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may/june 2013 volume 9, issue 2 Advancing Biomedical , , and Care

Medical school scientist named a Howard Hughes investigator Immunobiologist studies in creative new directions. hhmi “hhmi has a very simple mis- defenses against pathogens provides each investigator with his sion,” said hhmi President Robert or her full salary, benefits, and a re- Tjian, ph.d., when this year’s group at mucosal points of entry search budget over an initial five-year of new investigators was announced. appointment. “We find the best original-thinking It was announced on May 9 that The institute also covers other scientists and give them the resources Akiko Iwasaki, ph.d., professor of expenses, including space to follow their instincts in discover- immunobiology and of molecular, and the purchase of critical equip- ing basic biological processes that cellular, and developmental biol- ment. Investigator appointments may may one day lead to better medical ogy, has been selected as a Howard be renewed for additional five-year outcomes . . . And while we cannot Hughes Medical Institute (hhmi) terms, each contingent on a success- predict where their research take investigator. ful scientific review. them, we’re eager to help them move In addition to receiving one of Iwasaki is one of 27 top research- science forward.”

the most prestigious designations in ers, selected for their individual Responding to the news of her kike calvo biomedical science, hhmi investiga- scientific excellence from a group of new appointment, Iwasaki said, Akiko Iwasaki is one of 27 top researchers tors are given the support neces- 1,155 applicants, to be named hhmi “Funding from hhmi will enable nationwide named investigators by the sary to move their research forward investigators this year. my lab to pursue // HHMI (page 6) Howard Hughes Medical Institute.

A ‘ of ’ for disease? Life cut short by war inspires new gift for $10 million grant is awarded by the clinical education Blavatnik Foundation to explore In of a spirited young inflammation’s role in diverse illnesses School of Medicine alumnus who died in the Vietnam War just as his Theoretical physicists have long sought a grand academic career was about to begin, “,” which would account for all clinical-skills teaching at the School the physical phenomena in the universe by unify- of Medicine has received an unprec- ing Einstein’s general relativity with the so-called edented boost. standard model based on quantum mechanics. To mark what would have been In recent years, some biomedical scientists, her late husband’s 50th medical including School of Medicine immunobiologists school reunion, Cynthia Livingston, Richard A. Flavell, ph.d., and Ruslan M. Medzhi- m.a.t., has made a gift of $580,000 tov, ph.d., have proposed that deeply understand- to the medical school to establish the ing inflammatory processes might provide similar Peter B. Livingston, m.d. ’63 Fund unifying insights into a great range of seemingly shapiro harold for Excellence in Teaching, the first dissimilar chronic diseases: heart disease, cancer, The theory advanced by Richard Flavell (left) and Ruslan Medzhitov School of Medicine fund dedicated to type 2 diabetes, Alzheimer’s disease, and more. is a potential “ shift in the science of chronic diseases,” says teaching and mentorship in clini- Thanks to a $10 million grant from the Blavatnik Fam- philanthropist Leonard Blavatnik. cal skills. Income from the fund ily Foundation, a charitable organization started by Amer- will support faculty efforts to create ican industrialist and philanthropist Leonard Blavatnik, a beneficial balance, a steady state that scientists call clinical-skills curricula and to mentor Flavell and Medzhitov will now have the opportunity to homeostasis. The body even gets some outside help from students as they develop those skills. put their to the test. “The Blavatnik Family Founda- microbes, or commensal microorganisms, that reside “Peter had a good experience at tion is proud to support breakthrough scientific discov- on the skin and in the digestive tract and a part in Yale, and I’ve always wanted to honor eries that accelerate the impact of biomedical research,” maintaining core body temperature, blood pressure, blood his memory,” says Cynthia Livings- Blavatnik says. “The theory proposed by Drs. Flavell and sugar, sleep patterns, and a host of metabolic processes ton, who earned her Master of Arts Medzhitov represents a paradigm shift in the science of needed for fitness and survival. in Teaching at Yale in 1963. “I know chronic diseases and may lead to new prevention strate- When infection or tissue damage occurs, the body’s in- that Yale places great emphasis on the gies, treatments, and even cures for many disorders.” nate immune system activates inflammatory mechanisms basic in medical education, The healthy human body regulates its own tissues that help to combat these dangers and restore a proper bal- which is a wonderful thing, but I just and organs to maintain key physiological variables in ance, at least in the short term. Flavell, // Blavatnik (page 6) want to make sure // Livingston (page 7)

Non-Profit Org. inside this issue U. S. Postage 1 Church St., Suite 300, New Haven, CT 06510-3330 2 Lifelines www.medicineatyale.org paid Daniel Barchi is leading the charge on New Haven, CT Yale’s new electronic medical record system. Permit No. 526 3 Respecting our elders Research by the Yale Program on Aging leads to health care strategies that work. 5 Salt in the wound Study shows that high levels of dietary salt may trigger autoimmune diseases. also Advances, pp. 3, 5 Out & About, p. 4

@YaleMed f /YaleMed lifelines Emergency Medicine chair lauded for research

Gail D’Onofrio, m.d., m.s., pro- School of Medicine cio fessor and chair Daniel Barchi says his of the Depart- experience as a naval offi cer ment of Emer- gave him the confi dence to gency Medi- “jump into almost any role,” fl exibility that has come in cine, has been handy as he manages the honored with complexities of Yale’s imple- Gail D’Onofrio the 2013 Society mentation of the $250 mil- for Academic lion Epic electronic medical Emergency Medicine (saem) record system. Barchi says the new system will provide Excellence in Research Award. good service for the next The award, given for the fi rst two or three decades. to a woman, honors D’Onofrio’s accumulated body of research as well as her infl uence as a leader in academic Emergency Medicine.

