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Daniel Dunaief

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Assistant Professor Michael Lukey and postdoctoral researcher Yijian 'Evan' Qiu. Photo courtesy of Michael Lukey lab

By Daniel Dunaief

Cancer is a dangerous and wily adversary. Just when researchers think they have come up with a plan to defeat a deadly disease that takes many forms and that attacks different organs, cancer can figure out a way to persist.

Researchers have known that breast cancer uses the amino acid glutamine to power its high energy needs. To their disappointment, when they’ve blocked glutamine or reduced its availability, cancer somehow carries on.

An adaptable foe, cancer has figured out how to find an alternative metabolic pathway that can use the same energy or carbon source when its level gets low.

Cold Spring Harbor Laboratory Assistant Professor Michael Lukey and postdoctoral researcher Yijian “Evan” Qiu have discovered how a form of breast cancer has a back up plan, enabling it to survive despite glutamine deprivation.

“Analysis of tumor samples has revealed that glutamine is often depleted within the tumor microenvironment, so we were interested in understanding how seemingly ‘glutamine addicted’ cancer cells adapt to this challenge,” Lukey explained..

In research published last week in the journal Nature Metabolism, the Cold Spring Harbor Laboratory researchers discovered and quieted a type of breast cancer’s alternate energy source.

This form of breast cancer typically uses glutamine, which is one of the most common amino acids, to power its disease-driven machinery. When Qiu and Lukey blocked the formation of alpha-ketoglutarate, which is a metabolite normally derived from glutamine and then glutamate, they significantly repressed the growth of tumors in animal models of the disease.

Cancer cells turn on this alternative pathway that can catalyze glutamate into alpha-ketoglutarate.

“Cancer is always evolving and adapting,” said Qiu. “We need to stay ahead as scientists.”

The results of this research suggest a possible approach to treating cancer, depriving the disease of ingredients it needs to feed the kind of runaway growth that threatens human health. Limiting key ingredients could come from applying specific inhibitors, extracellular enzymes or antimetabolites.

Their work could have implications and applications in other forms of cancer.

The time between observing a promising result in the lab and a new therapy typically takes years. In this case, however, treatments that use inhibitors of glutamine have been well-tolerated in animals and humans. Qiu also did not observe any side effects in animal models in his study, which could potentially accelerate the process of creating a new therapy.

To be sure, developing treatments that cut off cancer’s primary and back up energy supply may not be sufficient, as cancer may have other metabolic moves up its figurative sleeves.

“Cancer cells typically exhibit metabolic flexibility, such that they can adapt to a variety of metabolic stresses,” said Lukey. “It remains to be seen if they can ultimately adapt to long-term blockade of the axis that we identified, but so far we have not seen this happen.”

A search for the back up plan

Qiu and Lukey speculated at the beginning of Qiu’s Cold Spring Harbor Laboratory experience in August of 2020 that cancer cells likely had another energy option.

“The fact that cancer cells that should be dependent on glutamine adapted in glutamine-free media in weeks made me believe that the cancer cells must have such a plan B,” Qiu explained.

To figure out why glutamine inhibitors weren’t shrinking tumors in animal models or humans, Qiu removed glutamine from cancer cells, causing over 99.9 percent of the cells to die. A few, however, survived and started proliferating in weeks.

Qiu used RNA-seq analysis to compare the parental and adaptive cells and found that the cells that are glutamine independent upregulated a serine synthesis pathway. These adaptive cells used PSAT1, or phosphoserine aminotransferase 1, to produce alpha-ketoglutarate.

As for human patients, the scientists don’t know what kind of stress is activating a Plan B for metabolism, which they are currently exploring.

A ‘passion’ for the field

Lukey and Qiu submitted the paper for publication about a year ago. After conducting additional experiments to verify their findings, including confirming that some of the metabolite entered the cell, these researchers received word that Nature Metabolism would publish the research.

Lukey appreciated Qiu’s passion for science and suggested his postdoctoral researcher combines his technical proficiency with good ideas to generate promising results.

Lukey suggested that researchers in the field have developed a growing consensus that effective strategies to target tumor metabolism will likely involve combination therapies that disrupt a critical metabolic pathway in cancer cells and simultaneously block the adaptive response to that intervention.

From China to Buffalo to LI

Born in Yiyang, Hunan province in China, Qiu moved several times during his childhood, to Sanya, Hainan and Changsha, Hunan.

Qiu knew he wanted to be a scientist when he was young. He enjoyed watching ants, observing the types of food they carried with them. He earned his PhD from Clemson University in South Carolina, where he built his knowledge about metabolism-related research and benefited from the guidance of his mentor James Morris.

Qiu and his wife Peipei Wu, who is a postdoctoral researcher in Chris Hammell’s lab and focuses on epigenetic gene regulation in skin stem cell development, live in Oyster Bay.

The scientific couple don’t have much overlap in their work, but they do get “lots of inspiration from each other, during our discussion outside of work,” said Qiu.

Qiu enjoys fishing and caught and ate a catfish from the Hudson River. He appreciates drawing scenery, animals and a range of other visuals, including cartoon characters. He designed T-shirts for his department during his PhD.

As for his research, Qiu hopes the metabolism finding may lead to new treatments for cancer. He also suggested that this approach may help with other cancers.

“What I have found in my study can be applied for many other cancer types that are also dependent on glutamine, such as lung and kidney cancer,” he said. He also can not rule out “the possibility that the treatment may help reduce metastasis.”

An important topic for follow up studies, Lukey suggested, is to address how the metabolic interventions Qiu used might affect immune cells and the anticancer immune response.

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Fire departments from Wading River to Mount Sinai came to the 9/11 Community Memorial in Shoreham Sept. 11, 2019 to commemorate that fateful day. Photo by Kyle Barr

By Daniel Dunaief

Daniel Dunaief

September 11th is not just another day.

The country, and the world, stood still for hours, horrified and stunned by the mass murder committed by terrorists in Manhattan, Washington DC and in a field in Western Pennsylvania.

We can focus on the bravery of the first responders that day, on the remarkable effort by the passengers aboard Flight 93 to retake the plane, the loss of 2,977 people, and the passage of time since that horrible day.

We can also consider the incredible generosity and sensitivity of the country in the days, weeks and months afterwards. I know that didn’t apply to everyone and I remember how taxi drivers from mostly Muslim countries put bumper stickers on their cars indicating they were proud Americans. I also recall the unfair and horrific questioning of people who looked different or who might have originally come from Saudi Arabia or any neighboring countries.

