DNA Uptake in Cholera May Increase Defense Mechanisms

Cholera, caused by the bacterium Vibrio cholerae, remains a major global health threat. Like most bacteria, Vibrio cholerae lives under constant attack from viruses. To survive, bacteria equip themselves with antiviral immune systems. Previous work has shown that V. cholerae carries a large genetic element called a sedentary chromosomal integron (SCI). This structure contains hundreds of small mobile DNA units known as “gene cassettes” arranged in a long array, like a chain of pearls. A new study by researchers at the School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), has now shown that V. cholerae can efficiently acquire new SCI gene cassettes from extracellular DNA released by other V. cholerae strains, and non-cholera vibrio species, potentially adding to their own defense arsenals.

Research lead Melanie Blokesch, PhD, and colleagues reported on their findings in Science, in a paper titled “Competence-mediated DNA uptake diversifies Vibrio cholerae sedentary chromosomal integrons,” in which they concluded “Given the widespread presence of SCIs and the conservation of natural competence across the genus, we propose that SCIs function as genus-wide reservoirs of exchangeable protective genes.”

Bacteria often survive viral attack and environmental stress by sharing genes that enhance their defenses, the authors wrote. A “defining genomic feature” of V. cholerae is its sedentary chromosomal integron (SCI), a genetic element containing hundreds of mostly promoterless gene cassettes. While the function of many cassettes remains unknown, some do encode antiviral immune systems. “Although most cassettes encode proteins of unknown function, ~10% encode phage defense systems, suggesting that SCIs as well as mobile integrons function as reservoirs, or “biobanks,” of defense genes,” the authors continued.

However, most of these genes are located far from the start of the array and remain silent. Prevailing models proposed that cassettes could be internally reshuffled to activate them, yet no such rearrangements have been observed in the pandemic lineage of V. cholerae for decades. “Cassettes are thought to reshuffle under stress to the favorable first array position, yet the SCI in pandemic V. cholerae has remained static for more than 60 years.”

This raises a key question: if internal reshuffling is rare, how are cassette-encoded immune systems activated, and how do new cassettes enter the array at all? To address this question, a team led by Blokesch at the Laboratory of Molecular Microbiology at EPFL investigated whether the SCI might capture gene cassettes from genetic material entering the cell from the outside. “We asked whether SCI cassettes move horizontally rather than by intracellular reshuffling.”

A key feature of this process is natural competence, the ability of bacteria to take up free DNA from their surroundings. V. cholerae becomes naturally competent when it grows on chitinous surfaces, a polymer found in the shells of crustaceans that is abundant in aquatic environments.

In the laboratory, the team mimicked these conditions by growing bacteria on chitin and supplying DNA from different Vibrio cholerae strains or from other Vibrio species. They then tracked whether newly acquired gene cassettes were inserted into the first position of the SCI array.

Through their studies the team confirmed that that V. cholerae can acquire new SCI gene cassettes from extracellular DNA. Collective experimental results, the authors stated, “We show that SCI cassettes are efficiently acquired by naturally competent V. cholerae and inserted at the first SCI array position in an integrase-dependent manner. This process incorporates cassettes not only from other V. cholerae strains but also from diverse Vibrio species.”

In aquatic habitats, DNA is released when bacterial cells are killed by viruses, antimicrobial compounds, or bacterial weapons. Nearby competent bacteria can take up this DNA and incorporate selected fragments into their own SCI. “A loose comparison would be the following,” said Blokesch. “Imagine your grandmother passes away and, as a farewell gift, hands over the immunity she built up against the Spanish flu a century ago, immediately protecting you from that same virus. Wouldn’t that be amazing? This is essentially what we show that V. cholerae can do.”

The team also showed that cassettes inserted in this position are functional. Several defense systems provided protection against viruses that infect Vibrio species, known as vibriophages. They stated, “In this study, we show that SCI diversification efficiently occurs by horizontal transfer linked to the genus’s aquatic lifestyle: DNA released from lysed cells is taken up by naturally competent vibrios and integrated into the first position of the SCI array, the primary site of strong expression, where it confers resistance to phage and potentially other threat,” the wrote in summary. “Together, these results demonstrate that SCI cassettes can cross species boundaries, supporting a model in which SCIs may function as genus-wide reservoirs of exchangeable genes, including defense genes, that confer selective advantages under certain conditions.”

