Friday, July 11, 2025

 

Hepatitis C treatment is not reaching some at-risk populations



Two studies show disparities in access for children, recently pregnant women



WashU Medicine

Megan Curtis 

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A study led by Megan Curtis, MD, an assistant professor in the Division of Infectious Diseases at WashU Medicine (right), and Caroline Cary, a third-year medical student, showed that recently pregnant women face disparities in access to treatment for hepatitis C infection. The research follows Curtis’ recent study that showed children are also undertreated for the virus.

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Credit: Matt Miller




As the opioid epidemic has worsened in the United States, prevalence of hepatitis C has also increased. Hepatitis C is a bloodborne virus that damages the liver. It is mainly spread through sharing needles or other injection equipment and can also be passed from a mother to baby during pregnancy or childbirth. It can be safely and effectively treated by direct-acting antiviral therapies that are approved for both adults and children.

Two recent studies from researchers at Washington University School of Medicine in St. Louis reveal that two vulnerable populations — children and recently pregnant women — face disparities in access to treatment for hepatitis C infection. Without treatment, these groups are at risk of long-term adverse health outcomes such as cirrhosis, liver cancer and death.

One study, published in Pediatrics in collaboration with researchers at Massachusetts General Hospital, found that few children with hepatitis C were referred for care. This study also revealed that there were significant disparities in whether these patients were provided care and treatment for their infection depending on a child’s race, geographic location and age. A second study, led by WashU Medicine researchers and published July 10 in Obstetrics & Gynecology Open, showed that recently pregnant women with the hepatitis C virus were significantly less likely to receive hepatitis C treatment than men or women who had not been recently pregnant.

“We have treatments for hepatitis C where it’s just two or three months of pills and then over 95% of people are cured,” said Megan Curtis, MD, an assistant professor in the Division of Infectious Diseases in the John T. Milliken Department of Medicine at WashU Medicine, who led both studies. “But we are still having difficulties in getting the treatments to the populations that need them the most. These kinds of studies can help us identify where those barriers are.”

Disparities in hepatitis C treatment for children

Curtis has focused her research on identifying which patients experience gaps in access to hepatitis C treatment. Using anonymized data from a national database, she identified 928 pediatric patients who tested positive for hepatitis C between 2000 and 2022.

In the study published in Pediatrics, Curtis found that only about one in eight of these children were treated for hepatitis C, but that ratio was affected by certain factors. Children born between 2014 and 2018 were more likely to be treated than were those born earlier, which likely reflects changes in Medicaid and insurance coverage during that period, as well as increased availability of treatment for younger children in later years. However, this group’s rate of treatment was still much lower than that of adult patients with hepatitis C.

The study found racial and ethnic disparities as well. Compared to Black children, Hispanic children had about twice the odds and White children had about three times the odds of receiving care for hepatitis C. Geographic region also played a role in disparities: Children with hepatitis C living in the South were least likely to receive treatment compared to those in other regions of the country.

Although these differences may stem largely from socioeconomic disparities in access to health care and regional availability of providers, Curtis noted that other factors can also contribute to low overall treatments rates among children.

“Parents might also delay because of the difficulty of administering a medicine to a young child,” she said, “and clinicians may delay treatment because some children who have hepatitis C will spontaneously clear it on their own. However, this isn’t always the case.”

Treatment for recently pregnant women lags

Hepatitis C infections have been increasing in people with opioid use disorders. Within that population, men have been shown to be more likely to receive treatment for hepatitis C than women are. To understand why, Curtis, in collaboration with Kevin Xu, MD, an assistant professor of psychiatry and co-senior author of the study in Obstetrics & Gynecology Open, and their team set out to see if pregnancy might be playing a role in these sex disparities.

