in pushing the frontiers of biomedical discovery,” said Glenn Fishman, MD, vice chair for research in the Department of Medicine.
          Scientific talks were kicked off by keynote speaker Scott Friedman, MD, Dean for Therapeutic Discovery at Icahn School of Medicine at Mount Sinai, who took the stage after opening remarks from Dr. Fishman. The department was also pleased to welcome Andrew Hamilton, PhD, president of New York University, who gave a featured lecture titled “Chemical Approaches for Modulating Protein-Protein Interactions.”
          The oral segments of the event were separated by poster sessions, giving junior department members a chance to engage colleagues in scientific discussion about their ongoing work. The seven young investigators with the highest-scoring posters were invited to give short “poster blitz” presentations. The poster blitz presentations included:

  • “Identification of a Gut Pathobiont Immunostimulatory Lipoglycan Antigen Linked to Lupus Nephritis,” presented by Doua Azzouz, PhD, post-doctoral fellow in the Division of Rheumatology (Laboratory of B-Cell Immunology / Silverman Lab)
  • “Acute Myocardial Infarction Induces long-term reprogramming of monocytes inflammatory and functional responses,” presented by Emma Corr, PhD, post-doctoral fellow in the Leon H. Charney Division of Cardiology (Kathryn Moore Lab)
  • “Immune Response to Percutaneous Cryoablation of Lung Cancer,” presented by Katherine Gershner, DO, fellow in the Division of Pulmonary, Critical Care, and Sleep Medicine
  • “Development of a reverse vaccinology pipeline for a protective Staphylococcus aureus vaccine,” presented by David Hernandez, PhD student in the Laboratory of B-Cell Immunology / Silverman Lab
  • “Multiplex Gastrointestinal Pathogen PCR Testing in Patients with HIV/AIDS: The Relationship between Enteric Infection and CD4 T-Cell Count,” presented by Ashley Hine, research associate
  • “Using machine learning algorithms to predict response and toxicity to immune checkpoint inhibitors (ICIs) in melanoma patients,” presented by Paul Johannet, MD, medical resident
  • “The Prognostic Accuracy of the “Surprise Question” in Geriatric Patients at a Large New York City Hospital,” presented by Gregory Rubinfeld, MD, medical resident

View the photo gallery (password: elsa)

See the Medicine Research Day Program


The Steven Lamm, MD
Master Clinician Award

Steven Lamm, MD, medical director of NYU Langone’s Preston Robert Tisch Center for Men’s Health, is a noted internist who emphasizes the value of coordinated and patient-centered care across his clinical practice. To celebrate Dr. Lamm’s longtime commitment to his patients, NYU Langone has established this esteemed award in his name. Every three years, the Chairman of the Department of Medicine will select one faculty member to become the next Steven Lamm, MD Master Clinician. The Steven Lamm, MD Master Clinician will be a gifted physician who, like Dr. Lamm, epitomizes NYU Langone Health’s profound dedication to patient care—and whose efforts and accomplishments bring prestige to the Department of Medicine.
        Lauren H. Golden, MD, director of the NYU Langone Center for Diabetes & Metabolic Health (shown at right with Drs. Lamm and Abramson), was named the inaugural recipient of the award and will hold the title for three years. 

 

Flashback Photo

The photo above features the Class of 2002-2003 from our Internal Medicine Residency Program. Do you recognize a colleague? Are you in the photo yourself? We’d love to identify all of the alumni in the photo who are still at NYU Langone.