An important exception emerged. In the pandemic 7PET lineage of V. cholerae, the SCI appears largely static. “The SCI of 7PET V. cholerae is large but remarkably stable,” the authors noted. They propose that this reflects adaptation to a human-associated niche. “We propose that this reflects adaptation to a human-associated niche, where chitin is less abundant and competence induction—requiring growth on chitin to high cell density plus relief from catabolite repression is unlikely to occur,” they suggested. “As a result, SCI-mediated diversification may be largely inactive in pandemic strains.”

However, if pandemic strains were to encounter environmental conditions that enable SCI cassette acquisition, they could expand their antiviral defenses. Blokesch commented. “This possibility matters because vibriophage-based approaches are currently being explored to prevent cholera in endemic regions, and such evolutionary flexibility could ultimately affect how effective these strategies remain.”

In their paper the team concluded that since onset of the seventh pandemic, “… acquisition of novel and diverse, large defense-related genomic regions by 7PET strains appears to have been relatively limited. Consequently, reduced SCI-mediated diversification may lower the capacity of this lineage to rapidly evolve new defenses—an important consideration for ongoing efforts to deploy phage-based prophylaxis against cholera in endemic settings such as Bangladesh.”

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New rules for CDC vaccine panel aim to address lawsuit, empower Kennedy’s allies

After a courtroom defeat, Trump administration health officials have revised the governing documents for a key federal vaccine panel to broaden its membership, increase its focus on potential harms of vaccines, and empower allies of health secretary Robert F. Kennedy Jr.

The new charter for the committee that advises the Centers for Disease Control and Prevention on vaccine use appears aimed at trying to evade the type of legal challenge that has left the currently appointed body in limbo. In addition, the document puts greater emphasis on the role of the Advisory Committee on Immunization Practices in studying injuries possibly linked to vaccination  — though the committee has always paid close attention to any emerging evidence that called into question the safety of individual vaccines.

Read the rest…

Labguru Customer Portal Launched for CRO/CDMO and Client Collaboration

Officials at Cenevo say the company has launched the Labguru Customer Portal to help streamline client communication for CROs, CDMOs, and others.

CROs and CDMOs operate in high-throughput, service-driven environments where speed, accuracy, and transparency are critical, explains Eran Sandman, product manager, Cenevo. Labguru allows CROs and CDMOs to centralize operational visibility across departments and projects, standardize workflows, and manage multiple client programs at scale, he adds.

Integrated with Labguru’s ELN and LIMS platforms, the new portal was designed to extend internal workflows to support external collaborators. With this structured approach, labs experience increased efficiency while minimizing version conflicts, human error, and compliance risks, maintains Sandman, noting that clients can submit requests, monitor progress and access results, while labs retain full control and visibility over shared information.

Lab managers can use the portal to gain actionable insights across every client individually and all clients in aggregate, as they relate to equipment and consumables usage, client activity trends, regulatory compliance, and other critical information, points out Sandman.

“Our goal is to make our clients’ operations run more smoothly,” he says. “High-performing CROs are moving toward shared digital environments. With the Customer Portal, CROs and their clients are able to see the same information and collaboration becomes faster and more strategic. Lab managers don’t have to spend all their time on back-and-forth communications.”

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Rangatahi Youth-Led Dissemination Campaign for Cocreated Eating and Well-Being Guidelines: Process and Pilot Implementation Evaluation

