Rochester Medicine | 2018 Volume 1

UNIVERSITY OF ROCHESTER MEDICAL CENTER

No Boundaries: The Spirit and Science of Lynne Maquat

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SCHOOL OF MEDICINE AND DENTISTRY

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2018 VOLUME 1­

On the cover More than four decades of persistence fueled Lynne Maquat’s discovery and understanding of nonsense-mediated mRNA decay (NMD), one of the most prominent surveillance systems in the body protecting against mistakes in gene expression. She and other researchers are now working toward a deeper understanding of NMD-related mechanisms to inform development of a new class of drugs to treat hundreds of genetic disorders. Pictured here on her way to a lecture at New York City’s Rockefeller University, the J. Lowell Orbison Endowed Chair and Professor in the Department of Biochemistry and Biophysics teaches and mentors up-and-coming scientists in Rochester and around the world.

Photo by Matt Wittmeyer

POINT OF VIEW Senior associate dean for Medical Education David Lambert, MD, takes a selfie with first-year medical students and dean Mark Taubman, MD, on the University quad after the Dr. Robert L. & Lillian H. Brent White Coat Ceremony in August.

Photo by J. Adam Fenster

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I

t brings me great pleasure to bring attention in this issue to the investigative work of Lynne Maquat, PhD, the J. Lowell Orbison Endowed Chair and Professor in our Department of Biochemistry and Biophysics. Lynne is an extraordinary scientist who has worked tirelessly behind the scenes for more than 40 years to unearth answers in the field of RNA biology.

Her spot in the limelight—as she continues to garner major awards from the most esteemed scientific societies in the world—is well-earned. Without question, her work represents a turning point in the understanding of gene expression that has catapulted science forward in the quest to cure disease.

Like so many of our faculty researchers, Lynne admits to “giving a large chunk of her life” to science. Yet, it is evident through her story how integral the pursuit of discovery is to her character—and we are better for it.

She is driven to solve puzzles that have mystified many other scientists, in order to fuel the creation of new treatments for devastating genetic disorders.

Continuously funded by the National Institutes of Health, Lynne represents the heart of our medical school in her desire

to influence, inspire, and teach others in Rochester and around the world.

You will also read about how our Orthopaedics Residency program has innovated to align with how the specialty is changing, the many ways residents learn today, and what they need to feel inspired and supported in their field. This is one example of how all of our residency programs are evolving to make us one of the best places to learn in the country.

Elsewhere in the magazine you will find stories of our community-minded medical students, our multi-talented residents, doctoral students and alumni, and the worldrenowned work of our faculty, past and present. Those we have sadly lost have passed a torch of fortitude, compassion, curiosity and creativity that burns bright for our students today and for years to come.

What do you think?

Email the Editor christine_roth@urmc.rochester.edu

Write to us! Rochester Medicine welcomes letters from

Submit Class Notes RochesterMedicineMagazine@urmc.rochester.edu

Write to Us Rochester Medicine magazine University of Rochester Medical Center 601 Elmwood Avenue Box 643 Rochester, New York 14642

Mark B. Taubman, MD CEO, University of Rochester Medical Center Dean, School of Medicine and Dentistry

Senior Vice President for Health Sciences

readers. The editor reserves the right to select letters for publication and to edit for style and space.

Brief letters are encouraged.

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CONTENTS

4 Students Care for City’s Most Vulnerable

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Medical Rounds

Cover Story 14 No Boundaries: The Spirit and Science of Lynne Maquat, PhD 30 Orthopaedics Program Innovates to Embrace Changes in the Field

40 Neuroscience Grad Student Paints the Brain

42 Philanthropy

44 Faculty News

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Arthur J. Moss, MD, Tribute

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In Memoriam

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Alumni Spotlight: Seymour I. Schwartz, MD, FACS

Class Notes

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40 Rochester Medicine is published by: The University of Rochester Medical Center, Department of Communications, in conjunction with the Department of Alumni Relations & Advancement

Editor Christine Roth

For questions or comments, contact:

Art Direction & Design Kathleen Mannix

Dept. of Alumni Relations and Advancement

Feature Photography

John Myers John Schlia Jeff Witherow Matt Wittmeyer (cover story)

for the School of Medicine and Dentistry

B. Chip Partner

Comments on this issue, e-mail:

for the School of Medicine and Dentistry

Assistant Vice President and Director of External Communications, URMC

300 East River Road, Rochester, NY 14627 Phone 800.333.4428 585.273.5954 Fax 585.461.2081

RochesterMedicineMagazine@urmc.rochester.edu Find us on facebook at: www.facebook.com/urmc.education ROCHESTER MEDICINE | 2018 – V1

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Students Care For City’s Most Vulnerable More than 60 medical students a year take part in volunteer programs that bring health care services to those who need it most: Rochester’s homeless community, and others living in poverty or lacking access to care.

Medical students in the URWell program operate three free clinics at Asbury Methodist Church, St. Joseph’s Neighborhood Center, and St. Luke’s Tabernacle Church. Under faculty advisement, students provide acute care for minor injuries, work physicals, flu vaccinations, health screenings, and referrals to other health services and community resources.

“We have really worked hard to embed our services in the neediest areas of the city,” says student Jonathan Lin (MD ’18), clinic director at the program’s newest St. Luke’s location. “We are particularly trying to reach out to the city’s large Spanish-speaking community, where there are major gaps in care. For many of the people we see, this is the first time they’ve had a health exam in years.”

Student Stephen Hassig (MD/MBA ’20), directs the Street Outreach program which goes a step further by reaching out to serve the area’s homeless. While many of their visits are made on foot—in order to visit tucked-away spots where individuals live in tents or other structures—the students also drive a specialized van to bring care to city neighborhoods. Retrofitted with exam tables, equipment, and supplies, the van was acquired two years ago through community donations.

Students are able to treat everything from frostbite to chronic conditions like diabetes and hypertension.

“This opportunity has challenged me to put myself in uncomfortable situations, with the ultimate goal of helping my fellow man. How could I turn that down?” says Hassig. “I saw this as an opportunity to have a positive impact on people in the Rochester community while also utilizing the skills and knowledge I gain through my studies. Real-life cases and conversations help cement lecture concepts and make them much easier to remember.”

Hassig and his Street Outreach colleagues also pay regular visits to Rochester’s House of Mercy homeless shelter.

“On my first outing, I was amazed at how readily people opened up once I explained I was there to talk about their health concerns,” he says. “The homeless are all too often pushed aside, discredited and stigmatized. When someone takes the time to sit down and talk to them, their response is palpable.”

URWell and the Street Outreach program are overseen by the medical school’s Center for Advocacy, Community Health, Education and Diversity (CACHED), and depend upon community donations to operate. For more information, contact CACHED director Adrienne_Morgan@urmc.rochester.edu.

Photos by Jeff Witherow, Catholic Courier

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LETTERS TO THE EDITOR

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always enjoy reading updates about Rochester. I am writing about the Rochester Medicine issue 2017 Volume 1, about a topic commented on before. Rochester makes a big deal about its diversity issues, but it’s really lip service it seems: There was a nice issue about diversity. But the current issue lead articles listed on the Table of Contents page are all about men.

Then pages 78-79 really drive it home. Five out of five of the endowed professors are men. It’s really shocking and disappointing.

Stephanie Wragg (PhD ’96)

G

reat work with Rochester Medicine. You’ve transformed it into a magazine that combines substantive articles with informative notes about faculty work (who don’t often receive top billing) that might otherwise be unknown to alumni.

Paul Griner (MD ’59, Res ’65)

YOUR SUPPORT MAKES A DIFFERENCE While medical schools across the country saw more than a 30% increase in student debt over the past decade, in comparison, the School of Medicine and Dentistry only saw a 10% increase. This is a direct result of the robust scholarship support from our generous donors.

With the increasing costs associated with attending medical school, scholarship support is more crucial than ever.

Thank you for your generosity and providing opportunities for our students that otherwise might not be possible.

Visit rochester.edu/giving/scholarships to make a gift today.

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MEDICAL ROUNDS

URMC Tapped as National Research Coordinating Center A $19 million award from the NIH’s National Center for Advancing Translational Sciences (NCATS) has established URMC

as the coordinating center for translational research taking place at more than 50 institutions across the country, and will help URMC researchers in their ongoing work to turn scientific discoveries into health benefits faster.

The grant establishes a Center for Leading Innovation and Collaboration (CLIC) within CTSI, a national hub to support clinical and translational investigators that will fuel collaboration and provide access to training materials, research tools, and data sets.

URMC’s CTSI was one of the first 12 institutions in the nation to receive NIH funding to support the work of

biomedical scientists, and since its inception in 2006, has received nearly $105 million in NIH funding. In turn, it has supported 98 trainees and funded 198 projects. CTSI-supported scientists have gone on to secure $102 million in external funding.

“This will allow our CTSI to increase its impact as well as the impact of over 50 of the nation’s top biomedical institutions working to bring new knowledge to everyday care,” said Mark Taubman, MD, Medical Center CEO and dean of the School of Medicine and Dentistry.

Watch a video of how the CTSI benefits URMC researchers: http://bit.ly/clicprogram

Golisano Children’s Hospital Opens New Operating Rooms, PICU In late 2017, Golisano Children’s Hospital celebrated the completion of Phase II construction on its fourth and sixth floors.

The $45 million endeavor was made possible by thousands of donations, and includes six new pediatric operating rooms in the William and Mildred Levine Pediatric Surgical Suite, the Clay E. and Rita M. Buzzard Pediatric Cardiac Cath Lab Suite, a gastroenterology surgical procedure suite, 23 new private pre-op and post-op recovery rooms, and the relocation of 12 ICU and 10 general care pediatric beds, plus the addition of six new pediatric ICU beds.

With more than 20,000 pediatric surgeries performed each year, Golisano Children’s Hospital’s pediatric operating capabilities now surpass other regional facilities and are on par with children’s hospitals in the country’s largest cities.

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MEDICAL ROUNDS

Neuroscience

URMC Joins Landmark Study of Childhood Brain Development URMC is taking part in the largest-ever study of brain development and child health. The Adolescent Brain Cognitive Development (ABCD) Study will follow the biological and behavioral development of more than 10,000 children nationwide from age 9 through early adulthood.

Created by the NIH, the study will evaluate the developmental period to better understand how children’s experiences impact brain maturation and other aspects of their lives, including academic achievement,

social development, behavior, and overall health.

“Adolescence is a time of extraordinary physical, emotional, and intellectual growth,” said John Foxe, PhD, the Kilian J. and Caroline F. Schmitt Chair in Neuroscience and principal investigator of URMC’s ABCD Study. “There is a great deal we don’t know about how experiences such as participation in sports or music programs, screen time, sleep patterns, and long-term exposure to

medications and stimulants impact transition to adulthood.”

URMC joins 20 other national study sites and will receive an expected $1 million boost in federal support per year over the next 10 years. URMC will seek to recruit 275 local children, and their parents, to take part in interviews, surveys, games and puzzles to measure cognitive function. Every two years, the children will undergo MRIs to collect detailed images of their brain structure.

Musician’s Story Draws Eyes (and Ears) to Neuroscience Advances Music teacher Dan Fabbio, and a team of URMC surgeons and neuroscientists, spent several weeks last fall in the national spotlight when the case of Fabbio’s brain tumor removal was published in the journal Current Biology.

The story—which drew broad attention from mainstream and social media—described how Fabbio played his saxophone in the OR while surgeons worked to preserve the part of his brain responsible for music function. The procedure and subsequent studies have shed new light on how music is processed in the brain.

Ernest and Thelma Del Monte Distinguished Professor in Neuromedicine and Chair of Neurosurgery Webster Pilcher (MD/PhD ’83, Res ’89), removed the benign mass from the 25-year-old’s brain in 2015. But before it took place, Fabbio underwent translational brain mapping developed and conducted by Pilcher and Brad Mahon, PhD, associate professor in the Department of Brain and Cognitive Sciences.

The mapping involves an individualized battery of tests and brain scans to identify the functions—such as motor control and language processing—that could be impacted by surgery.

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“The particular location at a fine-grain level of a given function can vary sometimes up to a couple centimeters from one person to another,” said Mahon.

To assess music ability, Elizabeth Marvin (MA/ESM ’81, PhD/ ESM ’89), professor of Music Theory at the Eastman School of Music, developed cognitive musical exercises that Fabbio performed while researchers used functional MRI to pinpoint brain areas crucial to music and language processing, and create a three-dimensional map for the surgeons.

Fabbio was directed to play his saxophone during the procedure to ensure that he would preserve his performing ability. A Korean folk song, modified to be played with shorter and shallower breaths, was selected to address deep-breathing limitations.

Fabbio, who has since recovered and returned to teaching, “played the song flawlessly, and when he finished the entire operating room erupted in applause,” said Marvin.

To watch a video detailing Fabbio’s story, visit: http://bit.ly/danfabbio

Exploring Link Between ‘Dirty’ Brains and Alzheimer’s A $3.2 million grant from the National Institute on Aging is bringing together URMC biomedical scientists and UR mechanical engineers to develop a detailed understanding of the brain’s waste removal system. The research holds major implications

Telemedicine as Effective as In-Person Care for Parkinson’s The Connect.Parkinson project—a URMCled program that uses in-home video conferencing to connect neurologists with Parkinson’s disease patients—has shown telemedicine to be equally effective as in-person doctor visits. Published in Neurology, the study represents the first national randomized-controlled clinical trial of telemedicine for Parkinson’s, and points to a new way to improve access to care for people with the disease.

for diseases like Alzheimer’s that occur when the glymphatic system breaks down and toxic proteins accumulate.

Co-director of the Center for Translational Neuromedicine Maiken Nedergaard, MD, DMSc, and her colleagues first described the brain’s glymphatic system in 2012, demonstrating how cerebral spinal fluid is pumped into brain tissue to flush away waste. Subsequent research has shown that the glymphatic system is more active during sleep and can be damaged by

“Virtual house calls for chronic diseases like Parkinson’s are not only as effective as in-person care, but the technology has great potential to be applied more broadly,” said lead author Ray Dorsey, MD, MBA, the David M. Levy Professor in Neurology.

“We now have the ability to reach patients anywhere, but the promise of telemedicine won’t be fully realized until changes are made in Medicare policy.”

Roughly 40 percent of people with Parkinson’s disease do not see a neurologist soon after diagnosis, increasing their risk of falls, hospitalization and death. Distance and disability are the top two barriers to care because most movement disorder specialists

stroke and trauma.

The grant supports collaboration between Nedergaard’s lab and John Thomas, PhD, Douglas Kelley, PhD, and Jessica Shang, PhD, experts in the field of fluid dynamics within the Department of Mechanical Engineering. They are also partnering with Ali Ertürk, PhD, at the Institute for Stroke and Dementia Research at Ludwig Maximilians University of Munich.

Ertürk and colleagues developed a method that alters the chemistry of biological tissue in mice, essentially rendering them transparent, so researchers can more easily observe the glymphatic system.

are located in large urban areas and most Parkinson’s patients live in suburban and rural areas and have impaired walking and driving ability.

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MEDICAL ROUNDS Neuroscience

Glial Cell Dysfunction a Culprit in Schizophrenia URMC researchers have identified a culprit behind the wiring problems in the brains of people with schizophrenia. When human brain cells generated from individuals diagnosed with childhood-onset schizophrenia were transplanted into mice, the animal’s nerve cell networks did not mature properly and the mice exhibited the same anti-social and anxious behaviors seen in people with the disease.

“The findings argue that glial cell dysfunction may be the basis of childhood-onset schizophrenia,” said neurologist Steve Goldman, MD, PhD, co-director of the Center for Translational Neuromedicine and lead author of the study published in Cell. “The inability of these cells to help nerve cells build and maintain healthy and effective communication networks appears to be a primary contributor to the disease.”

Glia, which include astrocytes and oligodendrocytes, play a critical role in developing and maintaining the brain’s complex network of neurons. Astrocytes are the brain’s principal support cells, facilitating communication between neurons at the synapses by regulating the flow of glutamate and potassium, and enabling neurons to “fire.” Oligodendrocytes produce myelin, the fatty tissue surrounding the axons connecting nerve cells. Both cells are produced by the glial progenitor cell (GPC).

At left is an astrocyte from a healthy brain; at right an astrocyte from a patient with schizophrenia.

myelin-producing cells and impairing signal In the study, researchers obtained skin transmission between the neurons. Similarly, cells from individuals with childhood-onset astrocyte development was slowed and cells schizophrenia and reprogrammed them were ineffective in guiding the formation of to create induced pluripotent stem cells neuron connections. The astrocytes also did (iPSC) which, like embryonic stem cells, not mature properly and became misshapen, are capable of giving rise to any cell type failing to support neuron signaling functions. in the body. Using a process developed by Researchers observed that mice with the Goldman lab, the team manipulated the glial cells from individuals diagnosed with iPSCs to create human GPCs. schizophrenia were more fearful, anxious, When transplanted into the brains anti-social, and had more cognitive deficits of neonatal mice, the human GPCs than mice with glial cells from healthy out-competed the animal’s native glia, people. They also identified a number of glial resulting in mice with both animal neurons gene expression flaws—appearing to create and human GPCs. chemical imbalances and disrupt neuron Researchers then observed that communication—which could represent new the development of oligodendrocytes therapy targets. was delayed, causing a shortage of

“Code Blue” Equals Lower Survival for Cancer Patients Patients with advanced cancer who suffer cardiac arrest in the hospital have a survival rate of less than 10 percent—half the rate of patients without cancer—according to a study by URMC researchers.

The data, published in the Journal of Oncology Practice, helps clear up some myths about cardiac arrest survival and may be a guidepost for hospitalized cancer patients and families when considering DNR orders, said Jeffrey T. Bruckel, MD, MPH, a third-year post-doctoral fellow in Cardiology who led the research.

Rochester researchers and collaborating institutions used a nationwide resuscitation registry to evaluate survival after cardiac arrest of more than 47,000 people at 369 hospitals.

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Patients who were in for surgery (before, during, and after), emergency treatment, rehabilitation, or treatment from cardiac catheterization labs or interventional radiology were excluded from the study, as were patients with implantable defibrillators.

Of the 47,157 patients who experienced cardiac arrest, 6,585 or 14 percent had advanced cancer at the time of the arrest.

Researchers also found no evidence that patients with advanced cancer receive less aggressive resuscitation care.

The average time doctors worked to resuscitate all patients (cancer and non-cancer) ranged from about 22 to 24 minutes, the study showed.

However, after cancer patients were successfully resuscitated, they more often signed DNR orders during the next 48 hours.

Ca ncer

A Gene Signature for High-Grade Breast Cancer?

Professor of Pathology and Laboratory Medicine Xi Wang, MD, who reported her findings in Human Pathology, analyzed hundreds of breast tissue samples and hypothesized that an alteration in the p53 gene might be the beginning of a cell’s cascade to becoming fully cancerous.

