Podcasts about Mount Sinai Health System

Shaking the Family Tree: Risk Factors, Genetic Testing and More.  Whether it is a concern for a cancer diagnosis, diabetes, heart disease or other condition, knowing your family history can be a key factor in early detection and treatment for inherited disease. Knowing something is not rooted in family history is important as well! Dr. Sarah Cate will help breakdown our understanding of genetics, epigenetics and more on this important episode. Bio: Dr. Sarah Cate is a breast surgical oncologist, specializing in breast cancer surgery. She joins Stamford Health as the chief of the division of breast surgery. She is a graduate of UMDNJ/ Robert Wood Johnson Medical School and trained in general surgery at Westchester Medical Center. She is a graduate of the Mount Sinai West and Downtown Breast Surgery Fellowship. Dr. Cate has a special interest in oncoplastic surgery, as well as nipple-sparing mastectomies with direct-to-implant reconstruction. She is board certified in general surgery and is certified in Hidden-Scar™ surgery. She was previously at Mount Sinai for 10 years, where she developed and lead high-risk programs for the Mount Sinai Health System, as well as lead the breast surgery quality program for the last two years. She will be bringing the latest research and innovations to Stamford Hospital. Dr. Cate also enjoys training the next generation of breast surgeons and was the associate program director of the Mount Sinai West Breast Surgery Fellowship. Her research has been published and presented at the national level. She is a sought after national and international speaker. Her care philosophy focuses on patient-centered care, with warmth, knowledge, and shared decision-making. Find Yonni & Heather here https://www.herhealthcompass.com/

We have a special guest on today's episode whose voice will be familiar to regular listeners. Last year at this time, Dr. Raven Baxter occupied the Raise the Line host chair for a special ten-part series we produced in collaboration with the Cohen Center for Recovery from Complex Chronic Illness (CoRe) at Mount Sinai in New York City, where she serves as the Director of Science Communication. The series explored the latest understandings of post-acute infection syndromes -- such as Chronic Lyme and Long COVID -- with an array of experts from the Center and other researchers and providers. In this episode, we check-in with Dr. Baxter to get an update on the work of the Cohen Center, especially with regard to its mission to educate providers. “We're building programs so that clinicians can earn credit for learning about chronic illnesses that are infection associated, and we've also developed a 200-page provider manual. I really think that we will be able to shift the narrative that currently exists,” Dr. Baxter tells host Michael Carrese. That narrative includes lingering skepticism among providers of some infection-associated illnesses, which Dr. Baxter witnessed herself as a Long COVID patient, an experience that has added meaningful perspective to her work. Dr. Baxter is also working on her own time to advance knowledge and combat misinformation through a robust social media presence as “The Science Maven” and helps other scientists and clinicians to do the same. "If we're not there to fill in that void, other people will fill it for us and the narrative may not be consistent with the truth or facts." This is a great opportunity to learn about the art and science of communications that can reach clinicians and patients alike.Mentioned in this episode:Cohen Center for Recovery from Complex Chronic IllnessThe Science Maven If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

In a conversation with CancerNetwork®, Viviana Cortiana, MS4, and Yan Leyfman, MD, spoke about their manuscript titled “Artificial Intelligence in Cancer Care: Addressing Challenges and Health Equity,” which they published in the April 2025 issue of ONCOLOGY®. Cortiana is a medical student in the Department of Medical and Surgical Sciences at the University of Bologna. Leyfman is a resident physician from the Icahn School of Medicine of the Mount Sinai Health System. Cortiana highlighted how artificial intelligence (AI)–based tools may mitigate the overdiagnosis of cancers, although she noted a need to validate these devices with diverse and high-quality datasets to avoid the risk of biased models. Additionally, she described how developing population-specific AI models may improve predictive accuracy in diagnosis as well as treatment planning, which can especially benefit patients in low- and middle-income countries. As part of ethically applying the use of AI to oncology and delivering equitable cancer care, Leyfman emphasized core pillars such as data security, transparency, clinical validation, and combatting algorithmic bias. Furthermore, he stated that potential applications of these tools include mobile diagnostics, cloud-based platforms, and remote consultation, which can help increase access to care. Regarding the potential next steps in the field, he highlighted that global partnerships with parties such as tech companies, governments, and non-governmental organizations may assist with the funding and deployment of AI tools, especially for underserved regions. “The future of AI in oncology is increasingly promising, not just in pushing the boundaries of what's possible in cancer care but also making sure that more precise and more accessible worldwide therapies are available,” Leyfman stated. “AI has the potential to fundamentally change how we detect, treat, and monitor [cancer], but realizing that promise, especially in a way that's equitable, will require collaboration, validation, thoughtful implementation, and a commitment to leaving no patient behind.”

In a conversation with CancerNetwork®, Viviana Cortiana, MS4, medical student in the Department of Medical and Surgical Sciences at the University of Bologna, and Yan Leyfman, MD, a resident physician from the Icahn School of Medicine of the Mount Sinai Health System, discussed their publication in the March 2025 issue of ONCOLOGY titled “Expanding horizons in T-cell lymphoma therapy: a focus on personalized treatment strategies.” Throughout the discussion, the authors spoke about the current lymphoma landscape, CAR T-cell therapy, and the evolving understanding of the tumor microenvironment. Specifically, Cortiana covered a shift from histology-based classification to molecular tumor type classification using next-generation sequencing, as well as a growing interest in biomarker-driven therapies. Regarding the limited efficacy of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in T-cell lymphoma, she listed potential advances in combination therapies for angioimmunoblastic T-cell lymphoma (AITL), which include combining P13K and HDAC inhibition as well as CD30- and TRBC1-targeting CAR T-cell therapies. Furthermore, Leyfman discussed strategies that “reprogram” the microenvironment to address malignant T cells, particularly through epigenetic and adoptive cell therapies. Leyfman concluded by discussing future implications for T-cell lymphoma treatment, emphasizing an emergence of precision medicines and armored CAR engineering strategies. Authors of the manuscript published in ONCOLOGY outlined the available treatment options for peripheral T-cell lymphoma (PTCL), which include targeted therapies through EZH2 inhibition, chemotherapy with CHOP, CAR T-cell therapies, and allogenic stem cell transplantation. Additionally, they highlighted encouraging results from clinical trials evaluating epigenetic-targeted therapies through the identification of molecular aberrations, which can help tailor treatments to individual patients.  Furthermore, the article explored limitations of chemotherapy as well as autologous stem cell transplantation (ASCT), which may not be feasible for older patients or those with comorbidities. Authors suggested that targeted therapies may enhance tumor specificity while reducing systemic toxicity. Given the risks associated with ASCT, they emphaisized a focus on the incorporation of optimized treatment strategies, such as novel pharmaceuticals and combination therapies, into clinical practice for patients with PTCL.

This episode is the ninth in a series of Stuart McMillan chatting with and introducing various presenters from The Speed Summit, brought to you by 3X4 Genetics. Our guest this time is Chris Miller Athletic Performance Coach at Mount Sinai Health System. Stuart and Chris talk about working in the NBA, the difference between team and individual sports, athletes being an organizational investment     ... and much more. The Speed Summit will take place June 6-8 in Chicago, Illinois. Registration is now OPEN. Big thanks to our sponsors 3X4 Genetics, 1080 Motion, STATSports, TeamBuildr and Output Sports.

EPISODE 1: Innovations in Performance Tech with Dr David PutrinoMartin and Jonpaul talk to neuroscientist Dr David Putrino, whose job it is to find innovative human performance technologies and roadtest them. From brain stimulation to mitochondrial supplements, David takes us through the tech that works and the stuff that doesn't live up to the hype. He also shares insights from his work with high-performance athletes at Red Bull. Guest, Cast & CrewDr David Putrino is the Director of Rehabilitation Innovation for the Mount Sinai Health System, a network of hospitals in New York City. He is also a consultant for Red Bull High Performance division, using evidence-based technologies to improve athletic performance. Hosted by Martin Jones & Jonpaul Nevin https://www.ophp.co.uk Edited by Bess ManleyResourcesLinkedin: https://www.linkedin.com/in/david-putrino-bb86aa11/ Blue Sky: https://bsky.app/profile/putrinolab.bsky.social Instagram: https://www.instagram.com/putrino_lab/ Icahn School of Medicine at Mount Sinai https://icahn.mssm.edu/research/abilities-research-center/about/directors Thanks for tuning in. If you found this podcast valuable, please take a moment to rate, share and review. If you have feedback, guest suggestions or topics that you'd love us to cover, then do email us at info@ophp.co.uk or connect with us on LinkedIn. Chapters01:46 David's Role and Research at Mount Sinai07:38 The rise of neuroscience10:05 The Hype and Reality of Brain Stimulation16:53 Effective Technologies for Enhancing Performance18:54 Mitochondrial Supplements and Probiotics23:18 David's Journey to Red Bull24:40 Meeting Andy Walsh and Red Bull Projects25:28 Pushing Athletes Beyond Limits26:06 Performance Under Pressure camps at Red Bull27:48 Insights from Project Endurance30:01 Understanding Stress and Flow35:35 Neuroplasticity38:59 Wearable Technology in Performance Hosted on Acast. See acast.com/privacy for more information.

Lisa S. Stump, BSPharm, MS, FASHP, Executive Vice President, Chief Digital Information Officer, and Dean of Information Technology at Mount Sinai Health System, discusses key areas of growth for the year, including advancements in AI and clinical innovation. She addresses anticipated challenges such as the rapid pace of change and transforming operating models, while sharing her strategies for setting the organization up for long-term success.

Lisa S. Stump, BSPharm, MS, FASHP, Executive Vice President, Chief Digital Information Officer, and Dean of Information Technology at Mount Sinai Health System, discusses key areas of growth for the year, including advancements in AI and clinical innovation. She addresses anticipated challenges such as the rapid pace of change and transforming operating models, while sharing her strategies for setting the organization up for long-term success.

This episode, recorded live at the Becker's Healthcare 12th Annual CEO + CFO Roundtable, features Dr. Arshad K. Rahim, CMO of Population Health and Clinically Integrated Network at Mount Sinai Health System. Dr. Rahim shares his perspectives on AI's role in population health, the challenges of value-based care, and the evolving relationship with payers. He also discusses the importance of data, patient engagement strategies, and the future of healthcare in 2025.In collaboration with R1.

Christopher Pizzute, MA, LCAT, MT-BC, is a music psychotherapist who works in inpatient and outpatient services at Mount Sinai Health System in New York City. His expertise extends to palliative, psychiatric, geriatric, pediatric, and neonatal care. Christopher is also a songwriter, artist, and video game advocate whose work now extends to exploring the benefit of […] The post Using Music to Support Patient Care (HLOL #257) appeared first on Health Literacy Out Loud Podcast.

Professor David Putrino is a physiotherapist with a PhD in Neuroscience. He is currently the Director of Rehabilitation Innovation for the Mount Sinai Health System, and a Professor in the Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai. Professor Putrino recently opened the Mount Sinai Cohen Center for Recovery from Complex Chronic Illness in New York also known as (CoRE) and serves as CoRE's Family Director and is also a member of PolyBio's Long COVID Research Consortium.Today's episode is the second in a two part series looking at research into potential treatments for Long COVID.REFERENCES1 Polybio Article - A clinical trial of repurposed HIV antivirals in Long COVID2 Patterson BK, Yogendra R, Guevara-Coto J, Mora-Rodriguez RA, Osgood E, Bream J, Parikh P, Kreimer M, Jeffers D, Rutland C, Kaplan G. Case series: maraviroc and pravastatin as a therapeutic option to treat long COVID/Post-acute sequelae of COVID (PASC). Frontiers in Medicine. 2023 Feb 8;10:1122529.3 Polybio Article - Long COVID low-dose rapamycin clinical trial4 Polybio Article - Lumbrokinase Long COVID & ME/CFS clinical trial

Professor David Putrino is a physiotherapist with a PhD in Neuroscience. He is currently the Director of Rehabilitation Innovation for the Mount Sinai Health System, and a Professor in the Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai. Professor Putrino recently opened the Mount Sinai Cohen Center for Recovery from Complex Chronic Illness in New York also known as (CoRE) and serves as CoRE's Family Director and is also a member of PolyBio's Long COVID Research Consortium.Today we talk about the pathophysiology of Long COVID in the context of describing research into targeted treatments for the disease.REFERENCES1 Proal AD, VanElzakkerMB, Aleman S, Bach K, Boribong BP, Buggert M, Cherry S, Chertow DS, Davies HE, Dupont CL, Deeks SG. SARS-CoV-2 reservoir in post-acute sequelae of COVID-19(PASC). Nature Immunology. 2023 Oct;24(10):1616-27.2 Klein J, Wood J,Jaycox JR, Dhodapkar RM, Lu P, Gehlhausen JR, Tabachnikova A, Greene K, Tabacof L, Malik AA, Silva Monteiro V. Distinguishing features of Long COVID identified through immune profiling. Nature. 2023 Nov 2;623(7985):139-48.3 Long COVID low-dose Rapamycin clinical trial4 Lumbrokinase LongCOVID & ME/CFS clinical trial5 Silva J, Takahashi T, Wood J, Lu P, Tabachnikova A, Gehlhausen JR, Greene K,Bhattacharjee B, Monteiro VS, Lucas C, Dhodapkar RM. Sex differences insymptomatology and immune profiles of Long COVID. medRxiv. 2024 Mar 2:2024-02.6 VanElzakker MB, Bues HF, Brusaferri L, Kim M, Saadi D, Ratai EM, Dougherty DD, Loggia ML. Neuroinflammation in post-acute sequelae of COVID-19 (PASC) as assessed by [11C] PBR28 PET correlates with vascular disease measures. Brain, Behavior, and Immunity.7 Fernández-CastañedaA, Lu P, Geraghty AC, Song E, Lee MH, Wood J, O'Dea MR, Dutton S, Shamardani K, Nwangwu K, Mancusi R. Mild respiratory COVID can cause multi-lineage neural cell and myelin dysregulation. Cell. 2022 Jul 7;185(14):2452-68.