Daniel Barchi terry dagradi D’Onofrio’s research, funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcohol- Sailing into a new platform ism, has focused on perfecting School’s CIO launches was president of the Carilion Biomedi- tion technology was ill-equipped to interventions for Emergency electronic medical records cal Institute in Roanoke, Va., before provide useful answers. Early emrs Department (ED) patients who joining Carilion Health System as cio. were merely digital versions of paper misuse drugs and alcohol, and has with military effi ciency “I had never done IT before,” says records, he says, and systems were led to effective, empirically tested Barchi, who relied on central designed primarily for billing, limit- techniques that have infl uenced in- As a surface warfare officer with the of leadership in solving a basic problem: ing the availability of data needed to tervention models across the U.S. U.S. Navy in the 1990s, Daniel Barchi Carilion was using multiple electronic answer clinical or research questions. D’Onofrio is a mentor to medi- sailed the world in American efforts tools that didn’t work together. By providing a single platform cal students, trainees, and junior to intervene in international conflicts. Barchi’s strategy was to introduce for all Yale users, Epic opens doors faculty in Emergency Medicine During the Bosnian War in 1994, his a single software system that would to numerous new possibilities. at Yale, and is also the principal ship stationed in the Adriatic Sea, unite these disparate tools. Today For instance, the system can offer investigator on a training grant Barchi led armed boarding parties that Barchi is managing the rollout of that prompts to physicians when a given funded by the Substance Abuse searched ships for weapons and con- same system, Epic, at Yale, an ongoing patient might qualify for a clinical and Services traband in support of nato sanctions. project since his arrival in 2010. trial—a feature that has enabled the Administration to train residents “My ship carried Tomahawk mis- At Yale, installing Epic means Cleveland Clinic to recruit more than in drug and alcohol intervention siles,” Barchi says. “During one of our introducing electronic medical records 10,000 new research volunteers. techniques in all medical settings. deployments we were ordered to (emrs) for all patients. The system, Bridgeport Hospital and the Saint D’Onofrio earned her bach- make a high-speed transit through the which cost more than $250 million, Raphael campus of ynhh will come elor’s degree at Duke University, Suez Canal into the Red Sea.” Although went live at Yale-New Haven Hospital online later this year, and Epic will be her m.s. at Boston University, his crew never had to take action, the (ynhh) at midnight on February 1, and fully implemented at Yale and the Yale and her m.d. at Boston University ship spent several weeks stationed was in operation the following day— New Haven Health System by early School of Medicine. She completed in the middle of the Red Sea, calmly with operating and imaging suites 2014. “Now we’re focused on using a residency in emergency medi- patrolling in case conflict arose. heavily booked—just in time for the the tool well,” Barchi says, adding that cine at Boston City Hospital, and Barchi himself is calm, polite, and next monthly billing cycle. he hopes that Epic will serve Yale for a fellowship with the Substance businesslike, with a military bearing “It went really well,” says Barchi, another 20 to 30 years. Abuse and Mental Health Services and a spartan, orderly office. Now attributing the smooth transition to Importantly, Epic also allows Administration. She serves as chief officer (cio) for the well-coordinated training sessions, patients to access important health physician-in-chief of Yale-New School of Medicine and the Yale-New talented medical staff, and the work of information—quickly, and from any Haven Hospital’s ED, and is a Haven Health System, he says military IT support teams that included many computer. Increasingly, Barchi pre- founding member of the American life gave him “the ability to jump into workers from outside organizations. dicts, the U.S. government will insist Board of Addiction Medicine. almost any role.” Another lesson Barchi learned in that patients have immediate access After leaving the Navy, Barchi the Navy: “Good leadership is about to health information. If is any worked for the telecommunications asking appropriate questions.” Until measure, under Barchi’s watch, Yale will company mci WorldComm, and then recently, however, health informa- be prepared. Editor Peter Farley Senior Editor Charles Gershman Contributors Jenny Blair, John Dillon, Colleen Shaddox, Sarah C.P. Williams Connecticut Mental Health Center opens new Wellness Center Design Jennifer Stockwell Medicine@Yale is published five each The Connecticut Mental Health “Our patients deal with extraor- include housing year by the Office of Institutional Planning and Communications, Yale School of Medicine, Center (cmhc), a New Haven-based dinary challenges daily,” said Mi- and residential ser- 1 Church St., Suite 300, New Haven, CT 06510-3330 community mental health center chael J. Sernyak Jr., m.d., professor of , Telephone: (203) 785-5824 Fax: (203) 785-4327 co-administered by the State of psychiatry and ceo of cmhc. services, and social E-mail [email protected] Website medicineatyale.org Connecticut Department of Mental Benefi ts for patients include an- rehabilitation. Copyright ©2013 by Yale University. All reserved. Health & Addiction services and nual check-ups, prevention plans, Community- If you have a change of address or do not wish to receive the medical school’s Department of sick visits, referrals to specialists, and based medical issues of Medicine@Yale, please write to us at the above address or via e-mail at [email protected]. Psychiatry, has opened a new Well- consultations with medical profes- partner Cornell Postal permit held by Yale University, 155 Whitney Avenue, New Haven, CT 06520 ness Center in partnership with the sionals about health concerns. The Michael Sernyak Scott-Hill Health Cornell Scott-Hill Health Center. availability of basic medical care will Center will provide The Wellness Center, which be one in a growing list of services primary care services at the Center Robert J. Alpern, m.d. serves mainly low-income residents cmhc offers some 5,000 patients per together with cmhc staff. Dean and Ensign Professor of Medicine Jancy L. Houck of New Haven who face challenges year in the greater New Haven area. The Wellness Center is supported Associate President for Development and associated with serious mental illness Patients treated for chronic in part by a $1.6 million grant from Director of Medical Development (203) 436-8560 Mary Hu or substance abuse disorders, opened mental illness and substance abuse the Substance Abuse and Mental Director of Institutional Planning and Communications in February and will serve as a medi- problems also have access to a net- Health Services Administration Cen- cal home to 600 patients annually. work of community programs that ter for Integrated Health Solutions. Printed on recycled paper ♻