Still, in the wake of a day that also lives in infamy, people gave of themselves and their time.

My family, which included our then three-month old daughter and my wife, walked to an upper east side fire station that lost several members when the World Trade Center collapsed.

There, we saw other people in our community who were bringing toys, pies, gifts and money to the department. The members of the fire station, whom we thanked, forced appreciative smiles on their faces and, more often than not, comforted many community members who choked out heartfelt words of thanks to the station’s survivors.

Outside the station, a car from one of those killed that day was barely visible under an enormous collection of flowers.

Prior to 9/11, I had spent considerable time writing about banks and financial services companies. I had a particular and lasting connection with several members of the boutique firm Keefe, Bruyette & Woods.

KBW provided research and investment banking services for a range of banks. In the months after the attack and the loss of lives, banks made sure to include KBW on investment banking deals, trying to help the survivors and the firm stay in business.

On Long Island, a range of companies donated construction materials to create lasting memorials to the people lost on that day, while offering families a place to go to reflect on the people they were fortunate enough to know.

The frenetic city that never sleeps entered a grieving cycle in which people implicitly knew the rules. A collection of cars passing by with their lights on behind a hearse required people always in a hurry to make way.

Despite the need to do things yesterday, to get somewhere faster than everyone else and to beat people’s own records in traveling from one place to another, people stood by, slowed down and made supportive eye contact with those who were putting up pictures of lost loved ones.

As we drove along the roads around New York City, we saw the efficient removal of debris from the World Trade Center site, with twisted metal and concrete sitting on passing flat bed trucks. Cars made room on highways for these huge trucks and turned on their lights in support and sympathy.

In a more insular way, many of us checked on our friends and family, setting aside ongoing familial disagreements.

I remember watching the video of President George W. Bush (41), who had lost the popular vote in 2000 to Al Gore but had won the election on the strength of the final recount in Florida. He was sitting in a classroom when the secret service whispered in his ear about the attacks. He seemed to take a long time to process what he heard.

Yes, people wondered where he went and what was happening with the center of government power and yes, some criticized him even as they flocked to the Churchillian resolve of Mayor Rudy Giuliani, who somehow symbolized the combination of pain and determination in the days after the attack.

People wanted to help each other, donating, volunteering and coalescing around the notion of a country in need of healing and recovery.

Many of the most helpful and supportive moments reflected the strength of a unified nation with a readiness to set aside political squabbles to defend the country. In our darkest moment, we gave flowers, food, support and respect.

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Firefighters train for a water rescue. Photo courtesy Setauket Fire Department
Firefighters train for a water rescue. Photo courtesy Setauket Fire Department
Firefighters train for a water rescue. Photo courtesy Setauket Fire Department
Firefighters trudge through a flooded street. Photo courtesy Setauket Fire Department
Firefighters training with a hovercraft, which they received three years ago. Since June, over 258 firefighters have taken a water rescue training course. Photo courtesy Halesite Fire Department

By Daniel Dunaief

Fire departments around Suffolk County are preparing, training and gathering equipment for the kinds of water emergencies that can require rescues from homes, cars or buildings.

Amid the sudden and intense rains that damaged parts of Stony Brook and surrounding areas, fire departments received far higher than average numbers of calls for help from residents.

“People used to tell stories [about heavy storms and flooding] every few decades,” said David Sterne, District Manager in the Setauket Fire District. “Now, we’re seeing it every few years.”

Fire departments including in Stony Brook, Setauket, Commack and Port Jefferson responded to dozens of calls for help through the evening as towns like Stony Brook received more than three times the normal amount of rain for the month of August in the hours after midnight.

“We handled over 54 alarms” on the overnight of the storm, said Sterne. The department, which encompasses a 28 square mile district, responds to an average of three calls per night. “It was pretty obvious that it was more than a regular rainstorm.”

The dispatchers, who handle calls for Setauket, Stony Brook and Port Jefferson, received over 70 alarms among the three departments.

Amid the potential for water rescues and emergencies that could occur far more frequently than in the past, fire departments and county officials have increased training and added various types of equipment that can offer assistance during water emergencies.

“We’ve got to be prepared for everything,” said Chief Dominic Spade of the Halesite Fire Department in the Town of Huntington. Halesite added a hovercraft about three years ago that doesn’t use a submerged engine and can travel through shallow waters to homes or stranded motorists.

Additional training

In anticipation of additional water-related emergencies, Suffolk County firefighters and rescue teams have been training for sudden heavy rains and storms.

The county started offering two new courses in water rescue this year: Water Rescue Awareness and Surface Water Rescue. Since June, the Suffolk County Fire Academy has trained 258 firefighters, according to Rudy Sunderman, Suffolk County Fire, Rescue and Emergency Services Acting Commissioner.

“Responders from Stony Brook, Rocky Point, and Port Jefferson, areas that were hardest hit by last week’s storms, were among many members who took the training,” Sunderman explained in an email.

The Suffolk County Urban Search and Rescue Team, which is made up of volunteer first responders capable of deploying up to 40 members, was established in 2012 and was created “to locate, extricate and provide immediate medical treatment to victims trapped in collapsed structures, and to conduct other life-saving operations,” Sunderman added.

Over the last three months, the USAR Team has focused specifically on water rescue incidents.

In addition, numerous local fire departments have improved their water rescue capabilities.

The Setauket Fire Department has sent members of its staff to Oriskany in New York, where people from all over the Empire State receive training for specific types of rescues.

Oriskany has “all types of specialized training,” said Sterne. The facility has a simulated town that they can flood, where rescue teams practice open and swift water responses.

“In the last four to five years, we’ve been sending people on a more regular basis” to Oriskany, said Sterne. “It’s definitely becoming more normal to have massive flooding in certain areas.”

The rescue teams that can’t attend the simulations in Oriskany still benefit from the classes their colleagues take.

“People come back and impart what they learned,” said Sterne. “When making split second decisions, it’s effective” to have considered various emergency measures during flood or surging waters.

Water rescues involve conditions that don’t often have the same challenges as rescues during snowstorms or other weather-related emergencies.

Heavy snow can cover signs or other sharp objects, while people maneuvering through flood waters can tear their protective gear or hurt themselves when they bump into or step on something they can’t see through dark waters.