P53 is a well-known tumor-suppressor gene. When it’s acting as it should, p53 keeps cancer at bay. But when it is mutated, p53 no longer suppresses cancer cells. It’s frequently mutated in lung cancer and also commonly mutated in a type of high-grade ovarian cancer. In breast cancer, the p53 mutation is detected in less than 25 percent of cases, Wang said, but the frequency is much higher in triple-negative

breast cancer, which is much harder to treat.

Her latest research looked at normal tissue samples from women who also carried the BRCA1 or BRCA2 genetic mutations, which increases the chance of getting breast cancer by more than 50 percent, and significantly boosts the likelihood that breast cancer will be the triple-negative subtype. Results showed that p53 is more frequently altered in the seemingly “normal” breast tissue in BRCA carriers, compared with the general population. This may help to explain why BRCA carriers are at much higher risk for aggressive cancer.

Wilmot Among First to Offer FDA-Approved CAR T-cell Therapy URMC’s Wilmot Cancer Institute is among the first sites in the world to offer CAR T-cell therapy to adults with aggressive lymphoma. The engineered gene therapy is one of the most powerful cancer treatments to emerge in recent years.

In 2017, the FDA approved Kite Pharma’s therapy, Yescarta, which boosts a patient’s immune system to seek and kill the cancer cells involved in diffuse large B-cell lymphoma, an incurable blood cancer.

“This is potentially transformative for patients with relapsed, aggressive lymphomas who have few other options,” said Wilmot director and Samuel E. Durand Chair in Medicine Jonathan Friedberg, MD, MMSc. Wilmot continues to be involved in clinical research to apply CAR T-cell therapy to additional types of lymphoma and leukemia, multiple myeloma, and some solid tumors.

Complex Biology, Gender Differences, in Kidney Cancer A URMC study is believed to be the first to describe the unique role of androgens in kidney cancer and suggests that targeting the androgen receptor (AR) is an approach worth further investigation.

Led by senior author Chawnshang Chang, PhD, the George Hoyt Whipple Distinguished Professor of Pathology, the study published in Nature Communications shows that androgen signaling can either stimulate or suppress kidney tumor cells’ movement to other locations in the body.

Chang’s lab conducted an epidemiology survey of nearly 4,000 cases of kidney cancer in China, and found that, generally, males were almost three times as likely to get kidney cancer as females. Among those

whose cancer spread to the lungs within 12 months, the male-to-female ratio jumped to nearly five to one. The gender differences were much less significant among patients whose cancer spread to lymph nodes versus the pulmonary system, presumably because the cancer cells contained fewer androgen receptors.

The next phase of their research included studying human cells and tissues to understand the signaling mechanisms

through which AR proteins interact with other known cancer-associated genes to enhance or reduce metastasis.

“In kidney cancer, many studies have provided conflicting information,” Chang said. “In some cases AR expression has been associated with less malignancy. We were able to begin to sort out AR’s function in this one disease, showing that AR-positive kidney tumors are more likely to spread to the lungs and AR-negative tumors are more likely to spread to the lymph nodes.”

Chang’s lab has also shed light on the duality of AR’s role in different cancers. For example, AR signaling can enhance bladder cancer cell invasion but suppress prostate cancer cell invasion, he has found.

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MEDICAL ROUNDS IMMUNOLOGY

New Tool to Fight Antibiotic Resistance on Horizon URMC researchers are developing a tool to help physicians more accurately prescribe antibiotics and reduce the number of antibiotic resistant infections, which claim 23,000 U.S. lives each year. Scientists from the NIH-funded Respiratory Pathogens Research Center (RPRC) identified 11 genetic markers in blood that accurately distinguish between viral and bacterial infections.

The finding, published in the journal Scientific Reports, was based on clinical data and microbiologic tests performed on a group of 94 adults hospitalized with lower respiratory tract infections. Led by Ann R. Falsey, MD (Flw ’91), professor and interim chief of the Infectious Diseases Division, in collaboration with Thomas J. Mariani, PhD, professor of Pediatrics and Biomedical Genetics, the study used complex genetic and statistical analysis to correctly classify patients with bacterial infections 80 to 90 percent of the time.

“It’s extremely difficult to interpret what’s causing a respiratory

tract infection, especially in very ill patients who come to the hospital with a high fever, cough, shortness of breath and other concerning symptoms,” said Falsey. “My goal is to develop a tool physicians can use to rule out a bacterial infection with enough certainty that they are comfortable, and their patients are comfortable, foregoing an antibiotic.”

Falsey’s project was one of 10 semifinalists in the Antimicrobial Resistance Diagnostic Challenge, a competition sponsored by the NIH and the Biomedical Advanced Research and Development Authority.

Selected from 74 submissions, she received $50,000 to continue her research and develop a prototype diagnostic test, such as a blood test, using the markers her team identified.

Falsey, who co-directs the RPRC, and Mariani say the main limitation of their study is the small sample size and the fact that genetic classifiers selected from the study population may not prove universal to all patients.

PSYCHI ATRY

Earlier School Start Times May Increase Risk of Adolescent Depression Teenagers with school starting times before 8:30 a.m. may be at higher risk of experiencing depression and anxiety due to compromised sleep quality, according to a study led by clinical assistant professor of Psychiatry Jack Peltz, PhD. Published in Sleep Health, it reinforces the theorized link between sleep and adolescent mental health, and is among the first to show that school start times have a critical impact on adolescent sleep and daily functioning.

“This is the first study to look at how school start times affect sleep quality, even when a teen is doing everything else right to get a good night’s sleep,” said Peltz. “Earlier school start times seem to put more pressure on the sleep process and increase mental health symptoms, while later school start times appear to be a strong protective factor for teens.”

About 90 percent of high-school-aged teens get insufficient sleep on school nights, or barely meet the American Pediatric Association’s recommendations of 8-10 hours. Among other interventions (i.e. limiting electronic use before bed), school start times have become a critical point of interest.

Peltz and colleagues collected data from 197 students between the ages of 14 and 17. Children and parents answered baseline questions about sleep hygiene, socioeconomic status, circadian chronotype, and school start times. For seven days, students reported on their daily sleep hygiene, sleep quality and duration, and depressive/anxiety symptoms.

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Results showed that good baseline sleep hygiene was associated with lower average daily depressive/anxiety symptoms, and levels were even lower in students with school start times after 8:30 a.m.

However, students with good baseline sleep hygiene and earlier school start times had higher average daily depressive/anxiety symptoms.

Rochester Model Keeps Mentally Ill Out of Jail and in Treatment People with mental illness are more than four times as likely to be arrested than other adults, and account for nearly 20 percent of the U.S. prison population. Behind bars, they often wait months to receive mental health treatment, if any.

Now a URMC intervention has been shown to reduce the population’s criminal convictions, jail time, and hospitalizations by roughly 50 percent, while keeping them in treatment twice as long as comparison programs.

The Rochester Forensic Assertive Community Treatment (R-FACT) model, developed 25 years ago by professor of Psychiatry J. Steven Lamberti, MD (Res ’87), and his colleagues, hinges on collaboration and shared problem-solving between mental health and criminal justice systems. In a three-year, randomized-control study published in Psychiatric Services, the R-FACT model withstood rigorous examination.

“Our research suggests it’s possible to prevent criminal recidivism among people with even the most severe mental illnesses and substantial criminal histories,” said Lamberti, principal investigator. “We found that by combining the expertise of mental health and criminal justice professionals in a certain way, we can promote both individual health and public safety.”

The number of mentally ill inmates nationwide began to climb with the downsizing of U.S. psychiatric hospitals in the 1980s. The Rochester Psychiatric Center, for example, once housed as many as 3,000 patients, but serves only about 100 today.

Lamberti initially believed the solution to the high rate of incarceration (often involving the same individuals repeatedly) was to give them more mental health treatment. With county funding in 1995, he assembled a team of psychiatric clinicians, social workers, and case managers to make “house calls” on inmates and ex-offenders across the Rochester area.

Other American cities developed similar outreach programs, all later shown to be effective at reducing hospitalizations, but not criminal involvement. In fact, the close monitoring of offenders and timelier

reporting of criminal infractions to the justice system resulted in higher recidivism.

Lamberti gradually turned his attention to understanding the “criminogenic risk factors” of mentally ill individuals—antisocial personality, criminal thinking, social support for crime, and substance abuse—and how these combine with issues like psychosis, paranoia, cognitive impairment and trauma to make people more vulnerable and less responsive to standard correctional intervention.

“The key to preventing recidivism is to engage these individuals in interventions that target the specific things driving their involvement with the criminal justice system,” he said.

Engaging individuals in treatment, however—especially those resistant or fearful of it—posed the greatest challenge.

After several years of studies, focus groups, and trial and error, the R-FACT prototype evolved, which uses legal leverage to engage individuals in mental health treatment that targets their criminogenic risk factors.

“Legal leverage is the appropriate, respectful use of authority to guide people toward engagement,” he said. “It requires

getting mental health and criminal justice professionals to problem-solve and consider therapeutic alternatives to punishment.

Our clients are men and women who are demoralized and discouraged, and need more rewards than sanctions.”

The Hon. Jack Elliott, a Rochester City Court Judge, one of two judges who took part in the study, said the program worked because of the high level of communication between judges and R-FACT team members, and the ability for individuals to be seen immediately by mental health providers upon court recommendation.

“Prior to that, people had to wait six weeks or more,” said Elliott. “But with FACT, they’re in treatment within a week, and the provider was always in court, so they knew someone was looking out for them. I met with the treatment team before and after court appearances to get straight information about each person. If they were doing well, I could reinforce that, give them praise, and if they were screwing up, I could address them in a very factual way.”

Lamberti and colleagues are working to help other cities adopt the model.

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Cover Story: No Boundaries Lynne Maquat No Boundaries

Illustration by John Cammarosano/K2

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No Boundaries: The Spirit and Science of Lynne Maquat

by Emily Boynton and Christine Roth

“Beam me up, Scotty!”

The famed Star Trek phrase sped through 17-year-old Lynne Maquat’s head while standing anxiously in front of her high school classmates in the spring of 1970. She was about to give a dreaded final presentation in a public speaking course, and prayed that she might be magically transported to the Starship Enterprise, or at least, that the right words would find their way from her brain to her lips.

Fast-forward to October 2017, and all eyes are on her again as she speaks before more than 200 doctors and scientists at one of the oldest and most prestigious medical lectures in the country.

There is no trace of the shy girl—the first in her family to attend college—as she flawlessly summarizes more than three decades of RNA biology research in 30 minutes, engaging the Harvey Society Lecture audience at Rockefeller University with her quick wit and humor. There is no fumbling for words as she effortlessly explains how solving the vast and complex mysteries of gene expression may one day help to cure nearly every disease on the planet.

Impeccably dressed—as is her trademark—in an elegant, custom-tailored ball gown, Maquat could be any graceful woman laughing and mingling over cognac at the post-lecture reception in New York City.

But beneath her feminine, fashion-forward

exterior is a gritty and determined iconoclast.

She is living proof that doing things the hard way—defying doubts, exceeding expectations, and pushing boundaries— is the right way, and the only way for her.

Poised on one of the newest and most promising frontiers of discovery, Lynne Maquat, PhD, is boldly going where few scientists have gone before.

“Lynne has always done things that seemed counter to doctrine, things so strange that you think they just couldn’t happen,” says her friend and colleague Gregory Petsko, PhD, professor of Neuroscience in the Brain and Mind Research Institute at Weill Cornell Medical College. “But she believes in what she’s doing and never gets discouraged. Her science is rigorous and deep, and you’re a damn fool if you don’t believe her.”

Years of meticulous focus led to Maquat’s discovery of nonsense-mediated mRNA decay (NMD), one of the most prominent

surveillance systems in the body to protect against mistakes in gene expression that lead to disease. Maquat and other scientists are now working to gain a deeper understanding of the sophisticated mechanisms related to NMD, knowledge that is contributing to the development of new drug therapies for genetic disorders such as Fragile X syndrome, cystic fibrosis, and hundreds of others.

“Before Lynne, we really didn’t know how NMD worked,” says Joan A. Steitz, PhD, the Sterling Professor of Molecular Biophysics and Biochemistry at Yale University and an investigator at the Howard Hughes Medical Institute. “It was clear that this process was important…but it was a huge, looming question in the field.”

Solving that looming question, and a litany of subsequent accomplishments as a researcher and mentor, place Maquat at a table with the most influential scientists in the world.

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“I have given a very large chunk

of my life to science, but science also saved me.”

J. Lowell Orbison Endowed Chair and Professor in the Department of Biochemistry and Biophysics Lynne Maquat, PhD, in her URMC lab

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A member of the National Academy of Medicine (2017) and National Academy of Sciences (2011), she is the recipient of Canada’s Gairdner International Award (2015), the RNA Society Lifetime Achievement Award in Science (2017), and the Vanderbilt Prize in Biomedical Science (2017).

In February, she received the 2018 Wiley Prize in Biomedical Sciences, one of the highest international honors recognizing the work of researchers who improve the understanding of biological systems and processes, champion novel approaches, and challenge accepted thinking.

Indeed Maquat’s success flows from her courage to go against the grain of conventional wisdom and her willpower to “get back in the ring” any time the strength and validity of her science was questioned.

Now at the pinnacle of her career, she admits it’s not always pleasant to revisit her early years when she wasn’t as sure-footed as she is now in the highly competitive, male-dominated arena. But she acknowledges the lessons other aspiring scientists—men and women—might learn from her journey.

“I have given a very large chunk of my life to science, but science also saved me,” she says, adding that the solitary pursuit of answers—sometimes huddled over a microscope in a darkened laboratory until the wee hours of the morning—helped carry her through difficult chapters in her life.

“There were hard times when it would have been easy to quit, but I never retreated. My salvation was always my work, not as an escape, but as a portal to a better place.”

Her work, she explains, not only enabled her to support herself financially, but also to make amazing discoveries, train young scientists now running labs all over the globe, and work toward desperately needed therapeutics for complex diseases.

“Today I can pretty much go anywhere in the world and have friends,” she says. “How wonderful is that? What’s most important to me now is staying devoted to my science, and giving back as much as I can.”

At age 65, the exceptionally youthful J. Lowell Orbison Distinguished Service Alumni Professor in the Department of Biochemistry and Biophysics, seems to be just warming up for the next stage of her career.

“She’s like the Energizer Bunny,” says Robert H. Singer, PhD, professor in the department of Anatomy and Structural

Biology at Albert Einstein College of Medicine. “When other people bow out, she keeps going.”

While Maquat frequently treks to far-flung locales for speaking engagements, conferences, award ceremonies, and mentoring work, she calls Rochester home.

“Being a part of the larger University and city community and being able to interact with such highly accomplished people here, not only in science but in history, music, and art, is inspiring and so important to my perspective and vision,” she says. “When I

have space in my brain to be perceptive, the best ideas come through.”

Making Strides Whether crossing city streets, navigating hospital hallways, running her laboratory in Rochester or visiting others around the world, Lynne Maquat doesn’t “walk” anywhere—she strides.

Her slender 5’11” frame is in constant motion even while meeting in her alwaysopen-door office as she chews on a piece of gum, peers over her glasses at data, pecks

away at her standing computer keyboard, or rolls her chair across the floor to grab a folder from a teetering pile on her desk.

Her physical energy is surpassed only by her quick mind, which you can almost hear whirring like hummingbird wings as she dives from one topic to the next.

She runs a relatively small lab for a scientist who has produced a football-fieldsized list of 130 publications, 23 book chapters, and too-many-to-count editorials and presentations. She’s trained more than 50 post-doctoral fellows, undergraduate

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“The culture of Bill’s lab was definitely unusual for the times, and it was always one of encouragement, regardless of your gender.”

and graduate students who now work at institutions such as the National Cancer Institute, University of Texas Health Science Center, Pasteur Institute in Lille, France, A*STAR Institute of Medical Biology in Singapore, and the University of Geneva in Switzerland.

It’s an impressive resume for any scientist, let alone a woman who was told in grammar school that she wasn’t college material.

“If you had told me when I was younger that one day I would be giving the Harvey Society Lecture, first of all, I wouldn’t have known what it was, and second of all, I wouldn’t have believed you,” she says.

What’s a Scientist?

Growing up in the pastoral town of Easton, Conn., Maquat’s mother was a registered nurse and operating room supervisor, and her father an industrial mechanical engineer trained under the G.I. Bill. Her first inkling of an interest in science was apparent in her love of the outdoors, and her ability to recall the names of native birds, plants, and trees. In school however, she gravitated more toward the arts. She liked English and writing, became fluent in Spanish, and played piano and clarinet.

“I didn’t have the foggiest notion of what a scientist was,” she says.

Though she was a strong student on paper, her intellect was often overshadowed by her shyness around her peers and her teachers. “I would clam up when my fourth-grade teacher called on me, because I was afraid of her,” recalls Maquat.

Later, that same teacher told her mother that Maquat didn’t have what it takes to go to college, and should put it out of her mind.

“I often tell that story to high school students

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as a reminder to never allow themselves to be defined or held back by anyone,” she says.

Indeed, Maquat’s grades spoke for themselves, and she enrolled at the University of Connecticut-Storrs in 1970. It was there, studying under biochemist Stuart Heywood, PhD, that she was drawn to the beauty and mystery of science.

She was fascinated by the subject matter of Heywood’s Cell Biology course, and his studies of protein synthesis in embryonic chick muscles. When the course ended after her sophomore year, she desperately wanted to work in Heywood’s lab, but wasn’t sure if it was allowed.

“Finally I asked him—I think while looking down at my shoes—‘Um, can I work in a lab?’ He replied, ‘A lab?’ and I eventually squeaked out, ‘Well…your lab?’ To my shock and surprise, he said, ‘Sure!’”

From there, any self-doubt began to take a back seat to her hunger for knowledge while working long hours in Heywood’s lab. She was in awe of what was already known about the steps of eukaryotic protein synthesis and the experiments that could uncover new effectors of mRNA translation.

Completing her research thesis in cell biology, Maquat graduated magna cum laude in Biology, packed a small suitcase and boarded a flight to start grad school in Biochemistry at the University of Wisconsin-Madison in 1974.

With no car and very few belongings, she was shocked and thrilled to learn the university would cover her tuition and pay her a $4,000 stipend.

“If you aren’t following in the footsteps of someone who’s been involved in academics at this level, you have no idea what grad school actually involves,” she says. “I couldn’t

Maquat in the early ’80s believe they were going to pay me to learn and conduct research…to do what I loved to do.”

She was thrown for a loop however, when she didn’t get a spot in the lab of her choice.

Instead of studying RNA in human cells, she landed in a lab focused on RNA in E. coli.

But the lab’s principal investigator, William Reznikoff, PhD, persuaded her to stick it out.