2 www.medicineatyale.org advances Making a real-world impact for elders Health & Science News Making an old brain By taking multiple health issues of elderly so the poa makes a point of aggressively recruiting medi- patients into account, Yale researchers are cal students and young physicians for training. “We make young again major investments in young investigators,” and not all are It doesn’t improving of life and independence geriatricians, says Gill, also professor of public health. The take a program works with doctors who specialize in cardiology, neuro- The number of Americans aged 90 and older has tripled infectious disease, or any other areas that come into play in scientist in the past three decades and will quadruple again over the health of older people. Increasingly, basic scientists are to observe the next four, according to the U.S. Census Bureau, and collaborating with clinical researchers. that old the majority of people in this age group have one or more The necessary element is that collaborators be “brave and young disabilities. But medical studies typically seek volunteers enough to embrace the complexity” of the field, says Gill, brains with one—and only one—disease so that variables can be who was once a trainee in the program himself, working differ: eliminated from research data. under Tinetti. He credits her with revealing this complex- children “Those people don’t exist!” says geriatric medicine ity—the “almost overwhelming” interrelationships among istockphoto.com and ado- expert Leo M. Cooney Jr., m.d., Humana Professor of the health problems facing seniors. But complexity has its lescents can learn new things more Medicine—at least not among easily and more quickly than adults, the patients he treats. In other and their brains can recover more words, there is a rapidly grow- fully from injury. Underlying these ing segment of the population differences is Nogo Receptor 1 (NgR1), that health researchers have a protein that fixes brain circuits in historically made a point of ex- place in adulthood to ensure stable cluding from studies. But that functioning. is changing, and the Yale Pro- Stephen M. Strittmatter, m.d., gram on Aging (poa), founded ph.d., Vincent Coates Professor of by Mary E. Tinetti, m.d., in Neurology and professor of neuro- 1991 and now one of the most , teamed up with William B. respected research programs Cafferty, ph.d., assistant professor on health and aging in the U.S., of neurology, and colleagues to study has led the way. NgR1’s role in brain plasticity—the The poa has developed re- brain’s ability to rearrange its connec- search that take tions based on new experiences. into account the multiple health In the March 6 issue of Neuron, the issues that seniors typically face to examine how these prob- group reports that adult mice lacking carl kaufman NgR1 exhibited plasticity at levels typi- lems interact and to develop cally seen in much younger mice; the -based interventions that promote quality of life Mary Tinetti (front row, left), Thomas Gill (back row, fourth from left), mice were more adept than control and independence. and Leo Cooney (back row, second from right) are part of a diverse and talented group of Yale researchers, clinicians, statisticians, and nurses mice at learning new tasks, and were “We have the opportunity of potentially solving some specializing in geriatrics. more able to recover from trauma. The of the most vexing issues in our society,” says Thomas M. findings, they say, could lead to new Gill, m.d., Humana Professor of Medicine, and current di- ways to treat brain injuries, such as rector of the poa and the affiliated Claude D. Pepper Older advantages, he adds, often leading to multiple strategies stroke, or memory loss in humans. Americans Independence Center, which was launched at to help elderly patients stay independent. For example, the School of Medicine in 1992. though numerous factors contribute to falls, by address- “Rather than adapt our research questions to the avail- ing just a few of these causes, clinicians have been able to able , we really adapted the methodology to make great in their prevention. // Aging (page 7) A microscopic syringe the clinical questions,” says Tinetti, the Gladys Phillips to deliver vaccines Crofoot Professor of Medicine and professor of epidemiol- Sometimes there’s a goof-up when ogy and investigative medicine. bacteria divide, and one cell, called a The program is home to a team of biostatisticians Bringing young physicians “minicell,” contains no chromosomal sought after throughout the medical school for their ability dna. Minicells can’t replicate (or to apply rigor to out-of-the-box questions. “We have one of into research on aging cause infection), and scientists can the best biostatistics cores in the country,” says Cooney. tweak them to carry proteins, making Tinetti has worked with this team to develop ways to them a safe vehicle for vaccines. explore complex issues in the lives of older people. Her Jorge E. Galán, ph.d., d.v.m., work has focused on falls, an area that many research- chair and Lucille P. Markey Professor ers would have seen as hopelessly broad. Many physical and chair of Microbial Pathogenesis factors play into falls, as do furniture arrangement, poor and professor of cell biology, had lighting, and other factors. But falls cause 95 percent of previously shown that a needle-like hip fractures and kill more than 20,000 elderly Americans machine possessed by the bacterium a year, according to the Centers for Disease Control, so Salmonella typhimurium could be Tinetti saw falls as a major public health issue that was engineered to inject into human cells worth pursuing. any particle that scientists wanted Tinetti’s research proved that falls, once thought an

the body’s immune system to attack. inevitable part of aging, could be predicted and prevented, istockphoto.com But using this syringe mechanism and that fall-prevention programs offer significant health Researchers at the School of Medicine are leading the way to care savings. meant setting a small number of bac- improve the quality of life and independence of older Americans teria loose in the body, which can be Demonstrating the success and cost-effectiveness of by developing effective, proven solutions to the health problems risky in some patient populations. interventions has been a hallmark of poa research, which faced by seniors. In a new study, published has led to widespread adoption of the fall-prevention Because these Yale innovations are also cost-effective, they March 12 in Communications, strategies Tinetti championed, and of strategies to prevent have been widely adopted across the country. Your support for Galán and colleagues isolated mini- delirium during hospital stays, devised by former poa continuing this work is crucial as the number of Americans reach- cells from a strain of Salmonella and member Sharon Inouye, m.d., adjunct professor of internal ing age 90 and beyond is increasing at a rapid rate. engineered them to contain all the medicine and assistant clinical professor of nursing. To secure the future, we must attract young physicians to components of the injection system. “We have taken our research to the next step that a lot geriatric research and care of the elderly, and gifts that support their work will have a lasting impact for seniors. When administered to mice, the mini- of researchers don’t,” says Tinetti. “Not a publication in a Current-use gifts can be targeted to support specific projects; cells elicited an immune response but top journal or a presentation at a national meeting. The endowments can generate perpetual support for investigators next step is working with the clinical community and the did not generate a full-blown infec- just launching their careers. tion, the ideal response to a vaccine. community at large.” For information about these and other ways to support the The system could be used to com- Tinetti’s work has received wide praise, and earned her a School of Medicine, contact Jancy Houck, associate vice bat cancer as well as a wide variety of MacArthur Fellowship (or “Genius Grant”) in 2009. But she president for development and director, medical development, infectious diseases, says Galán. maintains that research on aging remains “unglamorous,” at (203) 436-8560 or [email protected]

Medicine@Yale May/June 2013 3 out & about

January 2 The Yale Psychiatry Wellness Initiative joined forces with 1 February 22 Members of the medical school’s Class of 2015 per- New Haven’s Miya’s Sushi for a dinner to benefit the Immanuel formed in the annual Second Year Show in Harkness Auditorium, Baptist Shelter for homeless men. (Front, from left) Third-year an evening of theatre in which students poke fun at their profes- psychiatry resident Beth Grunschel, m.d.; C.J. Algarin-Cruz, a student sors with skits and choreographed musical numbers. Proceeds at Common Ground High School; Meredith Siefert, Miya’s Sushi in- from this year’s zombie-themed show, titled “The Walking tern; Common Ground students Jenny Edge and Janet Sakouvogui; Med,” were donated to the New Haven-based charities New second-year psychiatry resident Ayana Jordan, m.d., ph.d.; and Haven Community Soup Kitchen, Community Services, third-year psychiatry resident Yauss Safavi, m.d. (Back, from left) Continuum of Care, Inc., and the Yale Community Health Care Bun Lai, chef and owner of Miya’s Sushi, and David Ross, m.d., ph.d., Van. 1. Amanda King performed in “Escape to Histology Lab.” assistant professor of psychiatry. 2. (From left) Pierre Martin, Sean Bickerton, Lauren Krumeich, King, and Alex Scherer in “I’ll Make a Doc Out of You.” 3. (From left) Scherer and King in the same number. 4. (From left) Veronica Shi, Scherer, and Adam Kundishora in “Nowhere to Hide.” 5. (From left) Luis Rubio, Jared Sun, and Alex Svoronos in the show’s curtain call. 2 3 4 shane seger

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2 carl kaufman (2) February 25 Members of the Yale medical community con- vened for a ribbon-cutting marking the opening of the