Background: Youth should be partners in the development and dissemination of health information created for their demographic. The Manaora Rangatahi (youth) Guidelines comprise 10 eating and 10 wellbeing messages that were cocreated with rangatahi Māori (Māori youth) in Hawke’s Bay, New Zealand, and then disseminated through a digital media campaign. Objective: This study aimed to present the process evaluation of the co-design and implementation of the pilot digital media dissemination campaign of the Manaora Rangatahi Guidelines. Methods: The 17 rangatahi who were involved in the cocreation of the guidelines codeveloped a dissemination plan, filmed video clips for each of the 20 messages, and supported the 20-week digital media campaign. The codevelopment process over 4 wānanga (workshops) is described and critiqued, and the implementation was assessed using the data analytics from Instagram and TikTok, the main social media platforms for dissemination. The rangatahi participated in a short postcampaign review survey. Results: The dissemination plan included a website for the messages, a campaign name and logo, apparel with messaging and QR codes, and the design of a digital media campaign featuring the participating rangatahi. Video clips of each of the guideline messages featuring the rangatahi were professionally developed with support from 3 Māori influencers and a video production company. The 10 phases of the campaign involved the release of 2 messages (one eating and one wellbeing) every fortnight over 20 weeks. Instagram and TikTok analytics showed that the campaign achieved >1.48 million impressions and >19,000 engagement actions (eg, likes, comments, and sharing). The mean engagement rate (Instagram 6.2%, TikTok 1.2%) was greater than or similar to the platforms’ medians across all industries (0.36% and 1.73%, respectively). Various paid promotion strategies boosted the number of impressions, and paying one of the influencers to promote the messages in phase 8 created a more than 10-fold increase in impressions on Instagram. The estimated cost of the overall campaign was NZ $125,000 (US $72,500). The majority (about 60%) of rangatahi felt the campaign was successful and engaging. Conclusions: Rangatahi have expert knowledge in how to disseminate messages to their peers. They successfully co-designed and pilot-tested the implementation of a low-cost digital media campaign using peer-to-peer messaging and videos, which achieved substantial reach. The dissemination reach was good, but was significantly influenced by paid promotions. The cost per thousand impressions was equivalent to or better than much larger government-funded health promotion social media campaigns targeting youth. The development and dissemination of eating and well-being messages aimed at youth should ideally involve partnering with the target audience to enhance the relevance and reach of the messages. A well-funded dissemination campaign with paid promotions through influencers and digital platforms could expect to achieve substantial awareness of the messages.

Seer to Apply Deep Proteomics Tech to Singapore Population Cohort Study

This week, Seer, a developer of proteomics technology, said that scientists involved in the PRECISE-SG100K initiative will use the company’s Proteograph® product suite to profile the plasma proteome of about 10,000 participants. The data from this workflow will be combined with information from the same participants that was generated using Thermo Fisher Scientific’s Olink® Reveal, a next-generation sequencing-based proteomics solution, and its Orbitrap Astral™ mass spectrometers.

PRECISE-SG100K is the second phase of a broader initiative in Singapore that aims to support various research studies that advance scientists’ understanding of health and diseases. Touted as a landmark population study of approximately 100,000 Singaporean residents, PRECISE-SG100K is designed to integrate genomic, proteomic, lifestyle, imaging, and other health data from a multi-ancestry Asian population. By combining data from Seer’s Proteograph platform alongside information from other technologies that are being used for the project, the scientists aim to develop what they believe will be one of the most comprehensive multiomic datasets available to date. 

“PRECISE-SG100K is one of the most ambitious and carefully designed multiomic health initiatives in the world,” said Omid Farokhzad, MD, PhD, chair and CEO of Seer. And that fits with Seer’s vision for Proteograph, which was that “deep, unbiased proteomics becomes the mainstay for population-scale multiomic studies.”

Seer already has an existing relationship with Thermo Fisher dating back several years. In 2024, the companies announced a co-marketing and sales agreement that allowed Thermo to jointly promote Proteograph alongside Orbitrap Astral mass spectrometers to provide customers of the Orbitral Astral with an integrated solution for unbiased proteomic analysis. The combined solutions have since been used in a number of large population studies providing high-throughput, deep proteome coverage. 

“A key goal of PRECISE-SG100K is to create a deeply characterized, multi-ancestry resource that can reveal how genetics, environment, and lifestyle shape disease risk and treatment response,” said John Chambers, PhD, chief scientific officer of PRECISE and lead principal investigator of the PRECISE-SG100K study. “By adding deep, unbiased plasma proteomics enabled by Seer and Thermo Fisher, we can more directly link genomic variation to protein networks and health outcomes, uncovering insights critical to ensuring precision medicine reflects the diversity of Asian populations.”

Ultimately, the data generated from population projects like this are expected to support biomarker discovery in key disease areas including cardiometabolic, ophthalmic, and neurologic disorders. They could also inform the development of predictive models for assessing disease risk and response as well as efforts to validate and prioritize biomarkers identified through affinity-based platforms. 