“Broken street signs and sharp objects might become a real hazard to responders,” said Sterne. “Floor waters can, in many ways, become more dangerous.”

Emergency officials warned about the dangerous combination of water and electricity.

“One of our biggest concerns is when electricity mixes with water,” Sterne explained. “In those situations, our primary focus is to remove people from unsafe conditions when there is flooding mixed with live electricity.”

When a primary or secondary wire falls into water, “it’s a dangerous proposition” and “everything is charged,” said Spada.

Even metallic yellow lines on the street can become charged if power is still flowing into a submerged wire.

Advice for residents

Fire officials offered several pieces of advice for residents.

For starters, don’t enter a basement or other flooded areas without ensuring that electricity has stopped in the area.

Additionally, residents should not venture out onto the road unless it’s for some essential reason.

“Stay put,” Sterne urged. “Don’t become a liability yourself.”

That’s also true during snowstorms, as people leave their homes and block snow plows from efforts to clear the road.

Families should consider emergency locations to congregate, with back up plans if and when they need to leave the house.

Residents also might want to have an accessible bag with flashlights stocked with new batteries, clean clothing and jackets in case an emergency requires an evacuation, Spada suggested.

People trapped in cars should stay there until it’s not safe, Spada suggested. If necessary, they can climb onto the roof of the car and wait for a rescue.

Effective emergency response

Spada was impressed with the quick thinking and acting on the part of several fire departments in response to the stalled, heavy rainstorm.

“Stony Brook did a great job,” Spada said. “Sometimes, you need to improvise in these rescue situations.

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Pixabay photo

By Daniel Dunaief

Benjamin Luft. Photo courtesy of SBU

They bother us, particularly in the summer, but they don’t need us.

The 23 species of Borrelia bacteria, which cause Lyme disease, have been around for millions of years, dating back to when the continents were all linked together like pieces of a puzzle in Pangea. The bacteria likely infected early mammals in those days.

In a recent paper in the journal mBIO, researchers from over 12 institutions put together the genetic sequence of these bacteria, which include 47 strains.

The scope of the work “was enormous and we were lucky” to have so many dedicated investigators, said Ben Luft, Edmund D. Pellegrino Professor of Medicine at the Renaissance School of Medicine at Stony Brook University, including lead senior author Weigang Qiu, Professor of Biology at Hunter College of the City University of New York.

The work, which took about a decade to complete, could provide a valuable resource to researchers and doctors today and in the future. The genetic information could lead to advances in diagnostics, treatment and prevention of Lyme disease.

Scientist could use the database to compare the genomes of different species and variations that cause different symptoms to help diagnose the likely severity of an infection as well as to search for specific pathways that lead to the virulence of an infection.

Some infections can lead to fever, headaches, fatigue and a skin rash. Starting with the bite of an intermediate host such as a tick, these infections, when left untreated, can lead to problems in the joints, heart, and nervous system.

The number of new cases of Lyme disease each year has been climbing, reaching close to 500,000 per year in the United States.

Researchers added that creating a genetic catalog of the different bacterial species can also help current and future scientists and doctors manage new threats from strains of bacteria that move into new areas amid climate change.

These species haven’t interacted with each other in the past, but climate change may create opportunities for bacteria to create recombinant genes, presenting new threats to human health.

“You may start seeing things that you didn’t see before,” said Luft. “We don’t know what’s going to happen” amid climate change. “There might be new forms” of Lyme disease.

The challenge with Lyme is not necessarily what happens in 2024, but how it might change in 20 years, when organisms develop a new pathogenicity.

Lyme on four continents

An international team of researchers sequenced the genomes of many species of Borrelia, the cause of Lyme disease. By comparing these genomes, the researchers reconstructed the evolutionary history of Lyme disease bacteria. The map shows many of the global regions where the team sequenced a species. Borrelia burgdorferi, the most common cause of disease, is indicated in red. Other species are indicated by different colors. Image created by Saymon Akther

In addition to generating a database of the Lyme disease bacterial genome, the researchers wanted to develop an understanding of its phylogenetic history.

“The goal really was to show how genetically diverse Borelia is throughout the world,” said Luft.

The researchers gathered genetic data from this bacteria, which was sampled in Europe, Asia, and North and South America.

By collecting the genetic information in each of these locations, the scientists were able to recreate the history of a bacteria that’s lasted considerably longer than many other organisms that have since become extinct.

“The genetic make up (genes and plasmids) hasn’t changed very much since the last common ancestor on Pangea (otherwise we would see different sets of genes and plasmids from different continents),” explained Qiu.

An extensive collaboration

Qiu and Luft were grateful for all the work scientists around the world did to contribute to this study.

On Long Island, Lyme disease is transmitted mainly by the bite of an infected deer tick, also is known as the black-legged tick.

The team of Claire Fraser and Emmanuel Mongodin at the University of Maryland School of Medicine and Richard G. Morgan of New England Biolabs helped use next generation sequencing to determine the bacterial genome.

Indeed, Fraser was the first to map the complete genetic code of a free-living organisms. She worked with the Haemophilus influenza, which causes respiratory infections and meningitis in infants and young children, according to the University of Maryland School of Medicine.

Qiu, who earned his Phd from Stony Brook in 1999, suggested that the effort required regular, ongoing work. He supervised Dr. Saymon Akther for her thesis work, which was the basis of the paper. He also performed additional evolutionary analysis.

“For the past two years, we have been having weekly meetings on zoom,” said Qiu. “It’s a big relief” that the researchers published the study and shared the information with the scientific community.

Qiu credited Luft with being a consistent coordinator of the sequencing effort and diversity study for over 20 years.

The next steps

At this point, Luft and his colleagues are eager to share the information with the broader scientific community.

The researchers hope experts in artificial intelligence, bioinformatics and computer programming can use the data to understand more about the genome and develop potential therapeutic targets.

Luft is eager to see “how smart people take advantage of a decade’s worth of work that has been very carefully done, to move it all forward,” he said. “We have certain ideas that we are doing” to fill in the gaps.

Qiu has some existing grants he’s using to work on diagnostics and vaccine development.

Qiu, along with chemistry-department colleague Brian Zeglis, and Lyme diagnostic/ vaccine researcher Maria Gomes-Solecki, has a joint NIH/ NIAID grant to develop a novel PET-based technology to detect Lyme pathogens in vivo. They have also proposed a new Lyme vaccine design strategy.