Wellness Center at the Connecticut Mental Health Center (cmhc; terry dagradi (5) see related story, page 2). 1. (From left) John H. Krystal, m.d., Robert L. McNeil Jr. Professor of Translational Research, chair of the Department of Psychiatry, and chief of psychiatry at Yale-New Haven Hospital; Robert J. Alpern, m.d., dean and Ensign Professor 1 2 3 of Medicine; Nancy Wyman, lieutenant governor of Connecticut; Michael Taylor, interim ceo of Cornell Scott-Hill Health Center; Patricia Rehmer, msn, commissioner of Connecticut’s Department of Mental Health and Addiction Services; Michael J. Sernyak, m.d., professor of psychiatry and ceo of cmhc. 2. (From left) Larry Davidson, ph.d., professor of psychiatry; Robert A. Cole, m.h.s.a., coo of cmhc; Gale M. Banks, aprn, the cmhc’s staff liaison to the Wellness Center; Aniyizhai Annamalai, m.d., assistant professor of psychiatry and medicine and director of the Wellness Center; (3) shapiro harold Chyrell D. Bellamy, ph.d., assistant professor of psychiatry; Edwin F. 4 March 16 Patients of the Yale Children’s Diabetes Program Renaud, lcsw, ph.d., associate director of clinical services at cmhc; and their attended the annual Family Day Symposium. Rebecca A. Miller, ph.d., instructor in psychiatry and director of The half-day event, held on Yale’s West Campus, included peer support at cmhc; Jeanne L. Steiner, d.o., associate professor of lectures, discussions, and interactive programs for adults and psychiatry and cmhc medical director. children. 1. Eda Cengiz, m.d., associate professor of pediat- rics. 2. Amanda Rossi (left) and Jailene Lobo. 3. (From left) William V. Tamborlane, m.d., professor of pediatrics and chief of the Section of Pediatric Endocrinology, with Jon Borkowski March 15 On and Chris Frataza, sales representatives of the health care com- Match Day each pany Novo Nordisk. (From left) and year, graduating 4. Susan Berson Jennifer L. , , , instructor in pediatrics. medical students Sher m.d. ph.d. around the U.S. learn where they’ll head for residen- cies following their March 20 The Farid Foundation made a $100,000 gift time in medical to support pediatric oncology at the School of Medi- school. At the cine. The Connecticut-based philanthropic foundation School of Medicine was established in 2005 by brothers Tariq and Kamran this year, 91 mem- Farid, founders of Edible Arrangements. (From left) bers of the Class Robert J. Alpern, m.d., dean and Ensign Professor of of 2013 “matched.” Medicine; Gary Kupfer, m.d., professor of pediatrics terry dagradi Charles Odon- shapiro harold and pathology and chief of the Section of Pediatric kor (left), who matched in internal medicine at Yale-New Haven Hematology/Oncology at Smilow Cancer Hospital at Yale-New Haven; Kamran Farid; George Lister, m.d., Hospital, followed by physical medicine and rehabilitation at Johns Jean McLean Wallace Professor and chair of the Department of Pediatrics and professor of cellular and Hopkins Hospital, savored the moment with his friend Richard molecular physiology; Clifford W. Bogue, m.d., associate professor of pediatrics, chief of the Section of Arthur, m.p.h., a 2012 graduate of the School of Public Health. Pediatric Critical Care Medicine, and physician-in-chief at Yale-New Haven Children’s Hospital.

4 www.medicineatyale.org advances Health & Science News Salt is new culprit in autoimmunity In a surprising finding, high salt levels are Kleinewietfeld, ph.d., associate research scientist, Hafler, Applying muscle to and colleagues wondered whether there was something in muscular dystrophy found to spur the growth of immune cells the environment that affected TH17 cells. When they fol- involved in numerous autoimmune disorders lowed the diets of patients, something jumped out at them. “People who are at a fast-food restaurant more than once a The health risks of eating high amounts of salt make up week had higher levels of TH17 cells,” Hafler says. quite a laundry list: high blood pressure, heart attacks, To test whether it was the high levels of salt in most fast stroke, and kidney stones, to name a few. Now, School food that accounted for this difference—rather than levels of Medicine scientists have discovered another potential of fat or other compounds—the researchers first tested

courtesy of anton bennett detriment of a high-salt diet. Salt, they’ve found, may TH17 cells growing in the lab. When they added salt to A protein newly described by Yale re- drive the progression and severity of autoimmune diseases, the surrounding these cells, more than 10 times as searchers puts the brakes on the crea- through its interactions with certain immune molecules in many cells matured. tion of new muscle cells; when this the gut. Hafler’s group then tested the implications of this protein is inactivated muscle stem The research, which appeared in the March 6, 2013 finding in a strain of mice prone to developing a version cells make muscle. Using a mouse issue of Nature, is based model of Duchenne muscular dystro- on with mice, phy (dmd), a disease of progressive but likely applies to human muscle loss, the group discovered that autoimmune diseases, switching this protein off reduced including multiple sclerosis, symptoms of the disease. says David A. Hafler, m.d., In humans, dmd primarily affects Gilbert H. Glaser Profes- boys, with symptoms of muscle weak- sor and chair of Neurology, ness as early as infancy leading to an professor of immunobiol- average lifespan of only 25 years. There ogy, and senior author on is no treatment for the disease. the new paper. In the April 1 issue of the Journal of “This goes to show that Clinical Investigation, a team led by An- the immune system may ton M. Bennett, ph.d., associate profes- well be linked to what you sor of pharmacology and comparative eat, in unexpected ways,” medicine, reports that the protein Mkp5 Hafler says. He is confident keeps muscle stem cells in a state of enough in the findings, readiness, poised to make new muscle he adds, that he is already when needed. When Mkp5 is removed, recommending that his sacco william these stem cells are activated and em- patients who are prone to autoimmune disease reduce (From left) Associate research scientist Markus Kleinewietfeld, bark on generating new muscle. dmd their salt intake. m.d./ph.d. student Amanda Hernandez, and postdoctoral associate mice lacking Mkp5 showed both higher Scientists have long known that a type of immune cell, Mansoor Zaidi are exploring the potential effects of dietary salt on auto- immune diseases in the laboratory of David Hafler (right). levels of new muscle cell creation (pink called T helper 17 (TH17) cells, is involved in several auto- in photo) and lower rates of muscle immune diseases, including multiple sclerosis, psoriasis, degeneration. The team says that drugs type 1 diabetes, and rheumatoid arthritis. Patients with of multiple sclerosis. When they added moderate amounts that block Mkp5 in humans may open these conditions, scientists have shown, have higher levels of extra salt to the diets of these mice, the severity of their new avenues of therapy for dmd. of TH17 cells, which helps to explain why their immune disease increased. Normally, salt levels are much lower in systems are more likely to attack their bodies’ own cells. the blood than in surrounding tissues. While a high-salt Cellular gatekeepers But over the past 50 years, the incidence of these auto- diet doesn’t drastically increase the level of salt in the blood, immune diseases has increased, and first author Markus it does increase the salt that’s free in the gut, // Salt (page 7) of inflammation When a tissue in the body becomes injured or infected, white blood cells rush from nearby blood vessels to launch an immune response, gener- Prostate cancer: moving beyond ‘watchful waiting’ ally a positive first step in the healing Prostate cancer is the second-leading prostate cancer treatment, his Yale process. But if too many of these cause of cancer death in American men: doctors were able to offer a relatively first responders arrive on the scene, the American Cancer Society expects new, middle-of-the-road approach inflammation can result, so it’s vital the disease will claim nearly 30,000 called active surveillance. that the response is tightly regulated. lives in 2013. The disease mainly affects When Peter G. Schulam, m.d., A team of scientists led by older men—the median age of diagno- ph.d., came to Yale from the Uni- Anjelica Gonzalez, ph.d., assistant sis is 67—and it’s a slow-growing can- versity of California at Los Angeles professor of biomedical engineer- cer, so most men diagnosed with the (ucla) in 2012 as professor and chair ing, and Jordan S. Pober, m.d., ph.d., disease are likely to die of other causes. of the School of Medicine’s newly the Bayer Professor of Translational Brad Davis, a veterinarian with formed Department of Urology, one Medicine and professor of immuno- a family history of prostate cancer, of his first actions was to assemble biology, dermatology, and pathology, was diagnosed at age 54. A blood test the team and equipment necessary to suspected that cells called pericytes, he had taken showed elevated levels perform active surveillance. which form the outermost layer of of prostate-specific antigen psa( ), a Schulam, who directs Yale Cancer blood vessels, might act as gatekeep- protein that may indicate the presence Center’s Prostate and Urologic Can- ers that manage the release of white of the disease, and a biopsy confirmed cer Program, had seen good results blood cells into tissue. the diagnosis. with active surveillance in California, robert lisak The team created a model of “This put me in a quandary,” but the approach is so new that there Peter Schulam and colleagues in the Depart- blood vessels with discrete layers says. Davis, who knew he had many are not yet any national guidelines for ment of Urology offer “active surveillance” to of human pericytes and endothelial active years still ahead, and was the protocol. men diagnosed with prostate cancer. cells, which line the interior of vessels. concerned that surgery or radiation At Yale, patients like Davis who They found that pericytes precisely could compromise them. Still, he was have a high psa result or an abnormal So if a magnetic resonance imag- and selectively restrict the number young enough that the cancer, if left digital exam have a baseline biopsy, then ing scan reveals suspicious lesions in of white blood cells that exit vessels unchecked, could eventually kill him. a repeat biopsy after six months, and a the prostate, Yale doctors providing into injured tissues. The finding will Just a few years ago Davis’s op- subsequent biopsy every two or three active surveillance perform what is help researchers build better in vitro tions would have been limited to years—or more frequently if indicated. known as a fusion biopsy using the models of blood vessels, and could “watchful waiting” (close monitoring One biopsies are a pre- Artemis device, a 3D imaging and lead to new drugs to treat inflamma- by a doctor with treatment postponed ferred diagnostic tool in prostate navigation system that tracks the dis- tory diseases, especially those that until deemed necessary) or prosta- cancer is that the prostate is “the only ease’s progress with great precision. the lungs, eyes, and skin, which tectomy to remove part or all of his solid organ in the body in which we “We use Artemis and fusion have high levels of pericytes. prostate. But thanks to advances in cannot image cancer,” Schulam says. biopsy to take // Prostate (page 6)

