Published since 2015, this series includes scholarly articles in all areas of neurology and psychiatry. The series was established and edited by Daniel H. Geschwind (University of California, Los Angeles). For more information about past issues, see https://nyaspubs.onlinelibrary.wiley.com/hub/nyaspubs/reviews-series.html. Or click https://nyaspubs.onlinelibrary.wiley.com/doi/toc/10.1111/(ISSN)1749-6632.year-in-neurology-and-psychiatry.
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Keystone Symposia Reports
Beginning in 2021, Ann NY Acad Sci and Keystone Symposia are working together to produce scholarly reports on select Keystone Symposia. Keeping with the high quality and timeliness of past reports published in Ann NY Acad Sci, the Keystone reports are prepared from the presentations by symposia speakers and then vetted carefully for content. See https://nyaspubs.onlinelibrary.wiley.com/doi/toc/10.1111/(ISSN)1749-6632.keystone-symposia-reports.
The New York Academy of Sciences, Leon Levy Foundation Name First 10 Leon Levy Scholars in Neuroscience
The program supports exceptional young researchers from New York City’s five boroughs as they pursue innovative investigations in neuroscience.
New York, NY | June 14, 2023 — The New York Academy of Sciences and the Leon Levy Foundation announced today the first cohort of Leon Levy Scholars in Neuroscience; a continuation of an earlier fellowship program started by the Foundation in 2009 that has supported 160 fellows in neuroscience.
This highly regarded postdoctoral program supports exceptional young researchers across the five boroughs of New York City as they pursue innovative investigations in neuroscience and advance in their careers toward becoming independent principal investigators. Designed to broaden the field and to support researchers who might otherwise not have equal opportunity to secure postdoctoral funding, ten (10) scholars were selected for a three-year term from more than a dozen institutions across New York City that offer postdoctoral positions in neuroscience.
Honoring Leon Levy
“My husband, Leon, had a keen interest in studies of the brain after taking a psychology course as an undergraduate at City College of New York. He was fascinated by the minds of scientists,” said Shelby White, founding trustee of the Leon Levy Foundation. “We see these Leon Levy Scholars as the pathway to making great strides in neuroscience, so we are proud to support these gifted young researchers, providing them financial and career support, along with recognition, to advance their careers.”
“New York is an epicenter of neuroscience, with some of the best brain research being conducted in the United States,” said Nicholas Dirks, the Academy’s president and CEO. “Our distinguished jury selected 10 outstanding neuroscientists across the five boroughs conducting cutting-edge research. We are excited to be working with the Leon Levy Foundation to usher in this new group of young neuroscientists, providing guidance and financial support to encourage ground-breaking discoveries that will ultimately result in growth in this crucial field.”
The Scholars program features structured mentorship by distinguished senior scientists. Workshops will help Scholars with grant writing, as well as developing leadership, communications, and management skills. The programs will encourage networking, data sharing, cross-institutional collaboration and an opportunity for networking at an annual Leon Levy Scholars symposium.
The 2023 Leon Levy Scholars
- Thiago Arzua, Columbia University
Recognized for: How information about stressful events is encoded in the brain and how it can be passed through generations.
- Ana Badimon, The Rockefeller University
Recognized for: How contact system activation could affect the brain, and most notably the pathology of Alzheimer’s disease.
- Shai Berman, Columbia University
Recognized for: How the body’s physiological states—particularly hunger— affect value-based decision making.
- Cynthia Chai, Columbia University
Recognized for: Identifying the neural circuit and genetic elements that undergo the strongest selective pressures to enhance survival through the study of escape responses in closely-related fly species.
- Andrew Chang, New York University
Recognized for: How music and speech is perceived, processed and distinguished in the human brain and its relevance for individuals with communication disorders.
- Jonathan Gill, NYU Langone Health
Recognized for: Distinguishing the neural circuits that are correlated with odor identity and behavioral choice.
- Kelvin Q. Laracuente, NYU Langone Health
Recognized for: The neural circuitry of how we perceive visual social signals and how it relates to and integrates with other somatic sensory social input to shape social awareness.