While not the same as human cells, bacteria have a redeeming quality—they grow very fast. Maquat learned to use bacteria for many purposes, a process that helped her develop a level of technical precision she would call upon again and again in her career.

Reznikoff’s lab also gave her an opportunity that most others at the time did not.

“I’m old enough to have entered graduate school at a time when there were very few female faculty,” she says. “And the men in many scientific circles made no secret of the fact that they thought women did not belong there. That was the reality of the day.”

Reznikoff—whose wife Cathy was a scientist and daughter Sarah is now a university mathematician—was an exception.

He welcomed female grad students into his lab where they received equal respect and training as their male colleagues.

“The culture of Bill’s lab was definitely unusual for the times, and it was always one of encouragement, regardless of your gender,” says Maquat.

With Reznikoff’s guidance, Maquat earned her PhD in four-and-a-half years, and in 1979, chose to study RNA in human diseases as an NIH post-doctoral fellow in Wisconsin’s McArdle Laboratory for Cancer Research.

There, her advisor Jeffrey Ross, MD, now

professor emeritus of Oncology at Wisconsin, was working on human hemoglobin gene expression. It was in Ross’ lab that Maquat began to focus on beta0 thalassemia, a group of inherited disorders that reduce the body’s production of hemoglobin. Low levels of hemoglobin lead to a shortage of mature red blood cells and a lack of oxygen in the body, which can cause severe anemia, bone deformity, an enlarged spleen, slowed growth, heart problems, and other issues.

Like any young post-doc, Maquat had no idea where her investigations would lead.

“We just went where the research took us,” she says.

In 1980, the research took her to Jerusalem, Israel, to analyze bone marrow aspirates from four Kurdish-Jewish children with thalassemia major (Cooley’s Anemia).

Looking out at the tarmac before her first flight overseas, she was completely unaware that this trip would shape the trajectory of her science and career.

WATCH TO SEE A VIDEO ABOUT MAQUAT’S WORK, visit:

http://bit.ly/whatisrna

Making Sense of Nonsense The central dogma of biology is that genetic instructions in DNA are transcribed into messenger RNAs (mRNAs) that deliver the instructions to ribosomes, which then translate that information into the proteins that carry out myriad functions throughout the body. The production of mRNA is a crucial component of gene expression.

In simplest terms, disease is gene expression gone awry, and Maquat has devoted her career to elucidating one of the most important and incredibly complex aspects of gene expression: quality control.

As in most areas of life, mistakes in cells happen all the time. Humans have 20,000 protein-coding genes but are able to produce many more than 20,000 proteins through alternative pre-mRNA splicing. A single gene can generate multiple proteins by encoding a pre-mRNA from which various exons (including protein-coding regions) can be mixed and matched (alternatively spliced).

This ability to diversify greatly increases the margin of error, but fortunately, the human body has built-in systems to eliminate potentially harmful slip-ups.

Maquat is credited with discovering one of the most prominent of these quality control systems: nonsense-mediated mRNA decay, or NMD.

In blue are HeLa cells stained with DAPI (a dye that detects DNA and designates the nucleus), and in green is the RNAbinding protein, Staufen 1. This image shows that most of Staufen 1 resides in the cytoplasm of HeLa cells—outside the cell’s nucleus. Maquat’s lab seeks to gain a deeper understanding of the cytoplasmic steps of RNA regulation, mediated by Staufen 1, including the steps of mRNA translation and decay.

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“She gravitates toward

the most difficult, ambitious projects that she thinks will contribute new and significant insights to existing knowledge.”

With School of Medicine and Dentistry dean and URMC CEO Mark Taubman, MD, at the Harvey Society Lecture.

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One common flaw in gene expression is the introduction of an early “stop” signal.

Normally, this stop signal (termination codon) appears at the end of the genetic instructions in mRNA for protein synthesis to indicate that the instructions have been read start-to-finish and that all of the information has been translated into a full-length, functional protein.

Early stop signals, called “premature termination codons” or “nonsense codons,” prevent the genetic instructions in mRNA from being read completely. Consequently, protein synthesis is cut short, resulting in an incomplete or truncated protein that doesn’t function normally, and worse, could be toxic.

Similar to installing a sink with only half of the instructions, or baking a cake with half of a recipe, premature termination codons lead to undesired, and oftentimes dire, results in a cell.

Before Maquat officially arrived on the scientific scene in 1981 with her breakthrough manuscript, “Unstable beta-globin mRNA in mRNA-deficient beta0 thalassemia,” published in Cell, scientists didn’t understand the molecular cause of this disease.

Heading her own research lab, Maquat then set out to define the mechanism that helps cells detect the difference between a premature stop signal and a normal stop signal, and extended her studies to other

diseases. Her studies de-mystified NMD’s crucial role in gene expression, revealing how it works to identify and eliminate mRNAs containing premature termination codons and thereby prevents production of truncated proteins. Her paper also opened the floodgates for scientists to pursue an entirely new and auspicious field of research into how mRNAs are monitored and regulated, with Maquat leading the way.

“Before Lynne, nobody could come up with a logical explanation for how NMD worked,” says colleague Steitz, who follows Maquat’s work at Yale. “When everyone else abandoned ship, she stuck with it, and slowly made significant advances. It was hard, and at times the answers weren’t coming, but she really wanted a scientific explanation, so she kept at it. I admire her persistence, and her uncanny ability to keep thinking of the next experiment that would lead to answers.”

A Lucky Bout of Food Poisoning Maquat’s novel understanding of NMD’s role in human cells had its genesis in her 1980 study of bone marrow aspirates from four children in Jerusalem suffering from thalassemia major, the most severe form of thalassemia. Still a young researcher in Jeffrey Ross’ University of Wisconsin lab, Maquat set out to learn why the children’s marrow contained no beta-globin protein.

However, the study almost ended before it even began.

After retrieving and spending days working up the bone marrow samples provided by Israeli hematologist Eliezer Rachmilewitz, MD, Maquat stopped for lunch with a colleague at Israel’s Weizmann Institute of Science in Rehovot on her way to the Ben Gurion airport.

“We ate at an outdoor café in the blazing heat, and my colleague suggested I try the pickles, which were delicious,” she recalls.

“However, I realized later that they had probably been marinating in the hot sun for who knows how long.”

On the cab ride to the airport, Maquat’s stomach began to revolt and she fell ill with what was most likely food poisoning.

“I got to the airport, feeling horrible, just wanting desperately to get home, with my precious RNA and DNA samples sealed tightly in a Styrofoam container,” she says. “But after getting my boarding pass, security officers wanted to search the container, which would have been very bad. Everything in a tube looks dangerously foreign to non-scientists, and they would have contaminated my samples.”

Fortunately, just as she was about to be violently sick again, security was momentarily distracted by a scuffle at another checkpoint, and Maquat bolted to the

bathroom, container in hand.

“I honestly wasn’t trying to escape them, but I had a real emergency,” she says.

It worked nonetheless. She quietly left the bathroom and proceeded to the gate unnoticed.

“Having food poisoning probably saved me and my samples from being detained,” she says. “The airline was very kind, and let me sit by the bathroom on the flight back to the states. I must have looked a complete wreck. When my Columbia University colleague met me at JFK airport, his first words were, ‘What the hell happened to you?’”

From Little World to Big Impressions Right before her trip to Jerusalem, Maquat’s 1980 publication in Proceedings of the National Academy of Sciences began turning heads in the scientific community, as it was the first to show that a human disease (beta+ thalassemia) could be due to a pre-mRNA splicing defect.

But her landmark study arose from the series of carefully executed experiments she conducted on the bone marrow samples she retrieved from Jerusalem. Published in Cell in 1981, it was the first demonstration of a human disease (beta0 thalassemia) caused by unstable mRNA.

Honors & Awards 2006

2010

2011

2015

2017

2018

Elected to American Academy of Arts and Sciences

Lifetime Achievement Award in Service, RNA Society

Elected to National Academy of Sciences

Canada Gairdner International Award (First winner from upstate New York)

Vanderbilt Prize in Biomedical Science

Wiley Prize in Biomedical Sciences

Lifetime Achievement Award in Science, RNA Society Elected to National Academy of Medicine FASEB Excellence in Science Award

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The ABC’s of NMD The genetic information in DNA is transcribed into mRNA. DNA

x

The mRNA makes its way from the nucleus to the cytoplasm where ribosomes, during the pioneer round of translation, inspect it for a premature termination codon (early stop signal). This signal will prevent the genetic information from being read completely, barring the formation of a full-length and functional protein.

If a premature termination codon is detected, the mRNA is flagged and destroyed, averting the creation of a shortened, potentially disease-causing protein.

If there is no premature termination codon, the mRNA will be remodeled, allowing it to deliver the genetic information to the ribosomes, so that normal protein will be made.

mRNA

Nonsense-mediated mRNA decay (NMD) is one of the most important “quality control” mechanisms within gene expression. It keeps the body from creating truncated proteins that lead to disease. NMD is a valuable safeguard, but it may not always function properly, and sometimes causes more harm than good. Maquat and other scientists are seeking to gain a deeper understanding of NMD and its many related mechanisms, and are exploring ways NMD can be manipulated with therapeutics to prevent and treat genetic diseases.

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Above, Maquat works with research assistant professor Tatsuaki Kurosaki, PhD. Though her lab is centered on NMD-related research, she also encourages lab members to pursue new areas of investigation.

At left, post-doctoral associate Hana Cho, PhD

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Maquat’s 1981 discovery marked the beginning of years of investigation to understand the NMD mechanism, and more than 35 years later, insights are still emerging. mRNA surveillance was, and still is, such a notoriously difficult field, beset with such time-consuming, mind-bending questions, that many scientists simply gave up in frustration. But not Maquat.

“She doesn’t like run-of-the-mill projects that aren’t going to add much,” says Reyad Elbarbary, PharmD, PhD, who recently finished his post-doctoral fellowship in Maquat’s Rochester lab, and is now an assistant professor in the Center for Orthopaedic Research and Translational Science at Penn State University College of Medicine. “She gravitates toward the most difficult, ambitious projects that she thinks will contribute new and significant insights to existing knowledge.”

Maquat has not only identified the act of molecular gymnastics that is called NMD, but—much like analyzing a successful

football play—she has identified the molecular “players,” and the routes and patterns they need to follow, for NMD to work properly.

Among her most noteworthy contributions is her discovery of the exon-junction complex (EJC), a splicing-dependent “mark” that tags an mRNA so the cell can define which termination codons are premature and should trigger NMD. She defined the 50-55-nucleotide rule, which determines which mRNAs containing premature termination codons are subject to degradation by NMD. She also discovered the “pioneer round of translation,” during which NMD occurs.

Despite what most of her peers now describe as “flawless” experiments, there were doubters along the way, including Maquat herself.

Einstein professor Robert H. Singer, PhD, first met a “ruminating” Maquat more than two decades ago in a café following one of her early presentations on NMD.

“She was nervous about how the presentation went and concerned about whether she’d be taken seriously,” Singer recounts.

“She asked me, ‘Do you think people will believe it?’ I told her to keep on going, and fortunately, she did.”

When contradictory data emerged, Maquat pushed forward, evaluating and addressing opposing analyses with thoughtful answers in published reviews. Her science was so precise and her understanding so thorough, it was difficult to argue against her.

“Lynne’s grasp of detail is unparalleled,” says Singer. “The level of specificity that she reaches in her research is beyond what most scientists are capable of doing, or want to do. She drives ideas into the ground to their ultimate conclusion.”

Just as the creativity of many artists and musicians is fueled by past relationships, Maquat says her relentless research focus began in the aftermath of a failed marriage in her early 30s.

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STATES

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COUNTRIES

Green indicates where she has attended conferences; given lectures or consultations; mentored students; and where past and present trainees originated or conduct research.

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“At that time I lived in my own little world,” says Maquat, who conducted much of her early research as the only RNA-centric biologist at Roswell Park Cancer Institute in Buffalo from 1982 to 2000. “I could seek guidance and encouragement from faculty members when I needed it, but other than that I worked in relative isolation with my grad students and post-docs. I didn’t have people questioning me, or telling me ‘no,’ or that an idea I had was crazy. I just put my head down and focused on what I thought was right.”

Only at scientific meetings did she emerge from her bubble to share her findings with the world. It was at those meetings and through peer-reviewed publications that she slowly began to make her mark.

Anita Hopper, PhD, professor of Molecular Genetics at The Ohio State University, recalls a presentation Maquat gave at an RNA Society meeting in Banff, Canada, more than 15 years ago.

Maquat presented on the pioneer round of translation, the stage of gene expression where NMD occurs.

“The talk was so beautiful and the experiments so smart, that the room fell silent,” says Hopper. “You could hear a pin drop. She nailed it, and everyone knew she had done something special.”

The Power and Promise of RNA In 2000, Maquat came to the University of Rochester as professor of Biochemistry and Biophysics at the School of Medicine and Dentistry. In 2007, she founded the Center for RNA Biology: From Genome to Therapeutics.

Taking note of her research skills and long-term productivity, the NIH transitioned one of Maquat’s two existing R01’s to a MERIT Award, which secures funding for her research and training through 2023.

As she continues to peel back the layers of understanding with respect to RNA biology, her work clarifies that while NMD evolved to

shield humans from innate mistakes, it has the power to cause harm, too.

Inherited and acquired mutations can also introduce premature termination codons. In fact, one-third of all genetic disorders are caused by mutations that result in a premature termination codon.

Many individuals with beta0 thalassemia have a nonsense mutation that introduces a premature termination codon in the gene encoding the beta-globin protein.

The premature termination codon springs the NMD machinery into action and the mRNA transcript for beta-globin protein is destroyed. No beta-globin protein is produced and patients can’t make hemoglobin.

Some individuals with cystic fibrosis are similar. A nonsense mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene leads to a premature termination codon and NMD follows. The CFTR protein, which is responsible for regulating the flow of salt and fluids in and

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Research assistant professor Maximillian Popp, PhD, pictured here with graduate student Bronwyn Lucas, says one of the best parts of working in Maquat’s lab is “being able to work independently and find our own niche.”

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out of cells, is defective or isn’t made. The result is the buildup of thick mucus and persistent lung infections that characterize cystic fibrosis.

In both of these cases, if you could override or stop NMD—for example, by efficiently suppressing the nonsense codon— normal, healthy proteins would be made and individuals wouldn’t be sick.

Thanks to 35 years of research by Maquat and others, scientists are beginning to put the mechanistic findings related to NMD to use to design treatments. Maquat and her team are focusing on the many diseases that are dominantly inherited because NMD fails to occur, despite the presence of a premature

termination codon.

“RNA presents an alternative universe of drug targets and gives us an opening to correct diseases that you can’t reach with conventional drugs,” says Charles Thornton, MD (Flw ’90, ’92), the Saunders Family Distinguished Professor in Neuromuscular Research, who is partnering with several groups to develop RNA-based therapies for myotonic dystrophy and ALS. “Much that’s being done in this area builds on Lynne’s work, and I count myself fortunate to be in the same institution, to benefit from her wisdom, and indirectly, from the supportive, collegial environment she helps to create.”

Therapies in development include

One-third of all genetic disorders are caused by nonsense mutations that result in a premature termination codon. small molecules inhibiting the core NMD machinery, and so-called “read-through” therapeutics that aim to turn early “stop” signals into “go” signals so that genetic instructions are read all the way through and full-length proteins are made. These treatments fit squarely into the domain of precision medicine, as they are based on the molecular underpinnings that lead to disease in the first place.

In the last several years, Maquat has discovered that NMD is a more dynamic pathway than originally thought. It also helps cells adjust to changes in their environment and more rapidly respond to certain stimuli.

For example, Maquat and Maximilian

Popp, PhD, a research assistant professor in her lab, found that exposing breast cancer cells to a molecule that inhibits NMD prior to treatment with doxorubicin—a drug used to treat leukemia, breast, bone and other cancers—hastens cell death. They speculate that blocking NMD primes cells for programmed death by boosting the activity of genes that respond to the cellular stress caused by chemotherapy.

The study, published in Nature Communications in 2015, is one of several that describe a role for NMD beyond quality control, raising the possibility that drugs targeting NMD could prove useful in other situations. As new information regarding NMD continues to emerge, Maquat believes it could lead to additional technological and clinical advances not yet imagined.

Preparing the ‘Next Wave’ As Maquat’s years of dedication to her research catapult her into the scientific spotlight, she remains intently focused on training and encouraging the next wave of scientists to even greater heights.

In her lectures and award acceptance speeches, she’s quick to acknowledge that her success wouldn’t be possible without the graduate students and post-docs who have shared her lab over almost four decades.

“They’re my lifeline and I’m theirs,” she says. “I expect a very high level of commitment from them, but they also get that from me.”

Being her trainee isn’t easy, but is an experience you won’t regret, say past lab members.

“When I first joined the lab we sat down in her office and she said, ‘I know that being demanding, and asking for all you can give me, is what brings results,’” recalls Dobrila Nesic, PhD, who studied in Maquat’s lab in the early ’90s. “She also told me, ‘I’ll put you on the right track and when you leave my lab you will have all the tools you need to succeed.’ And that’s true.”

Although Maquat may be considered a tough mentor, she leads by example and is intimately involved in the day-to-day happenings in the lab. Her office is situated within the lab so trainees can walk in any time to design experiments, discuss data, talk over possible explanations for unexpected results, work on a manuscript for publication,

or share anything else on their minds.

“My goal is to never leave a lab member without an answer to a problem for more than a day,” she says. “If it’s outside my expertise, I’ll find the person who would know the answer, so that problems are solved without delay, and work moves forward.”

Though her lab is centered on NMD-related research, she welcomes new areas of investigation as long as ideas are scientifically sound and testing methods are available.

“Lynne is open-minded and lets us pursue projects that we think are interesting, even if she’s not familiar with the area,” says Popp, who is studying how Staufen 1, a protein involved in regulating RNA, influences translation and the innate immune response in macrophages. “With her guidance we’re able to work independently and find our own niche.”

Nesic, a recently appointed lecturer at the Clinic for Dental Medicine at the University of Geneva, Switzerland, aptly describes the sentiment of many former lab members.

“I was lucky and unlucky to have her as my PhD mentor,” she says. “Lucky because that was my most successful scientific period, and unlucky because with time and different experiences I came to realize that she was not the norm, but an amazingly rare exception. It was a privilege to work with her, to experience her way of mentoring, to feel that incredible energy and drive to learn, discover, grow and develop as a scientist and as a person.”

In 2003, Maquat founded the University of Rochester’s Graduate Women in Science program to address the “leaky pipeline” in science: the disappointing fact that fewer women than men who earn PhDs in science actually use the degree in their careers.

Each month, the program hosts high-profile speakers who are using advanced degrees in traditional and non-traditional ways. Twice a year, members can apply for travel awards to attend a conference or seminar that will advance their careers.