Medicine@Yale May/June 2013 5 // Blavatnik (from page 1) chair and Ster- which he received a Blavatnik Award // Prostate (from page 5) pictures and adding that men in their 60s are more ling Professor of Immunobiology, and for Young Scientists in 2007. In overlap them with real-time ultra- likely to find that active surveillance is Medzhitov, the David Wallace Profes- February, Medzhitov and Flavell were sound images to help us guide where an attractive treatment option. sor of Immunobiology, postulate that jointly awarded the 2013 Vilcek Prize our needles go,” explains Preston Doctors also assign a Gleason these same inflammatory mechanisms for Biomedical Science. Sprenkle, m.d., assistant professor of score to prostate cancers, a measure can have a cumulative damaging effect Robert J. Alpern, m.d., dean of urology. This method allows doc- of the likelihood a cancer will spread on homeostatic controls—an effect they the School of Medicine, that tors to take future biopsies from the based on its appearance under a believe is a root cause of many serious a unified theory of inflammation and exact same spot in the prostate where microscope. Men with a Gleason health disorders. With the new grant chronic disease will be a -changer. previous lesions were found, allow- score of 6 or below and with cancer from the Blavatnik Family Foundation, “This work offers a whole new way ing them to better monitor the most in only a few biopsy samples are also the scientists plan a detailed study to to look at the causes of many chronic troublesome part of the gland. good candidates for active surveil- define the molecular links between illnesses, including cardiovascular So far the evidence in favor of lance, Sprenkle says. Davis says inflammation, commensal microor- disease, type 2 diabetes, autoimmune systems like Artemis is promising. that his Gleason score of 6, in only ganisms, and chronic disease. diseases, asthma and allergies, neuro- A study published in January by Yale President-elect Peter Salovey degenerative diseases such as Alzheim- ucla researchers in the Journal of expressed the University’s gratitude to er’s disease, and cancer,” Alpern says. Urology found that targeted biopsies the Blavatnik Family Foundation for “A few years from now, I am optimistic were three times likelier than conven- what he called “an extremely generous that we will be in a position to develop tional biopsies to detect cancer, and and far-sighted” contribution. “The new therapeutics that can broadly im- there is hope that tools like Artemis research now under way in the Medzhi- pact human health and quality of life.” may enable doctors to treat prostate tov and Flavell laboratories has the po- The founder and chair of Access cancer more efficiently. tential to transform our understanding Industries, Leonard Blavatnik is deeply “We overtreat prostate cancer in of human biology and our approaches committed to supporting innovation in the United States,” says Schulam. to the most intractable diseases. This biomedical research and higher educa- Most cases are not life-threatening, grant will accelerate their work at Yale’s tion. In 2007, the Blavatnik Family but a vast majority of men with Department of Immunobiology, which Foundation established the Blavatnik prostate cancer diagnoses undergo