- Pablo Lituma, Weill Cornell Medicine
Recognized for: The role of RNA regulation in non-neuronal brain cells and its impact on neuronal function.
- Brian Sweis, Icahn School of Medicine at Mount Sinai
Recognized for: Combining neuroeconomics and transcriptomics to examine decision-making dysfunction underlying regret processing in rodent stress models.
- Geoffrey Terral, Albert Einstein College of Medicine
Recognized for Examining the morphology and connectivity of inhibitory neurons and subsequently, their functional ability to generate brainwaves.
About the Leon Levy Foundation
The Leon Levy Foundation continues and builds upon the philanthropic legacy of Leon Levy, supporting preservation, understanding, and the expansion of knowledge, with a focus on the ancient world, arts and humanities, nature and gardens, neuroscience, human rights, and Jewish culture. The Foundation was created in 2004 from Leon Levy’s estate by his wife, founding trustee Shelby White. To learn more, visit: leonlevyfoundation.org
For more information about the Scholarship program, contact: LeonLevy@nyas.org
What Near-Death and Psychedelic Experiences Reveal about Human Consciousness
A recent Academy event explored near-death experiences and the medical application of psychedelic remedies, combining elements of science and philosophy.
Published June 9, 2023
By David Freeman
What is the nature of consciousness? What happens to it at the brink of death—and beyond? In what ways can the scientific study of near-death experiences and the medicinal use of psychedelic compounds boost our understanding of the human condition and our ability to ease emotional suffering?
These and related questions were the focus of an Academy conference held on June 8, 2023, in New York City. The one-day event included presentations by psychologists, neurologists, biomedical researchers and a religious scholar. Additionally, there was a gripping first-person account of a near-death experience from renowned journalist and author Sebastian Junger.
What are Near-Death Experiences?
Near-death experiences, or NDE’s, are deeply affecting, often mystical episodes. Experts call them periods of “disconnected consciousness.” They affect some people who are close to death or in situations of grave physical or emotional danger. They are commonly marked by feelings of floating outside one’s body and the sensation of moving toward a bright light, as well with as encounters with dead relatives.
NDE’s have been documented across many different cultures and have been known since ancient times. “We’re talking about something that could be hundreds of thousands of years old,” said Brian C. Muraresku. He is the author of the 2020 book “The Immortality Key.” His book examines scientific evidence for the ritual use of psychedelics in classical antiquity. He was also one of the speakers at the conference.
There’s something about that kind of experience—near-death, psychedelic, mystical, whatever it is—that holds the entire human race together.
Brian C. Muraresku, author “The Immortality Key”
NDE’s are now known to be remarkably common. In recent research, 15 percent of intensive care unit patients reported having one. As did up to 23 percent of survivors of cardiac arrest. This is according to neuropsychologist Helena Cassol, Ph.D. Dr. Cassol is the scientific coordinator of Neurological Rehabilitation Center of the University Hospital of Liege in Belgium and also presented at the conference.
“More people have survived cardiac arrest and other situations and could recall those experiences” as a result of improved resuscitation techniques that have become available in recent years, she explained. She added that NDE’s now represent an emerging field of scientific research.
NDE’s can be personally transformative. Some people report a reduced fear of death in the wake of an NDE. Others report enhanced feelings of compassion or purpose. But some are saddled with a pattern of persistent intrusive thoughts or dreams or other negative after-effects. Given these possibilities, “I think it is important for people to be able to talk about these experiences and be heard in a nonjudgmental way,” Dr. Cassol said.
The Evolution of Near-Death Experiences
There may be an evolutionary basis for NDE’s. Daniel Kondziella, M.D., Ph.D., is a neurologist at Copenhagen University Hospital and an associate professor at the University of Copenhagen in Denmark. During his conference presnetation he described research linking the episodes to thanatosis. That’s the well-documented and remarkably consistent phenomenon in which animals—even insects—feign death in order to avoid being killed by predators.
The research suggests that the evolution of language in humans gave us the unique ability to transform this stereotyped behavior into the rich narratives used to describe the mysterious sensations and perceptions commonly seen in near-death experiences, Dr. Kondziella said. Not everyone is convinced by such research.