Sugar seems to be in everything we eat. While experts have warned against its health side effects, people continue to consume it in staggering quantities. Why is sugar so addictive? How can we break free from our cravings and take care of our bodies instead? In this episode, we sit down with Dr. Nicole Avena to discuss her newest book, Sugarless: A 7-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction. In this step-by-step guide, Dr. Avena teaches readers how to completely change their mindset around what they eat – using food for what it is intended to be: fuel for the body… Dr. Avena is a research neuroscientist and expert in the fields of nutrition, diet, and addiction. She is the Associate Professor of Neuroscience at Mount Sinai Health System and a Visiting Professor of Health Psychology at Princeton University. Tune in now to discover: What makes sugar so addictive. How reducing sugar intake can benefit your health. The connection between the gut and brain, and how diet dictates your health. The benefits of cutting back on added sugars. Evolutionary reasons why the body craves sugar. You can pick up your own copy of Sugarless here, and follow along with Dr. Avena's research here! Episode also available on Apple Podcasts: http://apple.co/30PvU9

#BRN #Wellness #1891 | What is a heart attack?  | Matthew I Tomey , MD, Mount Sinai Health System & the American Heart Association | #Tunein: broadcastretirementnetwork.com | #Independent. #GetTheFullStory. #JustTheFacts. #Everyday. #AllInOnePlace.

Welcome to season 2 episode 9 of A Friend for the Long Haul - A Long Covid Podcast! This week's guest is Dr. David Putrino, Professor of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai, Director of Rehabilitation Innovation for the Mount Sinai Health System was appointed the Nash Family Director of the CoRE - and so many other things. Dr. Putrino and I discussed the onset of the pandemic, its impacts on him and his team (we feel like we've aged about 10 years since March 2020), and how the work they did early on influenced their response when patients weren't getting better. We also talked about how he and his team care for their own mental health, impediments to research, upcoming studies they have planned, and he answered listener questions like “will you adopt me” and my question which was, “how do I set up a PO Box in New York so I can come to the clinic?”

In this episode, Patti Cuartas, Executive Director and Associate CMIO at Mount Sinai Health System, shares her expertise on leveraging technology to improve interoperability, care coordination, and health equity. She discusses the challenges and opportunities in data exchange, the impact of AI tools, and how Mount Sinai's global and community-focused initiatives are driving innovation in healthcare.

In this episode, Patti Cuartas, Executive Director and Associate CMIO at Mount Sinai Health System, shares her expertise on leveraging technology to improve interoperability, care coordination, and health equity. She discusses the challenges and opportunities in data exchange, the impact of AI tools, and how Mount Sinai's global and community-focused initiatives are driving innovation in healthcare.

Join us for an eye-opening conversation with breast cancer expert Dr. Sarah Cate as we dive into the different types of breast cancer, how common they are, and whether women are being diagnosed younger. Dr. Cate breaks down the role of genetic testing, the power of advanced imaging for early detection, and the latest in minimally invasive surgeries. We'll also debunk common myths, share lifestyle tips to reduce risk, and cover must-know advice on self-exams and mammograms. Don't miss this crucial episode! We also debunk common misconceptions about breast cancer risk factors, discuss the latest in minimally invasive surgical techniques, and share lifestyle tips for reducing risk. Plus, get expert advice on breast self-exams and mammogram frequency—along with potential changes to screening guidelines. Don't miss this essential episode! Dr. Sarah Cate is a breast surgical oncologist, specializing in breast cancer surgery. She joins Stamford Health as the chief of the division of breast surgery. She is a graduate of UMDNJ/ Robert Wood Johnson Medical School and trained in general surgery at Westchester Medical Center. She is a graduate of the Mount Sinai West and Downtown Breast Surgery Fellowship. Dr. Cate has a special interest in oncoplastic surgery, as well as nipple-sparing mastectomies with direct-to-implant reconstruction. She is board certified in general surgery and is certified in Hidden-Scar™ surgery. She was previously at Mount Sinai for 10 years, where she developed and lead high-risk programs for the Mount Sinai Health System, as well as lead the breast surgery quality program for the last two years. She will be bringing the latest research and innovations to Stamford Hospital. Dr. Cate also enjoys training the next generation of breast surgeons and was the associate program director of the Mount Sinai West Breast Surgery Fellowship. Her research has been published and presented at the national level. She is a sought after national and international speaker. Her care philosophy focuses on patient-centered care, with warmth, knowledge, and shared decision-making. _________________________________________________ Sponsor the JOWMA Podcast! Email digitalcontent@jowma.org Become a JOWMA Member! www.jowma.org Follow us on Instagram! www.instagram.com/JOWMA_org Follow us on Twitter!www.twitter.com/JOWMA_med Follow us on Facebook! https://www.facebook.com/JOWMAorg Stay up-to-date with JOWMA news! Sign up for the JOWMA newsletter! https://jowma.us6.list-manage.com/subscribe?u=9b4e9beb287874f9dc7f80289&id=ea3ef44644&mc_cid=dfb442d2a7&mc_eid=e9eee6e41e

In this episode of Neuro Innovation Talks, the newest podcast series in the DeviceTalks Podcast Network, the DeviceTalks editors invite Johnson & Johnson MedTech Neurovascular's Head of Global Marketing, John Murray to take over the podcast studio and bring to light the stories from the pioneering neurointerventionalists who have helped shape the stroke industry. In the first episode, Host John Murray sits down with Alejandro Berenstein, MD, Professor of Neurosurgery, Pediatrics and Radiology, Director of pediatric Cerebrovascular Surgery, Mount Sinai Health System, to discuss the incredible evolution of neurovascular surgery and its impact on modern healthcare. Dr. Berenstein shares his early inspirations, key breakthroughs, and the significant role mentors played in shaping his illustrious career. Highlighting landmark projects like the pioneering treatments for Vein of Galen Malformations (VOGM) and facial vascular anomalies, Dr. Berenstein shares the complexities and triumphs of his work. His story provides a blueprint for aspiring medical professionals and innovators, demonstrating how personal experiences, visionary thinking, and collaborative efforts can lead to groundbreaking advancements that significantly impact patient outcomes. Thank you to Zeus for sponsoring this episode of Neuro Innovation Talks. To learn more about how Zeus supports medical device companies, visit: www.zeusinc.com. Special thanks to the following for their support in the development of this podcast: Joanna Colangelo, Johanna Fifi, Whitney Garrett, Howard Riina, Lillian Medina, and J. Mocco. Tune in and subscribe to the DeviceTalks Podcast Network wherever you get your podcasts and follow youtube.com/@DeviceTalks to never miss an episode. Thank you for supporting the Neuro Innovation Talks podcast!

Dr David Putrino is the Director of Rehabilitation Innovation for the Mount Sinai Health System in New York City, his work in computational neuroscience shows in the recent HBO documentary QUAD GODS.The Harvard trained Chief Mad Scientist has worked with Red Bull's Sponsored Athletes as part of the High Performance Division and is pushing boundaries with Brain Computer Interfaces.Timestamps added below if you want to skip to your juice.Want to become a Keep Rolling Patron and help further support the channel, hit the Patreon link below and Roll with the Squad!https://www.patreon.com/street_rolling_cheetahAdd, Follow or Contact Dr David Putrino:X (formally Twitter): https://x.com/PutrinoLab Add, Follow or Contact me: Email: streetrollingcheetah@gmail.com Instagram: https://www.instagram.com/street_rolling_cheetah/?hl=enX (formally Twitter): https://x.com/St_RollCheetahFace book: https://www.facebook.com/StreetRollingCheetah/LinkedIn: https://www.linkedin.com/in/jake-briggs-77b867100/Timestamps(00:00:00)  Neuroscience and Harvard(00:08:00)  Mad Scientist and Innovation(00:15:00)  Creating Possibilities and Neuro Plasticity(00:23:00)  Gaming Therapy and HBO QUAD GODS(00:40:00)  Mark Cuban(00:42:00)  VR and AR(00:44:00)  Brain Computer Interface(00:51:00)  AUS and USA Healthcare(00:59:00)  Red Bull High Performance(01:10:00)  What's on the Horizon

Learn how to stay healthy after 65 including healthy diet tips, exercise benefits, supplements, incontinence solutions, and how much water to drink. Meet Dr. Joyce Fogel, a geriatrician at the Martha Stewart Center for Living at Mount Sinai Health System, the largest hospital system in New York City. 00:00 Video highlights 00:46 Meet Dr. Fogel 02:46 When to see a geriatric doctor 06:55 Decreased thirst as we age 07:23 How much water should you drink? 09:21 How to address incontinence 12:03 Hormonal changes 12:48 Addressing chronic issues at home 16:22 Benefits of exercise 18:35 What's a healthy diet? 21:36 Are supplements good or bad? Disclaimer: This podcast is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this video are the views of the expert and do not necessarily represent the views of yes2next.

