Columbia University Irving Medical Center (CUIMC) is an academic medical center and the largest campus of NewYork-Presbyterian Hospital. It includes Columbia University Vagelos College of Physicians and Surgeons, College of Dental Medicine, School of Nursing and Mailman School of Public Health, as well as the Morgan Stanley Children's Hospital, the New York State Psychiatric Institute, the Audubon Biomedical Research Park, and numerous other institutions. The campus covers several blocks – primarily between West 165th and 169th Streets from Riverside Drive to Audubon Avenue – in the Washington Heights neighborhood of Manhattan, New York City. CUIMC was built in the 1920s on the site of Hilltop Park, the one-time home stadium of the New York Yankees. The land was donated by Edward Harkness, who also donated much of the cost of the original buildings. Built specifically to house a medical school and Presbyterian Hospital, it was the first academic medical center in the world. Formerly known as the Columbia-Presbyterian Medical Center (CPMC), the name change followed the 1997 formation of New York-Presbyterian Hospital, a merger of two medical centers each affiliated with an Ivy League university: Columbia-Presbyterian with Columbia University, and the New York Hospital-Cornell Medical Center, with Cornell University's Weill Cornell Medical College. The Medical and Graduate Education Building was designed by architects Diller Scofidio + Renfro and Gensler with structural engineer Leslie E. Robertson Associates.In September 2016 the Campus was renamed for one of the Hospital and the University's greatest benefactors, Herbert and Florence Irving. Herbert Irving is a co-founder and former vice-chairman of Sysco Corporation, the nation's largest food distributor. It counts among its achievements the first successful heart transplant in a child, the first use of the anti-seizure medication, dilantin, to treat epilepsy, and the isolation of the first known odour receptors in the nose. It supported key discoveries related to how memory is stored in the brain, and Nobel Prize-winning developments in cardiac catheterization (1956) and cryo-electron microscopy (2017) - a technique used to reveal the structures of large biological molecules at atomic resolution.
Ventricular assist devices (VADs) have evolved from a bridge-to-transplantation strategy into a cornerstone of long-term advanced heart failure management. While continuous-flow technology has dramatically improved survival and device reliability, the paradigm shift toward extended mechanical circulatory support has exposed critical unresolved challenges. This review examines current limitations and four transformative technological directions shaping the next generation of VAD therapy. Four key areas are driving innovation in the field. First, growing evidence linking prolonged non-pulsatile hemodynamics to vascular dysfunction and hemorrhagic complications has renewed interest in miniaturized pulsatile devices, with multiple engineering approaches under active investigation. Second, the development of physiologically responsive "smart pump" technology represents a major advance, enabling dynamic modulation of pump output in response to patient hemodynamic demands. Third, transcutaneous energy transfer (TET) systems combined with advanced battery technologies are progressing toward fully implantable designs that would eliminate driveline-related infections, a persistent and clinically significant complication of current-generation devices. Fourth, total artificial heart (TAH) development continues to advance, with both pulsatile and continuous-flow platforms incorporating TET technology to address biventricular failure. Despite ongoing challenges in balancing miniaturization, durability, and biocompatibility, these four innovations collectively hold promise for transforming mechanical circulatory support into a viable long-term therapeutic option, improving both survival and quality of life for a broader population of patients with advanced heart failure.
Social support may improve clinician well-being and teamwork in primary care, yet evidence remains limited on how social support affects job outcomes, such as job satisfaction, burnout, and turnover intention among all members of primary care teams, including clinicians and staff. To investigate the relationship between social support network characteristics in primary care teams and their impact on job satisfaction, burnout, and turnover intention among clinicians and staff. A cross-sectional study using a sociometric network survey design. 652 primary care clinicians and staff in 23 primary care practices in New York (14) and Pennsylvania (9), which had implemented team-based primary care models. Social support network measures were calculated at two-levels. At the participant-level, these included in-degree (incoming connections), out-degree (outgoing connections), and betweenness (frequency of appearing on the shortest path between other member pairs) centrality. At the practice-level, measures included density (observed ties as a proportion of all possible ties) and transitivity (number of closed triads). Job outcome measures included job satisfaction, burnout, and intent to leave the job. Participants with higher out-degree centrality—indicating that they identified more team members who supported them—were less likely to intend to leave their jobs (OR = 0.77; CI 0.65–0.90; p < .001). Similarly, those in practices with greater support network density, indicating a heightened level of interaction among team members for support, were also less likely to express intentions to leave their job (OR = 0.63; CI 0.40–0.97; p < .05). Betweenness centrality was not significantly associated with the outcome variables. Social support within primary care teams can potentially reduce turnover among primary care clinicians and staff. A better understanding of social support in primary care teams can lay a foundation for network-based interventions. Future research should test the impact of support networks on patient outcomes.
