In an initial research trial led by Dr. King, iNav was used specifically for pancreatic cancer — he was investigating poor outcomes among African Americans. Now clinicians are applying the AI technology across all cancer types. “Oftentimes, the tests are ordered for a completely different purpose — say by a urologist to look for kidney cysts. iNav can capture that test and determine if there’s a risk for cancer,” he said. “Once you've trained the computer to look out for any set of words, it does it very, very fast,” he says. “Within a single second, the computer can easily read through thousands of scans and instantly output the answers you're looking for.”

And the results have been swift: Among pancreatic cancer patients, iNav has halved the number of days between diagnosis and securing an appointment with an oncologist, Dr. King reports, and iNav is doubling the number of patients being seen overall. Another contributing factor to its success, he adds, is the system’s cancer navigation team. “Once we have identified an abnormal scan, we then bring that information to a navigator and review the chart together to get a better sense of what that patient needs,” he says. “Our navigators, led by Tiffany Zavadsky, CRNP, are experts at facilitating that process with a language that's congruent with the patient while addressing any other needs they have.”

In 2023, iNav was among the winners of Northwell’s Innovation Challenge, an annual competition that supports employee-driven projects with $500,000. Building on this early success, the iNav team, which also includes Sandeep Nadella, MD, is devising a new trial to study the AI-driven model itself, which he says will include 150 patients being treated throughout Northwell Health’s catchment area.

More than 100 million people worldwide live with some form of paralysis stemming from disease or injury. If the paralysis is permanent, the patient has few options. In 2023, Feinstein Institutes’ researcher Chad Bouton announced results that provide new hope: He and his team were able to restore both movement and feeling in a patient paralyzed below the neck with the help of bioelectronic medicine by combining brain implant technology, artificial intelligence, and the latest in neurosurgical techniques.

Focused on finding a way to circumvent spinal cord injuries, one of the top causes of paralysis, Bouton and his colleagues developed a double neural bypass. “This technology forms a new line of communication between the paralyzed body, brain and spinal cord to restore lasting movement and sensation,” says Bouton, a professor with the Institute of Bioelectronic Medicine at the Feinstein Institutes and vice president of advanced engineering at Northwell Health.

In a first-of-its-kind clinical trial testing the efficacy of the double neural bypass, Bouton and his team worked with Keith Thomas, 45, who, in 2020, was paralyzed due to a spinal cord injury. In March 2023, Ashesh Mehta, MD, and team implanted microchips in Thomas’ brain to capture and redirect the brain's intent to move and provide electrical stimulation to restore feeling. Weekly sessions in Bouton’s lab followed, in which a computer equipped with artificial intelligence (AI) helped translate Thomas’ brain signals. As he thought about moving his hand or grabbing a bottle, the double neural bypass deciphered and re-routed signals to and from his brain. “Keith’s brain is literally connected to a computer,” Bouton says. “And signals from the motor area in his brain are going to the computer and the back to his body and spinal cord to help retrain it and strengthen damaged connections.”

Bouton’s team interpreted those signals using AI algorithms they developed to translate Thomas’ intentions into action. The signals then travel from the computer to similar electrodes placed on Thomas’ right hand, forearm and upper arm, as well as over his spinal cord. To close the loop, the team placed tiny sensors on his fingertips and palm; these sent touch and pressure information back to the sensory area of his brain, restoring sensation to his fingertips.

Just a month after the surgery, Thomas reported improved arm strength and sensations in his fingertips with the aid of the bypass, something he says that was almost impossible to believe. Now nearing the end of 2023, those gains have continued, with sensation now present in his wrist and forearm that persists — even when the bypass system is turned off.

“With the changes we are beginning to see in Keith, it is extremely encouraging that the double neural bypass technology may be a new treatment option in the future,” Bouton says. “In addition to offering hope for people with spinal cord injuries worldwide, we think this technology could also be used for a wide range of other conditions including stroke recovery, multiple sclerosis, Parkinson’s disease, and even traumatic brain injury one day.”

Of the approximately 3.1 million Americans living with inflammatory bowel disease (IBD), about 20% are children. The condition is particularly tough on kids because along with symptoms of abdominal pain, diarrhea and bleeding, IBD can also delay growth. While there are medications for IBD, they can trigger serious side effects and may not fully relieve the symptoms. In October 2023, Benjamin Sahn, MD, pediatric gastroenterologist at Cohen Children’s Medical Center and instructor at the Feinstein Institutes for Medical Research’s Institute of Bioelectronic Medicine announced preliminary results that suggest a simple stimulation from a widely available tool may offer lasting relief for children with IBD.