is world-renowned for leading major Awards for Young Scientists, awarded aggressive treatments—there are robert lisak advances in innate and adaptive im- through the New York Academy of between 100,000 and 120,000 radical (From left) Urologists Peter Schulam and Pres- munity,” Salovey said. Sciences, to recognize innovative and prostatectomy surgeries per year in ton Sprenkle discuss a patient’s case using the Medzhitov and Flavell, both of high-impact accomplishments in the the U.S. In 2012, the U.S. Preventive Artemis system, which offers new flexibility whom are Howard Hughes Medical In- life sciences, physical sciences, math- Services Task Force recommended to men diagnosed with prostate cancer who are not ready to pursue surgical treatment. stitute investigators, have led pioneer- ematics, and engineering. Blavatnik against psa-based screening for ing studies on the control of inflamma- has supported the Broad Institute at prostate cancer, reasoning that too tion by the innate immune system. Harvard University and mit, and he many patients were being treated for 20 percent of one core biopsy—con- Medzhitov is widely recognized has provided seed funding at Har- asymptomatic disease. The recom- firmed in a secondary biopsy with for classic studies he conducted in vard for highly promising, early-stage mendation “charges us as urologists Artemis—contributed to his decision. the late 1990s with the late Charles research in the life sciences. In 2010, he to better differentiate those who need Davis, now 55, was the first A. Janeway Jr., m.d., that clarified contributed more than $115 million to treatment from those who don’t,” patient in Yale’s active surveillance the functions and importance of the the University of Oxford to establish Schulam says. program, and he is happy to have had innate immune system, work for the Blavatnik School of Government. The patients referred to Yale who the choice available to him. benefit most from active surveil- When interviewed for this article, lance are at a low risk of developing Davis was symptom-free, his psa // HHMI (from page 1) questions that are there is no effective immunization, symptoms. Normally, Sprenkle says, level was at 3 and not a cause for risky but potentially very rewarding. and no cure. The researchers focused he would recommend radiation or concern, and he had “some benign We will be able to understand the on peripheral tissue in the female surgery in patients who, like Davis, hyperplasia”—prostate enlargement— types of immune responses generated genital tract, where viral exposure are in their 50s. “that’s not real significant,” he said. by sensing different levels of danger occurs. “The chance their cancer is going “The is many men diagnosed associated with infections, and to de- Working with mice, they explored to progress over the next 30 to 40 in their 60s may have lesions for termine how the bacteria and viruses a two-part vaccine strategy they years is very high,” says Schulam, years like mine before detection.” that inhabit our body influence the call “prime and pull”: The priming immune system. Ultimately, we hope involves conventional vaccination to to design vaccines that effectively elicit a system-wide T cell response. prevent diseases caused by viruses The pulling involves recruitment that enter through mucosal sites.” of activated T cells directly into the Eye for Science Iwasaki’s body of research has vaginal tissue, via topical application addressed the mechanisms of innate of chemokines—substances that help recognition of viruses and the initia- mobilize the immune cells. tion of antiviral immunity. Iwasaki and colleagues found Her lab focuses on sites where a that the recruited T cells were able virus encounters mucosal surfaces. to establish a long-term niche and Until now, most efforts to develop offer protective immunity against vaccines have focused on the immune genital herpes by reducing the spread system’s antibodies, or T cells, circu- of herpes simplex virus into sensory lating through the body. neurons. But efforts to harness these Other recent research by Iwa- circulating T cells have not been ef- saki, published in Proceedings of the fective in organs such as the vagina, National Academy of Sciences, showed intestines, lung airways, and central that, following influenza infection, nervous system, which restrict the the relationships among bacteria entry of these “memory” T cells. in the gut critically regulates the Iwasaki’s research has thrown generation of the immune response’s light on the crucial role of dendritic virus-specific CD4 and CD8 T cells cells, a special class of white blood and antibody responses. cells that form part of an early warn- Her results revealed the im- ing system against infection, in pro- portance of commensal (“good”) tecting the body from certain viruses. microbes in regulating immunity courtesy of yorgo modis Dendritic cells are abundant in in the respiratory mucosa through Pestiviruses, animal pathogens related to hepatitis C virus, are a major global skin and mucosal surfaces, where the proper activation of multiprotein health threat. They deliver their genome into hosts’ cells by fusing their envelope they act as sentinels against foreign complexes known as inflammasomes. with the cell membrane. In April, in Proceedings of the National Academy of Sci- invaders. A non-profit medical research ences, Associate Professor of Molecular Biophysics and Biochemistry Yorgo Modis In a study recently published in organization with an endowment and colleagues published the crystal structure of glycoprotein E2 from a pestivi- Nature, Iwasaki’s team developed a of more than $16 billion, hhmi was rus known as bvdv. Here, the glycoprotein (blue and purple) is seen on the viral new model for vaccination against founded by businessman Howard envelope (gray), poised to fuse with a host cell membrane. genital herpes, a disease for which Hughes in 1953.

6 www.medicineatyale.org AAAS Fellows Four School of Medicine faculty members have been elected fellows of the American Association for the Advancement of Science (aaas), an international nonprofit organization dedicated to advancing science around the world.

Lynn Cooley, ph.d., the C.N.H. Long Pietro De Camilli, m.d., Eugene Higgins Mark W. Hochstrasser, ph.d., Eugene David A. McCormick, ph.d., the Professor of Genetics, is renowned for Professor of Cell Biology and professor of Higgins Professor of Molecular Biophysics Dorys McConnell Duberg Professor her work on egg development in the neurobiology, is one of the world’s lead- and Biochemistry, works to understand of Neurobiology and vice director fly Drosophila melanogaster. Also ing researchers in the cell biology of the the mechanisms by which some specific of the Kavli Institute for Neurosci- professor of cell biol- synapse. De Camilli is proteins are rapidly ence at Yale, is an ogy and of molecular, also a director of the degraded within cells authority on the cellular, and devel- Program in Cellular while most others are organization and opmental biology, Neuroscience, Neuro- spared. Hochstrasser function of the Cooley directs Yale’s degeneration, and is also professor of cellular networks Combined Program Repair, and a Howard molecular, cellular, of the brain’s cer- in the Biological and Hughes Medical Insti- and developmental ebral cortex and Biomedical Sciences. tute investigator. biology. thalamus.

// Gift (from page 1) that the clinical studies of schizophrenia. He was pre- // Salt (from page 5) and Hafler believes not be as affected by diet. side of things has its own support.” paring a third paper on psychosis at the that a high-salt diet could activate John O’Shea, m.d., chief of the Born in 1937, Peter Livingston time of his death. Had he lived, says TH17 cells there. Such a diet also National Institutes of Health’s Mo- died on November 19, 1968 after Meltzer, “I would imagine Peter would could change the balance of bacteria lecular Immunology and Inflamma- months of providing psychiatric care have been a professor of psychiatry at a living in the gut, which could like- tion Branch, agrees. Changing official to soldiers at a division-level hospital leading medical school.” wise affect the immune system. dietary recommendations without at Long Binh Post, a major command If so, he might have found it chal- There are more than 150 genes clinical trials would be premature, he center for the U.S. Army. He had lenging to find time to teach clinical linked to autoimmune disease risk says, but also points out that low-salt been about to join Cynthia and their skills, as many practicing physicians in humans, and when Hafler took a diets are already recommended for baby son for a leave in Hawaii when and researchers do. The new Living­ fresh look at the genes on the list, he some patients with risk factors for his helicopter was shot down. ston Fund is expected to relieve some discovered that almost 30 percent of other disorders. His wife’s gift honors a man of that time pressure. these genes were activated by salt, “The findings are interesting and whom his friends say was broadly “We’re very grateful to Cynthia, further supporting the connection. provocative, but we don’t know if this educated, energetic, and warm—and especially for her appreciation of the “This really opens up a whole is pertinent to humans with autoim- one who had the makings of a dedi- effort that’s involved in teaching new area of investigation,” Hafler munity,” says O’Shea. “Lots more cated teacher himself. Livingston ma- mentoring and curriculum develop- says, adding that there are likely to be work needs to be done to establish jored in English at Tufts University ment, and the importance of attention environmental factors other than salt this point. Nonetheless, the study in Medford, Mass., where he wrote to clinical skill-building in the educa- that are responsible for the increased raises an exciting possibility for and published poetry. In medical tion of future physicians,” says Deputy prevalence of autoimmune disease, intervention.” school, full of what his friend and so there are numerous avenues of Motivated by that possibility, Yale alumna Sharon Meltzer M.A., research yet to be followed. Hafler and colleagues are beginning a Ph.D., calls “nervous keenness,” he David Fox, m.d., a rheumatologist new dietary study in humans to more was profoundly influenced by the at the University of Michigan, calls firmly establish the link between salt ecumenical approach to medicine Hafler’s results “exciting” but agrees intake and autoimmunity. championed by Frederick “Fritz” that more research is needed. “The But in his role as a physician, Haf- Redlich, m.d., then chair of the story may be more complicated than ler says, he’s not waiting to suggest Department of Psychiatry. Livings- it seems,” Fox says. “I don’t think dietary changes to his patients. ton took graduate seminars at Yale this one paper completely proves “If you have a high susceptibility in philosophy and and greatly that there is a link between diet and to autoimmune disease in your fam- admired the university’s legendary multiple sclerosis.” ily, especially if you have an infant, chaplain, William Sloane Coffin Jr. Moreover, he points out, the effect I would recommend trying to keep For his psychiatry residency, of salt on TH17 cells is unlikely to salt levels low,”says Hafler. “We have Livingston went to the Massachu- have the same impact on all auto- to be careful in extrapolating this to