“Evolutionary explanations are just-so stories,” said Christof Koch, Ph.D. Dr. Koch is chief scientist and president of the Allen Institute for Brain Science, and also presented at the conference. “They may be true. They made be false. It just doesn’t matter. But the fact that we do have experiences—that is the remarkable thing.”
Studies of the neurological underpinnings of NDE’s suggest that the phenomenon arises amid a sort of blending of conscious states: waking, rapid-eye movement (REM) sleep and non-REM sleep.
“The physiological balance between conscious states is disrupted during the conditions of near-death, leading the brainstem arousal system controlling conscious states to blend waking and rapid eye movement consciousness into a hybrid state” known as REM intrusion,” said Kevin R. Nelson, M.D., a University of Kentucky neurologist and another speaker at the conference. “REM intrusion leads to many key features of near-death, including lying still, visual activation, out-of-body, and the experience’s narrative qualities.”
Most individuals who experience near-death are physiologically predisposed to REM intrusion, according to Dr. Nelson.
Psychedelics as Medical Treatment
As some scientists work to gain a better understanding of NDE’s, others are pursuing clinical trials of psychedelic compounds, which have been shown to trigger an altered state of awareness similar to that seen in people experiencing an NDE. A growing body of evidence suggests that these compounds—given under expert supervision and in carefully controlled settings—can ease emotional distress in terminally ill people quite profoundly.
One landmark 2016 study by researchers including Anthony P. Bossis, Ph.D., clinical assistant professor of psychiatry at NYU Grossman School of Medicine and another speaker at the conference, showed that a single treatment with psilocybin—a psychoactive compound found in some mushroom species that humans have consumed for thousands of years—brought rapid reductions in depression, anxiety, and hopelessness in people with terminal cancer.
The benefits of psilocybin treatment were greatest among individuals who reported strong mystical experiences during the sessions, according to Dr. Bossis. “The more robust that mystical experience, the greater the outcome in terms of reduction of depression,” he said. “These aren’t NDE’s,” he added, “but they’re deathlike experiences with a similar phenomenology.”
Recent research shows that psilocybin is just one of many drugs that can induce NDE-like such experiences and suggests that those induced by ketamine, an anesthetic with hallucinogenic effects, show greater similarity to NDE’s than those induced by psilocybin. But “we only studied the phenomenological similarity between subjective experiences” and didn’t assess the extent to which any of the drugs might be effective treatments for depression, said Charlotte Martial, Ph.D., a neuropsychologist at the University of Liege in Belgium and another conference speaker.
Junger’s Brush with Death
Sebastian Junger’s brush with death came three years ago, following the rupture of an aneurysm in his pancreatic artery. As doctors rushed to stanch the bleeding that threatened his survival, he recalled, he encountered an “infinitely dark” pit that threatened to pull him in but also the welcoming “essence” of his beloved, long-dead father. “It wasn’t quite a vision. It was halfway between a vision and a feeling,” he said.
A self-described atheist whose father was a physicist, Junger said the experience nonetheless led him to reconsider his ideas not only about life and death but about the nature of the universe.
“I wish I could say I believe in an afterlife. I don’t. But I definitely have lost the certitude of my rationality,” he said, adding that he now believes it was possible that “some kind of energy or quantum phenomena” interacts with reality in ways we don’t understand.
If some see NDE’s as possible evidence of the supernatural or a phenomenon beyond the scope of scientific knowledge, others are convinced that they are simply the result of physiological processes—such as the oxygen starvation to the brain that can result from cardiac arrest.
There is a “perfectly natural explanation for NDE’s,” said Dr. Kondziella. “No need to postulate any supernatural events.”
But Raymond A. Moody, Jr., M.D., Ph.D., the keynote speaker whose remarks set the stage for the conference, expressed uncertainty over what near-death experiences actually represent.
Science? Or philosophy?
“I really just don’t know,” he said. “I think the questions that we are dealing with—a lot of them are not yet scientific questions,” he added. “They are philosophical questions.”
Dr. Moody is the author of the 1975 book “Life after Life” that sparked interest in near-death experiences. He has been documenting NDE’s for many years and is credited with coining the term near-death experience.