Additional sequencing of the variable plasmid, which is not a part of the chromosomal DNA but can replicate independently, would continue to help determine what genetic codes contribute to the level of virulence for each strain or species.

“That’s like the last mile for the communication network,” said Qiu. The challenges include annotating the genomes, providing comparative analysis and using informatics development to share the genome variability with the research community.

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METRO photo

By Daniel Dunaief

Daniel Dunaief

I’m a good person. Really, I am.

What’s my proof? I don’t drink single use plastic bottles, which are bad for the environment. 

I love the environment. I’m going to go hug a tree. Not that one, because it’s kind of prickly and it makes my skin itch. Not that one either, because it’s too wide and my arms are too short. The one over there doesn’t work either, because it’s too far in the woods and I might get poison ivy.

You know what? I’m not going to hug a tree literally, but I’m going to do it figuratively.

Wait, what’s that you’re holding? It’s a picture of me drinking out of a single use water bottle? That must have been taken a long time ago.

No? You have a date on it and it says it was taken in the last few months. Oh, well, I was helping someone and she needed a drink and I didn’t want her to feel like she was drinking alone, but it certainly wasn’t alcohol and I didn’t swallow the water because it was too hot.

You want to know who I was helping? That’s none of your business. Also, I don’t want anyone else to have to answer these kinds of questions, so to protect her privacy, I’m not going to tell you.

I don’t care whether you believe me. Okay, well, maybe I care a little. You’re right, you’re right, I wasn’t helping anyone, but that picture of me holding a water bottle? That’s not actually me. That’s someone else and I have 10 people who can confirm that I wasn’t drinking that water on that day, even though I don’t know what day it was and that shirt looks like one of the ones I wear all the time.

Other people have that kind of shirt, too. Yeah, I know it might be unlikely that someone would have the exact same soy sauce stain in the same place, but it’s still possible. 

So, you get my point, right, about being a good person. Maybe the water bottle wasn’t a great example, but I used to coach sports and I won a bunch of championships.

I know I said that the championships weren’t about me and I didn’t win anything. But that was then. Today? I’m taking a little credit.

What did I do? Well, I gave my players advice. Yes, I know some of them ignored me, while others got their own coaches and played well despite my advice.

Still, I won those championships. Well, I mean, I didn’t do it alone, but I was the leader and you can be sure that the team wouldn’t have won without me.

How can you be sure? Well, for starters, you can’t not be sure, and that should be good enough.

So, we agree, right? I’m a good person. No? What’s it going to take?

Oh, you want me to hold the door open for you? Yeah, I would but the air conditioning might get out. You see? I don’t want to waste energy. Oh, I know it’s not a waste of energy for me to help, but I don’t want to waste the energy it would take to cool the hot air I’m letting in. That’s even better than that bottle example.

So, to conclude, I’m a good person because I’m sure, deep down inside, beneath all the complicated layers that undoubtedly make me interesting mostly to myself, I care about things, people and stuff.

Sure, I might not do as much about as I could or should and yes, I have done the opposite of what that good deepness might suggest, but I know I’m a good person and I never lie.

Except that one. That was a lie, but that’s the lie that proves the truth. Right? No, I’m not running for office. Lots of other people would do a better job or even an adequate job, which would also be better. I’m just letting you and everyone else know that, basically, and with no hidden agenda beyond, maybe hoping for a few giggles, that I am a pretty good person who might one day, turn out to be slightly better than I am now.

After all, I’m just a man, standing in front of a crowd, asking them not to dismiss him totally. Is that too much to ask from someone whose goodness may, one day, surprise us all and come out?

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Stony Brook doctor, tending to a newborn baby. Courtesy Stonybrookchildrens.org

By Daniel Dunaief

Water inside a house isn’t just bad for the structure, it can also be damaging to your health.

Local health care professionals suggested that Stony Brook residents whose basements flooded from this weekend’s heavy rainfall should be careful about the growth of mold or mildew, which can be especially problematic for anyone with chronic breathing issues.

“People can inhale spores over a period of time and can develop respiratory symptoms,” said Dr. Sunil Dhuper, Chief Medical Officer at Port Jefferson’s St. Charles Hospital.

People with asthma, chronic obstructive pulmonary disease, bronchitis and emphysema “need to be particularly concerned about some of these issues,” he continued.

Dr. Sharon Nachman, Chief of Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents of Stony Brook, who experienced a localized 10 inches of rain this weekend, should “aggressively clean” their basements, from any standing water, as mold and mildew can start growing within a few days.

“You won’t see it because it’s small,” but people should dry the walls and under the floorboards and carpet, she said. “You want to get the water out.”

Local doctors, also, recommended dumping standing water off any surface that might become a breeding ground for mosquitoes, who can carry the West Nile virus.

At this point, the County Department of Health believed the West Nile threat wasn’t likely particularly high.

“The heavy rains and wind might have washed away adult larvae and adult mosquitoes,” Dr. Scott R. Campbell, Laboratory Chief in the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services, explained in an email.

“Wet springs and hot, dry summers — in which mosquitoes and birds may congregate at limited sources of water — may be conducive to higher West Nile virus transmission.”

The heavy rain, which was triple the usual average for the entire month of August, according to Weather Spark, likely reduced area mosquitoes.

Local medical care professionals suggested that residents should still remove standing water as a way to protect themselves against any remaining mosquitoes.

Congenital viral infection

Apart from the impact of local flooding, doctors discussed a host of other medical issues.

New York State has been testing newborns, since last fall, for congenital cytomegalovirus, or CMV, which infected mothers can give to their unborn children.

The testing so far has shown that CMV is less prevalent than previous estimates.

The state started the one-year study of the virus to track children who might develop symptoms, such as hearing loss or learning challenges, later on.

“The earlier you identify babies with hearing deficits, the sooner you can act, and there will be fewer ramifications on their intellectual development, as a result of it,” said Dr. Andrew Handel, pediatric infectious diseases expert at Stony Brook Children’s Hospital, and a co-leader, along with Dr. Nachman, of one of the 11 units across the state.

Dr. Sharon Nachman. Courtesy Stony Brook Medicine Facebook page

Earlier medical sources estimated that the infection rate for newborns was about one in 200 babies. But, with about 300 newborns testing positive, the rate is closer to one in 325.

The percentage of symptomatic babies is tracking with previous expectations, at around 10 percent. Symptoms of congenital CMV at birth include hearing loss, jaundice, low birth weight, seizures and retinitis.