Given that people with opioid use disorder are at risk of contracting hepatitis C, the researchers used an administrative claims database and similar epidemiologic methods as in the pediatric study to analyze data on patients in treatment for opioid use disorder who were also confirmed to have hepatitis C. They found that recent pregnancy was strongly associated with a lower likelihood of receiving treatment for hepatitis C. Recently pregnant patients with hepatitis C were almost 30% less likely to receive antivirals than men were (31.8% versus 40.6%, respectively), and about 11% less likely than women who were not recently pregnant (31.8% versus 35.7%).

Caroline Cary, a third-year medical student at WashU Medicine who is the first author on the study, said the results suggest that more resources are needed to reach patients who are likely to slip through the cracks.

“People with hepatitis C are often asymptomatic for years after being exposed, so if you are young, otherwise healthy and have a new baby, getting prompt treatment may not be a top priority, especially if it is challenging to access,” said Cary. “It’s imperative to make hepatitis C care more readily accessible to new moms considering the long-term consequences of the condition.”

For Curtis, it’s a troubling problem because treatments for hepatitis C are very effective when started early and taken consistently.

“We need to come up with better strategies for addressing hepatitis C,” she said. “We have all the tools to eliminate it. We have medications that can treat it. We know the people who need to get it. We just need to step up the availability and the awareness. We could be done with hepatitis C in a generation.”

 

Curtis MR, Munroe S, Biondi BE, Ciaranello AL, Linas BP, Epstein RL. Disparities in linkage to care among children with Hepatitis C virus in the United States. Pediatrics. April 18, 2025. DOI: 10.1542/peds.2024-068565

This work was funded by the National Institutes of Health grant numbers T32AI052074, T32AI007433, National Institute of Drug Addiction P30DA040500 and 1K01DA052821, the James and Audrey Foster MGH Research Scholar Award, the Charles A. King Trust Postdoctoral Research Fellowship, the Providence and Boston Center for AIDS Research P30AI042853, the Boston University Clinical and Translational Science Institute 1UL1TR001430, and a Boston University Chobanian & Avedisian School of Medicine Department of Medicine Career Investment Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Cary CB, McCrary LM, Marks LR, Kelly JC, Hartz SM, Hayibor L, Grucza RA, Xu KY, Curtis MR. Association between sex and recent pregnancy and hepatitis C virus treatment in people with opioid use disorder. Obstetrics & Gynecology Open. July 10, 2025. DOI: 10.1097/og9.0000000000000096

This work was funded by the National Institutes of Health grant numbers K12DA041449, K08DA061258, P50 MH122351, R21 DA057493, R01 HD113199, and R61 DA06232. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

About Washington University School of Medicine

WashU Medicine is a global leader in academic medicine, including biomedical research, patient care and educational programs with 2,900 faculty. Its National Institutes of Health (NIH) research funding portfolio is the second largest among U.S. medical schools and has grown 83% since 2016. Together with institutional investment, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently within the top five in the country, with more than 1,900 faculty physicians practicing at 130 locations. WashU Medicine physicians exclusively staff Barnes-Jewish and St. Louis Children’s hospitals — the academic hospitals of BJC HealthCare — and treat patients at BJC’s community hospitals in our region. WashU Medicine has a storied history in MD/PhD training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students, and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy, and audiology and communications sciences.

 

Maternal depression substantially compromises parenting quality



First systematic review in a decade finds consistent results across world regions



Wolters Kluwer Health





July 11, 2025 Mothers experiencing depression have considerable challenges across multiple parenting domains, according to a global systematic review published in the July issue of Harvard Review of Psychiatry, part of the Lippincott portfolio from Wolters Kluwer. Maternal depression is defined as major depressive disorder (MDD) that occurs during pregnancy or emerges within 4 to 30 weeks after birth.

Tiago N. Munhoz, PhD, a psychologist at Federal University of Pelotas, Pelotas, Brazil, and colleagues found that 97% of observational studies published in the past decade demonstrated an association between maternal depression and negative parenting practices. "Understanding this relationship is crucial for developing effective psychological methods and interventions," they emphasize.