Click on the photo for a closer look. Send your comments and guesses to DOMCommunications@nyumc.org

 

Artificial Intelligence, Predictive Analytics, and Healthcare

Three Questions with Yin Aphinyanaphongs, MD, PhD
Assistant Professor of Population Health (CHIDS) and Medicine
Director, Clinical Predictive Analytics, MCIT

Artificial intelligence has the potential to revolutionize healthcare systems. What are some areas in which AI has already been a game-changer in healthcare?
Here are several examples. The first company to get FDA approval for AI imaging was Arterys, which segments arteries in MRIs automatically—normally a manual process done by a 3D lab. AI imaging is also being used for intracranial hemorrhages, and even triage, where high-risk patients are prioritized to radiologists for faster treatment. On the international scene, Google has sponsored trials in India using a diabetic retinopathy risk stratification model which reads ophthalmoscope images and determines whether there is referable diabetic retinopathy. Applications like these can effectively triage patients to specialists quickly and cheaply. In China, meanwhile, there are also some automatic chest x-ray radiograph report writing systems that produce reports on par with those written by radiologists. The Apple watch arrhythmia detection work is also an example. In addition, in radiogenomic applications, the AI algorithms can detect signals from the raw images for classifying genomic subtypes that humans have difficulty discerning. There are additional applications listed in this review paper.

Tell us a bit about what your team in predictive analytics is working on. Can you give us an example of a project that has effected change here at NYU Langone?
One of our first projects was a two-month mortality prediction model that operates at 75% accuracy when the model predicts on a patient. The aim is to ensure that an advanced care planning note is written for these patients. While the AI doesn’t identify patients that would be surprising to a provider, the quantitative certainty of the model helps to assure that identified patients are having necessary end-of-life conversations in line with their wishes. We continue to refine the model with new techniques, data, and approaches, and aim to ensure that the sickest patients are notified appropriately.
           We recently deployed a deterioration model that predicts patient codes, rapid response team calls, and transfers to ICU up to 12 hours in advance. Preliminary results have been promising for a screening like workflow for identifying potentially sick patients. The key contribution of this algorithm is to have an automated system that can make sure that patients don’t fall through the cracks and are identified in near real time for triage.

Where do you envision the role of AI in healthcare in 5 years? 20 years?
Providers will be augmented and supported by more and more AI tools in the future. In some applications, AI will help prioritize patients and radiographic images so that those needing the most attention will receive it. In others, these tools will do specific tasks for trained providers, while allowing patients in resource-poor areas to get expert opinions. For patients, we will have health monitoring tools like the Apple watch, which can give them an indication of a serious health event and potentially triage them to care. The question, however, is still open about the volume of true sickness and false sickness identified by these devices and whether we have effective workflows in place to handle the potential care requests from these monitoring devices.

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If you have a machine learning/artificial intelligence idea or read a great paper that we should implement at NYU Langone, please send Yin an email at yin.a@nyulangone.org.

 Faculty Awards & Accolades,
Program News

Sondra Zabar, MD, director of the Division of General Internal Medicine and Clinical Innovation, has been selected to receive the New York University 2018-2019 Distinguished Teaching Award, which recognizes faculty who have contributed significantly to the intellectual life of the University through their teaching.

Amit Uppal, MD, has been named the 2019 recipient of the NYC Health + Hospitals/Bellevue "Physician of the Year" Award. Dr. Uppal's clinical leadership has been instrumental in several clinical initiatives for Bellevue which have revolutionized care delivery, including optimization of outcomes in patients with severe sepsis and septic shock; development of uniform, centrally stocked emergency airway boxes; and enhanced safety mechanisms for inpatients with tracheostomies, among others.

Roberta Goldring, MD, was chosen by the American Thoracic Society Assembly on Respiratory Structure and Function (RSF) Awards Selection Committee to receive the RSF Dr. Robert Crapo Memorial Lifetime Achievement Award. The award is to be presented at the International Meeting of the American Thoracic Society in Dallas, Texas on May 21, 2019.

Adina Kalet, MD, MPH, has been selected to receive the 2019 Society of General Internal Medicine (SGIM) Career Achievements in Medical Education Award, which provides recognition to an outstanding clinician-educator whose lifetime contributions have profoundly advanced, and had widespread impact on the art and science of medicine and medical education. The award will be presented at the 2019 SGIM Annual Meeting, held May 8-11 in Washington, DC.