In 2013, Maquat received the UR Presidential Diversity Award for her work. In 2014 she also received the Rochester Athena Award, presented annually by the Women’s Council of the Rochester Business Alliance.

It recognizes women who excel in their professions, give back to their communities, and inspire other women to lead.

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In the lab, Maquat expects “a very high level of commitment from my trainees, but they also get that from me.”

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Most of Maquat’s travels involve some form of mentoring, as well. As an example, every two years she attends a conference hosted by the International Center for Genetic Engineering and Biotechnology in Trieste, Italy. There, she teaches a course on RNA biology to graduate students from countries lacking strong histories in science, including countries in Africa, South America, and the Middle East. The sessions fill to the brim with students gravitating toward Maquat’s ability to make the content approachable and meaningful.

Since 2015, Maquat is also fast becoming an idol to high school and college students across Canada, where she visits often to inspire them toward science careers.

This past October she spoke to about 300 high-schoolers in Saskatchewan, where she opens each talk by telling them how life is very likely not going to happen the way you think it will.

“Did I think when I was a shy girl in high

school that one day I’d be talking about scientific research with high schoolers in Saskatchewan?” she says. “Not on your life.”

Going to the Dogs On her way to and from the Harvey Society Lecture at Rockefeller University, Maquat happily stops to greet every dog crossing her path on the New York City sidewalks—a practice that helps her make four-legged and two-legged friends in whatever city, state or country she’s in that day.

Last year, these places included Singapore, Crete, Prague, Bordeaux, Edinburgh and Oxford. Next up: Belgium, Italy, Germany, and Japan.

“There’s rarely a culture that doesn’t welcome me with open arms when I want to say ‘hi’ to their dogs,” she says.

Back in Rochester, long walks with her black Labrador Lia and trips to the gym and yoga studio are her recipe for good sleep, mental focus, and surviving the long winters.

Not surpringly, when she does take time off, Maquat prefers “adventure” vacations over lounging on a beach. Hiking the Himalayas, exploring ancient ruins, or captaining an 18-foot Hobie Cat are more her cup of tea.

The Joy is in the Challenge “There is no easy path to most things worthwhile,” Maquat says. “I never mind interesting work, although at times it can be very difficult to figure things out. To me, science is an area where the time and energy that we invest can return in amazing ways provided we are smart about what we do.

Science is like putting together a very large puzzle without being able to see all the pieces at once. And, if it’s not challenging, then where’s the innovation?”

To support research in the Maquat Lab, contact Dianne_Moll@rochester.edu or (585) 273-5506.

Enjoying a peaceful moment with her husband Mark and Labrador Lia. ROCHESTER MEDICINE | 2018 – V1

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Rewriting the Rules of Residency Training: Orthopaedics Program Innovates to Embrace Changes in the Field

by Barb Ficarra and Christine Roth

“Rochester has always been forward-thinking in its approach to clinical care, research, and education. We are committed to being a leader, not a follower, in the field of physician training.”

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– Paul Rubery, MD, Marjorie Strong Wehle Professor of Orthopaedics and Chair of the Department of Orthopaedics

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WATCH TO SEE A SLIDE SHOW OF ORTHO BOOT CAMP, visit: http://bit.ly/orthobootcamp

First-year residents use the arthroscopic surgical simulator in the DeHaven Skills Lab.

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Residency program director John Gorczyca, MD, demonstrates proper technique for fracture repair.

“It helps you In the late ’80s, when John Gorczyca, was working as an orthopaedic resident retain skills at Dartmouth-Hitchcock Medical Center, finding time to eat during his shift was an better when unexpected luxury. If he or his colleagues you’re not a deer saw food, they ate it, no matter what it was, because they didn’t know when they’d have in the headlights a chance to eat again. Long hours on duty could stretch into days, and Gorczyca often didn’t know when he’d be able to catch any in an operating shut-eye at the hospital, let alone sleep in his own bed. room.”

MD,

Like others in his class, Gregg Nicandri, MD, fought fatigue during hours-long lectures that sometimes put residents to sleep— even the unfortunate ones sitting in the first row. And, as a first-year resident at the University of Washington Medical Center in 2004, Nicandri would purchase raw pigs’ feet at the grocery store to practice his suturing techniques, anxious to acquire the fundamental skills that weren’t taught until his third year.

If you had told Gorczyca or Nicandri during their training that one day residents like them would have a healthier work-life balance—and be taught hands-on surgical skills in the first weeks of their residencies to boot—they probably would have thought to themselves, “When pigs fly.”

But that day has arrived, and both doctors have played a large part in helping these innovations take flight in Rochester. Not only have they rewritten the rules for orthopaedic

residency training at the School of Medicine and Dentistry, but their approaches are drawing attention from academic medical centers around the country.

Gorczyca, the Dr. C. McCollister Evarts Professor in Orthopaedics, is chief of the department’s Trauma division, and director of the residency program. Nicandri, an assistant professor, is an orthopaedic surgeon, a faculty instructor in the residency program, and a master instructor for the Arthroscopic Association of North America.

Both will assert, and their careers attest, that they received excellent preparation to become surgeons and teachers. They recall their own training as being the highest standard for the time, which wasn’t so long ago. Gorczyca completed his residency in 1993 and Nicandri in 2008.

But since then, a great deal has changed in how orthopaedic surgery is practiced and taught, including: •

•

•

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•

A shift from traditional, open surgeries to minimally invasive procedures that demand different skills; Increased emphasis on patient safety at academic medical centers nationwide, which can limit residents’ experience in the operating room; Federally mandated and/or independently imposed work-hour limits that have helped improve residents’ lifestyle and well-being, but can also mean less on-the-job learning; And, new regulations from the Accreditation Council of Graduate Medical Education (ACGME) that require more sophisticated, and more frequent, assessment and documentation of residents’ skills throughout their training.

Perhaps the biggest and most important change of all, however, is the residents themselves. Today they possess widely varying learning styles, have different definitions of what work-life balance means, and hail from far more diverse cultural and socioeconomic backgrounds than their predecessors.

“Residency programs like ours need to roll with the changes but also be tuned in to what’s coming around the corner, and what the expectations are going to be on these young physicians,” says Gorczyca. “It’s not ‘one size fits all’ anymore in terms of how you

URMC is a host site for The Perry Initiative, a national mentorship program that gives female high school, college, and medical students hands-on orthopaedics experience and encourages them toward the field.

Working to Bring More Women into the Field Although women account for approximately half of the medical students in the U.S., they represent only 13 percent of orthopaedic residents, and only 4 percent of the members of the American Academy of Orthopaedic Surgeons (AAOS).

Within URMC, 12 of 52 Orthopaedics faculty members (23 percent) are women, six of whom are teaching faculty in the residency program. Out of 42 total trainees, there are four female residents and one female fellow (8.2 percent).

These numbers continue to climb due in large part to the advocacy of department vice chair Judith Baumhauer, MD (MPH ’09), professor of Orthopaedics. One of the only female professors of foot and ankle surgery in the country, Baumhauer was the first woman named to the department’s faculty in 1995. She was also the first female president of the Eastern Orthopaedic Association (2009-10), the American Orthopaedic Foot and Ankle Society (2012-13) and the Board of

Directors of the American Board of Orthopaedic Surgery (2012).

Baumhauer was instrumental in establishing URMC as a hosting site for The Perry Initiative, a national program that gives female high school, college, and medical students early exposure to orthopaedics. For female residents, the program also develops valuable leadership and mentoring skills as they help instruct the younger students.

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train students, and we need to constantly evolve to keep up with rapid advancements in our field.”

Senior associate dean for Graduate Medical Education Diane Hartmann, MD, says the secret of Rochester’s success in physician training has always been “its ability to anticipate the needs of incoming residents, and stay ahead of the ways every specialty is changing. The Orthopaedic Residency Program is a perfect example of how residency programs across our Medical Center are evolving to make us one of the best places to learn in the country.”

Getting ‘Boots on the Ground’ Earlier Traditionally, up-and-coming surgeons hone their craft through apprenticeship: observing surgeries, applying skills in the operating room under the supervision of attending physicians, and eventually instructing other residents and medical students. “‘See one, do one, teach one,’ has long been the mantra,” says Nicandri.

But in recent years there has been a move to develop safer teaching opportunities outside the doors of the OR in order reduce any possible risk to patients, he says.

Additionally, the expeditious, patientcentered OR environment is limited in the amount of teaching time it can offer young doctors.

“We conducted a study in which medical students followed residents and logged what they did every day,” he says. “For each eight-hour day, the average resident had their hands on an instrument in an OR for only 90 minutes. That means they are only getting about 1,400 hours of hands-on training in their entire residency. Because OR time is so valuable, it becomes critical that they don’t spend precious time learning rudimentary skills like how to tighten a drill chuck.”

To address these educational gaps, about five years ago the ACGME began requiring all medical schools in the country to develop alternative types of surgical training programs.

“We were one of a handful of institutions nationwide that was well-prepared for these mandates because we were bringing first-year residents into our surgical skills lab for hands-on practice every week, well before that time,” Gorczyca says. “We were proud to be ahead of the curve, and have only 34

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continued to enhance our program since.”

In 2015, the residency program upped the ante by creating a “boot camp,” an immersive 30-day training experience for interns.

Taking place during the fourth month of every resident’s first year, the camp culls the curriculum of each of Orthopaedics’ 13 divisions, and is taught by a cross-section of faculty from each specialty.

Every weekday in October, interns spend the morning and evening in normal patient care activity, but devote four hours of the afternoon to boot camp classes in the DeHaven Orthopaedic Skills Laboratory within URMC’s Sawgrass Surgery Center.

Residents start with simple tasks, and over the next 30 days progress through a packed curriculum that puts a variety of surgical tools in their hands. They thread needles to suture skin on cadaver parts or a medical model. They hoist drills to set fractures, and screw plates into artificial bones. They command a surgical simulator—guiding arthroscopes and instruments while the device measures their speed and accuracy.

On the boot camp’s opening day, interns Andrew Liu, MD, Bowen Qui, MD, David Quinzi, MD, Steven Samborski, MD, Matthew St. John (MD ’17), Eric Vess, MD, and Zachary Zmich, MD, gathered for the first lesson: tying knots. The residents drew together in a tight circle around Nicandri as he spoke, their eyes locked on the surgeon’s hands as he spun knot after knot in rapid, fluid movements.

Then they divided among the lab’s work tables to practice. At each session, every resident gets the tools and time to try a new skill, learn from mistakes, and refine their techniques. Faculty members are close-by to observe, instruct, and answer questions. Among residents, there’s plenty of cross-chatter as they work, comparing results, competing to be the best, but always offering one another constructive feedback Gregg Nicandri, MD, left and below, helps interns like Andrew Liu, MD, gain experience— and confidence—early in their surgical training.

and encouragement.

The camp ends with a skills competition that scores residents on speed, accuracy and efficiency.

“Our goal is to get everyone to the same baseline before they’re too far along in training,” Nicandri says. “The experience enriches every lesson they receive down the line. After one month at this, they’re asking more pertinent questions and learning at a higher level.”

Residents thrive in the low-pressure, supportive learning environment. “It really helps to get your hands on the drills and other tools,” says Qui. “A lot of times, you don’t get to touch them until your third year, and by then, it’s terrifying. It helps you retain things better when you’re not a deer in the headlights in an operating room.”

The boot camp is one of the reasons St. John stayed in Rochester for his residency after graduating from medical school here, he says.

“Rochester takes its time to train everyone at every level, starting with interns,” he says.

“In a lot of places interns feel like the bottom of the barrel. Here, it shows how much they want us to succeed from the start.”

The boot camp demands a heavy investment of time for residents and the approximately 20 faculty members who assist Gorczyca and Nicandri in teaching.

But all agree that the program reaps dividends by building residents’ technical skills and confidence at a critical juncture, while nurturing their fresh enthusiasm about the field.

Residents are quick to point to a benefit that holds even deeper meaning for them.

“The best part was getting to meet my attending physicians and fellow residents,” says Qui. “These are people we will be spending the next five-to-six years with. It’s a true mentorship model, because it allows you to meet your mentors in a less-formal setting than an operating room.”

Observing residents early in their training also gives faculty an edge in identifying unique skills and goals of trainees, while establishing positive work relationships.

“Otherwise, some faculty won’t meet these residents until their fourth year,” says Gorczyca. “Plus, teaching residents keeps you (as a faculty member) sharp,” he adds.

“What we see is that they keep getting better, smarter, more hard-working and more talented every year.”

The Medical Center is now trading ideas with other leading medical schools around the country, such as Duke and Vanderbilt, as they build or expand their own boot camps for teaching basic surgical skills.

“This is a hard program to put together from scratch because it takes a lot of coordination,” Nicandri says. “Other programs have heard about what we’re doing, and it’s flattering to be asked about our approach.

We are totally willing to share our ideas, and to learn from what they’re doing as well.”

The number of women in Orthopaedics continues to climb, thanks to role models who inspire the next generation of surgeons. Below, Catherine Humphrey, MD, chief of Orthopaedics at URMC affiliate Highland Hospital.

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By the Numbers: URMC Orthopaedics Residency Program With more than 50 board-certified physicians, URMC’s Department of Orthopaedics is a regional center that receives more than 190,000 outpatient visits and conducts more than 12,000 surgical procedures annually.

Residents have vast opportunities to observe and take part in complex musculoskeletal trauma cases, and provide care in office, clinic, and hospital settings.

The curriculum encompasses 13 orthopaedics subspecialties: pediatric orthopaedics, fractures and dislocations, polytrauma, surgery of the spine (including disc surgery), hand, shoulder and elbow surgery, foot and ankle surgery, athletic injuries, musculoskeletal oncology and rehabilitation, geriatric fractures and joint reconstruction.

From almost 700 applicants each year, 80 receive interviews, and 7 are selected. The ACGME recently approved the program to train one additional resident per year which will make the program “home” to 40 residents in 5 years.

14 graduates have chaired departments at other institutions.

5 graduates head sports medicine divisions, including Michael Maloney, MD (Res ’97), chief of URMC Orthopaedics’ Division of Sports Medicine.

19 of 52 Orthopaedics faculty members completed at least some of their medical training in Rochester.

15 residents have provided medical care in developing countries (5 this year) thanks to an educational grant from the Corning Incorporated Foundation.

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At right, wood scraps and a Tupperware container were building blocks for Nicandri’s first arthroscopic skills training tool, which led to development of the FAST Workstation, at far right. The reconfigurable model is widely used in academic teaching programs nationwide.

Tupperware Takes the Lid Off Learning The reality is that arthroscopic simulators and cadavers like those used at the Medical Center are valuable—but very costly— teaching tools that many residency programs across the country lack. To address this, Nicandri and then-medical student Ryan Koehler (MD ’14), spent a year designing and building an arsenal that’s more affordable and accessible.

They found much of their inspiration at Home Depot.

Tupperware containers, two-by-fours, Velcro, and wine corks are just a few of the hardware store materials and everyday objects that Nicandri used to create “body parts” that residents could use to practice arthroscopic surgery.

As proof that orthopaedists are often natural craftsmen, Nicandri punched holes in an upturned Tupperware container so residents could insert and maneuver scopes and instruments, just like they would during a knee or shoulder surgery.

When Nicandri presented his models at a conference, a representative from the medical device company Sawbones was intrigued. The company took the prototypes and built a more sophisticated plastic device with interchangeable

parts. With it, users can simulate a variety of surgical procedures and build the skills needed in arthroscopic procedures.

In collaboration with the Arthroscopic Association of North America (AANA), the American Association of Orthopaedic Surgery (AAOS), and the American Board of Orthopaedic Surgery (ABOS), Nicandri also worked to develop a curriculum called FAST (Fundamentals of Arthroscopic Surgery Training).

Every year, Nicandri and other instructors teach FAST to residents from programs around the country at the AANA training center near Chicago. The Sawbones device is now dubbed the FAST Workstation, and can be reconfigured for practice tests with each of its six instruction modules.

“That Tupperware model has come a long way, and its more refined progeny is finding a home in academic medical centers around the country,” says Nicandri.

In 2015, none of the FAST participants had even heard of the Sawbones Workstation. At the 2017 class, half of the participants said they had used it in their school’s training programs.

Battling Burnout Before It Begins While doctors in their first year of residency are just beginning to understand what burnout means, that’s precisely when they must start to prevent it, says Gorczyca.

“Many practicing surgeons around the country have learned this the hard way,” he says. “It’s becoming more clear that high percentages of surgeons experience burnout in their careers and there is even more vulnerability to it now with the changes occurring in medicine. But it’s preventable if we help doctors learn how to create a balanced life. And the best place to start that is in residency.”

Whereas it used to be a point of pride when residents wouldn’t go home for a few days, Gorzcyca says, “that model is slowly changing. We’re friendlier with the way we teach because we recognize physical well-being as very important to medicine.

If a resident is severely fatigued, it’s very likely to affect not only them and the people they work with, but also patients. We work to ensure that residents are happy and performing well.”

To that end, URMC’s orthopaedic residents can’t exceed an occasional 80-hour work week—still a demanding workload—but far less than the norm for residents who trained 30 or 40 years ago. Residents can work shifts up to 27 hours, but must take eight-hour breaks afterward.

“Most of the time, we schedule shorter shifts so that residents can go home at night, sleep, and come in to work fresh the next day,” Gorczyca says.

Providing professional guidance and mentorship, and helping residents develop

leadership and life skills, builds a foundation to help prevent professional burnout years from now. Each class is assigned an attending to counsel residents on how to balance their busy schedules, and structure their days and weeks to include sufficient time to rest, eat, exercise, socialize and pursue outside interests.

In June, the department hosts a retreat, for interns and PGY-4 residents, devoted to topics such as interpersonal skills, work-life balance, professionalism, diversity, unconscious bias, leadership, and conflict resolution. Former residents often return as guest lecturers to advise on career goals and how to integrate the demands of a busy practice with personal and family lives.

Residents are also encouraged to explore opportunities for personal growth outside the program. One resident from each class is a liaison to the AAOS and represents the program at its resident assembly. Two chief residents also attend the American Orthopaedic Association (AOA) Evarts Resident Leadership Forum each year (named after Distinguished University Professor and Professor of Orthopaedics C. McCollister Evarts (MD ’57, Res ’59, Res ’64), a former residency program director and department chair.

“It helps to network and share ideas with peers across the country who are on similar paths,” says Nicandri. “They always return with renewed energy and inspiration.”

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Faculty members and first- and fourth-year residents attend an annual retreat emphasizing interpersonal skills, work-life balance, and leadership.

Modernizing for Millennials Millennials prefer a broad spectrum of learning styles—visual, auditory, kinesthetic—and the department has reshaped itself to align with them. Shorter, but more frequent lectures and group-based projects, combined with continual faculty assessments and feedback, are critical components of the learning environment.

“They prefer to learn in smaller increments, rather than in a four-hour lecture, and we’ve seen that this helps them in retaining information,” Gorczyca says.