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Peer Mentor Training and Supervision for a Digital Adolescent Depression Treatment in South Africa and Uganda: Mixed Methods Evaluation

Background: Blended digital mental health interventions combining technology with human support are more effective than stand-alone treatments. However, limited research has examined how to train and supervise personnel delivering human support components. The Kuamsha app, a gamified digital intervention for adolescent depression based on behavioral activation, was designed to be paired with low-intensity telephone-based peer support. A structured training and supervision program for peer supporters was codeveloped through workshops with mental health professionals and youth with lived experience of mental health challenges in South Africa and Uganda. To the best of our knowledge, this is the first study to evaluate a structured peer mentor model within a digital mental health intervention in low- and middle-income countries. Objective: This study assessed the feasibility, acceptability, and fidelity of a training and supervision program for peer supporters delivering a digital mental health intervention in South Africa and Uganda. Methods: We conducted a mixed methods evaluation of the peer mentor program. Quantitative metrics assessed the feasibility of recruitment, retention, and attendance among peer mentors (n=13, South Africa; n=4, Uganda), as well as training acceptability. Fidelity, adherence, and competence were scored at the session level and converted to percentages of the maximum possible score. Linear mixed-effects regression models with a random intercept for provider and site estimated adjusted marginal means (95% CI). In-depth interviews and focus group discussions explored program acceptability and implementation factors. Results: The peer mentor training and supervision program was feasible and acceptable in both settings, with high recruitment (South Africa: n=13/19, 68%; Uganda: 4/4, 100%), retention (South Africa: 9/13, 69%; Uganda: 4/4, 100%), and training attendance rates (89%‐92% in South Africa and 100% in Uganda), alongside qualitative reports of high satisfaction. All peer mentors met a minimum posttraining competency threshold (≥50%), with median competency scores of 70.7% (IQR 45.8%‐78.2%) in South Africa and 75.4% (IQR 73.8%‐77.3%) in Uganda. Independent ratings of recorded calls indicated high overall fidelity in South Africa (84.7%, 95% CI 80.3%‐89.0%) and Uganda (87.7%, 95% CI 83.4%‐92.1%). Adherence was higher in Uganda than South Africa (adjusted mean difference [AMD] 13.30 percentage points, 95% CI 8.99‐17.61; <.001), as was competence (AMD 4.88 percentage points, 95% CI 1.23‐8.53; =.009). The AMD in overall fidelity (3.06 percentage points, 95% CI −0.98 to 7.10) was not statistically significant (=.14). The qualitative findings emphasized the value of ongoing supervision and capacity development, interactive training approaches, and blended delivery models. Conclusions: Locally adapted training and supervision models can strengthen peer mentor capabilities to support digital interventions. Adequate supervisory capacity and incentive structures are critical to sustain engagement, retention, and fidelity. In settings with frequent network disruptions, periodic in-person contact between peer mentors and supervisors may enhance fidelity. Future research should examine how peer mentor fidelity influences user engagement and mental health outcomes. Trial Registration: Pan African Clinical Trials Registry PACTR202206574814636; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23792 International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2022-065977

Life Biosciences Raises $80M to Fund First Trial of Anti-Aging Gene Therapy  

Life Biosciences has announced an $80 million Series D round, which will fund the completion of a recently started Phase I clinical trial of a gene therapy designed to restore old, damaged cells to a younger, healthier state. 

The Boston-based biotechnology company was co-founded in 2017 by David A. Sinclair, PhD, professor of genetics at Harvard Medical School and founding director of the Paul F. Glenn Laboratories for the Biological Mechanisms of Aging. Sinclair is known internationally as a leading researcher on human aging and longevity, especially for his work on epigenetic changes as drivers of aging and using reprogramming factors to reset the age of cells and tissues. 

The oversubscribed round will support company operations into the second half of 2027, including the conclusion of a Phase I trial launched earlier this year to assess the safety and tolerability of Life Biosciences’ lead program, ER-100. The funds will also go towards exploring new candidates and advancing the company’s broader pipeline of therapeutics for age-related diseases. 

Aging is the main driver and risk factor for most chronic diseases, with over 75% of people over 65 being estimated to suffer from at least one chronic condition. As the world population continues to age, Life Biosciences aims to delay aging processes by rejuvenating cells and restoring their function across many age-related diseases.  