Caralee Caplan-Shaw, MD, medical director of the Tuberculosis Program and director of the Bellevue Chest Service of NYC Health + Hospitals/Bellevue, is being honored by United Hospital Fund’s Tribute to Excellence in Health Care. Dr. Caplan-Shaw is being honored "for leading a team of physicians, nurses, and administrative staff in a project to improve patient access to the hospital’s chest clinic, including through the implementation of a new e-Consult service." She will be recognized along with other honorees at an event on May 6.

The American Board of Internal Medicine Competency-based Medical Education Steering Committee has approved NYU School of Medicine for participation in the two-year, integrated Geriatric Medicine and Hospice & Palliative Medicine Competency-based Training Pilot. The integrated fellowship meets the core competency requirements of both specialties in a total of 17 months and allows for 7 months of scholarly activity and professional development in the area of research, education, or administration. Applications will be accepted beginning in July 2019 for the first integrated fellow to begin training on July 1, 2020. Special thanks to Megan Rau, MD, MPH, and Kelly McNamee for their hard work on this project.

Welcoming New Faculty

Yamen Homsi, MD, MPH, recently joined NYU Langone Health as section chief of the Division of Rheumatology at NYU Langone Hospital—Brooklyn. Learn more about Dr. Homsi.

Sam Serouya, MD, a gastroenterologist specializing in advanced therapeutic endoscopy—which allows direct evaluation of the gastrointestinal (GI) tract and noninvasive treatment of digestive disorders and diseases—recently joined the medical staff at NYU Langone Hospital—Brooklyn. Learn more about Dr. Serouya.

In Funding News

Jeffrey Berger, MD, received an R35 award for $5.5M over seven years from the National Heart, Lung, and Blood Institute (NHLBI) to fund the project "Mechanisms of Platelet Activity in Vascular Disease."

Peter S. Liang, MD, MPH, has been awarded a K08 grant by the NIH/NCI, to study longitudinal adherence to colorectal cancer screening in the VA health system.
[See below for additional grant news]

Recent Events & Conferences

Seminar in Advanced Rheumatology

The annual NYU Langone Seminar in Advanced Rheumatology welcomed almost 300 attendees to hear presentations on state-of-the-art treatment in rheumatology, at the leading edge between new clinical knowledge and its translation into practice.
See the agenda
See photos from the event (password: samantha)

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Big Gut Seminars: Focus on Complex Inflammatory Bowel Disease

The Division of Gastroenterology & Hepatology (Department of Medicine) and the Department of Surgery collaborated to hold the fourth annual “Big Gut Seminars: Focus on Complex Inflammatory Bowel Disease” CME/MOC course at NYU Langone Health on Friday, March 29, 2019. Led by course directors David P. Hudesman, MD; Lisa B. Malter, MD; and Feza Remzi, MD, the conference drew over 230 registrants.

 

A few of the speakers at the Big Gut IBD CME/MOC course. Shown from left to right: Justin Ream, MD; Michael J. Grieco, MD; Antonino Spinelli, MD, PhD (guest faculty from Milan, Italy); Lisa B. Malter, MD (course director); Seymour Katz, MD; Feza Remzi, MD (course director); Mark B. Pochapin, MD; Stephen B. Hanauer, MD (guest faculty from Chicago); David P. Hudesman, MD (course director); Bincy P. Abraham, MD, MS (guest faculty from Houston); Shannon Chang, MD; Jordan Axelrad, MD, MPH; Brian P. Bosworth, MD; Alec J. Megibow, MD, MPH.

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Asthma, Airways, and the Environment Symposium

Joan Reibman, MD, and Gail Schattner, MD, hosted the 2nd Asthma, Airways, and the Environment Symposium on March 22nd at NYU Langone. The focus was on environmental influences on airway diseases, including the microbiome of the built environment, the human microbiome, environmental tobacco smoke exposure, and traffic-related asthma. In addition, presentations included those on obesity and asthma and new advances in clinical management of asthma and COPD. Speakers included our own NYU faculty as well those from outside institutions. It was extremely well attended and met with great enthusiasm.