Neurologic infections become emergencies when they lead to a rapid decline in a patient's function; however, neurologic infections are often challenging to recognize. In this episode, Aaron Berkowitz, MD, PhD, FAAN, speaks with Alexandra S. Reynolds, MD, author of the article “Neuroinfectious Emergencies,” in the Continuum® June 2024 Neurocritical Care issue. Dr. Berkowitz is a Continuum® Audio interviewer and professor of neurology at the University of California San Francisco, Department of Neurology and a neurohospitalist, general neurologist, and a clinician educator at the San Francisco VA Medical Center and San Francisco General Hospital in San Francisco, California. Dr. Reynolds is an associate professor in the departments of neurosurgery and neurology at Icahn School of Medicine at Mount Sinai Health System in New York, New York. Additional Resources Read the article: Neuroinfectious Emergencies Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Transcript Full transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the Journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by visiting the link in the show notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the show notes. AAN members, stay tuned after the episode to hear how you can get CME for listening.     Dr Berkowitz: This is Dr Aaron Berkowitz, and today, I'm interviewing Dr Alexandra Reynolds about her article on neuroinfectious emergencies, which is part of the June 2024 Continuum issue on neurocritical care. Welcome to the podcast, Dr Reynolds. Um, would you mind, please, introducing yourself to our audience?   Dr Reynolds: Sure. Thank you for the invitation. I'm Alex Reynolds, and I am a neurointensivist at Mount Sinai Hospital in New York City.   Dr Berkowitz: Fantastic. Thanks for joining us. Dr Reynolds has written a really comprehensive article with lots of clinical pearls for the evaluation of patients with neurologic infections. So, to start off, when should we consider a neurologic infection as the cause of a patient's neurologic symptoms?   Dr Reynolds: That is a, really, much more complicated question than I think you recognize. I feel like a lot of it has to do with the risk factors of the patient. So, certainly, you know, a lot of times, we think about a patient who comes in with fever and altered mental status, and that's sort of the patient we're thinking about as having an intracranial infection – but, I do think there are a lot of risk factors that, sort of, may push us in that direction even if the patient doesn't have a fever or even if the patient doesn't seem like meningitis (for example). So, you know, a lot of patients nowadays are immunosuppressed, either because of infections or because of the therapies that we're using as immunosuppressants (so, autoimmune diseases, transplants, bone marrow patients). And then, I think, any patient who has had an intracranial procedure or a spinal procedure, we sort of just have to have in the back of our mind that surgical procedures come, by definition, with risk of infection (and so, that's always something to think about). And then, certainly, anything in terms of endemic risk factors (so a patient who has come from a country that has an endemic infection), we need to just be a little bit more broad about what we're thinking about in that patient population.   Dr Berkowitz: That's very helpful. You mentioned something I wanted to pick up on. We always think fever, of course we're going to be thinking about a neurologic infection, but some types of neurologic infections and in some patient populations, it's possible to have an infection of the nervous system with no fever, sometimes even no white count. What other clues should be considered, or when would you think about pursuing infection even in patients who don't have a fever or an elevated white count?   Dr Reynolds: So, certainly, in patients who have imaging that's a little abnormal. I think, oftentimes, the patients that I've seen with sort of indolent infections have a subdural collection that just doesn't look quite right or doesn't make sense with the clinical history (you know, you can have P. acnes infections that go on for months that people really don't necessarily notice) - so any imaging, oftentimes on MRI, you'll see, sort of, diffusion restriction where you don't really expect to see it. So, those sorts of patients might be ones where if the story is just not really fitting, you might want to think about infection. So, I think it's also important to remember that patients who have procedures elsewhere in the body can sort of seed themselves, and either by direct spread or by hematogenous spread, those infections can kind of seed the CNS - so, patients with valve procedures in the heart, patients who have intraabdominal procedures, there really is no reason that those infections can't travel to the CNS as well. And so, I was sort of always taught, you know, if the story doesn't make sense, then you have to consider infection, even if the patient doesn't have a white count or fever. So, I think just having, sort of, that suspicion in the back of your mind that if you can't really make sense of the story, then consider an infection.   Dr Berkowitz: Yeah. So, obviously, fever, white count, those would clue us in that a patient with new neurologic symptoms (signs) may have an infection as a cause. But, as you said, they may not be present in patients who have had any type of neurosurgical procedure (or you've just taught us even non-neurosurgical procedures elsewhere in the body) that could have led to bacteremia. And then, you mentioned earlier, also patients who are immunocompromised may develop a neurologic infection without fever or white count, and our threshold is certainly lower to pursue that possibility in that population as well. Other points on that before we move on?   Dr Reynolds: I had an attending that told me if you're thinking about a lumbar puncture, you better just do it – so, I think those are wise words to sort of live by. If you're thinking about an infection, you better just work it up.   Dr Berkowitz: Yeah. I think that's right. I heard something similar that if you're standing around on rounds debating whether the patient should get a lumbar puncture, probably, if you've talked about it that much, you should probably do it. I think we've heard the same things in different places. Along those lines of who needs a lumbar puncture, many patients with systemic infections can develop a headache, even if it's just from systemic infection (you don't necessarily have meningitis and cephalitis), and many patients, particularly older patients, develop confusion in the course of systemic infections, like pneumonia and urinary tract infections. And as neurologists, we are often consulted on these patients because they are confused, they are febrile, they may have an elevated white count, and people start to wonder, Could this patient have meningitis? Could this patient have encephalitis? In many cases, at least in my experience (I'm curious to hear your experience), it turns out that these patients have a systemic infection and the confusion and/or headache are related to that systemic infection, not a primary neurologic infection - but based on that topic we just discussed about, if you've talked about lumbar puncture enough, probably best to do it. How do you think about these patients who are, for example, admitted to a medical service for fever and confusion, may or may not have had a systemic source identified, but the suspicion is there? How do you think about which of those patients need a lumbar puncture, or what clues you into thinking to have a higher concern for meningitis, encephalitis, abscess, other neurologic infections in this context?   Dr Reynolds: It's such a good question, because I think, especially as we get older, you know, even things like nuchal rigidity might be hard to assess in a patient who's sort of started to fuse their spine - so, I think it can be really challenging. I think, you know, always go back to basics. Is there any new laterality that doesn't really make sense? Is there a sort of disconnect between imaging and how the patient looks? And it can be so confounded, because these are patients who are also on antibiotics (which themselves can be neurotoxic), and so, it can be really hard to sort of parse that out. But, I do think that there are some less invasive things you can try to do first to sort of help risk stratify your patient. So, you know, certainly, getting a CAT scan and just making sure that everything looks as you would expect it to look - there's no, sort of, hydro out of proportion to what you might expect. I've definitely seen patients who have meningitis that we caught because they have just a little bit of pus in the ventricles that was interpreted as intraventricular hemorrhage. And you sort of just have to sit there and think, like, Does that make sense, or is it an infection? EEG can be helpful, too, if it's lateralizing. You know, I think we don't think as much about HSV in the hospital. But, certainly, if you have something lateralizing on your EEG that just doesn't make sense, I think that could sort of push you in that direction as well. But, again, I think in most cases, unless the patient's very thrombocytopenic or coagulopathic, the risk of an LP sort of doesn't really outweigh the benefit of feeling confident that you haven't missed something, because I think, you know, one of the big points of this article is that if you catch these CNS infections early, people can actually do really well, and, really, most of the morbidity and mortality is from missing the infection - so we've been trying to move away from LP-ing everybody on admission, but I do think that you should be tapping some people that are not infected, because then you're probably catching everyone who is.   Dr Berkowitz: It's great to hear your approach, and I think that aligns with my thinking as well. I do want to ask as a follow-up to that question (I've asked this of internists I work with and other neurologists) - I totally agree with everything you said in the sense that, you know, we are consulted by our internists, we presume that they haven't found a reason that the patient is febrile and confused from a systemic standpoint, and that's why we're being consulted. There are, obviously, many patients who are febrile and confused in the hospital where neurology has not been called because there's other obvious reasons, as you have mentioned. However, as you said, if the patient has some immunocompromise, maybe there's some features that are suggestive in the history or nuchal rigidity - as you said, harder in older patients - but there's something there that you sort of think, maybe we should just do a lumbar puncture just to make sure we sort of settle this because we keep thinking about it. The question is, in your experience, when you've gotten a lumbar puncture more as a rule-out, or you think, I think this is the patient's pneumonia and they're confused because they're delirious in the hospital (sort of toxic metabolic encephalopathy), have you ever been surprised? Talking to an internist colleague, I've said, I feel like I haven't actually seen that much bacterial meningitis in the U.S., fortunately, thanks to vaccination. And, usually, the patient is coming in with a pretty profound syndrome of meningitis or encephalitis. But, as far as patients in the hospital with a fever, where you're thinking, "This is kind of a rule-out, so just make sure, even though I don't think I'm going to find meningitis in a patient who is immunocompetent”, have you ever been surprised and found meningitis encephalitis when you didn't expect to find it? Or, what's been your experience when you, as you said, tap these patients because you'd rather get a few normal ones in there to make sure you never missed the abnormal?   Dr Reynolds: I would say the few times that I've been surprised were not with fully immunocompetent patients. You know, someone with a splenectomy who otherwise looks immunocompetent, someone with pretty advanced cancer - those are examples where you wouldn't necessarily have thought about it as being immunocompromised, but they are. Certainly, I think patients with advanced cancer can, really - they're much higher risk than I used to think about. The more I've taken care of them, the more I've realized how sensitive they are to infections and how quickly that can spread, even if they're not actively getting chemotherapy. But, I would say in general, for the truly immunocompetent patient, I would say I haven't really diagnosed anything super exciting.   Dr Berkowitz: Yeah, that's good to hear. I love to, on these Continuum Audio interviews, poll experts in other institutions who trained other places and, you know, learn from different patient populations if your experience resonates with mine and others I've spoken to. Yeah, that sounds similar to my experience as well, yeah, if the patient is immunocompromised - and as you said, we maybe need to broaden that from being truly profoundly immunocompromised by congenital immunodeficiency or HIV or immunomodulatory therapy to have a slightly broader perspective on what could constitute immunocompromise - and, of course, we'd have an extremely low threshold to perform a lumbar puncture in such patients, as you said. You reminded me of a case I was trying to remember the details (which I don't) – it was a patient, actually, with a temporal lobe glioblastoma that had been resected and had some recurrence and was worsening, and it looked like it was tumor recurrence/progression. And I don't - wasn't my patient, I just sort of heard about it - but I don't know which attending or resident or fellow decided that the patient should get a lumbar puncture, and the patient actually developed HSV encephalitis of the temporal lobe, where the glioblastoma was.   Dr Reynolds: Wow.   Dr Berkowitz: Patients with cancer, especially with all the new immunotherapies - and even without them, as you said - this is a state in which people may be vulnerable to infections and ones you might not immediately think of. So, those are some great pearls. Speaking of pearls, you have a really fantastic section in your article on neurologic complications of CNS infections. In other words, you've already diagnosed the meningitis, encephalitis, abscess, or otherwise, and all the other neurologic complications that can occur in the course of this illness. So, it'd be great to talk with you a little bit about that here. So, if a patient is diagnosed with infectious meningitis or encephalitis (we've made that diagnosis by the clinical picture, the lumbar puncture findings, and/or the neuroimaging), we're following them along, we think we have them on appropriate therapy, (antimicrobial therapy), and their neurologic status worsens - what's the differential diagnosis for this worsening? What are some things we can think about? How do we look for them on exam? How do we work them up?   Dr Reynolds: Yeah. It's funny, because, you know, the topic of this is neuroinfectious emergencies, and when I first heard about it, I was like, “Every neuroinfection is an emergency”, and I think part of the reason I felt that way is because as a neuro ICU physician, I see the complications a lot more. You know, I think, from a meningitis and encephalitis standpoint, certainly cerebral edema (whether it be focal or global) is sort of your biggest concern. If you've used your adjunctive steroid therapy at the beginning before you've started antibiotics, you know the idea is that might help – and, certainly, it should help with potential hearing loss as a result of meningitis - but I would say cerebral edema or development of abscesses because of delayed antibiotic initiation is certainly a concern. If a patient's getting lethargic, hydrocephalus can often be a concern - and that may be obstructive hydrocephalus or communicating hydrocephalus – either way, that is a situation where, really, the patient may need, depending on the etiology of the hydrocephalus, either another lumbar puncture (for example, in the case of cryptococcal meningitis) or an external ventricular drain placement (which would bring them to the ICU in cases where there is an obstructive component). So, I do think hydrocephalus is hard to diagnose. My go-to is to sort of check tone in the legs every day, because a lot of times, patients with developing hydro will start to have really high tone in their legs - so, that's sort of my go-to physical exam finding, although, obviously, hydrocephalus can present as just sort of generalized lethargy or even, you know, worsening nausea and vomiting, for example. And then, I think, you know, if someone starts to be localizing on exam, I think that can be concerning not only for abscess, but potentially for ischemic stroke related to a vasculopathy, for example, or hemorrhage in the context of mycotic aneurysm formation, for example - and, so, I do think there is a role, if a patient starts to become lateralizing, for emergent imaging. And generally, we should be able to see most of the stuff on just a plain CAT scan to start. You know, certainly, localizing stuff can also be as a result of seizures, but I think that that's sort of a diagnosis of exclusion, and rapidly imaging a patient with new focal signs is probably the way to go before putting them on EEG.   Dr Berkowitz: Very helpful pearls. So, um, shifting gears a little bit, right before we began our conversation, you were telling me you had done some work in Malawi, and you were reflecting on some of the differences in epidemiology of neuroinfectious disease and resources available to diagnose neuroinfectious disease. So, I'm sure it would be very interesting for our listeners to hear a little bit about the perspective you bring to the diagnosis and treatment of patients with neurologic infections from your experience in Malawi.   Dr Reynolds: Yeah. So, I was lucky enough as a trainee to be able to go to Malawi for a few weeks with my neuroinfectious disease attending, and I think that it's pretty striking (the difference that we see in lower income countries, compared to the U.S.). I think a lot of the disease processes that we sort of take for granted as being easily treatable are not necessarily easily treatable, not only because of lack of access to medications and antibiotics, but also because of sort of a stigma that might be associated with the workup. So, for example, a lot of people were very hesitant to consent to lumbar puncture, because they had seen that their friends and family members who had gotten lumbar punctures ultimately died, and it didn't seem necessarily clear that the reason that they had died was from the primary infection itself. So, I think that really being attuned to disparities not only abroad, but even - you know, working in New York City, I can say that there are definitely disparities in terms of access to care and health equity, and, certainly, the timing of your presentation almost necessarily will change the outcome, and people who are presenting to the hospital later because of infections that were sort of ignored or because of lack of access to healthcare, those patients, really, by definition, end up doing worse - and so, I think that that is really a big thing to think about in our resource-rich areas, think about these infections.   Dr Berkowitz: Well, thank you for sharing those valuable and important perspectives both from Malawi and from your work in New York City.   Dr Reynolds: Thank you.   Dr Berkowitz: Well, thank you so much, Dr Reynolds, for joining me today on Continuum Audio. I've enjoyed our discussion and learned a lot from it. Again, today, we've been interviewing Dr Alexandra Reynolds, whose article on neuroinfectious emergencies appears in the most recent issue of Continuum on neurocritical care. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to all of our listeners for joining today.   Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, please consider subscribing to the journal. There's a link in the episode notes. We'd also appreciate you following the podcast and rating or reviewing it. AAN members, go to the link in the episode notes and complete the evaluation to get CME for this episode. Thank you for listening to Continuum Audio.