The company’s Partial Epigenetic Reprogramming (PER) platform is designed to partially reprogram the epigenome of old and injured cells through the expression of three Yamanaka factors: OCT4, SOX2, and KLF4 (together known as OSK). These transcription factors have been shown to reset organ-specific epigenetic code without creating induced-pluripotent stem cells, addressing the effects of aging without the risk of fully differentiating cells or inducing the formation of tumors.

This strategy has the potential to address a wide range of age-related diseases across multiple organs and systems within the human body. Life Biosciences’ Phase I clinical trial, which is currently actively recruiting, will assess the safety and tolerability of ER-100 in patients with open-angle glaucoma (OAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The trial will also assess early efficacy endpoints, including multiple measurements of visual function. 

Optic neuropathies like OAG and NAION are driven by damage to retinal ganglion cells, neurons that send sensory signals from the eye to the brain. These cells cannot naturally regenerate, meaning patients suffer permanent vision impairment. Unlike current treatments, which are unable to address the underlying mechanisms of neuronal degeneration, ER-100 aims to directly protect and promote the regeneration of RGC to preserve and restore sight in these patients.  

Jerry McLaughlin, chief executive officer of Life Biosciences, stated that the financing “reflects the growing interest in our platform and the opportunity we have to reverse multiple diseases of aging.”

He added: “This support enables us to advance our lead program, ER-100, through key clinical milestones while continuing the expansion of our pipeline, positioning Life Biosciences to deliver disease-modifying solutions for patients.” 

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In Memoriam: Edna B. Foa, PhD

Dr. Edna Foa served for decades as a professor of clinical psychology in psychiatry at the University of Pennsylvania, where she also directed the Center for the Treatment and Study of Anxiety (CTSA), the internationally renowned program she founded in 1979. Through the CTSA, Edna created not only a hub for groundbreaking research, but also a training ground that would shape the future of evidence-based treatment for anxiety, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

Foa_Edna

At a time when OCD was poorly understood and often ineffectively treated, Edna helped establish and rigorously validate exposure and response prevention (ERP) as a gold-standard intervention. Building on the early behavioral work of pioneers before her, she brought a level of empirical precision, clinical sophistication, and dissemination that transformed ERP from a promising approach into a cornerstone of modern treatment. In doing so, she fundamentally changed what recovery could look like for millions of people living with OCD.

Her influence extended well beyond OCD. Dr. Foa was also a central figure in the development of cognitive-behavioral models and treatments for PTSD, including prolonged exposure therapy, which has become one of the most widely used and effective interventions for trauma-related disorders. Across both domains, her work exemplified a rare integration of theory, research, and clinical application—always grounded in a singular goal: to reduce suffering and restore lives.

Her connection to the International OCD Foundation (IOCDF) was a natural extension of her commitment to bridging science and real-world impact. Edna was deeply engaged with the IOCDF community over many years, contributing to its mission of improving access to effective treatment and advancing understanding of OCD. The Foundation awarded her with the Outstanding Career Achievement Award in 2011. She was a frequent presence at conferences, where she not only shared her research but also helped elevate the standards of clinical care through teaching, mentorship, and collaboration.

The IOCDF’s growth into a global leader in OCD advocacy, education, and training reflects, in many ways, the scientific foundation that Edna helped build. Her work made it possible for organizations like the IOCDF to promote treatments that are not only evidence-based, but truly life-changing. And through her direct involvement, she helped ensure that the connection between research and practice remained strong, dynamic, and accessible.

Edna Foa showed us what it means to dedicate a life to advancing knowledge in the service of humanity. She illuminated a path forward for so many, and her influence will continue to guide the field for generations to come.

Below are several tributes to Dr. Foa from IOCDF community members.

From Jonathan Grayson, PhD

My mentor, Tom Borkovec, used to talk about our psychological lineage; that in 1979, you only had to go back a few generations of your “forefathers” to reach the founders of American psychology. In this respect, Tom is my psychology father – he taught me to discipline my thinking – he encouraged wild flights of speculation, but to always temper it in print with what could be researched and proved. With this in mind, Edna is my psychology mother. As I noted elsewhere, for all of us who work with OCD, we are her children, grandchildren and so on.