“Our numbers are matching up with the 90 percent” of those who have the virus, but are asymptomatic, Handel added.

“That’s why we feel screening is so important.”

For the asymptomatic newborns, about 10 percent will develop permanent hearing loss, which is why doctors are tracking them so closely.

The virus, which is a relative of the Epstein Barr virus, which causes mononucleosis, is spread through direct contact with body fluids, such as tears, saliva or urine. Over half of all adults have had a CMV infection, with some studies estimating the rate as high as 80 percent.

Adults can shed the virus for a few weeks after contracting it, while children can shed it for a few months.

While all newborns will receive CMV screening after birth, parents have five days to opt out of any link to a report of the presence of the virus in their children.

At this point, fewer than one percent of parents are opting out of the testing. Some of the parents aren’t interested in the test, others don’t believe it’s useful, while some believe their babies look fine, and don’t want the additional test.

Most parents appreciate the opportunity to gather information about their children’s health. Patients are “grateful the state has this program,” said Dr. Sunil Sood, Systems CMV specialist at Northwell Health.

At Stony Brook and other hospitals, doctors are monitoring those babies who test positive.

The County Department of Health supports the testing, as well.

“Routine screening of newborns for [congenital CMV] will help identify affected infants early on so they can receive appropriate follow-up and treatment,” Cynthia Friedman, Director of Public Health Suffolk County Department of Health Services, explained in an email.

“Infants who screen positive … should be followed closely by their pediatricians and referred to specialists as needed to ensure early detection of problems with hearing, vision or development so that appropriate care and support can be implemented.”

Once the funding for the testing runs out, which will be around October, hospitals around the state will no longer perform the test.

Parents can ask for a urine test, which doctors estimate could cost between $50 and $100, but which insurance, likely, won’t pay for — especially if the child is asymptomatic.

Legislators, including Assemblymember Linda Rosenthal (D-NYC) plan to introduce a bill in January that would fund tests, in future years.

“We would advocate that that become a permanent part of infant testing,” said Sood. “There are diseases that are far less common than CMV that have made it into the newborn testing programs.”

Immunization

Amid pushes by some pharmacies to encourage people to get flu shots, health care experts suggest waiting until closer to late September, or early October, for the inoculation.

“Vaccine efficacy is about three to four months,” said Nachman. “If you get it in August, when the flu season hits in January, you may not have much protection.”

The Centers for Disease Control and Prevention recommends similar timing, around September or October.

At the same time, Nachman expects a new batch of Covid vaccines will be available around September.

She recommends getting both shots at the same time, which increases both vaccines’ effectiveness.

Pharmaceutical giant, Pfizer, and BioNTech, recently reported that a single combined shot for Covid and flu was not effective against influenza B, which means that people interested in receiving vaccines this fall should plan to get two shots.

Covid numbers

As for Covid, the current strain has made the rounds this summer.

“Everybody and their neighbor had Covid,” said Nachman, who added that the virus has spread across all ages. Covid was “clearly more infectious than what we had in the spring” and people were sicker for longer.

While the number of infected people has decreased, the start of the fall semester could trigger an increase.

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From left, Xianghui Xiao, Yang Yang, and Qun Liu Photo by David Rahner/BNL
From left, Yang Yang, Qun Liu and Xianghui Xiao. Photo by David Rahner/BNL
From left, Qun Liu, Yang Yang, and Xianghui Xiao. Photo by David Rahner/BNL
From left, Xianghui Xiao, Qun Liu and Yang Yang. Photo by David Rahner/BNL

By Daniel Dunaief

Superman’s x-ray and heat vision illustrate an important problem.  On the one hand, the x-ray vision comes in handy if Superman is looking outside, say, at a bank and can see thieves dressed like the Hamburgler as they try to steal from a vault. On the other hand, Superman has heat vision, which he uses in battles to blow up concrete blocks or tear open a hole in a wall.

But, aside from a few realities getting in the way, the struggle scientists using x-rays to see inside cells contend with tracks with these two abilities.

Researchers would ideally like to use x-rays to see the inner workings of a cell. X-rays can and do act like Superman’s heat vision, causing damage or destroying the cells they are trying to study.

Recently, scientists at Brookhaven National Laboratory, however, figured out how to protect and preserve cells, providing an opportunity to study them without causing damage.

Not only that, but, to extend the fictional metaphor, they used the equivalent of Wonder Twin Powers, combining the structural three-dimensional picture one beamline at the National Synchrotron Lightsource II can produce with the two-dimensional chemical image from another.

After three years of hard work, researchers including Qun Liu, structural biologist; Yang Yang, associate physicist; and Xianghui Xiao, FXI lead beamline scientist, were able to use both beamlines to create a multimodal picture of a cell on different scales and with different information.

“Each beamline can create a full picture, but providing only partial information (structure or chemicals),” Liu said. “The correlative imaging for the same cell using two different beamlines provides a more comprehensive” image.

The key to this proof of concept, Liu explained, was in developing a multi-step process to study the cells.

“The novelty is how we prepared the samples,” said Liu. “We can take the sample from one beamline, move it to a second one, and can collect data from the same orientation. Before this, it was not easy” to put together that kind of information.

In a paper published in the journal Nature Communications Biology, the scientists detailed the cell preparation technique and showcased the results.

The potential application of this technique extends in numerous directions, from finding the way new pathogens attack cells, to understanding the location and site of action of pharmacological agents, to understanding the progression of disease, among other applications.

“Our technique combines both X-ray fluorescence and X-ray nano-tomography so we can study the entire cell for both the elements and the structure correlatively,” Yang explained.

Supported by the Department of Energy Biopreparedness Initiative, the scientists are doing basic research and developing techniques and protocols and procedures in preparation for the next pandemic. They have 10 projects covering different pathogens and aspects. Liu is the principal investigator leading one of them. 

To be sure, at this point, the technique for preserving and studying cells with these beamlines is in an early stage and is not available to labs, doctors, or hospitals on a routine basis to test biological samples.

Nonetheless, the approach at BNL offers an important potential direction for clinical and fundamental benefits. Clinically, it can help with disease diagnosis, while it can also be used to study stresses of cells and tissues under metal deficiency or toxicity. Many cancers include a malfunction in the homeostasis, including zinc, copper and iron.

Fixing and re-fixing

The process of preparing the samples required three steps.

The researchers started with a chemical fixation with paraformaldehyde to preserve the structure of the cell. They then used a robot that rapidly froze the sample by plunging it into liquid ethane and then transferring it to liquid nitrogen.