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Updates in Clinical Endocrinology

The Updates in Clinical Endocrinology CME course, held on April 11-12, presented the newest approaches and techniques in the diagnosis and treatment of endocrine disorders, including pituitary disorders, diabetes mellitus, bone and metabolism, as well as thyroid disorders. Led by course directors Nidhi Agrawal, MD, and Lauren H. Golden, MD, the conference drew more than 170 attendees. See the program.

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Division of Gastroenterology & Hepatology Welcomes Visiting Professor to Women in GI Reception, Grand Rounds

The Division of Gastroenterology and Hepatology recently welcomed Amy S. Oxentenko, MD (center, photo below), Professor of Medicine at Mayo Clinic, for a series of events at NYU Langone Health. On Monday, April 1st, the division hosted a Women in GI Cocktail Reception with Dr. Oxentenko as the special guest. Drawing on her strong interest in medical education and creating opportunities for women in medicine, she spoke about strategies to promote gender equity in gastroenterology. Then, on Tuesday, April 2nd, Dr. Oxentenko, whose expertise lies in celiac disease and malabsorption syndromes, gave an outstanding grand rounds presentation to the division, speaking about Celiac Mimickers: A Wolf in Sheep’s Clothing, or a Sheep in Wolf’s Clothing?
         Dr. Oxentenko was invited as a part of the Edgar Achkar Visiting Professorship Program from the American College of Gastroenterology. During her visit Dr. Oxentenko met with several faculty members along with the fellows to discuss interesting cases and career advice.

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Highlights from National Meetings

Faculty members and fellows from the Leon H. Charney Division of Cardiology had over 70 presentations at the American College of Cardiology (ACC) 2019 68th Annual Scientific Session & Expo, held March 16-18 in New Orleans.
         Below, group photo L-R: Drs. Barry Rosenzweig, Carlos Alviar, Robert Donnino, Larry Phillips, Adam Skolnick, and Nat Smilowitz; photo top right: Drs. Rosenzweig and Julie Friedman; bottom right: Dr. Daniele Massera

NYU Geriatrics had a great presence at the AMDA: The Society for Post-Acute and Long-Term Care Medicine Annual Conference, held March 7-10 in Atlanta. Benjamin Han, MD, MPH, participated in a symposium on opioid disorder and prescribing among older adults in post-acute and long-term care. Fellows Min Ho Cho, MD, and Helen Sun, MD, each received a competitive AMDA Futures scholarship to attend the meeting.

The annual assembly of the American Academy Hospice and Palliative Medicine (AAHPM) was held March 13-16 in Orlando. Our Palliative Care faculty represented NYU well at the conference. Some highlights include:

  • Fellow Hana Yu, DO, won the case poster award for “Newly Homeless at End of Life: Challenges Faced by a Chinese Immigrant Patient”
  • Rob Smeltz, NP, Angelika Golebiowska, MD, and Arianne Napier, LMSW, gave an oral presentation on a Case of a Homeless Woman with Breast Cancer
  • Akash Shah, MD, Deetta Vance, NP, Arum Kim, MD, Rob Smeltz, NP, and Michael Scott, MD, all presented posters
  • Audrey Tan, MD, led an educational session on behalf of Corita Grudzen, MD, on Optimizing the Delivery of Home-Based Palliative Care: Experiences from PCORI’s Ongoing Large Multi-Site Clinical Trials

Marc M. Triola, MD, and Patrick M. Cocks, MD, presented on “Using Public Data to Follow Graduates into Practice,” at the 2019 ACGME Annual Educational Conference. The talk explained how they have leveraged large databases of publicly available information to help understand the patterns of health care practice and outcomes among graduates from programs once they have left the programs.