“We put into effect a program that supports guaranteed mobilization of every patient at least twice a day, which is such a huge change from where we were before, where patients were maybe getting out of bed just to go to the bathroom or maybe just to sit in the chair for one meal a day. So it really had a huge impact on overall mobility,” Jennifer Pouliot, MSN, RN, OCN®, clinical program director of oncology safety and quality at Mount Sinai Health System in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the benefits of mobility in hospitalized patients with cancer. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by June 28, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to patient mobility. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 195: Exercise's Effect on Patient and Provider Well-Being Episode 82: Physical Activity Prescriptions in Cancer Care Episode 15: Incorporating Physical Activity in Patient Care  2024 ONS Congress® session: Benefits of an Early Mobility Program for Hospitalized Patients (Presented by Jennifer Pouliot and Mark Liu) ONS Voice articles: Does Dance/Movement Therapy Affect Outcomes for Pediatric Patients With Cancer? During or After Chemo, Exercise Fights Fatigue and Supports Cancer Recovery Exercise Program Improves Quality of Life in Patients With Breast Cancer—and Keeps Them Moving Daily Exercise the Evidence: How I Moved From an Idea to Program Development More Survivors Have Functional Limitations After Cancer What the Evidence Says About Low-Intensity Exercise in Cancer Care What the Evidence Says About Tai Chi in Cancer Care ONS courses: Incorporating Physical Activity Into Cancer Care Quality and Physical Activity Course Bundle Clinical Journal of Oncology Nursing articles: Increased Mobility and Fall Reduction: An Interdisciplinary Approach on a Hematology-Oncology and Stem Cell Transplantation Unit Multimodal Exercise Program: A Pilot Randomized Trial for Patients With Lung Cancer Receiving Surgical Treatment ONS's Get Up, Get Moving resources American Physical Therapy Association's Activity Measure for Post-Acute Care (AM-PAC) National Database of Nursing Quality Indicators (NDNQI) To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the Oncology Nursing Podcast™ Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Mount Sinai developed a mobility mission. And this mission included interdisciplinary approach. So that's talking with the whole team about mobility, knowing the patient's baseline, documenting and understanding the functional status and that it should not decline during hospitalization. Every patient is mobilized unless medically contraindicated. We have a mission to get patients out of bed for every meal. Physical therapy is not required before nursing can mobilize patients, and then to escalate the inability to mobilize patient to the provider upon admission, so we can address that in real time and see what we can do to make sure that they don't stay in the bed.” TS 7:30 “We measured the progress of the program through documented mobility interventions, trending the patient's mobility score and AM-PAC functional assessment, which is the Activity Measure for Post-Acute Care. And then also with NDNQI data like falls, falls with injury, pressure injuries, and then also patient satisfaction surveys.” TS 9:44 “We saw that 76% of our patients, they either maintained or improved their mobility score while they were in the hospital. We had a 6% reduction in excess days. We had a decrease in readmissions, about 6%. And then we saw an increase in our patient satisfaction score about the willingness to recommend the hospital from 63% to 91%. So we found those really powerful, meaningful, and we also had a lot of comment cards from patients highlighting the mobility program.” TS 17:16 “We know the literature is out there. We know the benefits exist. It's really just about advocating and having a business plan that benefits both the organization, the staff, and the patients. And then pilot; start small. So you learn, you grow, you adjust. You figure out what works, what doesn't, and then you scale it out.” TS 19:38

Clair Lunt, senior director of nursing informatics at Mount Sinai Health System, chats with nursing editor G Hatfield about the HealthLeaders Virtual Nursing Mastermind program, and what other health systems can learn about implementing virtual nursing programs.

In today's episode, Nanette Silverberg reviews the key highlights from her vitiligo sessions at the 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema Conference, also known this year as RAVE. Dr. Silverberg is the chief of pediatric dermatology for the Mount Sinai Health System and site director of pediatric and adolescent dermatology at Mount Sinai West and Mount Sinai Beth Israel in New York, as well as the conference chair of the vitiligo portion of RAVE. At the conference, Dr. Silverberg presented “Topical Therapeutics for Vitiligo” and “Excellence in Vitiligo Clinical Practice.” Today, Dr. Silverberg shares the top takeaways from her sessions that clinicians can utilize in their practice. 

In this episode, Alan Condon, Editor-in-Chief at Becker's Healthcare, discusses Mount Sinai Health System appointing Vincent Tammaro as the new Executive Vice President and CFO, effective in October. He also provides updates on health system financial results nationwide and reports on OHSU's plan to lay off at least 500 employees.

Today, we're excited to bring you the first episode in a special Raise the Line series that Osmosis from Elsevier has created in partnership with the Cohen Center for Recovery from Complex Chronic Illnesses (CoRE) at the Icahn School of Medicine at Mount Sinai Hospital. PAIS: Root Causes, Drivers, and Actionable Solutions is a ten-part examination of a range of post-acute infection syndromes such as long COVID, tick-borne illness, chronic fatigue syndrome, and connective tissue disorders. Your host, Dr. Raven Baxter, a molecular biologist and Director of Science Communication at CoRE, will be joined by an impressive array of specialists in the field to explore causes, symptoms, diagnoses and treatments, as well as the devastating impact on patients who often struggle for many months or even years with a troubling span of symptoms affecting everything from muscle movement to mental health. As you'll learn in the series, diagnostic protocols are lacking for many of these conditions, leading to delayed treatment and prolonged suffering for patients. In this inaugural episode, Dr. Baxter is joined by microbiologist Dr. Amy Proal, CEO of the PolyBio Research Foundation; Yale University Professor of Immunobiology, Dr. Akiko Iwasaki; and Dr. Edward Breitschwerdt, Professor of Medicine and Infectious Diseases at North Carolina State University College of Veterinary Medicine who will discuss the Building Blocks of PAIS.Mentioned in this episode: Mount Sinai Health System Steven & Alexandra Cohen Foundation 

How do SSAs work? Should all NET patients be on one? What are the side effects? Dr. Edward Wolin from Mount Sinai Health System answers several common questions about the current and future role of somatostatin analogues in NET treatment. MEET Dr. EDWARD M. WOLINProfessor of Medicine, Medical Oncology, Icahn School of Medicine Director, Center for Carcinoid and Neuroendocrine Tumors Tisch Cancer Institute, Mount Sinai Health SystemDr. Edward M. Wolin is an internationally renowned authority on neuroendocrine tumors. Dr. Wolin is the Director of the Center for Carcinoid and Neuroendocrine Tumors at the Tisch Cancer Institute at Mount Sinai and Professor of Medicine, Medical Oncology at the Icahn School of Medicine at Mount Sinai.The multidisciplinary Center for Carcinoid and Neuroendocrine Tumors features a robust research program with clinical trials aimed at finding the most effective treatments, including immunotherapy, biologic agents, targeted radiation therapy, and new approaches in molecular imaging for diagnosis. Dr. Wolin has pioneered innovative therapies with novel somatostatin analogs, mTOR inhibitors, anti-angiogenic drugs, and peptide receptor radiotherapy.Prior to joining Mount Sinai, Dr. Wolin was Director of the Neuroendocrine Tumor Program at Montefiore Einstein Cancer Center. Previously, he worked for more than two decades with Cedars-Sinai Medical Center in Los Angeles, where he founded and directed one of the largest Carcinoid and Neuroendocrine Tumor Programs in the country, and subsequently directed the Neuroendocrine Tumor Program at University of Kentucky. Dr. Wolin is also the Co-Medical Director for the Carcinoid Cancer Foundation and is on the Carcinoid Cancer Research Grants Scientific Review Committee for the American Association for Cancer Research. He has published in many prestigious journals, including the New England Journal of Medicine and Journal of Clinical Oncology, and is a reviewer for numerous journals, including Journal of Clinical Oncology, Molecular Cancer Therapeutics, Clinical Cancer Research, and The Lancet Oncology.During Dr. Wolin's two decades at Cedars-Sinai Medical Center in Los Angeles, he developed a close friendship with LACNETS founder Giovanna Joyce Imbesi. Dr. Wolin was instrumental in the co-founding and development of LACNETS. LACNETS has always been very dear to his heart and he cherishes and honors the memory of Giovanna. Dr. Wolin earned his medical degree from Yale School of Medicine. He completed both his residency in internal medicine and fellowship in medical oncology at Stanford University Hospital. He was also a clinical fellow at the National Cancer Institute of the National Institutes of Health. Dr. Wolin is board certified in internal medicine and medical oncology.TOP TEN QUESTIONS ABOUT SOMATOSTATIN ANALOGUES (SSAs) FOR NETS:1. What are somatostatin analogues (SSAs)? How do they work? 2. When and how are SSAs used?3. Which SSA should a patient be on? What is the difference? How do you decide?4. How do you know if a SSA will be helpful? Should ALL NET patients be on a SSA?5. What about patients whose tumors don't “light up” on a DOTATATE scan?6. How long can someone stay on a SSA?7. What side effects may patients experience from the shot? What can patients do to prevent or manage these symptoms? How might it affect one's day-to-day ability to work and function? Can I live a “normal life” while taking this medication? 8. If the tumor is growing does this mean the SSA did not work? Do you continue it when patients are treated with another treatment? When do you stop a SSA?9. What is the future of SSAs? I heard there is a pill that is available in a clinical trial. CaFor more information, visit LACNETS.org.

Join Joseph Pinto, Vice President of Pharmacy Operations at Mount Sinai Health System, as he shares insights on current healthcare trends, the evolution of their pharmacy program over the past few years, and opportunities for growth and value addition within the system. Gain valuable perspectives from a seasoned healthcare leader shaping the future of pharmacy operations.