Uncertainty about life’s transcendent questions is inevitable, according to Karen Armstrong, a London-based author of numerous books on religious affairs and the other keynote speaker at the conference.
“Neither religion nor science can really respond. Ultimately, we are all in a ‘Cloud of Unknowing,’” she said in a reference to an anonymous 14th Century text on spirituality and Christian mysticism. “We are all just trying to find some meaning in it all,” she added, “without which we humans fall very easily into despair.”
For Brian C. Muraresku, the strange perceptions and complex emotions seen in near-death and similar visionary experiences are central to the human experience. “There’s something about that kind of experience—near-death, psychedelic, mystical, whatever it is—that holds the entire human race together.”
Also read: Music on the Mind: A Neurologist’s Take
Blavatnik Awards for Young Scientists
The Blavatnik Awards for Young Scientists seek to identify and honor exceptional young scientists and engineers 42 years of age and younger. Honorees are selected based on the quality, novelty, and impact of their research and their potential for further significant contributions to science. For previous issues of awardee papers, see Ann NY Acad Sci (2012) 1260 and Ann NY Acad Sci (2013) 1293. Or click https://nyaspubs.onlinelibrary.wiley.com/doi/toc/10.1111/(ISSN)1749-6632.blavatnik-awards.
Collaboration is Key for 2023 Ross Prize Awardees
Ask Helen Hobbs, M.D. and Jonathan Cohen, Ph.D. about the secret of their research success, and it will come down to one core element: their partnership.
Published May 31, 2023
By David Freeman
The pair were recently awarded the 2023 Ross Prize in Molecular Medicine by the Feinstein Institutes for Medical Research and the journal Molecular Medicine for their pioneering and collaborative work in defining the genetic risk factors for dyslipidemias and metabolic liver disease that have led to the rational design of new therapies.
Hobbs trained as a physician and a human geneticist, while Cohen trained as a bench scientist and a physiologist. But they also recognize how the different perspectives they bring to their work contributes to its success.
“Helen’s got a very good feel for the big picture in terms of the scientific direction pathway areas to choose and which observations we should follow up…she is far more selectively curious than I am,” says Cohen of their research styles, “(while) I tend to pay attention to experimental details.”
Their complementary differences can also be seen in their personalities, “Helen is ‘s very exuberant and very extroverted, and I tend to be more introverted and certainly more self-contained,” says Cohen.
Hobbs adds, “Jonathan is very easy to work with… he’s got a very level disposition. We both need each other to balance each other out.”
In addition to their strengths both also cite good mentors as pivotal guides in their careers.
“A lot of people want to look for a lab that’s doing the latest technique or, you know, papers in Science and Nature,” says Cohen, “I think having somebody who’s a good first-rate mentor is a number one priority.”
Where it All Started
Cohen was fortunate to connect to Weiland Gevers, chair of biochemistry at the University of Cape Town in South Africa while he was still in high school. A similar relationship with Scott Grundy, head of the Center of Human Nutrition at the University of Texas Southwestern Medical Center, made it possible for Cohen to relocate to Dallas.
There, he soon would meet Hobbs, who moved to UT Southwestern in 1983. A trained physician, she was encouraged by Donald Selden, M.D., head of internal medicine at UT Southwestern to join Nobel Laureates Michael S. Brown and Joseph L Goldstein’s lab whose work in the regulation of cholesterol metabolism, laid the foundation for Hobbs’ own study of the genes that caused severe hypercholesterolemia.
In 1999 Hobbs was asked to help design an epidemiological study for a large grant that scaled from genes to populations. She knew she needed the right partner if she was going to take on the challenge.
“I was used to working with families, not populations,” recalls Hobbs. “I knew immediately if I was going to do this, … that I really needed a partner who had more quantitative skills than I did.”
She started talking to Cohen, and in just six weeks they launched the foundation for the Dallas Heart Study, a large multi-ethnic population study.
“We spent nights up in our labs writing this study, talking to each other, thinking about it, and getting advice from epidemiologists.”