“I’ve seen students nodding off during long lectures, and that’s not learning. But if you deliver content in a shorter, organized manner 250 times a year, it will stick.”

The program also strives to give residents the feedback they want and need.

“It used to be that if you didn’t hear anything from attending physicians during your residency, it was good news,” Gorczyca says. “But millennials really want to know how they’re doing. They will work as hard, if

not harder, than any generation before them, but it’s become clear that they are strongly motivated by meaningful feedback. So we give them feedback midway through every rotation, at the end of the rotation, and every three months. Each resident also meets with me every six months for a progress review.”

The ACGME also demands more assessments and progress reports, now requiring residents to demonstrate competency in 32 areas of orthopaedic surgery every six months. For faculty, it’s a heavier lift, but it’s also a way to identify any residents in need of more support.

“It gives us information we can act on,” says Gorczyca.

A Leg Up into Research URMC’s Center for Musculoskeletal Research (CMSR)—one of the top NIH-funded orthopaedic research centers in the world— also gives residents unparalleled learning opportunities. All residents work in the CMSR lab for two rotations, and one resident from each class is selected for an extra year of research training. There is also a two-month elective program that encourages residents to pursue research projects, and 10 residents a year are supported to present

their research at the AAOS annual meeting.

“The collaboration between clinical and research components of the department is a unique advantage for our residents,” says Gorczyca. “We have a deeply-rooted tradition of faculty such as doctors Ed Puzas, Randy Rosier, and Regis O’Keefe who loved basic science research as much as orthopaedic surgery, and excelled at it.”

“Our department feels basic science research is critical to orthopaedics,” says Edward Schwarz, PhD, the Richard and Margaret Burton Distinguished Professor in Orthopaedics and director of the CMSR. “Since its inception, the ‘research resident’ has played a major role as a liaison between this huge center and the attending physicians, residents and fellows in the department.

Residents have contributed to many CMSR projects, and will continue to play bigger roles in our work to inform evidence- and value-based medicine.”

URMC orthopaedic skills training is made possible with support from the Corning Foundation and private donors. To lend your support, contact Dianne_Moll@rochester.edu or (585) 273-5506.

“The collaboration between clinical and research components of the department is a unique advantage for our residents.”

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Calling all School of Medicine and Dentistry alumni whose class years end in a 3 or 8…

SAV E T H E DAT E

YOUR REUNION! OCTOBER 4 - 7, 2018 www.rochester.edu/smd/alumni

#URMW18

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In Her Mind’s Eye: Neuroscience Grad Student Paints the Beauty of the Brain

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The greatest scientists are often artists as well, Albert Einstein once said.

One look at the work of fourth-year neuroscience graduate student Rianne Stowell is proof that the two fields are indeed branches of the same tree.

Stowell’s 16” x 12” acrylic-on-canvas rendering, Cerebellar microglia, is not only attracting attention from her colleagues and mentors, but gaining a public following too, while reviving her childhood dream.

The Coopersberg, Pa., native, who works in the lab of associate professor of Neuroscience Ania Majewska, PhD, longed to become an artist since elementary school, but shelved her artistic pursuits in college to study biology and psychology, and eventually neuroscience.

“I’ve never looked back on my decision because I love neuroscience and couldn’t be happier about where I am now,” she says. “But I also love art and missed not being able to devote time to it along the way. So this is very exciting for me to be able to weave it into my scientific career.”

Stowell was inspired to pick up her

paintbrush while working on her inaugural first-authored paper, “Cerebellar microglia are dynamically unique and survey Purkinje neurons in vivo,” recently published in Developmental Neurobiology. Majewska is principal investigator and lead author of the study, which sheds new light on the critical role of microglia in the wiring and rewiring of the connections between nerve cells.

During the project, Stowell spent hours studying the images, shapes and color contrasts generated by a two-photon microscope.

“I found the contrast between the bright red fluorescence of the Purkinje neurons and the green of the microglia to be incredibly striking and it really made me want to paint them,” she says.

While this work and others in her portfolio are based on reality, Stowell says she enjoys playing with brighter colors, and creating more interesting contrasts with light and shadow, than what she may actually be observing.

“My paintings allow me to share what I see in my mind’s eye,” she says. “When I work on science-related paintings I get to bring life and dimension to what I see under the microscope.”

In addition to painting, Stowell helped develop the surgical method that enabled researchers to capture images deep inside the living brains of mice using two-photon microscopy. This led to the discovery that microglia in the cerebellum look, act, and function differently than microglia in other parts of the brain. Her thesis is focused on uncovering the precise mechanisms connecting the neurons and microglia in the parts of the brain that process visual input.

“I think art and science both require creative thinking and alternative approaches to problem solving,” says Stowell, who hopes one day to build a large enough art collection to show at one of Rochester’s art festivals. “With science, you spend a lot of time studying literature and trying to find relationships between different discoveries.

With art, you are also looking for conceptual relationships and ways to describe and present your observations. Both involve a lot of contemplating and assessing your own perspective on what you see or know.”

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PHILANTHROPY

Golisano Gift to Fill Gaps in Psychiatric Care for Youth Photo courtesy of Hanlon Architects

Tom Golisano’s legacy of philanthropic support for children’s health continues to grow. Golisano, namesake of UR Medicine’s Golisano Children’s Hospital (GCH), has pledged $5 million to support the construction of a critically-needed Pediatric Behavioral Health & Wellness Center.

It will be the Medical Center’s primary outpatient location to treat children with depression, anxiety, psychosis, substance abuse, post-traumatic stress disorder, and other behavioral and emotional conditions.

The center will be staffed by a multidisciplinary team that includes practitioners such as child psychiatrists, psychologists, social workers, mental health counselors, and nurses.

“I am pleased to partner with the University of Rochester Medical Center to build the new Golisano Pediatric Behavioral Health & Wellness Center, which will address gaps in care and accommodate more clinical staff to help reduce the number of children on the wait list for services,” said Golisano.

At the gift announcement in September: chief of the Division of Child and Adolescent Psychiatry Michael Scharf, MD; URMC CEO and School of Medicine and Dentistry dean Mark Taubman, MD; former patient Jakob O’May; and Tom Golisano. Sixteen-year-old O’May began advocating for more mental health services for teens after a friend committed suicide and O’May was admitted to Golisano Children’s Hospital for having

Services offered in the Center will be aimed at diagnosing and addressing potential issues before they become major concerns, thereby reducing the need for emergency visits and inpatient services (both of which will remain located at Strong Memorial Hospital).

The 30,000 square-foot, $10 million building will be located near the intersection of South Avenue and Science Parkway.

Construction is expected to begin next spring, with completion slated for 2019.

suicidal thoughts of his own. He created a GoFundMe page to support the growth of additional psychiatric programs to help kids with similar issues, and lent his voice to the project funded by Golisano. The NIH estimates that more than 20 percent of children in the U.S. between ages 8 and 15 struggle with mental health issues, or will at some point. Between 60 to 90 percent fail to receive treatment.

Thomas and Brenda Parkes, Linda (Parkes) and Joseph Clement, Walter and Barbara Parkes, Susan (Parkes) and Jon McNally 42

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Ciafaloni Named Robert C. and Rosalyne H. Griggs Professor in the Experimental Therapeutics of Neurological Disease Emma Ciafaloni, MD, was recently installed as the Robert C. and Rosalyne H. Griggs Professor in the Experimental Therapeutics of Neurological Disease. Ciafaloni is professor of Neurology and Pediatrics, specializing in the diagnosis and treatment of neuromuscular diseases in adults and children. She is currently codirector of the Muscular Dystrophy Association Neuromuscular Clinic, program director of the Neuromuscular Medicine Fellowship Program, and director of Pediatric Neuromuscular Medicine.

Ciafaloni has conducted clinical trials nationally and internationally in adult and pediatric neuromuscular diseases including Duchenne muscular dystrophy, myasthenia gravis, periodic paralyses, nondystrophic myotonias, myotonic dystrophy, and Facioscapulohumeral muscular dystrophy.

Robert “Berch” Griggs (Res ’70, Res ’71) is professor of Neurology, Medicine, Pathology and Laboratory Medicine, Pediatrics, and the Center for Human Experimental Therapeutics. Along with his wife, Rosalyne, a 1980 graduate of the University, he established this professorship to attract and retain faculty members committed to changing lives through neurotherapeutics research. Griggs is recognized as a leading authority on a variety of neuromuscular disorders and focuses on experimental therapeutics. He has

Emma Ciafaloni, center, with Robert and Rosalyne Griggs developed treatments for periodic paralyses, nondystrophic myotonia, Duchenne muscular dystrophy, and inflammatory myopathies. Griggs served as chair of the Department of Neurology and Neurologist-inChief at Strong Memorial Hospital from 1986 to 2008.

Thorpe Gift Supports Arthroscopic Surgical Training

William and Judy Thorpe

Kenneth DeHaven, MD

William Thorpe (Res ’81) and his wife, Judy, have made a generous $100,000 gift to establish the William and Judy Thorpe Endowed Fund in support of the Kenneth DeHaven Arthroscopic Surgical Skills Laboratory in the Department of Orthopaedics and Rehabilitation.

Thorpe, an orthopedic surgeon in Bluffton, S.C., the Skills Laboratory, said the gift recognizes the laboratory for being at the forefront in teaching specialized surgical skills.

The gift was made in honor of Kenneth DeHaven, MD, an emeritus professor of Orthopaedics and pioneer in the use of arthroscopic surgery in professional and amateur sports.

“During my residency, Ken was a role model and very instrumental in my involvement with arthroscopic surgery and sports medicine.

He gave so freely of his time during and after my training and I would often seek his advice on surgical matters,” said Thorpe. “I am thankful for the high level of training I received at the Medical Center. I left the program with confidence and it prepared me very well for my career.”

Thorpe said philanthropy is important to him “because I am truly thankful for all the gifts given to me in my life. I recognize that many people invested themselves in me and I want to give to those institutions and people who formed the person I became. It’s the right thing to do.”

Among the lasting memories Thorpe has of his time at Rochester is operating in the middle of the night with DeHaven on an open complex fracture, doing his first total hip replacement with C. McCollister (“Mac”) Evarts (MD ’57, Res ’59, Res ’64), and performing his first carpel tunnel release with Richard Burton, MD (Res ’64).

Philanthropy continued on page 61

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FACULTY NEWS

Anolik Named CFO Adam P. Anolik began a new role as chief financial officer (CFO) in the

fall of 2017, having served as interim director since June. A finance leader and strategist for the Medical Center for nearly two decades, Anolik previously served as CFO of Strong Memorial and Highland hospitals, and oversaw the financial management of URMC’s regional strategy and affiliate health care entities. He will remain as CFO of Highland Hospital.

Since 1999 he has progressed to senior financial management roles, deepening his understanding of issues related to research funding, support of the educational mission, culture and diversity efforts, and strategic initiatives. He has been a member of the Medical Center’s senior leadership team for three years.

“More than ever before, the operations of hospitals, practices, education, and research are intertwined,” said Anolik. “It’s essential we work as a team to make sound, long-term strategic choices that grow and enhance all of URMC’S missions.”

Apostolakos Appointed CMO for Strong and Highland Michael J. Apostolakos, MD (Res ‘90, Flw ’93) began as chief medical officer for Strong Memorial and Highland hospitals in November. He leads initiatives to improve the quality and safety of patient care and clinical outcomes, and advocates for providers and patients. Apostolakos succeeds Ray Mayewski, MD, who stepped down last June.

Having led Strong Hospital’s adult critical care program for 20 years, Apostolakos has an in-depth understanding of the organization and the people who keep it running.

“Dr. Apostolakos has devoted his entire career to the Medical Center,” said University of Rochester Medical Faculty Group CEO Michael Rotondo, MD, FACS. “It speaks well of our institution—and bodes well for its future—that we have someone like him ready to step into, and excel in, this key role.”

Apostolakos’s long list of quality improvement accomplishments include leading an effort to reduce central-line infections and ventilator-associated pneumonias; implementing rapid-response teams; and championing the “WashGlove-Wash” and “I Pledge” hand hygiene campaigns.

A regional expert on sepsis, he has served on several state and national committees and is a former-president of the New York State Thoracic Society. In addition to directing the adult critical care program, he directs the Internal Medicine/Critical Care Medicine Fellowship, chairs the Critical Care Quality Council and the Resuscitation Council, directs the Medical Intensive Care Unit and co-directs the Respiratory Care Department.

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Brophy Joins as Pediatrics Chair Patrick Brophy, MD, MHCDS, has joined URMC as the William H. Eilinger Professor and Chair of the Department of Pediatrics and physician-in-chief of Golisano Children’s Hospital (GCH). The eighth chair of the department, Brophy hails from the University of Iowa Health Care where he directed Pediatric Nephrology.

“Dr. Brophy has demonstrated exceptional skills as a clinician and a leader in improving quality and patient access to care via technology innovation,” said Mark Taubman, MD, CEO of URMC and dean of the School of Medicine and Dentistry. “He has great enthusiasm for the quality of our Pediatrics Department and a compelling vision to take it to the next level in clinical care, research, and education.”

Brophy spent the past decade at the University of Iowa, where he served as division director since 2007. He held the

Jean E. Robillard MD Chair in Pediatric Nephrology and was a professor at the Carver College of Medicine. He also served in additional roles, including assistant vice president of eHealth and Innovation, vice chair of Clinical Innovation for the Department of Pediatrics, and co-director of the Integrated Special Populations Research Core in the Institute of Clinical and Translational Science.

As founder of the University’s Signal Center for Health Innovation, Brophy led efforts to use technology—particularly telehealth—to reach patients. He also maintained a research lab focused on kidney development in utero.

Prior to his tenure in Iowa, Brophy spent almost 10 years at the University of Michigan Medical Center as a clinical and research fellow before joining the faculty.

Lawrence Named Environmental Medicine Chair B. Paige Lawrence, PhD, an 11-year faculty member and six-year director of the Rochester Toxicology Program, is the new chair of the Department of Environmental Medicine.

“Our medical center has a strong history of translating environmental research discoveries into improved care for patients,” said Mark Taubman, MD, CEO of URMC and dean of the School of Medicine and Dentistry. “I’m confident Dr. Lawrence will continue the department’s leadership in this critically important field.”

Basic research led by Environmental Medicine faculty focuses on how environmental factors influence a broad spectrum of diseases.

This contributes to innovative approaches that prevent or ameliorate exposure-based health consequences. The department also administers several nationally regarded, interdisciplinary programs, including the Environmental Health Sciences Center, Toxicology Program, Lung Biology and Disease Program, Life Sciences Learning Center, and two clinical programs in occupational medicine.

Lawrence is a professor of Environmental Medicine and Microbiology and Immunology who is widely recognized for her expertise in how environmental factors influence the immune system.

Her lab has implicated certain chemicals in dampening infants’ responses to vaccines, and has shown that maternal exposures to certain chemicals have enduring effects on the ability to fight

infections, leading to the development of autoimmune and allergic diseases.

Lawrence will direct the NIH-sponsored Environmental Health Sciences Center (EHSC), which supports investigators in determining how materials like lead, air and water pollutants, pesticides, and nanoparticles affect human health. EHSC investigators also study the underlying mechanisms of toxic substances and how early life exposures may contribute to diseases like Alzheimer’s or cancer.

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FACULTY NEWS

Lichtman Honored for Lifetime Achievement Hematologist/oncologist Marshall A. Lichtman, MD (Res ’66), a former dean of the School of Medicine and Dentistry, received one of the highest honors in his field from the American Society of Hematology (ASH) for his exceptional, 51-year career and contributions toward understanding blood cell diseases.

ASH presented the Wallace H Coulter Award for Lifetime Achievement in Hematology to Lichtman at the society’s annual meeting in December 2017. Several Wilmot Cancer Institute oncologists attended to celebrate with him.

“I’m deeply honored,” said Lichtman, 83, professor emeritus in the Department of Medicine, Hematology/Oncology, and of Biochemistry and Biophysics. “The society includes many people of achievement and I feel fortunate they recognized me this year.”

Lichtman built a career in Rochester as a physician, researcher, educator, administrator, and mentor after joining the University in 1960 for post-doctoral training and residency. He was senior associate dean for Academic Affairs and Research for 10 years and later became the sixth dean of the medical school, serving from January 1990 through December 1995.

“Marshall Lichtman spent his entire distinguished career in Rochester and continues to have a strong mentoring role for our leukemia team,” said Jonathan Friedberg, MD, MMSc, director of the Wilmot Cancer Institute and blood cancer specialist.

Lichtman’s interest in blood disorders and cancer was sparked while working summers in a research lab as a University of Buffalo medical student. A decade later, after President Nixon declared the “war on cancer” and signed the National Cancer Act of 1971, academic medical centers began shifting resources toward cancer

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research. Lichtman entered the field in 1967 studying leukemia cell membranes. Specifically, he studied contact inhibition—when cancer cells continue to divide uncontrollably despite cell-to-cell contact—and made several important scientific observations about how leukemic cells differ from normal cells.

Lichtman also led a project to address altitude sickness in U.S. Army troops, uncovering ways to improve red blood cell function and delivery of oxygen to the body. He developed a simple blood test for measuring hemoglobin/oxygen affinity that continues to be used today.

In 1975 Lichtman became chief of URMC’s Hematology Unit, specializing in leukemia, and became a frequent consultant on the diagnosis and management of complex hematologic diseases. Author of several textbooks, he co-edited Williams Hematology for seven editions and wrote numerous chapters on blood-cell diseases. He also helped start URMC’s Blood and Marrow Transplant program in 1989.

Lichtman helped train several generations of medical students and fellows in the clinical and laboratory aspects of hematology, including how to interpret and analyze blood and marrow samples. He taught Blood Cell Anatomy, Biochemistry, and Physiology to first-year medical students for more than 40 years and taught Hematology to secondyear students for more than 25 years. Last fall he began teaching a first-year course on human structure and function.

“I’m grateful for longevity,” said Lichtman, who continues to work in his URMC office. “It’s given me the opportunity to think more, read more, learn more, and write more. This has been an ideal institution for me to pursue my interests; it fosters interdisciplinary interactions.”

Lee Joins as Psychiatry Chair Hochang Benjamin (Ben) Lee, MD, has joined URMC as the new John Romano Professor and Chair of the Department of Psychiatry.

Lee comes to Rochester from Yale, where he was founding director and chief of the Psychological Medicine Service, which oversees all consultative and collaborative psychiatry programs at Yale New Haven Hospital’s York Street and St. Raphael campuses. He also directed Yale’s Psychological Medicine Research Center, which develops strategies to deliver psychiatric services to medical and surgical inpatients and prevent the onset of neuropsychiatric issues after major surgeries.