Joshua Chodosh, MD, MSHS, led a discussion on value propositions of telehealth in post-acute and long-term care (PALTC ) settings at the American Telemedicine Association (ATA) Conference in New Orleans on April 14th. The discussion was part of a pre-conference workshop, "Making Telehealth an Essential Component to Care Delivery for Older Adults," convened by West Health to debut its guidebook for telehealth implementation in PALTC settings, which Dr. Chodosh consulted on. The resulting guidebook covers a range of topics—from needs and readiness assessments to reimbursement models and performance monitoring—in detail to help providers understand the specifics of the technology’s use, the broader landscape of telehealth, and how to tailor these innovations to an organization’s requirements.

Brian Kaufman, MD, and Kevin Felner, MD, co-directed a post graduate course entitled “Advanced Case-Based Interactive Critical Care with Simulation” at the 2019 Society of Hospital Medicine Conference on March 24th in Washington, DC. This was the 4th critical care pre-course—a hybrid course involving simulation and lectures—that Drs. Kaufman and Felner have done at SHM’s annual meeting. Dr. Kaufman also gave a lecture on Hospital and Critical Care Radiology on April 13th at the 2019 American College of Physicians Meeting in Philadelphia.

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A Field Trip to Explore Medical History

NYUSOM students recently toured the historic Ellis Island Immigrant Hospital with David Oshinsky, PhD, as part of the History of Medicine club.

 
 

In the News

Gut Microbiota May Drive Lupus Disease Pathogenesis: Microbiota imbalances in the gut have previously been implicated in the pathogenesis of several inflammatory autoimmune diseases. Examining 61 patients with systemic lupus erythematosus (SLE), Gregg Silverman, MD, and colleagues discovered that microbiome dysbiosis was directly correlated with SLE disease severity (Ann Rheum Dis, Feb 2019). Specifically, intestinal expansions of Ruminococcus gnavus bacteria were most apparent in individuals with disease manifestation in their kidneys. Study findings could pave the way for the development of prognostic tests for lupus nephritis among patients with SLE. Read the paper.

Heart risk factors may predict lung damage in 9-11 responders: For firefighters who worked at “Ground Zero” around September 11, 2001, a group of heart-disease risk factors also predicted who was likely to develop World Trade Center-related lung injury years later, says research from Anna Nolan, MD, and colleagues (Chest, in press). Read the paper.


 

Funding News

  • Delmar, Mario - Recipient of a $2,333,812, 4-year NIH R01 grant, titled “The sodium channel ecosystem in the adult ventricular myocyte”
  • Fishman, Glenn/Maass, Karen - Recipients of a $3,021,052, 4 year NIH RO1 MPI grant, titled “Transcriptional regulation in the ventricular conduction system”
  • Katz, Stuart - Recipient of a $757,969, 2-year NIH R34 grant, titled “CABG vs. PCI to Improve Outcomes in Systolic Heart Failure: A Pilot Feasibility Study”
  • Long, Chengzu – Recipient of a $1,000,000, 2-year grant from the Kids Connect Charitable Fund to support OncoEditing: Precision correction of BRCA mutations in human iPSC-derived mammary-like organoids via genome editing by Dr. Long and his lab team.
  • Shah, Binita – Recipient of a $1,594,470, 4-year NIH R01 grant, titled “Studies on the effects of colchicine on neutrophil biology in acute myocardial infarction”
  • van Solingen, Coen - Recipient of a $210,000, 3-year AHA 2019 Career Development Award, titled “A micropeptide concealed in a putative lncRNA directs inflammation”
  • Sharma, Monika - Recipient of a $104,060, 2-year AHA 2019 Postdoctoral Fellowship Award, titled “Role of regulatory T cells in the atherosclerosis regression and inflammatory resolution

BATTER UP!
DOM SUMMER SOFTBALL

This summer, join your colleagues for a bit of friendly competition by taking part in the Department of Medicine softball league. Four divisions have teams, but anybody in the department is encouraged to join – there is always space and everyone who wants to play will be able to. If you are interested, please speak to your division administrator.

All games begin at 6pm at East River Park, Fields #3 & #4 (Houston St & East River). Click on the image to the left for the schedule.

We Want to Hear from You:

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