Inflammation is at the root of IBD trouble: When the body mounts an immune response to illness and injury, it triggers an inflammatory reflex, a group of first-responder proteins that rush to the affected area to aid in the healing process. When the immune response is too aggressive, the inflammation can do more harm than good and even lead to severe illness — think of autoimmune disorders such as rheumatoid arthritis or lupus. If the digestive tract is the target, IBD-related conditions can result, including Crohn’s disease and ulcerative colitis.

Dr. Sahn knew that one potential way to tame inflammation is through the vagus nerve. Often referred to as the body’s superhighway, it connects the brain with all major organs and controls functions like heart rate, breathing and the body’s immune response — including the release of inflammatory molecules. For a 2023 study, Dr. Sahn recruited volunteers between the ages of 10 and 21, all of whom had a diagnosis of either ulcerative colitis or Crohn’s disease. His plan: To train the volunteers how to use a simple electrical device on “a very special spot on the ear” that would stimulate the vagus nerve and potentially ease IBD-related inflammation in the gut. 

If you break a bone, new bone forms. If you cut your skin, it can regenerate to repair the wound. But if you damage cartilage — in particular, the articular cartilage that lines the ends of your bones where they form a joint, it won’t heal on its own, and that equals plenty of pain in the joint. Although some surgical procedures can help stimulate healing, in 2023 we saw a major advance in the quality and quantity of cartilage the body can produce after injury. A new implant called Agili-C has been approved for the treatment of chronic joint pain and osteoarthritis — and it’s powered by sea coral. 

“Coral is a living organism that has an exoskeleton nearly identical to human bone,” says Kenneth Zaslav, MD, director of the Center for Regenerative Orthopedic Medicine at Northwell. “We’ve known this for many years and the aragonite that makes up coral’s exoskeleton has been used as a bone substitute for spine surgery. Now, we’re using it to grow bone and hyaline cartilage.”

Dr. Zaslav was among a group of orthopedic surgeons recruited to join a company called CartiHeal, which developed Agili-C, an aragonite-based implant. Through the course of many trials they found that it stimulates a kind of stem cell in the bone marrow. Called mesenchymal stem cells (MSC), they can turn into several types of tissue, including bone and cartilage. “Once implanted into the defect in cartilage, aragonite acts like a magnet, not only for these MSCs, but cells from the surrounding healthy cartilage, which we’ve seen in these various trials migrating over into this coral implant and starting to make new cartilage,” says Dr. Zaslav, who served as medical director for CartiHeal, the company that conducted these breakthrough clinical trials over the last 15 years. “That had never been shown before."

Even better, Agili-C prompts the body to produce a higher quality type of cartilage called hyaline — it replicates the lost articular cartilage in the knee. “This smooth, durable surface has the lowest coefficient friction known to man and allows you to glide for decades on your joints,” Dr. Zaslav says. This is an improvement on the standard of care treatment, microfracture surgery and debridement. It involves drilling small holes into the bone near the lost cartilage and it can coax MSCs to turn into fibrocartilage, which carries the drawback of breaking down more rapidly.

In a two-year, multinational study, researchers in Europe, the U.S. and Israel tested Agili-C, against microfracture surgery and debridement. “Agili-C demonstrated clear superiority in various clinical metrics,” says Dr. Zaslav, who was among the principal investigators. At 24 months post-surgery, 88.5% of those receiving Agili-C had at least 75% regrowth of lost cartilage compared with 30.9% of those who received microfracture and debridement (the control group).

Agili-C received FDA approval for the treatment of articular cartilage damage, including those with mild to moderate arthritis in the knee. In 2023, Dr. Zaslav became the first surgeon in the U.S. to use Agili-C commercially for CartiHeal and has performed a number of implants since at Northwell Health Lenox Hill Hospital, one of just a few centers in the U.S. now offering this exciting new treatment.  

“We really feel we have come up with a cost-effective, off-the-shelf implant that can go in at any time when you see a defect in the knee through a small open incision,” he said. “They can then start to get your body’s own MSCs and your body’s own cartilage to form new cartilage.”

Brexanolone worked well, but Dr. Deligiannidis wanted to push further; the treatment can have significant side effects for a small number of women, and it has to be injected in a health care setting. In partnership with Sage Therapeutics and other researchers across the country, she kept working on an alternative. In July 2023, zuranolone (brand name Zurzuvae) gained approval as the first oral pill for PPD. The treatment is effective: Dr. Deligiannidis’ study found that some women reported relief from depressive symptoms after just three days (two doses) of starting treatment; the results were sustained through the end of her 45-day trial.

“This is such a victory for women’s mental health, but also now these neurosteroids are being tested in Alzheimer’s disease, traumatic brain injury, Parkinson’s disease and forms of epilepsy,” Dr. Deligiannidis concluded. “Now that we’ve unlocked what these neurosteroids can do, there is no stopping the development of these rapid-acting medications. To be able to see that come to fruition is incredibly gratifying.”