Looking at Gene Variations
While most researchers in the field at the time were operating under the assumption that gene variations found frequently in the population were the cause of common diseases (like hypertension), Cohen and Hobbs took a different approach – they looked for gene variations that were rare but were more likely to cause disease if a person had that variant.
The multi-ethnic nature of the Dallas Heart Study, made up of 50% African-Americans, the most genetically diverse population in Dallas, and including Hispanic and European participants, led them to quickly zero in on mutations in a gene called PCSK9 that were associated with reduced plasma levels of low-density lipoprotein (LDL) cholesterol and decreased risk of heart disease.
This revolutionary discovery meant that new drug development could be targeted at PCSK9 to lower cholesterol levels in patients, and two therapies have since been FDA-approved to do just that. Despite the opportunities such a discovery could yield, the pair are more focused on how their work solves problems, rather than profiting from their foundational work.
“I am really thinking about solving a problem in a lab and answering a question, and the thrill I get is in getting that answer,” says Hobbs.
Doing What They Love
Ultimately, the two are happy to be in a lab doing what they love.
“I like the whole package of being an academic scientist,” says Hobbs. “I love the research, and I like the teaching, the mentoring. There’s just so many aspects of our job that I enjoy, and I just didn’t want to be distracted from them.”
Cohen can’t picture himself as anything other than a scientist, “I can’t imagine…doing anything other than what I do.”
Today, The Hobbs-Cohen Lab continues to use human genetics to identify new therapeutic targets to treat cardiovascular and metabolic disorders and to define key pathways in lipid metabolism. More recently, they discovered the first genetic cause of fatty liver disease in humans. They also continue to employ their dynamic partnership in the way they run their lab.
“There’s always somebody in the lab for the students and post-doctoral fellows to talk with. I think that if you were to talk to the people in our lab, they would see this as a very good thing,” says Hobbs. “But one thing’s always true. Nobody can split us.”
“To have our work recognized by such an honor (as the Ross Prize) is incredibly gratifying, especially for us to be honored together…there’s just no way any of it could have been done without the other,” said Hobbs.
Cohen agrees. “I was just going to say the same thing.”
Read more about the Ross Prize and past awardees:
The New Wave of AI in Healthcare
In the healthcare field, artificial intelligence has the potential to improve everything from workflow efficiency to patient outcomes.
Published May 25, 2023
By Stephen Treffinger
Members of the Organizing Committee. (From left to right) Affiliated with the Mount Sinai Health System: Christina Virgo, Esq., Sara Roncero-Menendez, Silke Muehlstedt, PhD, Thomas Fuchs, Dr. sc., Marc Kaplan; Affiliated with The New York Academy of Sciences: Melanie Brickman Borchard, PhD, MSc, Barbara Knappmeyer, PhD
Appearing on the front page of news outlets nearly every day, artificial intelligence (AI) is already transforming the world. And it’s doing so at a staggering pace. In the healthcare field, it has the potential to improve everything from workflow efficiency to patient outcomes. But sifting through the hype can be a tremendous challenge.
The Windreich Department of Artificial Intelligence and Human Health at the Icahn School of Medicine at Mount Sinai and the New York Academy of Sciences hosted the ‘New Wave of AI in Healthcare’ symposium as a “call to action.” This brought together experts and leaders across the field to tackle this challenge through innovation, exchange, and collaboration.
The symposium took place over the course of two days: May 23 and 24, 2023. Researchers, academics, and industry leaders presented and discussed innovative research. They also focused on clinical solutions with the potential to advance the capabilities of AI. The goal is to better serve patients and clinicians from diagnostics to long-term care.
Opening remarks were delivered by, Nicholas Dirks, President and CEO of The New York Academy of Sciences, and Dr. Dennis Charney, Dean of the Icahn School of Medicine and President for Academic Affairs for the Mount Sinai Health System. They challenged attendees to identify ways to utilize the enormous amounts of health data available. If utilized properly, this can help predict, prevent, and develop more robust treatments for disease.
Advancing the Capabilities of AI
The two-day symposium featured sessions on foundational models that revolutionize diagnostics processes, infrastructural challenges to facilitate large-scale models and innovative deep learning solutions to deal with the petabytes of data generated in healthcare. Also, the symposium addressed ethical considerations for AI research in healthcare to eliminate bias and ensure its application is equitable as well as impactful.