JCO PO author Dr. Christian Rolfo shares insights into his JCO PO article, “Liquid Biopsy of Lung Cancer Before Pathological Diagnosis Is Associated With Shorter Time to Treatment.” Host Dr. Rafeh Naqash and Dr. Rolfo discuss how early liquid biopsy in aNSCLC in parallel with path dx is associated with shorter time to treatment. TRANSCRIPT  Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCOPO articles. I'm your host, Dr. Rafeh Naqash, Social Media Editor for JCO Precision Oncology and Assistant Professor at the Stephenson Cancer Center, University of Oklahoma.   Today we are thrilled to be joined by Dr. Christian Rolfo, Associate Director of Clinical Research at the Center of Thoracic Oncology at the Tisch Cancer Institute at Mount Sinai Health System. He is also the lead author of the JCO Precision Oncology article entitled "Liquid Biopsy of Lung Cancer Before Pathological Diagnosis is Associated with Shorter Time to Treatment."  Our guest's disclosures will be linked in the transcript.  Christian, it's great to have you here. Welcome to our podcast and we are excited to learn about some of the interesting results from your study.  Dr. Christian Rolfo: Thank you very much, Rafeh. It's a pleasure to be here and discuss about liquid biopsy. Dr. Rafeh Naqash: You have a very important role in different liquid biopsy consortiums. This is an initiative that you have been leading and spearheading for quite a while, and it's nice to see that it is becoming something of a phenomenon now on a global scale where liquid biopsies are being implemented more and more in earlier stages, especially. For the sake of our audience, which revolves around academic oncologists, community oncologists, trainees, and patient advocates or patients themselves, could you tell us a little bit about the background of what liquid biopsies are? And currently, how do we utilize them in the management of lung cancer or cancers in general? Dr. Christian Rolfo: Liquid biopsy has been gaining importance over the years. We started to talk about liquid biopsy in 2009 when we started to see some correlations with EGFR mutations. In practicality, what we are doing is the most common or most applicable indication is to go for liquid biopsies from the blood, peripheral blood. So we are doing a blood draw and from there, what we are capturing is the DNA or fragments of DNA that are still in circulation. But the liquid biopsy definition is a little bit more broad and we can apply the concept of a minimally invasive approach to different fluids of the body, including pleural effusion, urine, and including CSF that is another indication, there, we are going to be a little bit more invasive than peripheral blood, but it is also an emerging tool that we will have to find specific indicators. In cancer, we started the history of liquid biopsy in advanced disease with the identification of biomarkers, and then from there, we are moving to other scenarios, including, nowadays, monitoring minimal residual disease and early detection. And that is applicable also for other tumors. Dr. Rafeh Naqash: Thank you, Christian, for that summary. Now, as you've rightly pointed out, we have come to implement liquid biopsies more and more, both in the academic setting and the community setting. And this has definitely led to faster turnaround time in some ways compared to tissue. In this study that you have authored with the help of many other collaborators and Foundation Medicine Flatiron Health data, the goal here, from what I understand, was to look at liquid biopsies that were done before, resulted before the pathological diagnosis. Could you tell us a little bit more about the premise of this study, why you thought about this question and how did you try to implement that idea to get to some of the interesting results that you see here? Dr. Christian Rolfo: Yeah, so what we are seeing generally in lung cancer and also in people with other tumors is that patients are having a journey and that they start seeing different doctors until they get a diagnosis. Generally, after the pathological diagnosis, if you don't have an in-house technology that is doing reflex testing, generally, oncologists need to request for testing and that is taking time. So if we are looking for comprehensive days until a patients are able to get a molecular profiling before we start the treatment is sometimes very long. We are talking, in some cases, about months. So, how we can speed the process, that was the main question. We tried to include liquid biopsy in the staging procedures that we generally were doing when we have a clinical diagnosis of lung cancer. It's either images that we are used to do, PET scans, MRIs, and other assessments, we want to include liquid biopsy there before the biopsy. And that's what we did. We were searching for this specific aim using the Flatiron Health Foundation Medicine electronic health records from 280 centers across the United States. We included a big number of patients in this analysis, more than 1000 patients for the first analysis. Dr. Rafeh Naqash: That's phenomenal that you had real-world data from 200+ centers across the US. Of course, when you have patients on a clinical trial versus patients in the real-world, we all know that there are differences in terms of approaching, overseeing, and managing these individuals. So this data set is an extension of what we could see in the real-world setting.  Could you tell us a little bit about the number of patients that you eventually identified that had liquid biopsies done before pathological diagnosis? I think you have different cohorts here, a group that was before and a group that was after, and you compared several important metrics treatment-wise from what I see. Could you highlight those for our listeners? Dr. Christian Rolfo: Yeah. So we were looking for patients who had a liquid biopsy CGP, comprehensive genomic profiling, ordered within 30 days pre diagnosis and post diagnosis. We focused on 5.2% of patients, which corresponded to 56 patients who ordered a liquid biopsy before diagnosis. The median time was eight days between the order and diagnosis and the range was between 1 to 28 days. And that was compared with 1020 patients who ordered a liquid biopsy after diagnosis. It is important to be clear that both cohorts had a similar stage and ctDNA tumor fraction. We can explain later what tumor fraction is, because it was done in addition with a paper that we just published last week. Liquid biopsy patients were consulted to have this CGP median one day after diagnosis, versus 25 days after for patients who had their diagnosis and their liquid biopsy later on. So, from these patients, the majority of the patients, 43% of LBx-Dx were positive for an National Comprehensive Cancer Network driver, and 32% had ctDNA TF >1% but were driver negative, so that is what we call presumed true negative. From here, maybe I can explain what is tumor fraction and, in general, how we use it.  Dr. Rafeh Naqash: I think that would be great for our listeners. We see this often in more and more liquid biopsy results nowadays, and I've tried to explain it to some of my fellows also. So, it would be nice if you explain for the sake of our listeners what tumor fraction is, what does it mean clinically, can you use it in a certain way, what biological relevance does it have. Dr. Christian Rolfo: So we are analyzing another paper that came out this week in cancer research on the concept of tumor fraction and it's a new definition. So what we are doing with tumor fraction is an algorithmic calculation or mathematical calculation on the amount of DNA of the cells also taking into consideration the math, the quantity of DNA present in the sample. So we are going very low in the sensitivity of this analysis and capturing there the real informative results of the ctDNA of the liquid biopsy. So in practicality, when you see a report that says the threshold that was established in this study was more than 1% or less than 1%, so patients who have a tumor fraction of more than 1%, we can really consider this liquid biopsy informative. And also in this next publication, we compared with tissue. In patients with a tumor fraction of more than 1%, were completely 100% correspondent with what we found in the reflected tumor tissue, the NGS. But what happened in patients with a tumor fraction of less than 1%, we can say that these patients are not informative. So we need to wait for the tissue biopsy result to come in because we were able to recuperate several patients that the liquid biopsy was negative with the tissue biopsy positive. This is an important concept because we are distinguishing not only the informativeness of liquid biopsy, but also we can distinguish between patients who are considered not shedder based on what is considered a shedder. And that was a problem until this kind of introduction was a problem before with the technology because the technology wasn't very fast to distinguish the sensitivity or high sensitivity. Now, the sensitivity is no longer a problem. Maybe, there is really value of information in what we have in liquid biopsy, and using this mathematical help, we can get these patients distinguished and help more people. So that would be really interesting. Dr. Rafeh Naqash: You touched on a few important concepts here, and one question I have, and I think there's no better person to answer this question. You're the right person to answer this question for our audience. Do you think when you have a liquid biopsy tumor fraction of less than 1%, and you have a tissue that is pending with an NGS, where tissue NGS has not resulted yet, but liquid biopsy results come in and tumor fraction is less than 1%. But let's say you have a non-smoker with a typical driver mutation and clinical characteristic positive individual in the clinic, and the tumor fraction is less than 1%. How much can you trust that liquid biopsy when the tumor fraction is less than 1%. Because do you think some of these driver mutations, like you mentioned, could be low shedders and you could miss a potentially actionable mutation on a liquid biopsy if the tumor fraction is less than 1%? Is that something that you've looked at or correlated or understood what would be the clinical meaning of that? Dr. Christian Rolfo: Absolutely. So there are two concepts here. A liquid biopsy could be non-informative, and that is what we saw in this paper. So you have patients that have a liquid biopsy negative, and that we see in the clinic, a liquid biopsy negative tissue biopsy positive. That could be because the liquid biopsy is not informative, but it could be also that the patient, for some biological reason, and we don't have an answer about that, they are not shedding the ctDNA in the bloodstream, ctDNA that we can capture. What we saw in different studies, including one of the papers that we presented also in ASCO last year with a MET amplification and  METex14, for example. In the study that was the VISION study using tepotinib, you see that patients who have a liquid biopsy negative are doing a better outcome compared to a patient who have a liquid biopsy positive. So I believe that we still have patients who are not shedders for some biological reason, that could be put in together with patients who have more bone metastasis than organ metastasis, or patients who have more in location, for example in the brain. These patients are difficult to capture in ctDNA due to some biological reasons. But also you have patients who are non-shedders. For the technicality of the parts of this tumor fraction analysis, it is really important to distinguish that and we will hear more and more. So, as you say, we have already some reports in some companies like Foundation are doing, but some others like to incorporate this tumor fraction. And several in-house technologies allow also to have this kind of mathematical calculation. So that is what we are facing now, to really understand better the power of liquid biopsy. Dr. Rafeh Naqash: Now, some of the other things that your project or paper that you published with JCO PO does not necessarily cover is the payer aspect of this. Now, we've had more and more discussions, obviously, and more and more information has been highlighted with the payers that this is an important test and needs to be reimbursed, even though if you do tissue NGS, liquid biopsies are complementary to tissue. So taking both together is probably a better view of the overall tumor or the mutational status of the tumor. But one of the biggest holes in this whole process, and this is my personal experience, I want to know what you think, is that we can't order these tests when the patient is admitted to the hospital, and 50% or more patients end up getting diagnosed in the hospital during an inpatient stay. The average hospitalization for someone with lung cancer is five to seven days on average, and then another one to two weeks to get into the clinic to see an oncologist. So what would your thoughts be there? How can we improve things there in terms of, can we try to do something different so that the payers agree that, yes, you can send a liquid biopsy when the patient is admitted, because there's that 14-day Medicare rule? Has your team, or have you in particular, tried to navigate some of those issues, and what are your thoughts on how we can try to improve some of those conversations?  Dr. Christian Rolfo: Yeah, that's a really good question, because here we are talking about inequities in access to the technology and the results and it's crucial. Several of our patients, specifically in lung cancer, they are coming to our consultations or to the emergency with a very bad situation so they need to be admitted immediately. And as you say, they can be there for one month waiting for results or for recovery or for stabilization of their general condition before we can start. Several of these patients will have some biomarkers that we can target with treatment. So in other words, I will say that this is a stupid rule because we cannot have in 2024 these kinds of limitations to access to treatment when we have on one side, the FDA is doing a terrific job to get drugs approved in a very short time, and on the other side we have payers who are not understanding the concept of molecular or precision oncology.  So what we are trying to do in these cases, to be honest, is to navigate with the vendors and try to get this done. I generally send the samples because I consider that personally that it is a very crucial information. And in several cases, we have started targeted therapies while the patient is still admitted. So I think it's something that we need to put in a better effort, because already we are not doing enough for our patients, if you look at the data of the MYLUNG Consortium that was presented in ASCO some years ago on the testing performance in the community practice, 50% of the patients with lung cancer were tested there were only some in minority groups, African Americans, 39%. So I think we need to do better in education, but also from the payer side, it's really crucial that they understand this concept.  Advocacy groups have a lot of say here. They are also doing an important job on that. We are now launching with ISLC, ISLB, Lung Cancer Europe, and Longevity in a survey that is to make also the patients aware what is the importance of molecular profiling, tissue or liquid biopsy, it's very important that you get something to treat the patient and select the right treatment. And even to say, there'll be a whole other work in your case so that is really important.  Dr. Rafeh Naqash: Absolutely, I completely agree. We have made a lot of strides, but there is still a lot of room for improvement in terms of equity, access, and reimbursement.   Now, one of the things that I noticed in your paper, and you could tell me a little bit more about this, when you looked at the pre-diagnosed liquid biopsies, meaning before tissue diagnosis, 56 individuals there suspected to have lung cancer, community-based testing was identified in 53 individuals versus academic being three. This is very encouraging when you see something like this happening in the community. Did you look at that? Did you try to understand why or how that was the case? Because in a general community setting, I would think that community practices have a more complicated system of reimbursement because they are dependent on direct reimbursement, whereas in bigger academic centers, there's some leeway here and there. So did you try to understand how they were able to order this before tissue, could you give us some insights there? Dr. Christian Rolfo: Yes, I think it was not big in this specific question, but it's a very interesting topic. Because we, generally, in academia, will believe that we are doing the things in advance and we are more, compared with the practical and the general practitioners or the general colleagues in the community practice, we have more resources. But sometimes, and it's true, obviously, we have more resources in terms of research and more opportunities in terms of clinical trials in some cases. But I think we understood with this minimal example that there is an important interest among general oncologists in the community practice to get this done. And this is something we need to emphasize, because sometimes we are putting the blame on our colleagues that are outside the academic centers on this lack of testing, and it's not really true sometimes. So this is a good point to start to work together and try to get more things done for our patients and try to get also the reality.   I think one of the problems we will have in the future that we can face right now is the lack of new figures in this molecular profiling. I am referring, for example, molecular nurses or personnel that is working and helping to get this done. We need to have more people that are working in this education for the patients in the access to treatment and access to the technology, but also to navigate better these problems with payers that sometimes in some patients that seem to be overwhelming. Because when you talk about the $100 that could be extra, it's hard for some patients. So we need to be very conscious about that. So having a new figure in the hospitals and the community practices could help to test more patients.  Dr. Rafeh Naqash: And I think at the end of the day, the payers or the reimbursement mechanisms need to understand that genomics is part of the diagnosis these days. It's not ancillary, it's not an addition, but it is part of the diagnosis. I'm pretty sure you have had similar instances where you get a confusing pathology result but then a genomic result points in a certain direction. You treat the patient in that direction, and then you see the patient benefiting in the tumor shrinking, which suggests that genomics is complementary to the path diagnosis. It's not necessarily a surrogate.You can't replace pathological diagnosis, but you can use genomics as a complementary diagnosis as part of the whole paradigm of treating the entire patient. So I think we definitely need more and more conversations like the ones that you're having or your liquid biopsy consortium is having and then more education from the FDA. Of course, more legislation, more advocacy.   Going back to the paper, I did notice another interesting thing, which is, again, very encouraging is patients with lung cancer with a performance status of 2 or about had a decent proportion of testing done. Which, again, points out to the important concept of avoiding these preconceived biases that, “Hey. If somebody is not a great performance status, testing and finding something in that individual could potentially change a lot for the individual.” Do you have any personal examples from patients you have treated or seen in the clinic for our listeners where you identified something and maybe they were not doing as great initially, and then you identified something in liquid biopsy, treated them and it changed the entire course of their illness and whole trajectory for them? Dr. Christian Rolfo: Being working in lung cancer for years, everyone has this kind of patient that we see that their performance state was very bad. Obviously, as a clinician, we need to identify why the performance is bad and is deteriorating. So we see some patients in lung cancer, some of them, they can have a very important comorbidity packet that is associated with lung cancer. So in patients who have a deterioration for lung cancer, and we find a driver help in some patients that were doing a kind of a weakness, and that is something that we see in several patients, specifically in patients living with leptomeningeal disease. In some cases, when we start to do drivers that have a big impact in the crossing the blood-brain barrier, I have a good response.  I have patients that had an important recovery. So this is something we need to distinguish and sometimes when the patients seem very bad they say, “Okay, we go directly to targeted care or supportive care.” We try to test these patients as well because these patients have an important impact on the quality of life that we are treating. We will not be able to cure patients in this setting with targeted therapies, but we can certainly make an impact in the quality of life and also in our form of survival.  Dr. Rafeh Naqash: One of the other questions that comes up often when you're in a multi display team, since most cancers these days are on the multi display decision making opportunities to treat the patient the best possible way is: Who orders the liquid biopsy? I remember from my fellowship several years back, our program director Paul Walker, who is, again, an amazing lung cancer thoracic oncologist, he had advocated that our endoscopic suite folks, the bronchoscopist, whether it was pulmonary, interventional pulmonology or CT surgeons, whoever did the bronchoscopy for the first time in the patient that they would send it whenever they see the patient from the bronchs. This was around six, seven years back. And I think Paul was a little ahead of his time and I didn't necessarily understand the implications that this would have.  And now, as I progress in my own little career, I can see the vision that he had, which I think a lot of other sectors have tried to do, and I'm pretty sure you have a certain process, too. Is that something we should try to talk more and more about? Because, of course, when you do the bronch, then you get a diagnosis and the patient sees the oncologist. This whole process takes anywhere from two to three weeks, maybe even more for smaller centers. So, is that something that you're doing or you see that you're having more conversations that, “Hey. Whoever sees the patient first should be able to order the liquid biopsy.” It's not necessarily the medical oncologists, it doesn't mean I love to order sequencing results or  sequential tests, but it could cause a delay in the patient care. So, could you tell us a little bit more of that?  Dr. Christian Rolfo: So it's really important, this part, because we need to create in our institution flows that will have this very well organized. And ideally, in the ideal world will be that we have reflex tests coming from the pathologist, but it's not happened in several places, because we don't have our NGS at home, or we are sending to vendors, and sometimes we are not sending to them. So that is one of the aspects.  The second aspect, and that I think is still a problem in some treatment, is that we still have 24:30 cytologists coming out in place of covariances. And in our institution, we were working very hard with our interventional pulmonologists and interventional radiologists to get this quality of tissue appropriate, and we have a very good rate of success and issues in a very minimal quantity of patients. Obviously, some patients are very difficult to get samples, and we need to refer still with cytology. But in some cases, where our surgeons or our pulmonologists have sent in samples for NGS, and I think this is we are coordinating. “I will see this patient next week. Can you please start to order?” And here, our nurse practitioner, our nurses in the team are also playing an important role for the reason I insist in the idea to have new figures that could be these molecular navigators we can call, or molecular nurses that helping coordinate this, not only the coordination, but also in the discussion of molecular tumor boards. We did an experience like that some years ago at Maryland University, and actually it was a very important opportunity to decrease the number of quantities of issues and get the results done very quickly. So I think it's important to come to have conversations with our colleagues, pulmonologists, radiation radiologists, interventional radiologists, pulmonologists and pathologists to get this done very quickly.  Dr. Rafeh Naqash: I love the idea of molecular navigators. And of course, everybody in the current day and age, we're having staffing issues, so getting a molecular navigator would be awesome, but I'm not necessarily sure how everybody would be able to implement it. But I think in the bigger picture, whether it's molecular navigators or multi disciplinary nurse navigators in general, liaisons in general, I think we all can do a better job in trying to coordinate some of these testings. And we have tried to do that through our thoracic oncology group and of course, there's a lot of progress that needs to be made, one step at a time. Dr. Christian Rolfo: If somebody is interested in this topic on the International Society of Liquid Biopsy, we started with a project that is called a Certificate for Advanced Studies in Precision Oncology. So we are educating the healthcare team for all this process and trying to get practical insights to have this career later. Because I think it will be something that's interesting for nurses or pharmacists to get this kind of career later or get another approach in their career.  Dr. Rafeh Naqash: Thank you so much, Christian.  Now, going to not the scientific part, which I think is the most interesting part of this conversation is to talk about you and your personal journey. Could you tell us a little bit about where you started, what your career has been like, how did you progress? Because you have a lot of junior faculty that listen to this and it's always good to take inspiration from people like yourself.  Dr. Christian Rolfo: Thank you. As you can hear my accent, it's not from here. So I was born in Argentina, I did my medical degree there. And then I had the opportunity to get a scholarship in Italy. I went to Italy and I stayed there for seven years. I did my fellowship there again, and I started to know there precision oncologists. My journey started in sarcoma. And actually I was working in the group of Dr. Casali's group, a very well known sarcoma expert. And at that time we were running phase I trials for imatinib, I remember, known as GIST. I saw this kind of response and awakening of patients that were really in very bad condition, with only through this imatinib. Very little to treat that disease at that moment, a median overall survival of two months. So I started to be interested in that. Then I moved from there to Spain and met Dr. Rafael Rossell, who was my mentor. In Italy, I have also a mentor in breast cancer, Dr. Luca Gianni, one of the pioneers in breast cancer treatment. So knowing all these people and having the support of them, was really crucial.  So I think this is the first advice for junior faculty: try to choose your mentor, even if your mentor is not in your center. Like the case, for example, Rafael Rossell was not in my hospital, but he was my mentor. So having this kind of discussion, I did my PhD in EGFR mutation, at that time was the fashion, not immunotherapy, of the moment. And then from there, after eight years in Spain, I moved to Belgium. I have a short period of completing my training at MD Anderson and I went to Belgium to Antwerp University and that was the opportunity to become the Director of the phase I program in the Early Clinical Trials Unit. It was really exciting to see growing a unit, and now they continue  at the center in Belgium. My colleagues that stayed there, they are doing a terrific job of continuing this idea. And from there I went to Baltimore, three years working at Maryland University being the Director of Thoracic Oncology and early clinical trials as well. Three years after, I moved to New York, and here doing this journey in clinical research, also being the Director of Clinical Research at the Center for Thoracic Oncology.  Life has put me in different places, different cultures, different opportunities. For me it was a really good journey to be in different countries, knowing different ways to see oncology as well, and immediately to work, because it was a shock coming from Belgium to the area of Baltimore where I had the reality to discuss peer to peer conversations and things that are not usually discussed in Europe. So it was really a very nice journey to learn, to have the capacity to adapt.  That is the other thing, my second advice, if I can give advice, but if you have the opportunity to go to some place, adaptation is the most important. So try to enjoy what you're doing and try to enjoy and learn from the patients, hopefully, and contribute your knowledge as well. Dr. Rafeh Naqash: Thank you so much, Christian. Two last questions. For all the places that you visited, what is your favorite place? And what is your favorite food? Dr. Christian Rolfo: My favorite place to live, I have Italy in my heart. Obviously, Argentina is my place, family. But Italy is in my heart. And then Spain, Spain gave me my wife and my son. So I have very good memories there and it's a very nice place. Obviously, I'm Argentinian, so for me it means meat in some places, Asado, that is a typical Argentinean one. But also, I am very eager to enjoy the pasta and paella, so we have several things. Anyway, here in New York, the pizza of New York is great. It is not Italian. This new way to make pizza from New York is fantastic.  Dr. Rafeh Naqash: I can try to see you're trying to keep everybody happy in a politically correct way. Dr. Christian Rolfo: I didn't mention Belgium, but we have chocolates there.  Dr. Rafeh Naqash: That is true. Every place is special and unique in different ways.  Christian, thank you so much. This was very entertaining and very informative for me and hopefully for the audience. Thank you so much for being a part of this conversation. And thank you so much for submitting your work to JCO PO. We hope you consider JCO PO for future research in this exciting area as well.  Dr. Christian Rolfo: Thank you. Thank you very much, Rafeh, for the opportunity. And JCO Precision Oncology is a really great forum to discuss precision medicine. Congratulations for all your work. The last, if you allow me to give an advertisement here. We have our Liquid Biopsy Congress, the ISLB, the annual conference will be in Denver from 20 to 25 November, so just before Thanksgiving day. So if you are able to go there, we will have a lot of discussion on liquid biopsy like we did today. Thank you very much.  Dr. Rafeh Naqash: Thank you so much for highlighting that, and hopefully, our listeners will try to register and be part of that meeting.  Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review. And be sure to subscribe so you never miss an episode. You can find all our shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