“Dr. Lee stood out for his broad experience leading effective interdisciplinary teams that span all departmental missions, and his ability to develop innovative models of care delivery that serve as ripe platforms for training and scholarship.” said senior associate dean for Academic Affairs and professor of Psychiatry and Neurology Jeffrey Lyness, MD, who led the search committee.

URMC CEO and School of Medicine and Dentistry dean Mark B. Taubman, MD, said Lee’s ability to work well with other clinical departments to address behavioral health conditions “will further the department’s collaborative philosophy and its mission to improve outcomes for patients, supporting their transition to effective outpatient care. Ben will also fuel the expansion of Psychiatry’s research programs, particularly those that dovetail with the Del Monte

Neuroscience Institute’s multidisciplinary work to tackle major neurological and neuropsychiatric diseases.”

Millions of Americans struggle with some form of mental illness, and those with serious mental illness have expected lifespans 20 years shorter than the general population, largely due to treatable conditions. In hospitals, as many as 30 percent of all adult medical-surgical patients have concurrent psychiatric conditions contributing to high readmission rates and poor health outcomes.

Lee has devoted his career to proving that better integration of psychiatric care across health disciplines and departments will improve the general health status and quality of life for this disadvantaged population, and produce major savings to medical centers.

“In the fee-for-service health care environment, psychiatry is not viewed as a revenue-generating service, but in the new system of value-based care, it will emerge as a leader,” Lee said. “By far, behavioral issues are the leading reason for re-hospitalization and non-adherence to treatment, so it’s critical we focus our energies here.”

At Yale New Haven Health System, Lee transformed an understaffed and struggling Consultation-Liaison Psychiatry Service into what is now its Psychological Medicine section, which embeds and integrates behavioral health services into medical and surgical specialties. Lee also co-led the development and implementation of a Behavioral Intervention Team concept, through which all medical patients are

screened for mental health issues at their initial point of contact to drive earlier intervention. Now replicated at Johns Hopkins, Dartmouth, Mt. Sinai, SUNY Stony Brook and elsewhere, the model was demonstrated through his research to help shorten lengths-of-stay, lower costs of care, and potentially reduce readmission rates of medical patients with concurrent psychiatric conditions.

In addition to his top-tier research about how best to provide psychiatric services to hospitalized patients, Lee is leading nationallyfunded studies to determine how to prevent neuropsychiatric conditions in elderly patients after major surgery like coronary artery bypass graft (CABG). Nearly a half-million Americans undergo CABG surgery annually, and as many as 30 percent are affected by depression in the year after surgery. The elderly are at particular risk of depression, delirium and/or dementia.

John Foxe, PhD, director of the Ernest J. Del Monte Institute for Neuroscience, said Lee brings an “extremely strong clinical research agenda, clinical expertise, and deep compassion” for patients.

“Rochester’s Neuroscience community is extremely excited to have Ben on board,” said Foxe. “He is an ideal partner with The Del Monte Institute as we focus on developing new understanding of severe mental illnesses and bringing new therapies online to treat these devastating diseases.”

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FACULTY NEWS

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Moxley, Pioneer in Muscular Dystrophy Research and Care, Steps Down

Wang, Champion for Child Neurology, Steps Down

Richard (Dick) Moxley III, MD, one of the founding fathers of URMC’s Department of Neurology, retired in 2017 after a career spanning more than four decades. Moxley holds the Helen Aresty Fine and Irving Fine Professorship in Neurology and is widely recognized for revolutionizing the understanding of muscular dystrophy and the care of patients with the disease.

“Over his 40-plus years at the Medical Center, Dick has been a central figure in making the Department of Neurology a magnet for patients, and a national leader in research and education,” said Mark Taubman, MD, CEO of URMC. “His legacy, particularly in the field of neuromuscular diseases, will leave a mark not only on this institution, but on countless patients and families.”

The Edward A. and Alma Vollertsen Rykenboer Chair in Neurophysiology Bob Holloway, MD (Res ’93, ‘MPH ’96), said Moxley’s contributions as a clinician, scientist, and a mentor have transformed the way physicians care for patients with myotonic dystrophy.

“His decades of unwavering focus on patients and their quality of life have helped transform the disease into a manageable chronic illness and set us on the path to a potential cure,” said Holloway.

Moxley was recruited as a child neurologist in 1974 by Robert Joynt, MD, and Robert Griggs, MD (Res ’71), to direct the Strong Memorial Hospital EMG Laboratory and help start a NIH-funded muscular dystrophy research program, which now regularly ranks among the top 10 in NIH funding.

Educated and trained at the University of Pennsylvania, Harvard, Johns Hopkins, and the NIH, Moxley immediately helped start a Muscular Dystrophy Association-funded research program focused on Duchenne muscular dystrophy, a childhood disease found primarily in boys. His research team, including Griggs and Shree Pandya, DPT, MS, was first to establish prednisone as an effective treatment for the disease.

Moxley later turned his focus to myotonic muscular dystrophy (DM), the most common form of muscular dystrophy found in adults, and partnered with Charles Thornton, MD (Flw ’90, Flw ’92), to establish a pre-clinical and clinical research program in 1992 that furthered understanding of DM’s biological mechanisms and the complex way the disease manifests.

In 2002, Thornton, Moxley, and colleagues were the first to discover how a genetic flaw in individuals with the disease interferes with important muscle and cell functions. A National Registry for Myotonic Dystrophy and Facioscapulohumeral Dystrophy established in 2000 by Moxley, Thornton, Fields Endowed Professor in Neurology Rabi Tawil, MD (Res ’91, Flw ’93), and colleagues, was key to the research success. The NIH-supported database now includes more than 2,200 people and enables researchers across the county to study the disease and recruit for clinical trials.

The efforts of Moxley and colleagues have brought scientists to the doorstep of a new therapy that could reverse the genetic cause of DM type 1.

Neurologist David Wang, MD (Res ’77, Flw ’77), who helped establish the Medical Center’s child neurology program, has retired after more than 40 years on the faculty.

“Our pediatric programs that today provide comprehensive care to any type of neurological disorder in children, exist in large part because of David’s efforts,” said Department of Neurology chair Bob Holloway, MD (Res ’93, Flw ’96, MPH ’96). “He helped build and grow these programs, train current providers, and was a stabilizing force when many of our programs underwent difficult periods. David will leave an indelible mark on this institution and the large community of patients and families he treated.”

A graduate of National Taiwan University Medical College in 1969, he studied Neurophysiology at the University of California, Berkeley, where he was mentored by Horace Barlow, a descendant of Charles Darwin. After completing his residency and fellowship at URMC in 1977, he joined the faculty and progressed to become professor in the departments of Neurology and Pediatrics.

Specializing in epilepsy, Wang operated a clinical practice at Rochester General Hospital from 1977 to 2001, while holding a joint faculty appointment at URMC, teaching medical students and neurology residents.

In 2001, he shifted his work to Strong Memorial Hospital and was instrumental in establishing URMC’s pediatric neurology program as a national leader. Together with two of his trainees, Inna Hughes, MD, PhD (Res ’12, Flw ’15), and Laurie Seltzer, DO (Res ’11, Flw ’13), Wang established URMC’s Pediatric Epilepsy Program in 2014. The formation proved timely, as it coincided with the closure of a program in Syracuse, adding 500 new patients to a busy caseload. Today it draws patients from across Upstate New York.

The program has also taken part in many clinical studies, such as an examination of the benefit of medical marijuana on a rare, severe form of epilepsy, and an evaluation of telemedicine to manage the care of children with epilepsy in the region.

A forward thinker in applying technology to education and care, Wang pioneered the use of video recordings of seizure patients to teach residents who had never witnessed one before.

“David’s patients and families loved him and in many cases he provided care to more than one generation,” said Jonathan Mink, MD, PhD, the Frederick A. Horner MD Endowed Professor in Pediatric Neurology and unit chief of Child Neurology. “For those families there is a real sense of loss that he has stepped down.”

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Rochester Medicine goes digital UNIVERSITY OF ROCHESTER MEDICAL CENTER

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No Boundaries: The Spirit and Science of Lynne Maquat

No Boundaries: The Spirit and Science of Lynne Maquat

No Boundaries: The Spirit and Science of Lynne Maquat

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No Boundaries: The Spirit and Science of Lynne Maquat

Rochester Medicine magazine is now available in an interactive, reader-friendly format on your desktop, laptop, tablet and smartphone.

Read the full issue online. rochestermedicine.urmc.edu ROCHESTER MEDICINE | 2018 – V1

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IN MEMORIAM IN MEMORIAM

Arthur J. Moss, MD Cardiologist Arthur J. Moss, MD (Res ’62, Flw ’65), whose research saved hundreds of thousands of lives and improved the standard of care for legions of people with heart disease, died Feb. 14, 2018. He was 86.

During his six-decade career, Dr. Moss, the Bradford C. Berk MD, PhD Distinguished Professor, made some of the most significant and long-lasting scientific discoveries in the prevention and treatment of sudden cardiac death. His patients were the heart of his research, and his accomplishments were fueled by his ability to listen, build trust, and collaborate with them to find answers.

As well, his close collaborations with other investigators led to some of the most productive clinical trials in all of cardiology.

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“Arthur was a man of absolute integrity, both of science and of character, and an amazing visionary who could see where the field of electrophysiology was headed long before others,” said Wojciech Zareba, MD, PhD, director of URMC’s Heart Research Follow-up Program, who worked closely with Dr. Moss for the last 26 years. “He was eternally optimistic in all aspects of his life.

He brought a positive attitude to everything he did, and didn’t worry

about the small stuff, which helped him accomplish great things.”

His entrance to the field of cardiology was serendipitous. After earning his medical degree from Harvard in 1958, he began a hematology internship at Massachusetts General, but was soon called to serve in the U.S. Navy. There, his commanding officers assumed he was a cardiologist and asked him to teach electrocardiography to flight surgeons. Undaunted, he read multiple books on the topic to instruct them, and he became captivated by the intricacy of the heart’s electrical activity. He never looked back.

Dr. Moss spent the first half of his career figuring out which patients were at high risk of sudden cardiac death, and the second half finding the best ways to treat them. He became an eminent authority on common arrhythmias that afflict hundreds of thousands of adults with heart disease and often lead to sudden death, as well as rare heart rhythm disorders that are smaller in number, but no less deadly.

An unexpected patient visit in 1970 started what Dr. Moss called the most rewarding part of his career: his life-long quest to help individuals with Long QT syndrome (LQTS). Doctors could not understand why this patient—a woman in her 30s—would fall unconscious when she was bowling.

An unusual EKG led Dr. Moss, then a young cardiologist at URMC, to diagnose LQTS, an uncommon genetic condition caused by a glitch in the heart’s electrical system.

Dr. Moss devised the first effective surgical treatment for the disorder and had the foresight to create the International Long QT Syndrome Registry in 1979, one of the first rare disease registries in the world. The registry allowed Dr. Moss and colleagues to identify risk factors that enable early diagnosis; develop multiple treatment options that have achieved an 80 percent reduction in life-threatening events; and contribute to the discovery of multiple genes associated with the disorder. The NIH has supported the registry since its creation, and in 2014 Dr. Moss received an NIH grant to fund the registry and associated research projects through 2019.

“Not only was Arthur extraordinary in understanding the immediate problem, but he was a visionary in starting the registry and preserving blood samples long before we knew how to analyze genes,” said Mark B. Taubman, MD, CEO of URMC and dean of the School of Medicine and Dentistry. “The registry is now one of the most important repositories in the world, preventing thousands of untimely deaths from Long QT and enabling in-depth investigation of how genetics influence a form of heart disease.

The impact of his work is unparalleled.”

In the 1990s, Dr. Moss led the MADIT (Multicenter Automatic Defibrillator Implantation Trial) series of clinical trials, which showed implantable cardioverter defibrillators (ICDs) significantly reduce the risk of sudden death in patients who’ve had a heart attack. In the early 2000s these findings altered medical guidelines worldwide and led to the use of life-saving ICD therapy in hundreds of thousands of patients.

In 2009 Dr. Moss completed the MADIT-CRT trial, which found that cardiac resynchronization therapy plus defibrillator (CRT-D therapy) prevents the progression of heart failure in patients living with mild forms of the disease. The device was originally approved to treat patients with severe heart failure, but Dr. Moss’ work opened the door for infinitely more patients to benefit and live longer, better lives.

“Arthur’s research was so powerful because the results of his studies were usually either strikingly positive or negative,”

said Bradford C. Berk, MD, PhD, professor of Medicine and Cardiology. “This came from his rare ability to ask a simple question, and use a simple clinical trial design. He was a superb clinician with remarkable insight into the underlying pathologic mechanisms of heart disease.”

Colleagues state that Dr. Moss’ success also sprang from his unique ability to bring academicians together, trigger discussion, and make everyone—from the highestranking physician to the newest graduate student or fellow—feel welcome and valued.

“I first met Art in 1976 and was at least three academic ranks lower than anyone else at the meeting,” said Henry (Hank) Greenberg, MD, special lecturer of Epidemiology and Medicine at Columbia University Medical Center. “Art sensed this and stated that everyone at the table contributed. This carried forward for four decades and is why his trials were always superbly done. His ego did not get in the way.”

Dr. Moss was founding director of URMC’s Heart Research Follow-up Program, a worldwide hub for studies of medical interventions for sudden death, cardiac arrhythmias, heart attack and heart failure.

He published more than 750 scientific papers, including a 1962 article—his first of many in the New England Journal of Medicine — highlighting the first three published cases of cardiopulmonary resuscitation (CPR).

URMC chief of Cardiology Charles Lowenstein, MD, said Dr. Moss should be best remembered “for the hundreds of medical students, residents, and fellows he trained and inspired.”

After his service in the U.S. Navy, Dr. Moss finished his residency and cardiology fellowship in Rochester. He joined the URMC faculty in 1966 where he remained the rest of his career, ultimately becoming the Bradford C. Berk, MD, PhD Distinguished Professor in Cardiology. He received the Eastman Medal in 2012, the University’s highest honor, recognizing those who embody UR ideals through outstanding achievement and service.

In 2008 he received the Glorney-Raisbeck Award in Cardiology, the highest honor of the New York Academy of Medicine, and a year

later received the prestigious Golden Lionel Award at the Venice International Cardiac Arrhythmias Meeting. He received The Heart Rhythm Society’s top honor, the Distinguished Scientist Award, in 2011, and was presented with the Pioneer in Cardiac Pacing and EP Award in 2017.

Four months before his death, Dr. Moss received the 2017 James B. Herrick Award at the American Heart Association’s Scientific Sessions. The annual award is given to scientists who have contributed profoundly to the advancement and practice of clinical cardiology.

“Arthur’s passing is very sad news for the world of cardiology and clinical trials,” said David Cannom, MD, director of Cardiology at Good Samaritan Hospital in Los Angeles.

“There was no one quite like him in terms of intelligence, judgement, leadership skills, and thoughtful friendship, plus good humor. An era is closing and he will be sorely missed.”

Growing up during the Great Depression contributed to the development of Dr. Moss’s unique fortitude in the face of challenges, his family says. His children—Kathy, Debbie and David—recounted at his funeral how inspired they were by their father’s “purposeful positivity, insatiable curiosity, and total engagement” in every endeavor.

“My dad whistled when he woke up in the morning and whistled when he walked in the door at 8 p.m. after a long day,” recalled Debbie. “I’m convinced he drew this energy from doing just what he wanted to do every day of his life. He genuinely embraced the joy of work, of working to make a difference, of family and friends, and cultivating meaningful relationships. He was a role model for how to live a meaningful life.”

– Emily Boynton Donations in Dr. Moss’ memory may be made to the UR Heart Research Follow-Up Program, Alumni & Advancement Center, 300 East River Road, P.O. Box 270032, Roch., N.Y. 14627.

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IN MEMORIAM IN MEMORIAM

Robert J. Haggerty, MD Robert J. Haggerty, MD, professor emeritus and former chair of the Department of Pediatrics, died Jan. 22, 2018. He was 92.

During a career spanning six decades, he led initiatives that changed the way pediatricians—and in some cases, entire health systems— practice medicine. His contributions were so wide-reaching and varied that a colleague once referred to him as “the Joe DiMaggio of pediatrics.”

“Without question, Dr. Haggerty was one of the most important and impactful leaders of his generation, and generations that followed,” said Philip Pizzo (MD ’70), the David and Susan Heckerman Professor of Pediatrics and Microbiology and Immunology and former dean of the Stanford University School of Medicine. “He redefined pediatrics and child health, developed programs that improved communities, and connected pediatricians with educators to address the impact of poverty and disparity.”

In Rochester, Dr. Haggerty was the third chair of the Department of Pediatrics from 1964-75. He oversaw development of Rochester’s Anthony Jordan Health Center, Oak Orchard Health Center, and Threshold Center for Alternative Youth Services, which earned worldwide acclaim for their approach to providing ambulatory pediatric services to underserved children. His 1968 co-authored textbook, Ambulatory Pediatrics, was the first to focus on preventing childhood illness and caring for those with chronic illnesses and problem behaviors.

“When he first proposed community and ambulatory pediatrics, it was a very unique and revolutionary notion,” said Nina Schor, MD, PhD, deputy director of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health, and past chair of the URMC Department of Pediatrics. “Lucky for us, Dr. Haggerty had many enthusiastic and extraordinarily creative colleagues with whom he made enormous strides in closing a large gap between academic pediatrics and the health of children and families in the ‘real world.’”

Adds Ruth Lawrence (MD ’49, Res ’58), Northumberland Trust Professor of Pediatrics, “Prior to these programs, doctors were taught how to cure diseases in children. He wanted to prevent disease. That meant families would bring babies to pediatricians when they reached a certain age, not when they reached a certain illness.”

In his 1975 book, Child Health and the Community, Dr. Haggerty discussed pediatricians’ crucial role in identifying the behavioral, emotional, and psychosocial problems that accompany—or sometimes cause—health problems in children. He labeled these problems the “new morbidity,” and the term quickly entered the health professional lexicon. In 1982, the American Academy of Pediatrics (AAP) published a statement on the “new morbidity,” defining the role of pediatricians in addressing these issues.

The son of a Worcester, N.Y., pharmacist, Dr. Haggerty earned his MD from Cornell and began his association with Rochester in 1949 as continued on page 54 52

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Robert Klein, MD

Robert Klein, MD (Flw ’63), professor emeritus of Medicine, died Oct. 31, 2017, at the age of 88.

Dr. Klein was a fellow of biopsychosocial model pioneer George Engel, MD (1913-99), who made major contributions to URMC’s Departments of Psychiatry and Medicine—as a clinician, program innovator, and educator for nearly five decades.

Like Engel in his day, Dr. Klein held dual appointments in Medicine and Psychiatry, and from this platform developed programs to better address the complex needs of individuals with both medical and psychiatric concerns. Most notably, he is credited with the 1974 formation and direction of URMC’s “Klein Group,” a group of internists who provided medical treatment and/or consultation for psychiatric inpatients. It was the precursor for Strong Memorial Hospital’s Inpatient Medicine in Psychiatry Unit (IMIP), which functions in a similar manner today and is one of only a few like it in the country.