“Today, patients are dying not because of AI, but because of the lack of it,” stated Thomas J. Fuchs, Dr. Sc, Dean for AI and Human Health at Mount Sinai, lead member of the scientific organizing committee in opening the symposium, Dr. Fuchs further emphasized that although machine learning has already led to significant achievements across the field of healthcare, we are only at the beginning of an AI revolution in healthcare.
(From left to right) Panelists: Eric Lium, PhD, Mount Sinai Health System, Brandon D. Gallas, PhD, U.S. Food and Drug Administration, Emma Benn, DrPH, Mount Sinai Health System, Moderator: Eric Nestler, MD, PhD, Icahn School of Medicine at Mount Sinai
AI Fundamentals – Facts, Fictions, and Possibilities
Despite the immense hype around AI (as Dr. Fuchs remarked, “If you haven’t talked about ChatGPT, you’re probably living under a rock.”) and excitement in the start-up scene (including 14,000 healthcare startups in the AI realm), the reality is not quite as dramatic. There are only a few AI applications that practitioners currently use in the clinical setting to benefit patients. “While the FDA cleared hundreds of systems in radiology, in pathology, for example, there’s one single system that has proven to be safe and effective.”
Dr. Fuchs stated that AI gives us the possibility to truly democratize access to healthcare for the first time in history. “The AI we’re developing here and you’re developing at your fabulous institutions can be used in community clinics throughout the U.S. and throughout the world.”
A Deep Crisis in Healthcare
The fact that clinicians are burned out and leaving practices has, according to several of the speakers, resulted in a deep crisis in healthcare. But AI is able to help combat this trend by automating workflows. One of the keynote speakers at the symposium was David C. Rhew, MD, Global Chief Medical Officer and VP of Healthcare at Microsoft. He presented developments in Ambient Clinical Intelligence. This system can, among other things, capture clinician-patient conversations and bring the information into the medical record.
“We have an ability now to pull data about individuals from every aspect. We can look at the perspective of what EHR [Electronic Health Record] data we have, what genomics data we have, and real-time data collection through remote monitoring.” This creates a 360-degree view of a person and one that changes as they evolve. “Now imagine having that at a population level,” he says. “That’s where the real power comes.”
(From left to right) Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, President for Academic Affairs, Mount Sinai Health System
Nicholas B. Dirks, PhD, President and Chief Executive Officer, The New York Academy of Sciences
Thomas J. Fuchs, Dr.sc., Co-Director of the Hasso Plattner Institute for Digital Health at Mount Sinai, Dean of Artificial Intelligence and Human Health, and Professor of Computational Pathology and Computer Science at the Icahn School of Medicine at Mount Sinai
AI for Healthcare and Life Sciences – Accelerated Discovery
Will more data and data-driven models yield better patient outcomes? This was a central theme throughout the symposium. Speakers utilizing foundational models in research and clinical diagnostic support tools to create deep learning models. Researchers develop these across heterogenous data modalities to improve patient outcomes.
The conference’s second keynote was delivered by Jianying Hu, PhD, from IBM Research. Dr. Hu is also an adjunct professor at the Icahn School of Medicine at Mount Sinai. In addition to IBM’s use of AI to drive accelerated discovery, she discussed what it means to go beyond large language models to apply foundational models to healthcare and life sciences research.
“In our view, [it’s] really all about enabling the journey from data to impact. AI can be used to help with the development of new molecular entities through novel generative methods, as well as computational screening tools [that] can be used to also identify new indications for drugs that are already approved,” says Dr. Hu. In addition to drug repurposing, AI is critical, she says, for being able to identify multimodal biomarkers.
From the Laboratory to Practice: Clinical Applications of AI
Moving from the theoretical to the practical and harnessing the full power of AI will require a change in approach, especially as it pertains to data: how much of it is required, how it needs to be treated, and how to maximize its effects. Abundant medical data is playing an important role, as precision medicine tries to determine the right treatment for the right patient at the right time.