They freeze-dried the cells to turn the water into ice that is not crystallized. As a part of that process, they left the cells in a controlled vacuum to turn the ice slowly into gas. Removing water is key because the liquid would otherwise be too mobile for x-rays to measure anything reliably. After absorbing the x-rays, the liquid would heat up and further deform the cells.

The preparation work takes one to two days.

“If you fail in any of the steps, you have to start all over again,” said Yang.

Zihan Lin, who is a postdoctoral researcher in Liu’s lab and the first author on the paper, spent more than a year polishing and preparing the technique.

“We believe the cells were preserved [near] their close-to-native status,” said Yang.

They used an X-ray computed tomography (XCT) beamline, which provides a three-dimensional view of the structure of the cell. They also placed the samples in an X-ray fluorescence beamline (XRF), which provided a two-dimensional view of the same cells.

In the XRF beamline, scientists can find where trace elements are located inside a cell.

Liu is collaborating with researchers at other labs to understand the molecular interactions between sorghum, an important grain crop, and the fungus Colletotrichum sublineola, which can damage the leaves of the plant.

The DOE funded project is a collaboration between BNL and three other national laboratories.

Liu is grateful for the help and support he and the team received from the staff working at both beamlines, as well as from the biology department, NSLS-II, BNL, and DOE. The imaging may help create bioenergy crops with more biomass and less disease-caused yield loss, he suggested.

Future work

Current and ongoing work is focused on the potential physiological states of the cell, addressing questions such as why metals are going to specific areas.

Yang is the science lead for a team developing the Quantitative Cellular Tomography beamline at the NSLS-II. Within five years, this beamline will provide nanoscale resolution of frozen cells without requiring chemical fixation.

This beamline, which will have a light epi-fluorescence microscope, will add more detail about sub-cellular structure and will not require frozen cells to have chemical fixation.

While the proof of concept approach with these beamlines is still relatively new, Yang said she has received feedback from scientists interested in its potential.

“We have quite a few people from biology departments that are interested in this technique” to study biomass related structures, she said.

A future research direction could also involve seeing living cells. The resolution would be compromised, as the X-rays would induce changes that make it hard to separate biological processes from artifacts.

“This could be a very good research direction,” Liu added.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

Fear sells. It’s as true when companies are urging people to buy products to protect themselves, families, homes and cars as it is when politicians are trying to scare you  into voting for them or, just as importantly, voting against their opponent.

Sure, they make some effort to suggest that their policies will help you, but they spend considerably more time showing unnerving images of what might happen if you vote for the other team.

One side suggests that a vote for the other candidate could mean the end of democracy, elections and a host of freedoms, while the other suggests that a vote for the other side could mean an end to the world.

Whatever you believe, we have clearly reached an extreme of brinkmanship. 

On top of that, the news is filled with stories and images of murder and mayhem.

These days, all you need to do is turn on your phone and someone, somewhere, is struggling, threatened, or dying.

On top of that, people are sharing concerns about existential threats to the future, with global warming and declines in the food and water necessary to sustain the population.

Regardless of where people check in with the information of the day, threats lurk around every corner.

It’s no wonder that mental health has declined. The world is a place with dark shadows and horrifying possibilities.

Happily ever after has become the launching pad for fractured fairy tales, where couples can’t find affordable homes and, even if they did, couldn’t carry the mortgage.

This mental health strain and the difficulty of disconnecting from a phone that shares these bad news bulletins in constant alerts may be contributing to the record low fertility rate for the country reported this spring in the National Center for Health Statistics at the CDC. 

Specifically, the rates declined for women aged 20 to 39, hitting a record low for women between 20 and 24.

There are numerous other reasons people are foregoing the spectacularly rewarding and challenging decision to have children. Yes, men and women are pursuing careers.

And, yes, people may be more confident and comfortable having children later, putting off the life-altering decision until after a set of vacations, a work milestone or other goals.

But to know exactly why any one or group of people are making the decisions they do requires more than statistics or even surveys. When people answer questions in a survey, they sometimes offer the kinds of replies that look good or that the questioner expects.

I spoke anecdotally with a few 50’ish parents and some children around 30 and got a range of responses about the decision to have or not have children.

Both sides suggested that developing careers made it tougher to start a family. Parents, some of whom seemed eager to have grandchildren, expressed some frustration and, perhaps, judgement, about the decisions of their children and step-children.

Some of the younger crowd said their friends didn’t receive much parenting help from their partners, making the task of raising children more difficult and exhausting and dissuading them and their friends.

They also shared concerns about the high cost of raising children.

One of the younger set added that her mother had been dealing with a lifelong illness and that she had caretaking responsibilities from the time she was young. Her mother continues to need medical and family attention, which she said has made caring for a child less appealing.

One of the younger set asked me what I thought about being a parent. It has filled me with unbelievable joy, affection, love, and laughter and has helped me understand my own parents and grandparents better. Of course, we’ve had our share of challenges interspersed with stomach dropping moments.

Not to blame the media entirely, as I work and live inside that profession, but I feel like the nonstop stream of information, stories, videos, and social media shaming has left people feeling vulnerable and exhausted.

Parenting requires energy and optimism. When people lose sleep, they don’t have much energy and, if they look at their phones, they risk losing their hold on optimism. 

If we want to encourage this generation to continue the chain, we should let them know when they’re ready and when they ask, about the amazing and fulfilling moments, large and small, that make parenting the role of a lifetime.

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Hiro Furukawa Photo courtesy of CSHL

By Daniel Dunaief

Following a relentless drive to succeed, scientists have a great deal in common with athletes.

In addition to putting in long hours and dedicating considerable energy to improving their results, these talented professionals also enjoy moments of success — large and small — as opportunities to appreciate the victories and then build to greater challenges.

And so it is for Hiro Furukawa, a Professor at Cold Spring Harbor Laboratory.

Hiro Furukawa. Photo courtesy of JMSA

Working with a team of scientists including at Emory University, Furukawa recently published a paper in the prestigious journal Nature in which he demonstrated the long-sought structural process that leads to the opening of an important channel in the brain, called the NMDAR receptor.

When this cellular channel doesn’t function correctly, it can lead to numerous diseases, including Alzheimer’s and depression. Understanding the structural details of this channel could, at some point in future research, lead to breakthrough treatments.