I first met Edna  in 1979 at Joseph Wolpe’s Behavior Therapy Unit at Temple University. She hired me as an adjunct research assistant professor. This was in the ancient days at the height of the first wave. There was no cognitive behavioral therapy. ABCT was AABT, American Association of Behavior Therapy. The disorder we were studying was OC, the DSM labeling it obsessive compulsive disorder doesn’t yet exist. Edna was on the first of her landmark OC grants.

She was the flashpoint for all that we do with OCD.  Don’t get me wrong, she didn’t invent ERP, but her work was/is the basis of all OCD treatment today. In the same way that cognitive therapy techniques existed before Aaron Beck, but his work was the flashpoint of that second wave; and the techniques of ACT pre-exist Stephen Hayes, but his work and thinking were the flashpoint of the third wave. There was no OC Foundation.

I joined Edna and Gail Steketee and to work with Edna was always a collaboration. So many hours of discussing, designing and analyzing research. Writing papers together often until midnight and beyond. You may have heard that Edna was demanding.  She was, but that had nothing to do with the hours we worked.  The same clinical skills she used with patients, she used in choosing those who worked with her. We were all driven. There are those who found her direct delivery difficult, but it wasn’t anger or belittling, it wasn’t intimidating (okay, maybe a little), she was simply direct without sugar coating. The truth about Edna was that she was caring and very generous.

As I said, our research was a collaboration and the order of authors on publications reflected our contributions. If you had a research idea that was tangential to her main projects, she would support you.  When I told her I thought we should have support groups to help sufferers maintain their gains, I was given a free hand to develop and run GOAL as I saw fit. When my son was nine months old and I told Edna that I was going to change my work hours to: one and a half daytime hours and the rest of my hours after 4 pm, she accepted this. She didn’t have to admonish me or warn me to do my job, Edna knew the kind of people she had chosen.  She wanted the people who worked with her to grow. When it came time for me to move on, she was like any parent, sorry for me to go, but happy for me to pursue my life.  She was like that with all of us.  So many of those who have shaped the OCD world worked with Edna.  While I was there, Michael Kozak joined the team and later Edna and Michael published their ground breaking paper on emotional processing. Alec Pollard, Charly Mansueto and Rich McNally also passed through our center. Marty Franklin and Jon Abramowitz came after me making up the many generations of her “children.”

For those whom I’ve neglected to mention, forgive me, but the list is too long. My OCD career began in 1979. Her loss is a hole in the fabric of reality, but her legacy and wisdom lives on through all of us whose OCD psychological lineage can be traced back to Edna Foa.

From Marty Franklin, PhD

I am writing this tribute while waiting at an airport gate for a flight to a national conference. Over the course of the next few days I will have the opportunity to present applied research data, participate in a clinical roundtable about OCD and its treatment, & engage with colleagues as we toss around ideas for how best to move the field forward. Edna’s profound influence on my career, my life, and even my thinking is most often accessible during relatively quiet moments like this, where opportunities for reflection make their way forward amidst the work I have committed to myself to doing.  Indeed, I learned of Edna’s passing a few weeks ago while right in the middle of presenting a clinical training about exposure-based treatments for OCD. I paused for a moment to take it all in, but before I could decide how best to proceed under the circumstances, I heard Edna’s voice, in her characteristic and unmistakable Israeli accent, telling me that these clinicians took time out of their busy schedules to receive this training, and therefore I must continue straight through to the end. My feelings?  You can process those later. Classic Edna.

My very first day of internship in 1991 at the Medical College of Pennsylvania was spent in Edna’s presence at her Center for the Treatment and Study of Anxiety, the unit she established in 1979 to develop, test, and disseminate cognitive-behavioral interventions for anxiety and related conditions. Edna’s work even by then was highly influential, and her legend was already well in the making.  At that initial meeting, Edna slid a formidable stack of old-school medical charts across the table to me and said, “Marty, is it?  These are your OCD cases for this rotation.” I thanked her, then asked the first of myriad naïve questions in the legendary Tuesday Meetings:  “When will I receive the training to treat these cases?” She pivoted back to look at Michael Kozak, her Clinical Director, as if to wax nostalgic about the process of indoctrinating yet another green intern. Edna then gestured at the pile, and said, “The training is in there.” Edna was a fine clinician too, and thus read well my horrified expression, then offered, “But don’t worry: we’ll help you.” True to her word, she did exactly that.