“When we think about precision medicine and AI in medicine, we think about the health state of a patient and how we can model that health state of a patient,” says Gunnar Rätsch, PhD, ETH Zürich, who is currently conducting research as a visiting scientist within Mount Sinai’s AI Department.
Evidence of the health state comes from heterogeneous data modalities such as EHRs, pathology images, genomic profiles, drugs, and mobile health data. Integrating this data into computational representation enables practitioners to access a patient’s health state. This requires new advances in AI approaches to exploit the specifics in the medical data, which requires genuine partnership between clinicians and machine learning/AI researchers.
Christina Virgo, Esq., Director of Operations Hasso Plattner Institute for Digital Health at Mount Sinai
The Impact of the New Era of Large-scale Deep Learning Models
Increasing the speed by which researchers can process and analyze vast amounts of data is an ongoing challenge in AI. The exponential growth of healthcare data, genomics, electronic records, and imaging can overload systems and slow the path to progress.
But processing capacity and speed aren’t the only issues. Another challenge is to better merge clinical medicine and data science, the two being mutually beneficial. Anthony Chang, MD, from the Children’s Hospital of Orange County, thinks this is an essential—albeit largely absent—duality. Few people understand both sides of the equation.
Dr. Chang also sees the need for a shift to a new paradigm of databases, i.e. graph databases. “These are more three-dimensional and much more accommodating of the complexities of healthcare data. […] I can’t imagine we’re going to get a lot more dividends using deep learning healthcare without a change in how we look at databases, which is relational databases.”
In the detection of breast cancer, to cite one example, having very large scan sizes is advantageous, but dealing with these enormous images efficiently can be problematic due to the amount of memory in the GPU and other factors. Krysztof J. Geras, PhD, NYU Langone Health, discussed the particulars of multiple instance learning. “We have this ability to indicate those parts of the image that are important. We can actually look at this image with greater detail with a higher capacity network, but just at a certain region of it, and then we can fuse this information. And that works amazingly well.”
AI at Mount Sinai
The Mount Sinai Health System is dedicated to leading an AI-driven transformation of healthcare. This is done through innovative research, pioneering clinical care, and personalization for each patient. The aim is to have a wide-reaching impact on human health. In 2021, Mount Sinai established the Windreich Department of Artificial Intelligence and Human Health. This is the first department focused on AI and Human Health in any medical school in the United States.
As a leader in the AI in healthcare space, researchers at Mount Sinai are building an “intelligent fabric” of AI that will underpin all interdisciplinary efforts. They are combining AI, computer science, machine learning, and data science across the Health System to support every individual who comes through the hospital doors for care. It will also support nurses, physicians, scientists, hospital operations and leadership,
Several Mount Sinai researchers presented their AI-integrated research during the symposium. They highlighted the various ways in which this new technology can benefit researchers, clinicians, and patients. This ranges from diagnosis to treatment, as they are developing some of the most exciting advances in the field.
Highlights include:
- Ipek Ensari, PhD, who works with AI and machine learning combined with statistics in the field of women’s health, noted the possible link between indicators in the female reproductive system to diseases such as coronary artery disease, and stroke.
- Hayit Greenspan, PhD, focuses on AI in the medical imaging space. “We are developing a platform that provides tools for collection of the data, support of annotation of the data, and support of modeling that can be done to extract information that is useful from the imagery data.”
- Xiaosi Gu, PhD, focuses on the fast-growing sub-sector of mental health in health tech. “We need to both achieve a mechanistic understanding of the brain and of the mind at the algorithmic level and to use brain-related data to try to create predictive models.”
- John F. Crary, MD-PhD, is a neuropathologist and runs a research lab in neurodegenerative diseases. “Alzheimer’s is a monumental public health crisis. It’s really important […] to get […] tissues digitized, organized, and made available to scientists and computational people.”
- Bruce J. Darrow, MD-PhD, who leads Mount Sinai’s AI ethics committee, often works on creating spaces and treatments that are not only safe and effective, but also equitable, being tested across the right demographics and taking into account factors such as insurance coverage, income, and zip code.
- Robert Freeman, RN, MSN, NE-BC, is working on moving from the reactive to the predictive and preventative AI. In practice, this would lead to shorter patient time in the hospital and improved overall 30-day mortality.