“Each moment of discovery is exciting and priceless,” Furukawa explained. “When I finally see what I have sought for many years — in this case, the mechanism of NMDAR channel opening — it fills me with immense euphoria, followed by a sense of satisfaction.”

That sounds like the kind of mountaintop moment that star athletes whose achievements people applaud share once they’ve reached a long-desire milestone, like, perhaps, winning a gold medal in the Olympics.

The thirst for more for Furukawa, as it is for those with a passion for success in other fields beyond science and athletics, is unquenchable and unrelenting.

“This feeling is fleeting,” he added. “Within a few hours, a flurry of new questions arising from the discovery begins to occupy my mind.”

Indeed, Furukawa suggested that he expects that many other scientists share this experience.

Forming a winning team

Furukawa and Stephen Traynelis, Professor and Director in the Department of Pharmacology and Chemical Biology at Emory University School of Medicine in Atlanta, started to work together on a series of modulators for the NMDAR protein about eight years ago.

Hiro Furukawa. Photo courtesy of JMSA

This particular protein binds to the neurotransmitter glutamate and to glycine, which is another compound. Once bound to both, the channel, as if responding to the correct combination in a garage door, opens, creating electrical signals that contribute to brain functions.

To study the way the binding of these molecules opened the channel, the researchers needed to figure out how to keep the receptor in the open position.

That’s where a combination of work in the labs of Traynelis and Dennis Liotta, also a Professor at Emory, came in. Liotta’s lab made over 400 analogs that Traynelis ran in his lab.

Liotta created a compound called EU-1622-A, which is now known as EU-1622-240, that upregulates NMDAR activity, Furukawa explained.

“We used cryo-EM [electron microscopy] to capture the NMDAR structure with the compound, validated its conformation through electrophysiology and elucidated the activation mechanism,” he said.

Incorporating EU-1622-240 along with glycine and glutamate into the GluN1-2B NMDAR sample, which is a specific subtype and is the easiest to work with, enabled a visualization of the open channel.

Furukawa described the compound Traynelis created at Emory as the “key factor in capturing the open channel conformation.”

Determining the structure of a functioning protein can provide clues about how to alter those that may be contributing to the onset or progression of a disease.

To be sure, Furukawa recognizes the work as one step in what’s likely to involve an extensive research journey.

“We still have a long way to go, but we’ve made progress,” Furukawa said. “In this study, a compound bound to NMDAR gave us a clue on how to control the frequency of ion channel openings. Both hyperactive and hypoactive functions of NMDAR ion channels have been implicated in Alzheimer’s disease, so being able to regulate NMDAR activity would be significant.”

Furukawa can’t say for sure if this compound could alleviate the symptoms of certain diseases, but it serves as a new series of potentially clinically relevant options to test.

The researchers are developing a method to purify NMDAR proteins from animal tissues. Once they accomplish that task, they should be able to isolate NMDAR from Alzheimer’s brains to compare them to a normally functioning protein.

Furukawa suggested that it’s probable that specific NMDAR conformations are stabilized to different extents in various diseases compared to normal brains.

The researchers have not yet presented this work at meetings. First author Tsung-Han Chou, who is a postdoctoral fellow in Furukawa’s lab, plans to present the work at upcoming conferences, such as the Biophysical Society Meeting.

The review process for the research proceeded quickly, as the team submitted the paper in February of this year. 

Next steps

As for what’s next, Furukawa suggested that the team planned to solidify their findings.

“We must determine if the channel opening mechanism applies to other types of NMDARs,” he said. “Although we observed that EU1622-A compound binds to NMDAR, its structure was not sufficient resolved.”

To facilitate the re-design of EU1622-240, the scientists will need to improve the cryo-EM map resolution.

Traynelis, meanwhile, said that he and Liotta are synthesizing new modulators in this class and related classes and are working on mechanisms of action for this series at all NMDA receptors as well as actions in neuronal systems.

“We have a robust synthetic program with our collaborator [Liotta], whose laboratory is synthesizing many new modulators in this class and related classes,” Traynelis explained.

Traynelis added that his goal is to “develop new medicines to address unmet clinical needs. We want to find new and effective therapeutic treatments that help patients.”

The Emory professor is excited about the “potential development of positive NMDA receptor allosteric modulators that could enhance NMDA receptor function.”

Broader perspective

Furukawa, who lives in Cold Spring Harbor and whose sons Ryoma, 16 and Rin, 13, attend senior and junior high school, respectively, was interested in international politics and economics when he attended Tufts University as an undergraduate.

These non-science topics provide additional perspective that enrich his life.

“I remain very interested in understanding history and the reasons behind current events in Europe, the Middle East, and the U.S.,” he said. “This endeavor is far more challenging than decoding NMDAR structures and functions.”

As for his collaborations, Furukawa suggested that the findings from this research inspire him to continue to search for more answers and greater scientific achievements.

“We will continue to unravel these mysteries in future studies,” Furukawa said. “The best is yet to come.”

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Imoigele Aisiku. Courtesy Imoigele Aisiku

By Daniel Dunaief

Stony Brook University named physician-scientist Dr. Imoigele “Imo” Aisiku as chair of the Department of Emergency Medicine at the Renaissance School of Medicine, starting Aug. 15.

A national leader who has dedicated his career to critical care and neurocritical care in emergency medicine, Aisiku worked for more than a decade at Brigham and Women’s Hospital and Harvard Medical School.

Aisiku, who was born in Nigeria and raised in Brooklyn and Auburn, Massachusetts, found several factors appealing about the Stony Brook role.

“My immediate family is predominantly in the Northeast” stretching from New York to Richmond, Virginia,” he said. Additionally, he suggested that numerous aspects of the role were “right in my area of expertise.”

His experience at Brigham and Women’s Hospital involved integrating systems, and he recognizes the opportunity to deploy that skill set at Stony Brook, where he will help integrate the emergency department at different hospitals.

He also has considerable experience in critical care, which is a strength at SBU.

“There are some natural synergies that you couldn’t script” he added, including strong clinical interest in stroke, telehealth, critical care and a desire to develop a systems integration model

Indeed, before he came to Brigham and Women’s Hospital, Aisiku worked at the University of Texas at Houston. UT Houston/Memorial Hermann was one of the earliest to be named a JCAHO Comprehensive Stroke Center.

Aisiku was the medical director of their neurosurgery intensive care unit, which had one of the first mobile stroke units in the country. The unit was a collaboration between EMS, neurology, the stroke division, EM and the ICU.