Updated review was global and had no language restrictions

Until now, the most recent systematic review to explore the association between maternal depression and parenting only included data collected up to 2013 and was limited to English-language reports. To find more recent evidence, Dr. Munhoz’s team searched the MEDLINE/PubMed, SciELO, BVS, LILACS, Embase, Web of Science, and PsycInfo databases for articles published from November 2013 through 2023. They included observational studies in which mothers were diagnosed with MDD or were screened for depressive symptoms postpartum or in their child's youth or adolescence.

The researchers looked for studies on parenting practices—specific behaviors directed toward children—and excluded those pertaining to parenting styles (e.g., authoritarian, permissive, or neglectful). They selected 29 articles for data extraction: 27 published in English and two in Portuguese. Of these, 10 studies were conducted in Europe/Central Asia, six in East Asia/the Pacific, six in Latin America/the Caribbean, five in North America, and two in the Middle East/Africa. Eight studies were conducted in middle-income countries and one in a low-income country. Some studies involved videotaping interactions between mothers and children.

Maternal depression was linked to impaired mother-baby bonding and reduced sensitivity

Fourteen studies investigated mother-baby bonding, and all found that maternal depression impaired this bond. In studies that used both the Edinburgh Postnatal Depression Scale and the Postpartum Bonding Questionnaire, higher depression scale scores indicated more damage to the bond. Four studies showed that women who did not manifest depressive symptoms bonded more closely with their babies than women who were depressed or experienced depressive symptoms throughout their lives.

Maternal depression was also associated with:

  • Low sensitivity (recognizing and responding to a child's needs)
  • Reduced involvement (participating in daily interactions and activities)
  • Diminished commitment (fulfilling childcare responsibilities)
  • Less smiling at, touching, or interacting with the baby
  • Decreased pleasure in interacting with the child
  • Heightened negative emotions
  • Increased hostility
  • Inconsistent punishment
  • Relaxed discipline

One study found no significant associations between maternal depression (during pregnancy and postpartum) and sensitivity or positive regard for the child. That study was conducted in the US and involved 36 low-income mother-child dyads.

"[E]xisting literature suggests that depression-alleviating interventions based on cognitive behavioral therapy and mindfulness improve parent–child relationships and reduce negative parenting behaviors," the authors remind their colleagues. "Such tactics benefit maternal well-being and the overall family dynamic."

Read Article: The Impact of Maternal Depression on Early Parenting: A Systematic Review

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers, and students in effective decision-making and outcomes across health care. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health.

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About Wolters Kluwer

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KTU experts reveal why cultural heritage is important for community unity





Kaunas University of Technology

Prof. Dr Lina Šeduikytė 

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Prof. Dr Lina Šeduikytė

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Credit: KTU





Why do some communities unite in times of crisis, while others fall apart? The study of Kaunas University of Technology researchers revealed a surprising link – cultural heritage is not just a historical asset, but also a powerful tool that helps people build a sense of belonging and act collectively when challenges arise.

Along with trust and emotional attachment to place, it becomes a foundation for communities to care for their environment, maintain relationships, and respond to crises together.

“A resilient community is a group of people who can unite, work together to overcome challenges, and care for their surroundings and neighbourhood. It doesn’t mean there are no problems or that all issues can be solved, but a resilient community looks for solutions and maintains relationships even in difficult times,” says Eglė Januškienė a PhD student at KTU, co-author of the study on resilient communities.

According to the study, the resilient communities are open, interconnected, and willing to share responsibility. In contrast, vulnerable communities often experience isolation, lack of information, and a sense of helplessness.


Cultural heritage as a foundation for resilience

Interestingly, the KTU study revealed that cultural heritage plays a vital role in fostering community resilience. “Cultural heritage is a key part of a vibrant community identity – it helps people understand both their uniqueness and their connectedness,” says Indrė Gražulevičiūtė-Vileniškė, associate professor at KTU.

According to her, cultural heritage forms the foundation of community identity, nurturing a sense of place, continuity, ownership, and belonging. Preserving heritage not only strengthens historical ties but also promotes trust, collective responsibility, and shared vision for the future – qualities that help communities withstand external pressures.