BackgroundThe Lynch syndrome INtegrative Epidemiology And GEnetics (LINEAGE) consortium was established to address gaps in understanding genotype-specific cancer risks and risk-modifiers in contemporary North American Lynch syndrome (LS) populations. LINEAGE is a multi-center, longitudinal cohort to systematically collect data on risk factors, adherence to care, quality of surveillance, and patient-, provider-, and system-level factors associated with incident LS-associated cancers.MethodsLINEAGE recruits individuals with confirmed pathogenic or likely pathogenic variants in LS-associated genes from participating institutions. Data includes retrospective and prospective collection, encompassing clinical abstraction (demographics, surgical history, endoscopic data, treatments), patient-reported surveys (behavioral/lifestyle factors, quality of life, procedures), endoscopist-level data, and biosample metadata. A standardized REDCap database, data harmonization protocols, and a virtual biobank support reproducibility and linkage of clinical data and biosamples. Rigorous quality assurance/quality control processes are embedded for data integrity.ResultsParticipating centers will contribute data to determine gene-specific risks, and gene-environment interactions for Lynch-associated, and other cancers. We will evaluate associations with exposure to, and quality of cancer risk-reduction care, including endoscopic surveillance, risk-reduction surgery, and chemoprevention. The inclusion of provider-level variables, such as endoscopist training and experience, enables unique research into modifiers of post-endoscopy cancer risk. The linked biosample resources will further facilitate mechanistic studies and biomarker discovery.ConclusionsLINEAGE provides a robust platform for advancing LS research by integration of clinical, pathological, epidemiological and genetic data across institutions. Its standardized, collaborative framework enhances the validity and generalizability of risk estimates that will guide decision-making and policy for surveillance to ultimately reduce morbidity and mortality for individuals with Lynch syndrome.
Retinopathy of prematurity (ROP) remains a leading cause of childhood vision loss, often resulting in long-term complications such as strabismus, amblyopia, and glaucoma. Despite advances in screening, limited data exist on which infants are at highest risk and when these complications typically emerge—an important gap given the nationwide shortage of pediatric ophthalmologists. This study aimed to identify predictors of post-ROP ocular complications and determine the optimal timing and frequency of pediatric ophthalmology follow-up visits. We retrospectively reviewed 223 infants who underwent ROP screening between 2018 and 2021 and subsequently followed up with pediatric ophthalmology. The primary outcome was the development of ocular complications following ROP resolution, including their type and timing of detection. Univariate and multivariate logistic regression were used to identify independent risk factors, and Kaplan-Meier analysis assessed time to complication onset. Of 223 infants, 54 (24.2
BACKGROUND:Obinutuzumab, a glycoengineered type II anti-CD20 monoclonal antibody, induces potent B-cell depletion and is approved for the treatment of active lupus nephritis. Its efficacy and safety in patients with active systemic lupus erythematosus (SLE) are yet to be determined. METHODS:We conducted a phase 3, multicenter, double-blind, placebo-controlled trial involving adults with active SLE but without proliferative or membranous lupus nephritis who were receiving standard therapy. Patients were randomly assigned in a 1:1 ratio to receive obinutuzumab (1000 mg) or placebo on day 1 and weeks 2, 24, and 26. In the prespecified analysis, the primary end point at week 52 was a response on the SLE Responder Index 4 (SRI-4), defined by a reduction from baseline of at least 4 points in the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score, no worsening of disease as assessed by the British Isles Lupus Assessment Group (BILAG) 2004 index and Physician's Global Assessment, and no intercurrent events (i.e., major concomitant-therapy violation, receipt of rescue medication, or early discontinuation of trial participation due to death, lack of efficacy, or adverse events). RESULTS:Of 303 patients who underwent randomization, 151 were assigned to receive obinutuzumab and 152 to receive placebo. At week 52, an SRI-4 response was observed in 76.7% of the patients in the obinutuzumab group and in 53.5% of those in the placebo group (adjusted difference, 23.1 percentage points; 95% confidence interval [CI], 12.5 to 33.6; P<0.001). In an additional analysis whereby nonfatal intercurrent events did not affect response status, the respective percentages were 85.4% and 68.5% (adjusted difference, 16.8 percentage points; 95% CI, 7.1 to 26.4). Obinutuzumab was superior to placebo with respect to all key secondary end points: BILAG-based Composite Lupus Assessment response, sustained reduction in glucocorticoid dose, sustained SRI-4 response, SRI-6 response, and time to first BILAG-defined flare. Adverse events were reported in 88.7% of the patients in the obinutuzumab group and in 81.5% of those in the placebo group, and serious adverse events in 15.9% and 11.9%, respectively. One patient in the obinutuzumab group and 3 in the placebo group died during the double-blind period. CONCLUSIONS:Among adults with active SLE, treatment with obinutuzumab was superior to placebo with respect to the primary and all key secondary end points. (Funded by F. Hoffmann-La Roche; ALLEGORY ClinicalTrials.gov number, NCT04963296.).