A mobile stroke unit can provide critical and timely diagnostics and care for people having a stroke, which can not only save lives but can also lead to a dramatic improvement in the outcome after a stroke event for patients.

Stony Brook currently has two mobile stroke units and is working on adding a third.

“I hope to leverage what is the strength of Stony Brook with my experiences” and strengthen any weaknesses in a bidirectional manner, said Aisiku, who will report to Peter Igarashi, dean of the Renaissance School of Medicine.

For his part, Igarashi was eager to welcome the new addition to the emergency department.

“We are thrilled that Dr. Aisiku will lead Stony Brook’s remarkable team of emergency physicians,” Igarashi said in a statement. “As a pioneering physician-scientist in neurocritical care, and as an emergency medicine scholar and researcher, Dr. Aisiku will help advance our capacity to save lives and care for critically ill patients in the years to come.”

Evolutionary change

The new emergency department chair is hoping to learn more about Stony Brook’s strengths and weaknesses before implementing any changes.

“I hope to make a change and a difference,” Aisiku explained in an email. “I believe it is prudent to aim for evolutionary change and, if there is an opportunity, for positive revolutionary change.”

His goal is to see the department grow from a regional strength to a national and even an international strength.

He plans to develop partnerships with other chairs and departments and hopes to enhance programmatic and faculty development.

Aisiku also hopes to develop opportunities for faculty at Stony Brook, including in areas that involve research. He would like to see the department earn more National Institutes of Health and federal funding.

DEI experience

An accomplished physician, researcher and administrator, Aisiku also has considerable experience building and encouraging opportunities for underrepresented groups in medicine.

Aisiku was the founder and director of the Offices of IDEaS, which stands for Inclusion, Diversity, Equity and Social Justice, in Emergency Medicine at Brigham and Women’s Hospital, where he credits a team of faculty administrative staff and supportive chair for the success of that effort.

Aisiku “played a crucial role in the development of the office of IDEaS,” Jayelani Hall, administrative manager for Emergency Medicine and the Office of IDEaS at Brigham and Women’s Hospital, explained in an email. Aisiku’s vision for creating an inclusive environment and commitment to equity and diversity were “instrumental in shaping the initiatives and programs that define IDEaS today.”

IDEaS has launched several initiatives, such as the Profile in Diversity Series and the SPAK Grant program, which provides funding to projects that advance diversity, equity and inclusion.

The office established scholarship programs to support underrepresented students pursuing careers in medicine and health care, Hall added.

The president of Brigham and Women’s Hospital named Aisiku endowed Distinguished Chair in Health Equity and Diversity.

The broader Stony Brook area extending to New York City “draws diverse and international people to the region,” Aisiku explained. “While I acknowledge that [DEI] is an area of controversy in our country, I believe continuing to strive for diversity has a significant role for the development of our youth all the way to impacting our patients.”

In speaking with the leadership of the hospital and medical school, Aisiku believes his diversity goals are “aligned in these efforts” as he looks forward to developing strategies that will lead to diverse students, residents and faculty.

In addition to providing opportunities to students in the health care field, a more diverse population of caregivers enhances the patient experience, Aisiku contends.

A diverse health care force provides greater opportunity for patient choice and advocacy, he added.

Aisiku, who has master’s degrees in business administration from Goizueta School of Business and a master’s in clinical research from Rollings School of Public Health at Emory University, would like to partner with the business school and the school of public health, among others, to build diversity, which may broaden and enhance his efforts in this area.

People who have worked with Aisiku appreciate his commitment and openness to those around him.

Aisiku is “known for his compassion and dedication both as a physician and as a leader,” Hall wrote. “He consistently goes above and beyond to ensure that his patients receive the best care possible and his commitment to equity in health care is evident in all his endeavors.”

Hall suggested that the Stony Brook community is fortunate to have Aisiku in this role.

“Given his track record, I fully expect him to engage deeply with students, faculty and community members, fostering connections and driving positive change,” Hall explained.

From left to right, Robert Samuel Decosta Higgins, Jayelani Hall, Imoigele Aisiku, Ron Walls and Mike VanRooyen, at a ceremony for Aisiku. Photo courtesy Imoigele Aisiku

Telehealth experience

Over a decade ago, Aisiku started iDoc Telehealth Solutions, a telemedicine company dedicated to critical and neurocritical care and tele-stroke services, with the goal of providing this type of care to people in areas that didn’t have enough clinicians with that experience.

Since then, he has become co-CEO of a public company called VSEE Health.

He expects to pass the torch on to other executives. His commitment is to the university as his obligation to the company is for about four more months.

To be sure, he wants to ensure there are no conflicts of interest in his roles at Stony Brook and in the decision about how and in what ways the university can continue to build telehealth capacity.

“If there is an opportunity to enhance an area, with full disclosure, there can be pathways to achieve things that improve the patient experience while separating ‘church’ and ‘state’ so to speak,” he explained in an email.

Morana Lasic, interim chief diversity & inclusion officer at Brigham and Women’s Hospital, suggested that Aisiku has served as a personal and institutional resource for a wide range of people.

Aisiku “works with those who are yet to enter the medical field and need mentorship, just as he does with institution presidents,” Lasic explained in an email. “He empowers those on his team and pays special attention to those who are often forgotten in mentorship (such as young administrative staff.)”

Lasic added that Aisiku was generous with his time and has reached out to her with emails and new thoughts and ideas at any time of day.

“Just like the rest of his life, his sleeping schedule is unique and his own, and he wears an Oura ring (which tracks sleep patterns) just to confuse it,” Lasic said.

In his research, Aisiku has focused on three areas: traumatic brain injury, subarachnoid hemorrhages and acute respiratory distress syndrome/sepsis.

Aisiku is living with his wife Diana, who is a nurse, and their 4 1/2-year-old son Myles in Westbury. They are in the process of searching for a home.

Outside of work, Aisiku has a black belt in the martial art of Jeet Kune Do, enjoys working out and played Division 3 tennis and basketball, at Worcester State University. He is also a motorcycle enthusiast.

As for his likely contribution to the Stony Brook community, Lasic, who has been at Brigham and Women’s Hospital for 25 years, suggested that she anticipated he would continue on an impressive journey.

Aisiku is “one of the most innovative leaders in academic medicine I have seen in a long time,” she wrote. “He is a true role model in his ability to connect with those around him.”

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