In this episode of Big Shot, we're honored to host business mogul Peter May. But his path to managing more than $7 billion is not what you might expect. What started as a career as an accountant at the prestigious KPMG quickly became something much different once Peter crossed paths with Nelson Peltz, igniting a dynamic partnership that spanned decades. Together, they founded Triarc Companies and pioneered innovative funding strategies, revitalizing numerous struggling businesses. They eventually sold the company and founded Trian Partners, a multi-billion dollar investment firm. Peter's commitment to philanthropy extends beyond financial contributions, as he invests his time and expertise. Notably, his impactful work with Mount Sinai Health Systems and Operation Exodus showcases his dedication to making a difference. Join us as Peter generously imparts invaluable insights and practical wisdom applicable to all aspects of life. In This Episode We Cover: (07:28) What it was like growing up during the Cold War in Long Island (12:12) How his father was a great role model (14:33) Peter's time at The University of Chicago (16:25) How Peter was inspired by his father's saying, “Do more than what's expected of you” (22:24) The Jewish value of education (24:53) How Peter was able to avoid being drafted to Vietnam (30:59) Getting started as an accountant at KPMG (32:40) How Peter met Nelson Peltz (34:24) The importance of adding value (36:11) The origins of Home Depot (38:16) How Peter and Nelson Peltz went into business together (41:00) When Peter and Nelson took their company public (44:25) What happened after Peter and Nelson sold Flagstaff foods (49:20) Peter and Nelson's funding strategy emerges (50:42) How MPM group consulting got its start (51:57) What constructive capitalism is (54:10) How Peter and Nelson bought Triangle Industries (1:00:29) How Peter and Nelson transformed Triangle and made it profitable (1:03:18) The purchase of America Can and National Can (1:17:03) The meaning of Nelson's phrase “I'd rather be rich than right” (1:18:53) Why Peter doesn't look back much (1:20:14) Why chutzpah is so quintessential to the Jewish entrepreneurial experience (1:22:23) Why Peter doesn't feel like he's made it still (1:23:30) About “engaged philanthropy” and how Peter helped turn around Mount Sinai Health (1:30:15) Peter's advice to the next generation (1:33:26) About Operation Exodus (1:36:33) Peter's legacy— Referenced: Green tea benefits: https://www.firebellytea.com/blogs/all/green-tea-benefits Firebelly Tea: https://www.firebellytea.com/ The University of Chicago: https://www.uchicago.edu/en Pogroms: https://encyclopedia.ushmm.org/content/en/article/pogroms Nelson Peltz: https://www.forbes.com/profile/nelson-peltz/ Arthur Anderson: https://en.wikipedia.org/wiki/Arthur_Andersen KPMG: https://kpmg.com/ Emerson Radio: https://www.emersonradio.com/ Bernard Marcus: https://en.wikipedia.org/wiki/Bernard_Marcus Mike Milken: https://en.wikipedia.org/wiki/Michael_Milken Saul Steinberg: https://en.wikipedia.org/wiki/Saul_Steinberg Victor Posner: https://en.wikipedia.org/wiki/Victor_Posner Alcoa: https://www.alcoa.com/global/en/home/ Mount Sinai Health System: https://www.mountsinai.org/ Engaged philanthropy: https://engagedgiving.org/philosophy Operation Exodus: https://operationexodususa.org/ — Where to find Peter May: Mount Sinai Health: https://www.mountsinai.org/about/board-leadership/peter-may Wendy's: https://www.wendys.com/who-we-are/board-directors/peter-may Where To Find Big Shot: Website: ⁠https://www.bigshot.show/ YouTube: ⁠https://www.youtube.com/@bigshotpodcast⁠ TikTok: https://www.tiktok.com/@bigshotshow⁠ Instagram: ⁠https://www.instagram.com/bigshotshow/⁠ Harley Finkelstein: ⁠https://twitter.com/harleyf⁠ David Segal: ⁠https://twitter.com/tea_maverick⁠ Production and Marketing: ⁠⁠https://penname.co

New York State's highest court issued a new ruling on Tuesday morning that could upend the way New York City collects billions in property taxes each year after a coalition of homeowners and real estate industry groups claimed the property tax rates for rental buildings and small homes were far higher in lower income neighborhoods. Meanwhile, a coalition of progressive organizations in the city are issuing a slate of proposals about housing and work permits for migrants to policy makers. Plus, recently, thousands of patients at Mount Sinai Health System have been forced to look for new health care providers after Mount Sinai ended its contract with UnitedHealthcare at the end of 2023. Now another large hospital network, New York Presbyterian, is in a dispute with Aetna. If they don't agree on a new contract by the end of March, thousands more patients could lose access to their doctors. WNYC's Tiffany Hanssen speaks with health reporter Caroline Lewis to explain these disputes.