(From left to right) Thomas J. Fuchs, Dr.sc., Mount Sinai Health System, Keynote Speakers: Jianying Hu, PhD, IBM Fellow, Director, HCLS Research, Global Science Leader, AI for Healthcare at IBM Research, David Rhew, MD, Global Chief Medical Officer, Vice-President of Healthcare, Microsoft
Governance and Ethics for the Use of Large Healthcare Datasets for AI
The use of massive amounts of patient data for AI naturally raises key governance and ethics issues. This includes data privacy, transparency, regulatory compliance, and bias screening to ensure fair representation. These issues and more were covered in a panel discussion moderated by Dean Eric Nestler, MD, PhD, Icahn School of Medicine at Mount Sinai.
The role of bias in large healthcare data models can take many forms. This is especially thru when it comes to populations of color and members of underrepresented communities. One of the panelists, Emma Benn, DrPH, is a biostatistician at Mount Sinai, applies her training to health equity research. She addressed the governance and ethics of the topic. In terms of race, she posed the question of whether the algorithms and technology are just describing racial and ethnic differences versus being able to operationalize race in a way that gets closer to identifying mutable targets for intervention.
“If we’re not operationalizing things correctly, we’re not going to be able to use AI to reduce health inequalities,” says Benn.
The Importance of Data Privacy
Another panelist, Dr. Erik Lium, PhD, discussed the importance of data privacy. Dr. Lium is the Chief Commercial Innovation Officer for the Mount Sinai Health System and the President of Mount Sinai Innovation Partners. One question posed by the audience was which processes a hospital uses to protect a patient’s personal health data. The answer depends on who is going to use said data, be it internally for research or with an external partner. Internally, an institutional review board decides acceptable usage. For use with external partners, it involves legal agreements with copious protections. These protections bar anyone from taking, for instance, de-identified data and attempting to re-identify the data.
“You can use the data for a stated purpose that we think is ultimately beneficial to patients. If you go outside of that purpose, then you’re doing something that’s inappropriate,” says Dr. Lium.
Keynote speaker Dr. David Rhew ended his address on a key philosophical and ethics-focused note. He brought up the idea of AI taking a pause to prevent potentially harmful aspects like the spreading of misinformation. “If the good actors pause on this, that doesn’t mean that the bad actors are going to pause.”
In Conclusion
Throughout the symposium, speakers were able to address successes, challenges, and future initiatives. This is needed to further the development of new AI technology in the field and how it can be implemented to better patient outcomes. Some of the key takeaways from the symposium’s sessions include:
- Increasing cooperation between institutions.
- Figuring out how to obtain and efficiently process ever larger data sets.
- Using AI to enhance patient experience and outcomes.
Finally, these developments will need to be carefully and continuously filtered through the lenses of equitability and security to ensure that every patient receives the highest level of care no matter the setting. The ‘New Wave of AI in Healthcare’ symposium was an important step towards this equitable, AI-integrated future, with more advancements and discussions to come.
Innovators in Science Award
In 2016, The New York Academy of Sciences and Takeda Pharmaceuticals announced the establishment of the Innovators in Science Award. The Award recognizes a promising Early-Career Scientist’s and an outstanding Senior Scientist’s contributions to biomedical science and is intended to support their commitment to innovative research. Two prizes of US$200,000 are awarded each Award cycle, in a specific therapeutic area, one to an Early-Career Scientist and the other to a well-established Senior Scientist from around the world. The winning scientists have distinguished themselves for the creativity and impact of their research. See https://nyaspubs.onlinelibrary.wiley.com/doi/toc/10.1111/(ISSN)1749-6632.innovators-science-award.
Antimicrobial Therapeutics Reviews
Published since 2010, this series includes scholarly reviews in all areas of antimicrobial therapeutics. The series was established and edited by Rexford S. Ahima (The Johns Hopkins University). For more information on past issues see https://nyaspubs.onlinelibrary.wiley.com/hub/nyaspubs/reviews-series.html.
Nutrient Modeling Consortium
This collection of papers was in collaboration with The New York Academy of Sciences Nutrition Science program.