Emotional attachment to a place also matters. As Dr Aušra Mlinkauskienė, associate professor at KTU and one of the authors of the study, explains, when people take care of parks, old buildings, or symbolic sites, they reinforce their bond with the environment and create traditions that are passed down through generations. This encourages volunteering, builds social capital, strengthens trust, and boosts a community’s ability to address local issues independently.

Invisible factors such as a sense of belonging, local spirit, and social ties are just as important. Though absent from budgets and city plans, they are crucial for mobilising communities in times of crisis. “These are the elements that often ensure unity, mutual support, and creative problem-solving,” says Gražulevičiūtė-Vileniškė.

Another key ingredient of resilience is trust. “Trust among community members and between citizens and institutions acts like glue – it helps communities come together more quickly and solve problems more effectively,” says Prof. Dr Lina Šeduikytė. She emphasises that trust is not just an emotion – it’s a structural element that enables responsible, efficient action, especially in times of need. The more transparency, inclusion, and dialogue there are between institutions and citizens, the stronger and more resilient the community becomes.

A rich heritage but limited citizen power

While cultural heritage and trust are crucial, true resilience also requires genuine public involvement in city planning and decision-making. The KTU researchers and foreign partners conducted a study in Lithuania as part of the Erasmus+ project UPRUN. The study found that although Lithuanians value their heritage and environment, many feel powerless to influence their surroundings.

“Urban planning may include formal surveys, but real opportunities to participate are often lacking. There’s little feedback, and information doesn’t always reach everyone. This causes frustration and erodes trust in institutions,” says Dr Mlinkauskienė.

Gražulevičiūtė-Vileniškė adds that true inclusion goes beyond surveys – it requires meaningful engagement in decision-making, workshops, and interactive platforms where people’s ideas are seen and implemented.

Researchers from KTU’s Faculty of Civil Engineering and Architecture (SAF) stress that participation must be inclusive – not just for the most active or educated citizens. Information should be accessible in different formats, both online and in person. “We have to go to the people, not wait for them to come to us,” says Januškienė. According to her, resilience begins with listening, empathy, and recognising diversity as a strength.

Many other European cities face similar challenges – passivity, limited engagement, mistrust of institutions, and planning processes that exclude real community input.

“Studying communities in Lithuania is a particularly valuable case because it reflects the broader situation in many post-communist countries – there is a rich heritage and active local communities, but also structural barriers to full citizen participation. It’s akin to a laboratory of transition, where old governance models collide with the demands of modern citizenship and democracy,” says Prof. Šeduikytė.

She believes that a resilient city is not a utopian dream – it’s an achievable goal. It’s a city where citizens are engaged, and heritage is not just a museum exhibit, but a living part of the urban fabric.

“Such cities are not built by one big decision, but through many small, purposeful steps – honest dialogue, trust-building, and collaborative initiatives. This is how we create the city of the future, where the community is not just a bystander, but an active creator,” she says.

The article Fostering Resilient Communities Through the Interaction of Heritage, Policy, and Participation: Insights from a Lithuanian Case Study, is available here.

 

What’s driving America’s deep freezes in a warming world?




The Hebrew University of Jerusalem






Despite a warming climate, bone-chilling winter cold can grip parts of the U.S.—and this study explains why. Researchers found that two specific patterns in the polar vortex, a swirling mass of cold air high in the stratosphere, steer extreme cold to different regions of the country. One pattern drives Arctic air into the Northwest U.S., the other into the Central and Eastern areas. Since 2015, the Northwest has experienced more of these cold outbreaks, thanks to a shift in stratospheric behavior tied to broader climate cycles. In short: what happens high above the Arctic can shape the winter on your doorstep.

As winters in the United States continue to warm on average, extreme cold snaps still manage to grip large swaths of the country with surprising ferocity. A new study offers a powerful clue: the answer may lie more than 10 miles above our heads—in the shifting patterns of the stratosphere.