Edna’s influence on the field broadly speaking, on the development and expansion of cognitive-behavioral theory, on using clinical science to alleviate human suffering, and in pushing the proverbial envelope, has been chronicled elsewhere and cannot ever be overstated. Edna was one of the true pillars of clinical psychology, and the effects of her work will live on in perpetuity, of that I have little doubt. What was less well known except for those of us fortunate enough to have been mentored by Edna was the incredible amount of time and emotional investment she made in seeding the field with the next generation of theorists, scholars, and clinicians who would carry that work forward in the years to come. I count myself in that incredibly lucky group, all of whom were blessed by her personal investment in our training and careers. Edna had exacting standards for herself and for us, and fully expected that same level of investment and intensity on our part. Vigorous debate was just part of the process, where occasionally the fur would fly. But Edna also knew us well enough to understand what each of us needed in order to help us make the commitment needed to join her in the vanguard. In one of our many career development conversations back in the mid 1990s, likely in her East Falls office well after 8 pm, I was fretting about the “soft money” environment of academic psychiatry, and openly wondering if it was time to pivot to hard-line academic psychology or even to private practice. Edna stopped my rumination dead in its tracks, looked into the depths of my soul (which she did regularly), and said, “It’s only soft money if you can’t get it…and I know you can get it. Plus, academia is a really fun way to make a living, and a life.” Edna Foa believed in me:  it was about damn time to believe in myself as well, and to make the commitment required to honor that belief. And to always keep pushing to get better at the work, which is truly a never-ending process.

Sitting in this airport now, on my way to give another set of talks on topics I have come to know very well and continue to pursue with the passion that comes from also believing that this work is vital, I concur with Edna’s assessment of academia, and am truly grateful that I listened. Thank you, Edna, for illuminating a path forward for me, as I know you did for countless others. You were unforgettable, and your work will continue on in the hands of those you mentored and trained to carry on the legacy.

From Gail Steketee, PhD, MSW

I had the pleasure and helpful educational challenge of training under Dr. Edna Foa beginning in 1976 and continuing for a decade during which I worked closely with her studying OCD and co-authoring manuscripts and federal grant applications.  Edna generously provided me with excellent clinical supervision during my training at the Behavior Therapy Unit at Temple University where I learned how to treat phobias, agoraphobia and panic, and especially OCD.  Edna’s encouragement and specific feedback guided my understanding of patients and how to provide effective treatment.  Her supervision coincided with the end of her important early study of the impact of exposure and response prevention, following in the steps of Victor Meyer, Isaac Marks, and Jack Rachman. I treated the last few patients with OCD in her study and co-authored a case report stemming from that work – my first published paper in the field in 1977.

Edna opened many doors for me to join colleagues around the world who were studying OCD and behavioral treatment methods. Together we wrote and published 26 papers and 14 book chapters.  And I mean “together”.  We would schedule writing times during which Edna generated ideas and spoke aloud in her heavily accented Israeli English while I contributed my thoughts and sharpened the language as we went along. Grant applications were a special challenge as NIMH became strict about page limits.  More than once we stayed up all night writing grants to meet the deadline – we were both younger then – and once we actually drove to Bethesda to deliver a grant application just in time for the deadline.  I joined Edna at many conferences in the U.S. (especially AABT [now ABCT] and OCF [now IOCDF]) and in Europe at EABCT and WCBCT (the World Congress of CBT). We met many delightful OCD researchers and clinicians – it was an exhilarating time.  I traveled with Edna and friends to her home country of Israel where she treated us to delightful sights and experiences including the Dead Sea.

The 10 year period with Edna was a heady time as my career unfolded. She supported my decision to get a PhD in social work at Bryn Mawr while working full time with her on our research. Eventually, I left Temple to take a full-time faculty position at Boston University, arriving with a strong publication record already in hand thanks to Edna’s masterful training and modeling of how to design and conduct research, how to write papers that accurately reflected the study and its findings, how to write strong grant applications, and how to connect with energizing colleagues around the world.  I am grateful for her mentoring that enabled me to establish my own career and become a mentor to others.  She was a brilliant theoretician who spawned impressive thinking and research on OCD, PTSD, behavior therapy, and related topics.  Hers was a long and full life.  She will be sorely missed.

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