setts Mental Health Center (MMHC) courtesy of cynthia livingston immune diseases. The incidence of human disease at this point,” but, in Boston, where he taught Harvard Peter Livingston, of the School of Medicine’s rheumatoid arthritis, for example, like O’Shea, he believes the potential medical students with enthusiasm, Class of 1963, died in the Vietnam War. On the has not risen over the time period benefits of a low-salt diet outweigh recalls School of Medicine classmate occasion of the 50th reunion of his class, his that multiple sclerosis has, so it may any risks. and fellow Harvard resident James widow, Cynthia Livingston, has endowed a fund to support the teaching of clinical skills. S. Dalsimer, M.D., now a psycho- // Aging (from page 3) Gill’s work fo- on days he doesn’t report to the life analyst in Boston. MMHC’s overall cuses on disability in the elderly (also study. learning atmosphere was “a treat Dean for Education Richard Belitsky, once thought to be part and parcel of If the intervention proves effec- beyond treats,” says Dalsimer, and it m.d., a psychiatrist and Harold W. aging) and how relatively simple in- tive, it could be widely and easily was there that Livingston published Jockers Associate Professor of Medical terventions might slow or prevent it. adopted by existing facilities, such his first two papers and decided to Education. “It is through her generosity He is the primary investigator at Yale as senior centers or ymcas. “This pursue schizophrenia research. that our faculty will have the time and for the Interventions and society generally and policymakers But while still a resident, Liv- resources needed to design and imple- Independence for Elders (life) study, specifically are really looking for cost- ingston was drafted into the Army. ment innovative approaches to clinical a multi-site project funded primarily effective interventions to decrease the Though Livingston opposed the education.” by the National Institutes of Health’s rate of increase in the Medicare bud- Vietnam War, says another medical That’s just what Livingston is National Institute on Aging, in get,” says Gill. Tinetti agrees, saying, school classmate, Herb Meltzer M.D., hoping for. A retired teacher herself, which researchers are examining how “We spend an awful lot of health care who is now a research psychiatrist at she has fond of joining her physical activity affects people who dollars on things that don’t work.” Northwestern University, he took his husband to hear superb discussions at are sedentary and at risk of disabling Cooney first became interested in deployment gracefully. “He mastered Grand Rounds while he was in medical illnesses and injuries. geriatrics in 1969 at Boston City Hos- whatever feelings he had about the school. And their son, Oliver M. L. When a patient named Richard pital. “I started seeing older patients bad luck he had in being sent over Bacon, m.d., m.p.h., who graduated (a pseudonym) first joined the life who I felt were not being very well there,” says Meltzer, “and did the job from Yale College in 1988 and from the study, he was recovering from hip cared for.” The level of disability in he was supposed to do.” School of Medicine in 1996, is now a surgery, and walking for 20 minutes the elderly population has dropped Much of that job involved teach- clinical faculty member at the Univer- was a challenge. “I was really out of since then, he says, and there is a ing, and Livingston wrote to his wife sity of California–San Francisco. shape,” he remembers. growing awareness among physi- about the daily teaching marathons he “As medicine changes in the 21st Now, less than three years later, cians of the need to treat “people, not undertook in the Army hospital. “He century and becomes a little more ab- Richard arrives early for his twice- diseases.” said by the end of these things he’d stract, I think the clinical skills that weekly sessions on a walking track Tinetti believes that there is a be hoarse but happy,” recalls Cynthia. are passed on are still really impor- so he can get in a full hour. “It’s hopeful trend of rejecting the While still in Vietnam, he was accepted tant,” Livingston says. “Freeing up definitely helped me,” says Richard, that quality of life must decline as a fellow at Cambridge University, some time for teaching clinical skills who at 83 reports that he’s healthy sharply with age. “The baby boomers where he planned to continue his is essential.” and takes long neighborhood walks won’t stand for that,” she says.

Medicine@Yale May/June 2013 7 Inaugural Lurie Prize awarded to School of Medicine scientist In a May 14 ceremony at Northwest- A jury of scientists headed by receptors (tlrs) act Snyder said in an announcement of ern University’s Feinberg School of Solomon H. Snyder, m.d., of Johns as a pathogen-de- Medzhitov’s selection. “He is a true Medicine, Yale immunobiologist Hopkins School of Medicine, selected tecting sentinel and pioneer of medical science.” Ruslan M. Medzhitov, ph.d., was Medzhitov from a group of 154 nomi- activate adaptive The prize was established by awarded the inaugural Lurie Prize nees for the award, which carries an immunity. Since Chicago philanthropist Ann Lurie “to in the Biomedical Sciences from the honorarium of $100,000. then, tlrs have be- reward and acknowledge a scientist Foundation for the National Insti- Medzhitov, elected to the National come the subject of who makes a discovery that is clearly tutes of Health (fnih). Academy of Sciences in 2010, came to intense research ac- a game changer in terms of medical The newly instituted award, which Yale in 1994 from Moscow, Russia, Ruslan Medzhitov tivity in laboratories and biological research.” honors early-career researchers whose having been inspired by the then-con- around the world. In accepting the prize, Medzhitov findings have advanced basic biomedi- troversial of innate immunity “Dr. Medzhitov’s painstak- said, “This award is a tremendous cal science, was given to Medzhitov, championed by the late Yale immuno- ing studies paved the way for the honor, and I am very grateful to all the David W. Wallace Professor of Im- biologist Charles A. Janeway Jr., m.d. identification of multiple tlr fam- my colleagues, teachers, and trainees. munobiology and a Howard Hughes At that time the innate immune ily members and their respective I am especially grateful to the fnih Medical Institute investigator, for his system was receiving little scientific ligands, which help bind molecules and its scientific jury for recogniz- groundbreaking studies of the innate attention, but by 1997 Medzhitov, forming larger complexes, advancing ing the tremendous progress in the immune system, the body’s first line Janeway, and colleagues had estab- the entire field of immunology and field of innate immunity to which of defense against bacteria and viruses lished that innate immune system opening the way for the development so many of my colleagues have (see related story, page 1). components known as toll-like of new vaccines and treatments,” contributed.”