The international team includes Prof. Chaim Garfinkel (Hebrew University), Dr. Laurie Agel and Prof. Mathew Barlow (University of Massachusetts), Prof. Judah Cohen (MIT and Atmospheric and Environmental Research AER), Karl Pfeiffer (Atmospheric and Environmental Research Hampton), Prof. Jennifer Francis (Woodwell Climate Research Center), Prof. Marlene Kretchmer (University of Leipzig). The study published in Science Advances, reveals how two specific patterns in the stratospheric polar vortex—a high-altitude ribbon of cold air circling the Arctic—can trigger bone-chilling weather events across different parts of the U.S.

“The public often hears about the ‘polar vortex’ when winter turns severe, but we wanted to dig deeper and understand how variations within this vortex affect where and when extreme cold hits,” said the researchers.

Two Vortex Patterns, Two U.S. Outcomes

The team identified two distinct variations of the polar vortex, both linked to what scientists call a “stretched” vortex—a distorted and displaced circulation pattern that leads to unusual weather on the ground.

  • One variation pushes the vortex toward western Canada, setting the stage for intense cold in the Northwestern U.S.
  • The other nudges the vortex toward the North Atlantic, unleashing frigid air across the Central and Eastern U.S.

Both versions are associated with changes in how atmospheric waves bounce around the globe—essentially altering the jet stream and dragging Arctic air far southward.

A Westward Shift in the Cold

Perhaps most striking is the discovery that since 2015, much of the northwestern U.S. has been getting colder in winter, contrary to broader warming trends. The researchers tie this shift to the increased frequency of the westward-focused vortex pattern, which also coincides with stronger negative phases of the El Niño/Southern Oscillation (ENSO)—a key global climate driver.

“Climate change doesn’t just mean warming everywhere all the time. It also means more complex and sometimes counterintuitive shifts in where extreme weather shows up,” explained the researchers.

Why It Matters

These findings help explain recent cold waves in places like Montana, the Plains and even Texas as in February 2021 (which was very costly in terms of deaths and insured losses), while other regions may experience milder winters. Understanding the stratosphere’s fingerprints on weather patterns could improve long-range forecasting, allowing cities, power grids, and agriculture to better prepare for winter extremes—even as the climate warms overall.

The work was funded by a US NSF-BSF grant by Chaim Garfinkel of HUJI and Judah Cohen of AER&MIT.




The Mount Sinai Hospital / Mount Sinai School of Medicine




A traditionally overlooked type of RNA plays an important role in promoting resilience to depression—but only in females. According to a new study led by the Icahn School of Medicine at Mount Sinai, researchers have now discovered a novel role this molecule plays in how the female brain makes decisions. The authors revealed brain-region-specific and sex-dependent effects of this biomarker, translated from humans to animals, on how individuals make only certain types of choices. This study uncovered differences in how each sex decides whether to change their minds after making mistakes, including when to cut their losses and move on as well as how they process regrets about missed opportunities.

This research sheds important light on how specific types of decisions that could negatively impact mood engage the male and female brain in very different ways. The study, published July 11 in Science Advances, using laboratory animal models, helps uncover new biological and psychological mechanisms that may be linked to psychiatric vulnerabilities.

Women are twice as likely to develop depression than men. Furthermore, depression can manifest with different symptoms between the sexes, including alterations in negative rumination on the past. However, the neurobiological mechanisms underlying these differences remain unclear.

“Our motivation for this work stemmed from a major gap in understanding why depression is more prevalent in females and how symptoms related to negative rumination take shape in the brain,” said Brian Sweis, MD, PhD, Assistant Professor of Psychiatry, and Neuroscience, at the Icahn School of Medicine and senior author of the paper. “We set out to investigate how the brain at risk for developing depression thinks about one’s prior choices and how neural circuits that process such computations could contribute to disease burden in this way.”

This study builds on a recent breakthrough involving a traditionally overlooked class of molecules known as non-coding RNA that were found to play a pivotal role in depression pathology.