In 1982, Dr. Klein also initiated the hospital’s first program to treat alcohol dependency, and later, the area’s first Methadone Maintenance Treatment Program for opioid addiction, which became the cornerstones of today’s Strong Recovery Program.

Beyond these innovations, Dr. Klein provided medical care to psychiatric patients and clinical training to hundreds of students and residents until his “retirement” in 1992. He then taught the SMD’s Introduction to Clinical Medicine course through 2015.

“Dr. Klein contributed to the development of psychiatry at URMC as much as anyone I have ever known,” said professor of Clinical Psychiatry and Clinical Medicine Telva Olivares, MD (’77, Res ’99), who directs Strong’s inpatient and outpatient Medicine in Psychiatry Services. “He was a devoted clinician and teacher, and lived the biopsychosocial philosophy, working to create new models of care that addressed all of the issues faced by our most vulnerable patients.”

Born in St. Louis, Mo. in 1929, he moved with his family to Mobile Ala., during WWII, and graduated from Spring Hill College and the University of Alabama Medical School. He completed his internship and residency at Duke University, and spent two years in the U.S. Navy, before coming to Rochester for a two-year fellowship with Engel and then-chair of Psychiatry John Romano, MD. “My mind got stretched by Engel and Romano,” said Dr. Klein, who turned down the opportunity of becoming chief resident at Duke to take the fellowship. “I loved them both. It was the happiest time in my

In Memoriam life. I was enjoying myself.”

Following his fellowship, he returned to Duke as an assistant professor of Medicine for six years, but soon realized, “I wasn’t the Duke type. I am a clinicianteacher, not a researcher.

That’s what I loved to be.”

Returning to Rochester once more, he spent the remainder of his career doing just that, and was Dr. Klein and Psychiatry chair Ben Lee, MD. “happy as a lark” teaching SMD’s Introduction to Clinical Medicine course from 1992-2015. “Teaching interviewing skills to medical students is the greatest joy I ever experienced in Rochester,” he said. “Watching students getting in touch with a total stranger around the story of their illness, listening and responding— or not—to their patients’ emotions was like feeding little birds…a love experience.”

When Dr. Klein was hospitalized at Strong in October with advanced heart failure, he asked chief of Palliative Care Robert Horowitz (MD ’93, Res ’98), if he could meet Psychiatry’s recently appointed John Romano Professor and Chair of Psychiatry, H. Benjamin (Ben) Lee, MD. “When I went to see Dr. Klein in the Palliative Care Unit, he looked quite frail, but his mind was still sharp, and he was a consummate gentleman,” said Lee. “During our conversation, he became quite animated, almost exuberant, as he described his younger days ‘at Rochester.’ He asked me to remember his work for the Department of Psychiatry and honor his teachers, George Engel and John Romano.

I promised both, and that made him very happy.”

The next day, when Lee presented at the Department of Medicine Grand Rounds, Dr. Klein was seated in his wheelchair in the front row, a nurse at his side.

“Dressed in a hospital gown, he had an IV line in his left arm, and he waved at me with his right arm,” said Lee. “Despite his precarious health, he kept smiling and cheering everybody on. You wouldn’t have guessed that he had received his last rites a few days earlier.”

Dr. Klein also toured the Inpatient Medicine in Psychiatry Unit he had helped to found, escorted by IMIP unit director Marsha Wittink, MD, MBE, associate professor in the Departments of Psychiatry and Family Medicine.

“It was such an incredible privilege to host him,” said Wittink.

“He was absolutely beaming when he visited the unit, and made us promise to spread the word about the work we’re doing. He regaled the team with anecdotes about George Engel, lessons learned from patients, and the joy of teaching our medical students.”

He was discharged Oct. 30, and died the following day, but not without first making a decision to donate his body to science. When he did, he noted, “I’m still teaching medical students after all! I love the idea that I am still giving, as Rochester has been such a wonderful place for me.”

– Christine Roth

Word has reached us of the passing of the following alumni and friends.

The School of Medicine and Dentistry expresses its sympathy to their loved ones. (as of February 28, 2018)

Julian Alexander (MD ’49) Carl H. Andrus (MD ’61, Res ’72) George M. Angleton (MS ’52) Charles R. Bales (MD ’61) James Michael Bestler (MD ’60) Roger Charles Breslau (Res ’65) David Warren Brown (MD ’63, Res ’73) Alan K. Bruce (MS ’54, PhD ’56) Leon John Canapary (Res ’66) Jerry Cassuto (MS ’60) Lane M. Christ (MD ’51) David Graham Clark (MD ’72) David V. Clough (MD ’58) Nathan Cohen (MD ’57) Frank J. Colgan (MD ’53) Anneva French Covey (Res ’46) Rose Dagirmanjian (MS ’54, PhD ’60) Gordon Davenport (MD ’48, Res ’50) Marilyn A. Deamicis (PhD ’77, Pdc ’94) Brewster C. Doust (BA ’50, MD ’52) Robert L. Eberly (MD ’63) Mark R. Eckman (Res ’69) Richard M. Engel (Res ’79) Constantino Fernandez (Res ’76) William B. Forsyth (MD ’46) Donald F. Gaiser (Res ’66) Francis Xavier Gavigan (MS ’55) Richard D. Gerle (MD ’57) Robert J. Gill (MD ’48) Adrian W. Grubs (MD ’59) Bernard Grunstra (Res ’89) Robert Johns Haggerty (Res ’51) Arthur Thomas Hall (MD ’52) Donald B. Hunton (MD ’54) J. Kempton Jones (Res ’47) Richard Wier Katzberg (Res ’77) Alfred Schutt Ketcham (MD ’49) Robert Krederick Klein (Res ’63) Richard Knapp (MD ’58) A. Karen Kreutner (BA ’60, MD ’63, Res ’66) Seymour Levitt (Flw ’83, Res ’93) Michael J. McKenna (PhD ’75) Edmond Campbell McLane (Res ’61) John F. Mira (Res ’74) James F. Morris (MD ’48) Arthur Jay Moss (Res ’62) Philip R. Nader (MD ’62) Laura Ann Napolitano (MD ’91) Carl F. Needles (BA ’56, MD ’60) Donald C. Oliveau (MD ’62) Susan Presberg-Greene (MD ’86) David George Publow (BA ’61, Res ’73) Cynthia Rask (Res ’82, Res ’85) Suzanne Hooker Rodgers (PhD ’67) Charles A. Rogers (MD ’43) Robert M. Roy (Res ’54) Alexander Strasser (MD ’62, MS ’67) John R. Thornbury (Res ’93) James Heber Warram (Res ’63) Robert William Woodhouse (Res ’61) Richard L. Worland (MD ’70) Robert Scott Zeiders (MD ’65) ROCHESTER MEDICINE | 2018 – V1

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IN MEMORIAM

Bernard “Bernie” Weiss, PhD Bernard “Bernie” Weiss (PhD ’53), professor emeritus of Environmental Medicine and Developmental & Behavioral Pediatrics, passed away Jan. 22, 2018 at the age of 92.

Dr. Weiss was a monumental and beloved figure in the scientific community, and helped found a field of research that tracks the impact of toxic chemicals on human behavior. His research was foundational to national discussions about the dangers of artificial food dyes, pesticides, and chemicals in plastics, and he advocated for better policies to protect the public.

As recently as 2015, Dr. Weiss participated in a national debate over the safety of food dyes, which the FDA had declared safe. Citing studies that showed an association between children ingesting food dyes and hyperactivity, he supported a ban. Several manufacturers, including Kraft, agreed to remove artificial dyes such as Yellow No. 5 and Yellow No. 6 from macaroni and cheese, replacing them with natural ingredients such as turmeric and paprika.

Later in his career, Dr. Weiss sat on advisory boards reviewing data and making recommendations about dioxin, metals, dental amalgams, the environmental conditions on NASA spacecraft, and the air quality aboard commercial airplanes. Until about two years ago, he could still be found in lab several days-a-week and was happy to offer research consultation and support. A scientific paper he co-authored is in the process of being published.

Deborah Cory-Slechta, PhD (Flw ’82), professor and former chair of Environmental Medicine, trained as a post-doc under Dr. Weiss and his long-time colleague and collaborator Victor Laties (PhD ’54), professor emeritus of Environmental Medicine.

“Many of the issues Bernie began to address 30 or 40 years ago are still major issues in the field today,” she said. “He moved them forward with creativity and foresight and his legacies will be with the field for a long time to come.”

Dr. Weiss’ career began and ended in Rochester. He earned a doctoral degree from UR in Psychology in 1953 and returned to the faculty 12 years later. In the intervening years, the WWII Air Force veteran conducted research at the Air Force School of Aviation Medicine in Texas (then Johns Hopkins University). He developed ways to measure the impact of drugs, nutrients and chemicals on the brain, and built one of the first mini-computers ever used in research.

In 1965, he was lured back to UR to help launch one of the world’s first doctoral degree programs in toxicology.

Named Scientist of the Year by the Association of Children and Adults with Learning Disabilities in 1986, Dr. Weiss also received a Distinguished Investigator Award from the Neurotoxicology Specialty Section of the Society of Toxicology in 2003. During the mid-1970s, he took part in the U.S.-U.S.S.R. Environmental Health Exchange Agreement, leading U.S. delegations in world-wide discussions of behavioral toxicology.

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“We are all gamblers,” he wrote in Neurotoxicology 40 years ago.

“We scheme to conquer chance, to beguile it into surrender, to lull it into forgiveness. In the end, it subdues us; but without malice, and at times to our advantage. Like other lives, mine has been hostage to random collisions…Neurotoxicology will continue to be an adventure as long as its practitioners remain adventurers.”

–Susanne Pallo Donations in Dr. Weiss’ memory may be made to The Bernard Weiss Endowment Fund, 300 East River Road, P.O. Box 278996, Roch., N.Y. 14627. Attn: Christie Cullinan.

Robert J. Haggerty, MD

continued from page 52 an intern at Strong Memorial Hospital. He then served two years as a U.S. Air Force captain before completing his pediatrics residency at Children’s Hospital in Boston, and a teaching fellowship at Harvard Medical School. Over the next 10 years, he became an assistant professor of Pediatrics at Harvard, founding medical director of the Family Health Care Program and director of Boston’s Poison Information Center.

Dr. Haggerty returned to Rochester in 1964 to chair the Department of Pediatrics, and become Strong’s pediatrician-in-chief.

He remained 11 years before returning to Harvard Medical School to become the Roger Irving Lee Professor of Public Health.

From 1978-88, he served as senior program consultant and director of the General Pediatric Academic Development Program of the Robert Wood Johnson Foundation. In 1980, he began a 12-year post presiding over the New York City-based William T. Grant Foundation, supporting research on children’s mental health.

Upon his “retirement” in 1992, Dr. Haggerty came back to Rochester as professor emeritus. He spent the next eight years as executive director of the International Pediatric Association, and editor of many academic journals including the New England Journal of Medicine. He was founder and, for 25 years, editor-in-chief of the AAP’s Pediatrics in Review, the world’s largest journal devoted to pediatric continuing education.

His awards include the highly prestigious Howland Award from the American Pediatric Society and the Alfred I. du Pont Award for Excellence in Children’s Health Care. The Robert J. Haggerty Child Health Services Research Laboratories in URMC’s Golisano Children’s Hospital is named in his honor.

In 2016, Dr. Haggerty and his family, along with the family of Stanford Friedman (MD’ 57), (1931-2013), endowed the HaggertyFriedman Professorship in Developmental/Behavioral Pediatric Research, now held by Tristram Smith, PhD. – Sean Dobbin Donations in Dr. Haggerty’s memory may be made to the Haggerty/ Friedman Fund at Golisano Children’s Hospital, 300 E. River Road, P.O. Box 278996, Roch., N.Y. 14627.

ALUMNI SPOTLIGHT

Sy Schwartz Feted By ACS for Iconic Surgery Textbook The American College of Surgeons (ACS) held a special session in late October to honor one of its true legends: Seymour I. Schwartz, MD, FACS (Res ’57), founding and longtime editor of the world’s leading surgery textbook, Schwartz’s Principles of Surgery. The text is now in its 10th edition and celebrating the 50th anniversary of its first publication.

Schwartz, Distinguished Alumni Professor of Surgery at the School of Medicine and Dentistry, delivered a lively talk highlighting the session, chaired by one of his protégés, David Linehan, MD, FACS, Seymour I. Schwartz Professor and Chair of the Department of Surgery.

In his introductory remarks, Linehan reminded the audience that Schwartz chose to chronicle extraordinary progress in fields that did not even exist when Schwartz’s Principles began: liver transplantation and molecular diagnostics of solid tumors.

“We stand on the shoulders of giants,” said Linehan. “I don’t think you can find a taller one than Dr. Schwartz.”

Now 89, Schwartz was ACS president in 1997–98. He began his remarks by recalling the start of the eponymous textbook, which he led for 35 years through seven editions during a time of breathtaking advances.

“The other five associate editors all had administrative positions, and so they designated me as the one to be traumatized as the editor-in-chief,” he said.

Though he claimed to hate the phrase “paradigm shift,” there were many in his time. For example, the first surveillance for malignancy, the PSA test for prostate cancer, was introduced in 1984. He cited changes in engineering, biochemistry, and genetics that have resulted in more sophisticated, non-invasive diagnostics “which changed the very profile of lesions subject to surgical excision,” as well as engineering advances that enabled minimally invasive surgical procedures.

He noted that the TIPS procedure to reduce vascular resistance in the liver replaced his own favorite procedure, the flow shunt, which he said hasn’t been performed in the past two decades at URMC. He then modestly took personal responsibility for a list of entries in the textbook that were later revealed to be erroneous, such as a declaration that antibiotic use was unnecessary in a patient with acute appendicitis because the appendix must be removed as soon as possible. The editorial board of the first edition accepted a statement by contributors that adenomatous polyps of the colon “had negligible attention for subsequent malignancy.”

Textbooks, he said, should be considered evanescent.

“Print often, if not usually, outlasts the facts that it promulgates,” he said.

The 50th Anniversary Celebration of Schwartz’s Principles of Surgery: First Edition: A Retrospective and Futuristic View, was held October 24, at the 2017 Clinical Congress of the American College of Surgeons in San Diego, Calif. The program, webcast, and audio information are available at FACS.org/clincon2017.

Schwartz, at left, with companion Lyn Kayser, assistant professor of Surgery Rachel L. Farkas, MD, FACS (Res ’11) and associate professor of Surgery Jacob Moalem, MD, FACS ROCHESTER MEDICINE | 2018 – V1

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CLASS NOTES If you see any alumni whom you would like to contact, use the Online Directory at www.alumniconnections.com/URMC to find address information.

Submit class notes to your class agent or to RochesterMedicineMagazine@ urmc.rochester.edu.

Note: MD alumni are listed alphabetically by class. Resident and fellow alumni follow in alphabetical order, and graduate alumni are listed separately in alphabetical order.

MD Alumni 1959

Myron Liptzin (Res ’63) updates, “I retired at age 63 from the University of North Carolina as professor of Psychiatry & chief of Psychiatry at UNC Student Health. I enjoyed clinical work at various locum tenens sites around the U.S. for the next six years, and fully retired from practice since. I enjoy keeping up with some ’59ers by e-mail and visits on occasion. Annie and I are well, enjoying travel and life in Chapel Hill. We left our grand home after 25 years and now live at a lovely retirement center. Our needs here are few since we no longer need to change ceiling light bulbs, clear leaves or shovel the (rare) snow. The excellent food service has relieved Annie of cooking chores, and me of the dishes and clean up. I am singing with the Triangle Jewish Chorale. Two years ago we performed in Buenos Aires followed by a brief tour including avoiding getting soaked at Iguasu. I invite any ’59ers passing through North Carolina or anywhere in the vicinity to stop in for a visit.”

Frank Cegelski (Res ’64) writes, “I have been widowed for 5-1/2 years after a terrific 57-year love affair with Anne. I have four children and eight grandchildren spread around the country: Maine, California, North Carolina, and New York. I am now sharing my senior life with a wonderful woman, in excellent health, and spending my days trying to make lives better for friends, family, and

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myself. I’m getting back to golf after some orthopaedic problems. The ball doesn’t go as far as it used to, probably due to global warming. I look back on medical school and my early days of practice as the best years of my life, but it’s not too bad now! I still belong to Oak Hill Country Club and keep a house in Rochester for the summer, but have been a Florida resident since retirement 18 years ago.”

1962

Charles Halsted is enjoying retirement with his wife, Ann, in Davis, Calif. He has established a new career in poetry, which includes an emphasis on doctor-patient relationships. He retired from academic medicine at the University of California-Davis in 2016 after 43 years. There, he specialized in GI/clinical nutrition and his primary research focus was on the mechanisms of alcoholic liver disease in an animal model.

His first wife and fellow ’62 classmate, Crystie, passed away in 2008 from diabetic complications. The couple has three children and three grandchildren.

1963

Paul H. Levine (Res ’64) is a research professor in the Department of Epidemiology at the University of Nebraska School of Public Health. In addition to his research and online teaching, Levine runs the Inflammatory Breast Cancer Registry and is participating on an NIH grant investigating chronic fatigue syndrome as an autoimmune disease, with a link to non-Hodgkins lymphoma and brain cancer—which he first reported on in the 1980s. In 2017, Levine celebrated his 80th birthday with 21 family members.

He writes, “I enjoy the contact I have with classmates like Lowell Weitkamp, who I see occasionally, and I regret not following up with other classmates, particularly in the Washington, D.C. area. I’m hopeful that with better communication, that will improve.

I would love to hear from colleagues via paulhlevine@earthlink.net.”

1964

Michael Amin Hamilton is enjoying retirement from the jewelry store he helped found in Durham, N.C. When not spending time with his family and pets, Hamilton stays busy managing an Airbnb apartment. He also enjoys reading The New Yorker and watching Morning Joe, Ari Melber and Curb Your Enthusiasm.

1966

Richard C. Friedman was recognized

by Marquis Who’s Who for Excellence in Psychiatry. Friedman’s career spans more than five decades, including faculty appointments at Weill Cornell and Columbia universities. He now lives and works in New York, where he is writing his third book and maintains an active psychoanalytic practice.

1968

Mary Costanza (’58) is looking forward to attending her 60th college reunion and 50th medical school reunion at the University of Rochester in 2018. Costanza is in her final year of teaching and research in medical oncology at the University of Massachusetts School of Medicine. She retired from clinical care in 2009 and is enjoying life at a retirement community in Needham, Mass.

She informs us that she does not miss raking leaves or tending to the leaky roof of her previous Victorian house.