Sugar seems to be in everything we eat. While experts have warned against its health side effects, people continue to consume it in staggering quantities. Why is sugar so addictive? How can we break free from our cravings and take care of our bodies instead? In this episode, we sit down with Dr. Nicole Avena to discuss her newest book, Sugarless: A 7-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction. In this step-by-step guide, Dr. Avena teaches readers how to completely change their mindset around what they eat – using food for what it is intended to be: fuel for the body… Dr. Avena is a research neuroscientist and expert in the fields of nutrition, diet, and addiction. She is the Associate Professor of Neuroscience at Mount Sinai Health System and a Visiting Professor of Health Psychology at Princeton University. Tune in now to discover: What makes sugar so addictive. How reducing sugar intake can benefit your health.  The connection between the gut and brain, and how diet dictates your health. The benefits of cutting back on added sugars. Evolutionary reasons why the body craves sugar. You can pick up your own copy of Sugarless here, and follow along with Dr. Avena's research here! Take advantage of a 5% discount on Ekster accessories by using the code FINDINGGENIUS. Enhance your style and functionality with premium accessories. Visit bit.ly/3uiVX9R to explore latest collection. Episode also available on Apple Podcasts: http://apple.co/30PvU9

Dr. Jeanine Cook-Garard learns about Occupational Health - an area of work in public health to promote and maintain highest degree of physical, mental and social well-being of workers in all occupations. She speaks with Dr. Michael A. Crane, the Medical Director of the Selikoff Centers for Occupational Health, and of the World Trade Center Health Program Clinical Center of Excellence, in the Mount Sinai Health System, and a Professor of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai.

Senior paper author and neurosurgeon, Konstantinos Margetis, MD, PhD, along with the team of contributing authors, discuss their recent article "Ultra-early (≤8 hours) surgery for thoracolumbar spinal cord injuries: A systematic review and meta-analysis" with NASSJ deputy editor Tobias Mattei, MD.   Margetis is assistant professor of neurosurgery at Mount Sinai Health System; Mattei is a neurosurgeon at St. Louis University's School of Medicine.   Contributing Authors: Abhiraj D. Bhimani, MD, Matthew T. Carr, MD, Zahraa Al-Sharshai, MD, Zachary Hickman, MD

David Putrino is a physical therapist with a PhD in Neuroscience. He is currently the Director of Rehabilitation Innovation for the Mount Sinai Health System, and a Professor of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai. He develops innovative rehabilitation solutions for adults and children in need of better healthcare accessibility, and in 2019, he was named "Global Australian of the Year" for his contributions to healthcare. Since the beginning of the COVID-19 pandemic in 2020, David has been recognized globally as a leading expert in the assessment, treatment and underlying physiology of Long COVID. His team has managed the care of over 3000 people with Long COVID and published multiple peer-reviewed scientific papers on the topic.

On this week's episode, discover how to navigate the often-overlooked waters of health literacy and body knowledge with Dr. Gylynthia Trotman, MD MPH. Dr. Trotman is an expert in pediatric and adolescent gynecology. She is the Director of Pediatric and Adolescent Gynecology within the Mount Sinai Health System in New York, where she specializes in diagnosing and treating patients with medical and surgical gynecologic problems from infancy through young adulthood.Together, we navigate the path toward a world where every individual feels empowered to make informed decisions about their reproductive health.In this discussion, Dr. Trotman and I delve into strategies that transcend financial boundaries, offering insights to enhance understanding of one's body. Brace yourself for an exploration of crucial yet sometimes uncomfortable conversations between parents, caregivers, and children surrounding reproductive health. Our aim is clear – to demystify sexual health and menstrual cycles, dispel dangerous myths, and empower you to become an advocate for yourself or your loved ones during medical visits. Throughout this dialogue, we tackle the use of anatomical terms, explore the concepts of good touch and bad touch, and confront cultural stigmas that often impede these discussions. Discover with us the keys to fostering proactive health behaviors and the pivotal role healthcare providers play in patient advocacy and more.So, grab a cup of London Fog and join us as we unravel the complexities of health literacy, advocacy, and the sheer power of knowledge.Follow Dr. Trotman on InstagramSupport the showThank you for listening to Tea With Tanya. To join the conversation on social media, use the hashtag and tag us on Instagram #teawithtanya #Teawithtanyapodcast visit the website at tanyakambrose.comFollow us on IG @teawithtanyapodcast, @tanyakambroseSign up for our Tea Talk newsletter Support the podcast by buying a cup of tea.

It's nearly impossible not to get caught up in the excitement around digital tools and AI, but if the right approach isn't taken, it could be all for naught, according to Robbie Freeman, CNIO at Mount Sinai. In this interview, he talks about his team's strategy to “get it right on a small scale” before going too big. Source: “Technology Isn’t the Barrier”: Q&A with Robbie Freeman, CNIO, Mount Sinai Health System on healthsystemcio.com - healthsystemCIO.com is the sole online-only publication dedicated to exclusively and comprehensively serving the information needs of healthcare CIOs.

More than three years after the outset of the Covid-19 pandemic, many long Covid patients are still experiencing brain fog, extreme fatigue, and myriad other health issues, leaving some unable to complete even the most basic of daily tasks. How should long Covid patients approach treatment, let alone everyday life? In this episode, Sanjay speaks to David Putrino, the director of rehabilitation innovation for the Mount Sinai Health System. He tells us about his latest research into identifying a possible biomarker for the condition and how we can all help those at high risk of developing it. Learn more about your ad choices. Visit megaphone.fm/adchoices

On this episode of DGTL Voices, Ed welcomes Kristin Myers, Chief Digital and Information Officer and Dean of Technology at Mount Sinai Health System to dig into her career, women in healthcare, the importance of developing relationships across your career and so much more! 

“When we say ‘treatment for menopause,' it implies that menopause is a disease, when really it's a normal and expected time of life,” says Dr. Anna Barbieri, an integrative medicine physician and specialist in menopause certified by the North American Menopause Society. That attentiveness to word choice is reflective of a new perspective that's driving Dr. Barbieri and her peers to see menopause more holistically than in the past and to forge new approaches to the care they provide. "Menopause care is not checkbox medicine. We have to work with our patients individually," Barbieri shares with special guest host Dr. Deborah Enegess, herself a practicing gynecologist as well as a clinical content writer for Osmosis. A personalized approach involves tailoring care plans that take exercise, nutrition, sleep, stress management and other lifestyle and psychological factors into account in an effort to help patients feel better in the short term and longer term.  Providers also have to contend with a shift in long-held thinking about the use of hormone therapy and a bewildering array of supplements that are touted as effective remedies for various symptoms.  To help sort through all of this complexity, new resources have come on the scene in recent years, including the digital platform Elektra Health -- of which Barbieri is the founding physician -- that describes its mission as “smashing the menopause taboo.” Check out this engaging exploration of what looks to be a promising time for women in search of individualized, integrated and informed care during their menopause journey.Mentioned in this episode: https://www.elektrahealth.com/

In this episode I speak with Dennis S. Charney, MD, Dean of the Icahn School of Medicine and President for Academic Affairs for the Mount Sinai Health System and Jonathan M. DePierro, PhD, Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Associate Director of Mount Sinai's Center for Stress, Resilience, and Personal Growth. They are the co-authors of "Resilience: The Science of Mastering Life's Greatest Challenges, third edition," dedicated to their late third author, Steven M. Southwick, M.D., which is possibly the definitive book on the topic. Their wakeup calls came from violent traumas they each suffered and tested their resilience. https://www.amazon.com/Resilience-Science-Mastering-Greatest-Challenges/dp/1009299743/

Stand Up is a daily podcast that I book,host,edit, post and promote new episodes with brilliant guests every day.   Please subscribe now for as little as 5$ and gain access to a community of over 700 awesome, curious, kind, funny, brilliant, generous souls   Check out StandUpwithPete.com to learn more Life presents us all with challenges. Most of us at some point will be struck by major traumas such as the sudden death of a loved one, a debilitating disease, or a natural disaster. What differentiates us is how we respond. In this important book, three experts in trauma and resilience answer key questions such as What helps people adapt to life's most challenging situations?, How can you build up your own resilience?, and What do we know about the science of resilience? Combining cutting-edge scientific research with the personal experiences of individuals who have survived some of the most traumatic events imaginable, including the COVID-19 pandemic, this book provides a practical resource that can be used time and time again. The experts describe ten key resilience factors, including facing fear, optimism, and relying on role models, through the experiences and personal reflections of highly resilient survivors. Each resilience factor will help you to adapt and grow from stressful life events and will bring hope and inspiration for overcoming adversity. Get the book NOW ! Resilience : The Science of Mastering Life's Greatest Challenges Dennis S. Charney, Icahn School of Medicine at Mount Sinai, New York Dennis S. Charney, MD, is Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs for the Mount Sinai Health System. Dr. Charney is a world expert in the neurobiology of mood and anxiety disorders. He has made fundamental contributions to our understanding of the causes of anxiety, fear, and depression, and among his discoveries is use of ketamine for the treatment of depression – a major advance in the past fifty years of clinical care. He also focuses on understanding the psychology and biology of human resilience, which has included work with natural disaster survivors, combat veterans, and COVID-19 frontline healthcare workers. He has over 600 publications to his name, including books, chapters, and academic articles. In 2016 he was the victim of a violent crime that tested his personal resilience. Jonathan M. DePierro, Icahn School of Medicine at Mount Sinai, New York Jonathan M. DePierro, PhD, is Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Associate Director of Mount Sinai's Center for Stress, Resilience, and Personal Growth. Dr. DePierro, a clinical psychologist, is an expert in psychological resilience and the treatment of trauma-related mental health conditions. After many years working with individuals impacted by the 9/11 terrorist attacks, he now focuses on supporting the mental health needs of healthcare workers. Having experienced extensive bullying throughout his childhood, he learned important lessons about resilience that continue to inform his clinical and research work. Pete on Tik Tok Pete on YouTube Pete on Twitter Pete On Instagram Pete Personal FB page Stand Up with Pete FB page All things Jon Carroll  Follow and Support Pete Coe  