Expert in minimally invasive, image-guided Chair of pediatrics, critical care medicine pediatric surgery is new Pritzker Professor specialist, is appointed as Wallace Professor Pediatric surgeon Michael G. Caty, surgeons use to George Lister, m.d., chair of the Francisco. There, he m.d., m.m.m., has been named the see the insides of Department of Pediatrics, chief of began research that Robert Pritzker Professor of Pediatric organs. He is also pediatrics at Yale-New Haven Hospital led to his specializa- Surgery. Also professor of pediat- working to develop (ynhh), and physician-in-chief at Yale- tion in critical care rics and chief of pediatric surgery at prototypes that will New Haven Children’s Hospital, has medicine, a field in Yale-New Haven Children’s Hospi- make it possible to been named the Jean McLean Wallace its formative stages tal, Caty’s clinical interests include repair esophageal Professor of Pediatrics. at the time. neonatal surgery, thoracic surgery, atresia with an en- A 1973 graduate of the School of Lister’s long- intestinal motility disorders, pedi- Michael Caty doscopic approach. Medicine, Lister focuses his research George Lister standing research atric surgical oncology, pediatric He earned his on the factors affecting infants at risk interest in oxygen laparoscopy, and minimally invasive bachelor’s degree at Boston College and for Sudden Infant Death Syndrome transport has contributed significantly thoracic surgery. his m.d. at the University of Massachu- (sids). He was a member of the medi- to the understanding of cardiopulmo- Prior to his arrival at Yale in 2012 setts, then completed general surgery cal school’s Department of Pediatrics nary interaction in congenital heart Caty was professor of surgery and pedi- training at the University of Michigan for 25 years before moving in 2003 to disease and cardiorespiratory control in atrics at the University of Buffalo School and finished his residency in pediat- the University of Texas Southwest- infants at risk for sids. of Medicine and Biomedical Sciences, ric surgery at Children’s Hospital of ern Medical School, where he was He has also played an active role and surgeon-in-chief, division direc- Boston and Harvard Medical School. professor, the Robert L. Moore Chair in medical education throughout his tor of pediatric surgery, and program Additionally, he holds a master’s degree of Pediatrics, and associate dean for career. A member of the Institute of director in pediatric surgery at Women in medical management from Carnegie education until 2011. He also served as Medicine, he has had numerous nation- & Children’s Hospital of Buffalo. Mellon University’s Heinz School of pediatrician-in-chief at the Children’s al leadership roles in pediatric profes- Caty is an expert in minimally Public Policy, and is a member of the Medical Center of Dallas. sional organizations and, among other invasive surgical techniques, as well American College of Surgeons, the Lister completed a residency in publications, is co-editor of the 21st and as the development of an imaging Society of University Surgeons, the pediatrics at ynhh, and a fellowship 22nd editions of Rudolph’s Pediatrics, technique called “augmented real- American Academy of Pediatrics, and in pediatric cardiology and neonatol- one of the most widely read pediatric ity,” three-dimensional models that the American Surgical Association. ogy at the University of California-San textbooks in the world.

Program for Anxiety Disorders director Young Professor, chair of Ob/Gyn, is an is named Alfred A. Messer Professor expert in uterine development and genetics Wendy K. Sil- American Psychological Association Hugh S. Taylor, Health. As chief of reproductive en- verman, ph.d., from 2006 to 2007, was chair of the m.d., has been docrinology and infertility at ynhh, newly named as the National Institute of Mental Health named the Anita he has grown the clinical service to inaugural Alfred A. (nimh) Interventions Committee for O’Keeffe Young one of national renown. Messer Professor of Disorders Involving Children and their Professor of Obstet- A 1983 graduate of Yale College, Child Psychiatry, Families from 2007 to 2010. rics, Gynecology, Taylor earned his m.d. at the Univer- focuses her re- She has published numerous scien- and Reproductive sity of Connecticut School of Medi- search on develop- tific papers and chapters in the area of Sciences. Taylor, cine. He completed his residency in ing and evaluating Wendy Silverman child and adolescent anxiety disorders, who became chair of Hugh Taylor Ob/Gyn at ynhh in 1992, followed by psychosocial inter- and is the author of five books on the the Department of a postdoctoral fellowship in molecular ventions for child and adolescent topic. She has been principal investiga- Obstetrics, Gynecology, and Repro- biophysics and biochemistry at Yale anxiety disorders. tor on nimh research grants to develop ductive Sciences in 2012, is a noted and a fellowship in reproductive endo- A child and adolescent clinical psy- and evaluate treatments for anxiety clinician, scientist, and educator whose crinology and infertility. chologist, Silverman became director of disorders in children and adolescents clinical research is in the areas of infer- Taylor has been named a Mentor the Yale Child Study Center’s Program for the past 20 years, and has been an tility, endometriosis, menopause, and of the Year by the American College of for Anxiety Disorders in January. She invited lecturer both nationally and diethylstilbestrol (des) exposure. Obstetricians and Gynecologists and previously served on the psychology internationally. Also professor of molecular, cel- Honoree of the Year by the Endome- faculty at Florida International Uni- Currently co-editor of Clinical lular, and developmental biology and triosis Foundation of America. He versity and at the University at Albany, Psychology Review, Silverman previously chief of obstetrics and gynecology at received the President’s Achievement State University of New York (suny). served as editor of the Journal of Clinical Yale-New Haven Hospital (ynhh), Award from the Society for Gynecologic A graduate of Binghamton University, Child and Adolescent Psychology, as well as Taylor’s basic science research focuses Investigation (sgi) in 2008. suny, Silverman received her m.a. and associate editor of other major journals on uterine development, the regula- He serves as editor-in-chief of the ph.d. in clinical psychology from Case in her field. She was recognized with an tion of developmental gene expression journal Reproductive Sciences and editor Western Reserve University. nimh mid-career development award by sex steroids, endocrine disruption, of Endocrinology and is on the board of Silverman, who was president of (K24) from 2005 to 2010 for her research and stem cells. His research has been directors of the American Society for Division 53 (Society of Clinical Child as well as for her mentorship of trainees continuously funded for more than Reproductive Medicine and a member and Adolescent Psychology) of the in both psychology and psychiatry. 20 years by the National Institutes of of the governing council of the sgi.

8 www.medicineatyale.org