Ronald Eckert was recently featured on the PBS show Second Opinion. The episode, “Immunotherapy in Cancer Treatment” featured Eckert and two other panelists in a roundtable discussion on the effects of immunotherapy. Eckert was diagnosed with stage IV malignant melanoma in 2012, and was treated with immunotherapy at Massachusetts General Hospital for one year.

He was a physician at South Buffalo Mercy Hospital for 35 years.

1973

Dennis Clements and his wife, Martha Ann Keels, are now grandparents to five boys and one girl, all living in the San Francisco area, where their three daughters live. A seventh grandchild (a boy) is due in spring 2018.

Clements is also teaching a new course at Duke University, “Entrepreneurial Problem Solving in Global Health,” to complement the capstone course he has been teaching for 10 years. Recently, Clements and Keels participated in the naming of the Pediatric Dental Clinic at the Eastman Institute for Oral Health.

Lewis J. Smith (Res ’76) is enjoying “semiretirement,” after 38 years at Northwestern University’s Feinberg School of Medicine.

Smith became professor emeritus of Medicine on September 1, 2017. Since joining the faculty at Northwestern in 1979, he has served as Pulmonary and Critical Care division chief, associate vice president for Research, co-director of the Center for Education and Career Development, and director of the Center for Clinical Research in Northwestern’s Clinical and Translational Sciences Award program. He also maintained a research program supported by several government and philanthropic organizations. Smith says he is now focusing solely on his research and mentoring. His newly found “free” time is enabling him to spend more time with his wife of 46 years, their two daughters and husbands, and four grandchildren. Smith looks forward to traveling more, both near and far, to visit old friends and new locations.

1974

John Vanek had the first of three novels, DEROS, published in February 2018 and was recently released worldwide. It is available in paperback and e-book at Barnes & Noble and Amazon. Visit the author’s website, JohnVanekAuthor.com for more details.

1975

W. Reed Kindermann earned a 2017 Top Doctor Award in Cherry Hill, N.J. Kinderman is an ophthalmologist at Kindermann Eye Associates, and is affiliated with Cooper University Hospital and Wills Eye Hospital.

Certified by the American Board of

Ophthalmology, Kindermann specializes in cataract surgery, but also treats and diagnoses eye-related conditions for patients of all ages.

He is a member of the American Academy of Ophthalmology, the New Jersey Academy of Ophthalmology, the American Society of Cataract and Refractive Surgeons, and the American Association of Pediatric Ophthalmology and Strabismus.

1980

Wendy Harpham will be recognized in April 2018 by the American College of Physicians with the Nicholas E. Davies Memorial Scholar Award for Scholarly Activities in the Humanities and the History of Medicine.

1976

Jean Ann Hinklicky recently closed her child psychology practice and realized a lifelong dream by moving to Sante Fe, N.M. She now spends her free time volunteering, tutoring and singing in the Zia Women’s Chorus. Her husband Larry also scaled back his teaching responsibilities at Johns Hopkins University, which has eased the couple’s transition to retirement. Their son, Matt, and his wife, Julia, just moved to Boston, where he will begin a new position with Ford Motor Company and she has earned an assistant professorship in Public Health at Boston University. Their daughter Sarah married her husband, David, in July 2017. Sarah currently works at the University of California-San Francisco conducting research in women’s reproductive health and family planning.

1978

David A. Diamond proudly informs us that his daughter, Rachel Diamond, recently completed her residency in Pediatrics at the University of Rochester, where she was Chief Resident. Rachel also finished her fellowship in Pediatric Palliative Care and has joined the URMC’s pediatric palliative care faculty.

1979

Robert Brodell (Res ’81) is retiring from his role as interim chair of the Department of Pathology at the University of Mississippi Medical Center after 20 months of service.

He will continue as chairperson of the Department of Dermatology.

Harpham will be an honorary lecturer and present her keynote address, “On Healing Hope: The Promise of Healthy Survivorship.”

At the age of 36, Harpham was diagnosed with stage III Non-Hodgkin’s lymphoma.

Today, in addition to her internal medicine practice, she is a patient advocate, author, and nationally recognized speaker.

1982

Michael D. Terranova is currently the managing partner of Lancaster-Depew Pediatrics in suburban Buffalo, N.Y., and district vice chair for New York State District II American Academy of Pediatrics.

1984

Bruce D. Gelb is a 2018 recipient of the Jacobi Medallion, one of the highest honors the Mt. Sinai Health System bestows upon current or former colleagues. The award recognizes doctors who have made exceptional contributions to Mt. Sinai’s Icahn School of Medicine, the Mt. Sinai Health System, Mt. Sinai Alumni Association, and the fields of medicine or biomedicine. A pediatric cardiologist, Gelb directs Mt. Sinai’s Child Health and Development Institute, a collaborative multidisciplinary research

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CLASS NOTES environment to advance translational research into prevalent childhood diseases. In his quest to uncover the causes of congenital heart disease, Gelb has developed an extensive program in genomics and gene investigation, focusing on traits associated with heart malformations. Gelb is also founder and co-director of Mt. Sinai’s Cardiovascular Genetics Program, which cares for patients and families with genetic-based cardiovascular disorders. A recipient of the E. Mead Johnson Award from the Society for Pediatric Research and the Norman J. Siegel New Member Outstanding Science Award from the American Pediatric Society, he is current president of the International Pediatric Research Foundation and council member of the American Pediatric Society. URMC CEO and URSMD dean Mark Taubman, MD, helped recruit Gelb to Mt. Sinai in 1991 when Taubman was then-director of Icahn School of Medicine’s cardiology fellowship, PI of an NIH training grant in molecular cardiology, and director of the medical scientist training program.

1985

William J. Turtle was inducted to the Cranston, R.I., Hall of Fame in November.

Turtle graduated from Cranston High School West in 1977 and was voted by his classmates and faculty as the “Ideal Cranstonian” and “Most Likely to Succeed.”

Turtle has been in practice since 1989, specializing in pediatrics, and often claiming “Top Doc” honors in Rhode Island Monthly magazine. He also served as clinical associate in Pediatrics at Northeastern University from 2009 to 2015.

1988

Immanuel Ho is currently a clinical professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania, as well as the director of Interventional Endoscopy at Pennsylvania Hospital, and trustee at the American College of Gastroenterology.

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James M. Musser was recently elected president-elect of the Federation of American Societies for Experimental Biology (FASEB).

Musser, who also holds a PhD from the University of Pennsylvania Health System, is chair of the Department of Pathology and Genomic Medicine at Houston Methodist Hospital. Musser will serve as FASEB President for 20182019, and for three years as a member of the FASEB executive committee. FASEB represents 125,000 international members and is recognized as the international policy voice of biological and biomedical researchers around the world.

1990

Robert Babkowski (Res ’95) is in his 12th year as chief of Pathology and laboratory medical director of Stamford Health System in Stamford, Conn., and serves as president of Stamford Pathology Group PC, which he founded in 2005. His younger daughter, Nicole, is a freshman at the University of Rochester and has an eye on medicine, perhaps a future pathologist. His older daughter, Alexandra, is a junior at George Washington University and studying for her LSAT. Babkowski and his wife Marilyn are now empty-nesters and living life to its fullest. He shares that his golf game is muchimproved and writes, “Visiting the UR in October for Meliora Weekend reminded me of what a special place the University is, and how proud we should all be of our alma mater.”

Ellen Louise Singer (Res ’94) is now the Northwest Permanente director of Graduate and Undergraduate Medical Education in Portland, Ore. She also continues to maintain a busy primary care practice in Internal Medicine and Pediatrics.

1992

Bernard Plansky continues his family medicine practice with his wife in Pittsford, N.Y. The couple is also in their third year of directing Shakespearean plays with a cast including at-risk teens, counselors from Hillside Family of Agencies, and members of the Rochester Police Department. Work on Macbeth began in January with a performance scheduled for spring. Plansky continues to run weekly addiction medicine groups and classes at the VA Medical Center in Bath, N.Y.

1993

Marleece Sherman Barber is currently the chief medical officer for Lockheed Martin Corp., in Bethesda, Md. Robert K. Horowitz (Res ’98) was recently named chief of the Division of Palliative Care and the Georgia and Thomas Gosnell Distinguished Professor in Palliative Care at the University of Rochester Medical Center.

Horowitz joined URMC’s Palliative Care Program in 2010 and has served as its clinical director, acting chief and interim chief leading up to his current appointment.

1998

Katrina Weller writes, “I’ve been at the same clinic since finishing residency. In 2015, my private practice became a Federally Qualified Health Center. I still see patients two days-aweek, but I’m loving my three days-a-week as chief medical officer, working to help meet the community’s needs while focusing on the Quadruple Aim.”

2000

Brian T. Sick has been elected chief of staff for the University of Minnesota Medical Center. Since 2013, Sick has led the University of Minnesota Academic Health Center’s interprofessional education program.

He is currently in his 10th year as the medical director for the University of Minnesota’s student-run free clinic, Phillips Neighborhood Clinic. In recognition of this work, Sick was awarded the Minnesota Medical Association’s Community Service Award in 2013, and the University of Minnesota Outstanding Community Service Award in 2017.

2003

Maia Hightower (MPH ’03), is the chief information officer and a clinical assistant professor at University of Iowa Health Care.

2004

Karen M. Wilson (MPH ’95, Res ’07, Flw ’09) has moved to the Icahn School of Medicine at Mount Sinai Hospital in New York City, as the Debra and Leon Black Professor and Division Chief of General Pediatrics, and vice-chair for Clinical and Translational Research.

2007

Jared A. Tomlinson (Res ’10) has joined Carthage Area Hospital in Carthage, N.Y. Tomlinson is one of two new board-certified general surgeons as the hospital recently opened a new surgical clinic. The move comes through a partnership with Synergy Surgicalists, based in Bozeman, Mont.

2010

Deepak Sobti climbed Mt. Kilimanjaro to raise funds and awareness for blinding cataracts. Sobti is an ophthalmologist at Kleiman/Evangelista Eye Center in Arlington, Tx. Sobti, along with three friends, nicknamed, “Team Kili,” raised $21,288,

surpassing their goal of $19,341 ($1 per foot of elevation climbed). The group took the eight-day Lemosho Route up the mountain, which took six days up and two days down.

“Team Kili” (minus one who suffered a serious case of altitude sickness in the early morning of the last day), made it to the top on August 10.

2011

Andrew J. Rand recently joined St. Anthony’s Hospital in St. Petersburg, Fla. He previously worked as a fellow and clinical instructor of surgical pathology at the Medical University of South Carolina.

2016

Allan Augillard and Steve Morgan took time out of their Emergency Medicine residencies (at Case Western and Louisiana State

Resident & Fellow Alumni

Seymour Schwartz (Res ’57) was honored as a Surgery Icon at the American College of Surgery Clinical Congress in San Diego, Calif. on October 25. Schwartz has been a faculty member at the University of Rochester for 60 years, including chair of Surgery from 1987 to 1998. His textbook, Principles of Surgery, published in 1969, is widely known as the “surgeon’s Bible” and he has penned more than 250 scientific articles and several textbooks. Schwartz is an elected member of the National Academy of Medicine, where members advise the nation and international community on issues of health, medicine and policy. See story on p. 55 Myron Liptzin (’59 MD, ’63 Res) See MD Class of 1959 Frank Cegelski (MD ’59, Res ’64) See MD Class of 1959 Paul H. Levine (MD ’63, Res ’64) See MD Class of 1963 Theodore L. Mobley (Res ’67) received a 2017 Top Doctor award in Phoenix, Ariz., recognizing the most influential and respected physicians in medicine. Mobley is a urologist affiliated with the Phoenix VA Hospital, is certified by the American Board of Urology and is a founding member of the Arizona Urological Society. He graduated from the Keck School of Medicine at the University of Southern California in 1959 before completing his residency in Rochester.

Lewis J. Smith (Res ’76) See MD Class of 1973 Robert Brodell (Res ’81) See MD Class of 1979

2009

James M. Hildebrand accepted the position of department chief for Emergency Medicine at St. Joseph’s Hospital in Bangor, Me. He was formerly a physician for Emergency Medicine at St. Joseph’s and a resident at the University of Massachusetts.

University) to provide emergency relief to Louisiana residents in the wake of Hurricane Harvey and Hurricane Nate in 2017.

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CLASS NOTES

Peter A. Wyman (PhD ’87, Flw ’88) was named co-chair of the recently formed New York State Suicide Prevention Task Force. Wyman currently serves as a professor for the URSMD’s Department of Psychiatry, specializing in child and adolescent services. The task force will focus on suicide prevention for high-risk groups, including teens, veterans and members of the LGBTQ community.

Ellen Louise Singer (Res ’94) See MD Class of 1990 Gregory P. Brown (Flw ’96) was recognized

by Continental Who’s Who as a Pinnacle Lifetime Member for Excellence in Psychiatry and Forensic Psychiatry for his work as a general and forensic psychiatrist at the University of Nevada. Brown has more than 20 years of experience, including handling psychiatric evaluations for civil, criminal, and family court, independent evaluations, psychodynamics, hypnotherapy and neurolinguistics mapping.

Robert K. Horowitz (Res ’98) See MD Class of 1993 Aaron Olden (Res ’06) was named to Rochester Business Journal’s “Forty Under 40” list. The list is composed of professionals younger than 40 who demonstrate leadership in the workplace and the community. The awards were presented at a luncheon on Nov. 16, 2017 at the Rochester Riverside Convention Center. Olden currently serves as the medical director at Lifetime Care/Home Health Care and Hospice.

Karen M. Wilson (MPH ’95, Res ’07, Flw ‘09) See MD Class of 2004

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Jennifer Findeis-Hosey (Res ’11) was part of a national research team that discovered alterations in four main genes that are responsible for how long patients survive with pancreatic cancer. The study, published in JAMA Oncology, found that patients who had three or four of the following genes altered—KRAS, CDKN2A, SMAD4 and TP53—had worse survival rates compared to patients with one or two altered genes.

2012

Angel Boev (Res ’12) received the Distinguished Alumnus Award from Voldosta State University’s College of Arts and Sciences. Boev graduated with honors from VSU in 1996 with a BS in biology. He earned his MD from Mercer University School of Medicine and completed his residency training in neurosurgery at URMC in 2012.

Boev is currently a practicing neurosurgeon at Rochester General, F.F. Thompson, Highland, and Unity hospitals. He also founded and is managing partner of the Boev Clinic, which offers patients spinal care throughout the Rochester and Finger Lakes regions.

PhD Alumni

Mary Mowrey-McKee (PhD ’78) currently serves as a consultant in the contact lens industry for Alcom, primarily participating in standards development in ANSI and ISO. She is also ISO project leader for development of a standard evaluation of amoebicidal efficacy of contact lens care products against Acanthamoeba trophozoites. She retired as senior research fellow from CIBA Vision in 2011.

Peter A. Wyman (PhD ’87) See Residents and Fellows Class of 1988 Lauren Campbell (PhD ’17) recently started as a Health Services Researcher at RTI International in Waltham, Mass.

Graduate Alumni

John Henry Baker (MS ’59) MD, FACP, writes, “My single year at Rochester was one of the strongest educational and enjoyable of the many years I spent in school. They are all gone now, but I remember a score of great teachers, especially Dr. Crain, Dr. Stannard, Prof. Mermagen, and Dr. Jim Sterner and the Eastman Kodak medical staff. It was a ‘perfect storm’ educationally, being allowed to complete the degree in Radiation Biology and Occupational Medicine in just over one academic year. Tough, but rewarding! Stop by when you are visiting the Sunshine State.”

Mary Maher (MPH ’10), PhD, recently started as the founding director of Public Health Undergraduate BA/BS Major and chair of the Nursing Department at Nazareth College. After earning her PhD at URSMD, Maher earned her PhD from the University of Rochester School of Nursing in 2012.

Student Earns Rare Tropical Medicine Fellowship Celia Fung (MD ’20) was one of only 21 students nationwide to earn a 2017 Benjamin H. Kean Travel Fellowship in Tropical Medicine from the American Society of Tropical Medicine and Hygiene (ASTMH).

The fellowship is the only medical student award dedicated to nurturing a career path for physician-scientists in tropical medicine.

The grant supported Fung’s work in Swaziland from March to July 2017 to complete her selected project, “Evaluation of DNA Methylation as the Repressive Means of Helminth-Induced Immune Perturbation.” The fellowship is named for Benjamin H. Kean, MD (1912-1993), an internationally acclaimed tropical medicine expert and mentor, who was committed to the idea that early hands-on experience in developing countries is the best way to stimulate a career in tropical medicine.

Fung and other fellows in the program represent a new generation of soon-to-be physicians working to alleviate suffering and long-term disability caused by both common and lesser-known tropical diseases, said Kean Fellowship Committee Chair Desiree LaBeaud, MD, MS, Stanford University. “We expect to see extraordinary things from these fellows in the near future,” she said.

Fung is also a three-year grant recipient of the HIV Medicine Association (HIVMA) Medical Students Program. The program supports students and mentors in carrying out longitudinal HIV-related clinical learning and/or research projects during medical school. Students and mentors have flexibility in designing their curriculum to complement the school’s training requirements.

Philanthropy continued from page 43

Prasad Named Dr. Jude S. Sauer Family Distinguished Professor in Cardiac Surgery Sunil Prasad, MD, was recently installed as the Dr. Jude S. Sauer Family Distinguished Professor in Cardiac Surgery. Prasad is associate professor of Surgery, chief of Cardiac Surgery, director of the Cardiac Intensive Care Unit, LVAD Surgical Director, and surgical director of the Heart Transplant Program. He performs a range of complex surgical procedures, including heart transplants, with special expertise in the use of mechanical devices to help patients in heart or respiratory failure.

Prasad helped pioneer the next generation of ECMO, known as “walking ECMO,” which uses portable devices that allow patients to get out of bed and walk with their device, often reducing complications and improving outcomes.

ECMO is a machine to oxygenate the blood when the heart or lungs are failing.

Sunil Prasad, left, with Eva and Jude Sauer He has published more than 40 academic papers on topics including the prevention of complications from LVADs, the use of radiofrequency ablation to treat atrial fibrillation, and improving the preservation of donor hearts used in transplants.

Jude S. Sauer (BA ‘81, MD ‘85, Res ’88) is clinical assistant professor of Surgery and founder, president, and CEO of LSI Solutions® in Victor, N.Y., a medical device company dedicated to advancing minimally invasive therapeutics through research, development, manufacturing, and marketing proprietary products. The company was founded in 1986 during his surgical internship. Sauer’s nearly 150 domestic and international awarded patents provide the basis for products in the fields of general, gynecologic, bariatric and, most importantly, cardiac surgery. These licensed inventions have been used to treat tens of millions of patients throughout the world. Sauer’s wife, Eva (Flw ’89), is LSI’s secretary and treasurer. She started her life in the U.S. at the University of Rochester, having moved here from Austria in 1986.

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Bone Boot Camp see page 30