In this healthcare podcast, I am talking with Dan Serrano; and we're talking about payer/provider collaboration—blocking and tackling, I'm gonna say—from primarily a financial and revenue point of view. I'd classify this as, say, a 201-level discussion (ie, not entry level, but it's also not super deep in the weeds). We mainly cover the ins and outs of why a provider organization should probably be looking to get paid to better take care of patients with chronic disease and drive better patient outcomes at lower downstream costs and, to some degree, also why payers should be helping provider organizations in their local communities to do so by providing some help and shelter on the journey from here to a capitated payment. The focus today is really, I'd have to say, on the messy middle, where a provider organization does not have capitated contracts nor access to any premium dollars, which, by all accounts, is the holy grail here. The premium is where it's at, and provider organizations might want to be aiming to get a piece of that action. The why for this “get the premium dollar” prime directive is pretty self-evident when you look at the big bucks rolling around in the coffers of those who are collecting said premium dollars. So, this “get the premium” endgame is, for sure, a big piece of the why—why, if I am a provider organization, I might want to take the time and energy and spend the money to embark on a path that might lead me to be able to get compensated for the stuff that patients really want and need to do better, which includes all of the things that I spoke about with Eric Gallagher in episode 405. Also, Vivek Garg, MD, MBA, in episode 407 and Amy Scanlan, MD, in episode 402. Spoiler alert: It's not easy. Now, I asked Dan Serrano, as aforementioned my guest today, to offer up his advice here in the context of CKD (chronic kidney disease) patients. Why did I ask Dan to use the CKD case study, as a touchstone? Well, first of all, talking about this topic in totally theoretical terms is not ideal. We need an actual example for a lot of this to kind of make sense, combined with the first step for most outcomes improvement programs, which is to study your data and pick a patient population to focus on where the data suggests that you can have a big impact. And speaking of impact, did you know that an underlying reason why heart failure patients get hospitalized and rehospitalized is because of underlying CKD? So, impact in the short term and longer term, which I'll get to in a sec. Another reason is—and I'm quoting John Rodis, MD, MBA, here, who is the independent medical director of QC-Health®—Dr. Rodis said the other day, “I sure as heck hope I don't get CKD, because if I do, chances are I'm not going to be diagnosed. And even if I am diagnosed, I won't be treated properly.” So, there's that. And I can see why he's saying that. Two out of five patients with ESRD (end-stage renal disease) don't even know they have kidney disease at all. And the number of patients with progressing CKD on any kind of evidence-based treatment plan is stunningly low. But also, here's another reason I asked Dan Serrano to talk about CKD patient populations specifically as his example: I and Dr. Rodis and the team at QC-Health are not the only ones who have figured out that CKD patients are notoriously expensive and way underdiagnosed. You know who else has figured this out? Payers. Also, private equity. In fact, I was in a meeting with a payer recently, and they stated they had to get CKD patients into point solutions. This payer—and I've heard of others, too—none of these entities are waiting around. And I guess, fair enough, if you look at some of the population health data, that I'm sure these payers and others are looking at. But if you work for a payer and you're listening right now, what I would say, “Okay, with the point solutions, one that you have carefully vetted, of course, because we have patients suffering right now and dollars being frittered away right now.” But I also would submit that those point solutions will perform a whole lot better if we are all gunning for synergies. PCPs (primary care physicians) and traditional FFS (fee-for-service) models in this country need your help. The payment models and admin burden are decimating. Payers certainly are a group with some culpability here. (Sorry to be saying the quiet part out loud.) Instead of forgoing them, please help PCPs. Am I saying be altruistic? Actually, no. Listen to episode 409 with Larry Bauer or episode 391 with Scott Conard, MD, or an upcoming show with Jodilyn Owen and what you will hear is the amazing ability for clinicians rooted in the community to actually drive change in their local markets. In fact, I'd hypothesize that these community-rooted organizations probably have a better track record for actually moving the needle on patient outcomes than any snazzy tech that I have seen, although I am sure that there are one or two very effective snazzy techs out there—the exception proves the rule and all that. Bottom line: As I do so often, I am advocating for payers and provider organizations within communities to collaborate, regardless of whether there's a third party also in the mix. I am reporting all of this in the spirit of being helpful but also with some degree of urgency for any care delivery organization because, I mean, really, forget about the holy grail of trying to capture a percentage of the premium if the money is already going elsewhere to too many point solutions who are already capturing a portion of the premium. IRL, this is what's already going on out there. But where there's a challenge, there is also opportunity. As I have said pretty repeatedly for the past four minutes, because the bar is so low and because CKD patient outcomes are bad news, in general, from a lot of angles, CKD is actually a great place for providers to work hard to improve care and quality. From a financial standpoint, I think there's also a great business case for payers to help provider organizations do so. Doing better than the local standard of care is not hard, sadly. And what that means is that there's so much money that's possible to save due to the expense of this condition. And if you're a payer, even a payer with a third-party CKD solution, if you can help local PCPs and others level up their care, then either you don't have to pay for the third-party point solution for patients who can be managed successfully locally and/or there's a more frictionless path for those patients to be identified and get into the point solutions that are available to them. Let's all keep in mind that patients at rising risk are falling through a lot of cracks. You can have the best point solution in the world, but if patients aren't making it there, then, yeah, no outcomes will improve. No costs will be reduced. Everything I just went through are also all of the reasons why we picked CKD as our focus for a national Groundswell Movement™ that the benefit corp I am co-president of is kicking off to improve CKD patient outcomes. If you are also thinking about improving CKD patient outcomes, for sure, hit me up. On to a few thank yous. Thank you so much to Carl Hansen, MD, a direct primary care physician, for a really generous tip in our tip jar. Also, thanks so much to Keith Passwater, who is CEO of Havarti Risk Services and Pasco Advisers, for a really nice donation to the cause over here. It was such an honor and a pleasure to moderate a panel at the Society of Actuaries' latest meeting at Keith's invitation also. Additionally, may I extend thanks to Dffdgg, RKC2023, and Healthy economist for super nice iTunes reviews. The shout-outs are amazing, especially when public like this. Also much appreciated how you have shared Relentless Health Value with your colleagues. Back on track, let's hear from Dan Serrano, who is a consultant with COPE Health Solutions, where he works to help clients figure out the best way to make investments that drive better outcomes in a more cost-efficient way.   You can learn more at the COPE Health Solutions Web site or by emailing Dan at dserrano@copehealthsolutions.com.   Dan Serrano joined COPE Health Solutions in September 2022 as principal and senior vice president. He supports Analytics for Risk Contracting (ARC) finance build and cost models in terms of drive and delivery with Great Lakes Integrated Network (GLIN). He is a seasoned healthcare/finance professional with 20+ years' experience and has held a number of roles across the industry and has primarily served as a senior finance leader with proven ability to drive strategy development and execution across multiple business lines for complex organizations in various stages of maturity. Prior to COPE Health Solutions, Dan served as senior vice president of finance at CareAbout, a private equity–backed start-up focused on driving performance for primary care physicians. He also was the vice president of value- and risk-based contracting at Mount Sinai Health System, where he worked to align contracting, operational performance, and network strategy for employed and voluntary physician groups. Prior to his role at Mount Sinai, Dan served as vice president of commercial products at Healthfirst, market chief financial officer at ChenMed, and Mid-Atlantic Region chief financial officer at Aetna, where he focused on driving strategic financial decisions by analyzing the value drivers for each of the stakeholders across the industry. Dan holds a bachelor's degree in finance from the Peter J. Tobin College of Business at St. John's University.   09:08 What is the importance of payer/provider partnerships in reducing costs with chronic condition care? 10:52 Josh Berlin, JD, of rule of three; look out for his episode in a few weeks. 11:19 What's the endgame here with this payer/provider collaboration? 11:43 What advice does Dan have for providers who want to do better by patients with chronic conditions? 15:11 Who's driving costs in the system? 15:50 Why is lowering the average cost of chronic condition care important? 17:03 Why is there a meaningful delta between well-controlled CKD patients and those who aren't well managed or identified? 21:57 What does a realistic time horizon look like for addressing chronic condition care? 22:38 Why is it important to start in a shared savings place? 25:25 William Shrank, MD, of Andreessen Horowitz; look out for his episode in the fall. 26:35 Financially, what is the goal and how are we achieving a sustainable goal? 29:06 What is the balance between progress and risk here?   You can learn more at the COPE Health Solutions Web site or by emailing Dan at dserrano@copehealthsolutions.com.   Dan Serrano of @COPEHS discusses #chronicconditions and #payer #provider #collaboration on our #healthcarepodcast. #healthcare #podcast   Recent past interviews: Click a guest's name for their latest RHV episode! Larry Bauer, Dr Vivek Garg (Summer Shorts 3), Dr Scott Conard (Summer Shorts 2), Brennan Bilberry (Summer Shorts 1), Stacey Richter (INBW38), Scott Haas, Chris Deacon, Dr Vivek Garg, Lauren Vela, Dale Folwell (Encore! EP249)  

Ellacor is a new technology called fractional micro-coring and is a non-surgical solution for mid-to-lower face wrinkles and excess skin. Dr. Michael Cameron, a board-certified dermatologist with a private practice on the upper west side of Manhattan and an assistant clinical professor at Mount Sinai Health System, has one of the few devices commercially available in New York City. Ellacor is an option for patient who want to avoid surgery but address jowels or your heavy lower face. He talks with Michelle about this and how it compares to other cosmetic options.It's hard to believe but back-to-school season is already upon us and now is the perfect time to equip your kids with everything they need to take on the new school year. Justine Santaniello, Lifestyle & Parenting Expert, helps alleviate the stress that comes with back-to-school prep and share ways that parents can set their kids up for success at the start of the new school year. Justine will also provide tips on preparing fun lunch and snack ideas, time saving hacks, how to stay organized, and more!Diggerland USA is the only construction theme & water park in the US. Families can drive, ride & operate real machines in a safe, clean and fun gated theme park. During the summer months, guests can splash, soak and slide at The Water Main water park, nestled inside the theme park and included in admission. Children over 36” tall can enjoy most rides in the park with an accompanying adult. Along with over 40+ rides and attractions, the park also offers a full-service arcade, cafes, gift shop with unique merchandise, eating pavilions, cabana rentals and more. The park was started in 2014 by brothers, Ilya and Yan Girlya, who had previously been in the construction industry and wanted to find a way for families to enjoy construction machines and increase awareness in the general field. Michelle talks with Ilya about how unique this park is and what a blast it was for her family!Dr. Mothaffar F. Rimawi is a Professor of Medicine, co-Leader of the Breast Cancer Research Program, and Executive Medical Director of the Dan L Duncan Comprehensive Cancer Center (DLDCCC) at Baylor College of Medicine. Metastatic breast cancer (mBC) is the most serious form of the disease and occurs when the cancer has spread beyond the breast to other parts of the body, such as the brain, bones, or liver.1 mBC has no cure and takes a life in the United States approximately every 12 minutes, creating an urgent need for treatment proven to extend life while maintaining quality of life. Despite remaining gaps, there have been important advancements in treatment for patients with hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) mBC. For example, KISQALI® (ribociclib), a prescription medicine indicated for HR+/HER2- mBC in combination with endocrine therapy (ET), has consistently demonstrated across three phase III clinical trials a significant benefit in overall survival (OS) – the length of time that patients diagnosed with mBC continue to be alive – while preserving or improving quality of life.

As AI continues to develop, scientists are figuring out new and improved ways to use it in the medical field. When it comes to widespread diseases such as cancer, could AI be the tool we've been looking for to develop cutting-edge functional treatment?  Thomas Fuchs, a scientist in the groundbreaking field of Computational Pathology, sits down to enlighten us on this intriguing subject… Working with The Mount Sinai Health System, Thomas is interested in building AI models that can enhance cancer care and research. By looking at molecular differences in cancer cells, he believes that this will help predict the right treatment for patients.  Offer: TRĒ House products are crafted to bring you the best that legal, delivered-to-your-door THC has to offer. TRĒ House utilizes unique blends of carefully selected minor cannabinoids that get you lit in ways you've only ever dreamed of. TRĒ House offers an array of premium, legal THC products including gummies, vapes, prerolls, and more. Head over to trehouse.com and enjoy 30% off your order AND get a free Acapulco Gold HHC preroll when you use coupon code GENIUS. This offer expires August 31, 2023. In this podcast, you will learn about: The specific technology used to model images of cancer cells.  How it takes for sequencing results to come back to determine the status of cancer in patients. How AI is being used to improve different medical applications.  So, how does AI analyze and model diseases in the human body? Join the conversation to find out for yourself! To discover more about Thomas and his research, click here now! Episode also available on Apple Podcasts: https://apple.co/30PvU9C

We are joined today by Dr. Shawn Anthony, Associate Chief of Sports Medicine for the Mount Sinai Health System and Assistant Professor of Orthopedic Surgery at the renowned Icahn School of Medicine at Mount Sinai. Dr. Anthony is a orthopedic consultant for the US Tennis Association and provides side-line medical coverage at the US Open Tennis Championship each year. He has published extensively on the management of ACL injuries, so we're excited to have him join for our discussion today on the Bridge-Enhanced ACL Repair or “BEAR” technique. So, without further ado, let's get to the Exhibit Hall!

After a yearlong hiatus, Road to Resilience returns with a new producer and host. Stephen Calabria is the Director of Podcasting for the Mount Sinai Health System. He comes with a background in print and TV journalism, as well as years of experience in podcast hosting and producing. On this relaunch episode of Road to Resilience, Stephen explores where the show has been in the past several years – and where he and Mount Sinai look to take it from here.  Road to Resilience brings you stories and insights to help you thrive in a challenging world. From fighting burnout and trauma to building resilient families, we explore what's possible when science meets the human spirit.   Get Road to Resilience and other Mount Sinai podcasts in your inbox.   Listen and subscribe to Road to Resilience on:  Apple Podcasts https://apple.co/2Nve2Kt Spotify https://spoti.fi/2UbuTVY Google Podcasts http://bit.ly/3aWL5Ag Stitcher http://bit.ly/2UarLcQ Pocket Casts https://pca.st/VW6A YouTube http://bit.ly/2RH5ZMh Recorded at the Levy Library at the Icahn School of Medicine at Mount Sinai Music by Blue Dot Sessions 

June 2, 2023: Chief Digital and Information Officer Kristin Myers shares what innovations Mount Sinai Health System has been implementing and other priorities. How has Mount Sinai Health System transformed digitally? How do they ensure seamless digital experiences for patients and employees? How does the clinical community contribute to and guide digital projects? How is artificial intelligence (AI) being applied and governed at Mount Sinai Health System? How do they balance rapid adoption of digital initiatives with oversight and quality control? What initiatives are in place to improve healthcare access for underserved communities? How do they incorporate patient feedback to improve their digital solutions?Key Points:Digital transformationAI and intelligent automationClinical community involvementGovernance of AIHealthcare access for underserved communities"The Future of Care Spaces" is an upcoming webinar that explores the latest healthcare technologies and solutions transforming care spaces in America. Hospitals, clinics, and at-home treatments are all affected by the advancements in healthcare technology, which can improve workflows, treatments, and patient outcomes. What are the latest remote monitoring tools, advanced telehealth solutions, and other innovative technologies transforming care spaces across America? Join us June 8th, 2023 1:00 PM ET and Register HereSubscribe: This Week HealthTwitter: This Week HealthLinkedIn: Week HealthDonate: Alex's Lemonade Stand: Foundation for Childhood Cancer

Recovering from a brain injury can be a challenging experience, and often the social supports required simply do not exist. David Putrino, Director of Rehabilitation Innovation for the Mount Sinai Health System, Jenny Clarke, co-founder and CEO at the advocacy organization SameYou, and Clemency Burton-Hill, a former classical music broadcaster at WQXR who suffered a brain injury in 2020, discuss the recovery process, and what systemic changes could help patients who survived brain injuries. Former WQXR classical music presenter Clemency Burton-Hill had to re-learn how to play music, which she then used as a therapeutic part of her recovery from a brain injury. (Courtesy of Clemency Burton-Hill)