In a 2020 study that leveraged analyses of postmortem human brain tissue, researchers also involved in the current study (Issler et al.) discovered that expression levels of the long intergenic non-coding RNA termed LINC00473 were reduced, specifically in the prefrontal cortex, in the brains of women—but not men—diagnosed with major depressive disorder.

Orna Issler, PhD, Assistant Professor of Neuroscience, and Anesthesiology, at the NYU Grossman School of Medicine, lead author of that 2020 study, and co-author of the present study, said, “We translated these findings into an animal laboratory model and demonstrated a causal role of prefrontal LINC00473, when experimentally increased, in promoting resilience to stress in female mice only.”

The prefrontal cortex is a key brain region essential for integrating mood with decision-making. In a key finding of the present study, researchers demonstrated that by surgically manipulating LINC00473 in the prefrontal cortex in mice, they could enhance how females, but not males, changed their minds while foraging for rewards. By applying principles of neuroeconomics to their analyses, the authors discovered that increased LINC00473 levels drove behavioral differences in females by enhancing sensitivity to sunk costs [overvaluing lost investments] and regret [sensitivity to missed opportunities] related to change-of-mind decisions—traits that may be associated with resilience to stress. Importantly, this is the first study to show that non-coding RNA plays a functional role in cognition in any capacity.

“We were able to selectively alter decision-making behavior involved in re-evaluating a recently selected choice without altering the initial judgement itself,” said Romain Durand-de Cuttoli, PhD, Instructor in Neuroscience at the Icahn School of Medicine and first author of this study. “Choices that depend on reflecting on the past are neurobiologically distinguishable from those that involve planning for the future. These are fundamentally distinct types of decisions processed in separate circuits in the brain, differently in males and females, that could in turn affect emotions in unique and complex ways.”

The implications of this research are significant. The study points to a novel molecular target for new drug development as well as an anatomical target for brain stimulation therapeutics that could potentially treat depressive symptoms related to negative rumination, specifically for females. Furthermore, the study sheds light on psychological aspects of resilience vs. vulnerabilities to depression in females. This work offers new insights for establishing a mechanistic link between the neurobiology of stress responses and how affective states interact with our choices.

“This research helps us appreciate that sensitivity to regret may not always be a bad thing. There are many ‘flavors’ of regret that could come from different parts of the brain and that can manifest very differently in males and females. Ruminating on the past, while potentially unpleasant, can still be useful for learning and can contribute to how we process emotions, deal with stress, and grow from past experiences,” explained Dr. Sweis. “The challenge will be to disentangle what aspects of this are maladaptive and feed into worsening depressive symptoms and which are healthy, adaptive, and part of an intact coping strategy. It is also exciting that behavioral findings from an animal study can push us to ask new questions about human psychology in ways that could directly inform advances in psychotherapy tailored to the individual. This study is a step in the right direction toward these goals.”

Ongoing work from this group is beginning to both forward- and back-translate efforts between the lab and the clinic to examine the manyfold dimensions of decision-making that may be altered in depression.

“This work emphasizes the importance of interdisciplinary research at the intersection of multiple fields, including psychiatry, psychology, and neuroscience,” said Eric J. Nestler, MD, PhD, Interim Dean, Icahn School of Medicine at Mount Sinai; Chief Scientific Officer, Mount Sinai Health System; senior author of the Issler et al., 2020 study; and co-author of the present study. “Translational cross-species research that includes leveraging animal models is crucial for making unexpected discoveries and accelerating the development of richer diagnostics, innovative treatments, and improved outcomes for those struggling with mental illnesses.”

This work was supported by the National Institute of Mental Health, the National Institute on Aging, the Burroughs Wellcome Fund, the Leon Levy Foundation, the New York Academy of Sciences, the Brain and Behavior Research Foundation, the Seaver Foundation, the American Society of Clinical Psychopharmacology, and the American Psychiatric Association.

About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across seven hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.

Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 11 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2024-2025.

For more information, visit https://www.mountsinai.org or find Mount Sinai on FacebookInstagramLinkedInX, and YouTube.

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