ten years closer to Alzheimer’s prevention

CELEBRATING A DECADE OF ACCELERATED PROGRESS

Select a moment below, or flip between highlights from the past ten years.
2015
ATRI Founded as a San Diego Institute of USC
The Alzheimer’s Therapeutic Research Institute (ATRI) was founded by Paul S. Aisen, MD  and a group of about 40 faculty and staff who had been working together for many years at the Alzheimer’s Disease Cooperative Study (ADCS), which at the time was the primary National Institutes of Health (NIH) funded program conducting clinical trials in Alzheimer’s disease (AD).  

Located in San Diego and part of the University of Southern California (USC) Keck School of Medicine, the mission of ATRI is to accelerate the development of effective therapies for AD.  
ACTC Funded and Established under the leadership of USC, Mayo Clinic, and Harvard
In 2016, NIA released a funding opportunity announcement inviting applications for a new academic network called the Alzheimer’s Clinical Trial Consortium (ACTC). The announcement incorporated many new ideas resulting from decades of experience in the field, including the value of a central institutional review board, standing support for trial sites and separation of project funding from the parent grant mechanism, among others. The first ACTC grant was awarded to a team of investigators at three institutions, USC, Harvard and the Mayo Clinic.
PRIME Study Results Published
The PRIME study publishes its findings on Aducanumab, demonstrating its ability to clear amyloid from the brain in Alzheimer’s patients. 
Blood Biomarkers for Early Detection
Innovative blood tests for Alzheimer's biomarkers emerge, offering simpler, earlier, and more accurate diagnostic options.
The single institutional review board (sIRB) mandate goes into effect
The single IRB (sIRB) mandate, a requirement for multi-site research to be reviewed by a single institutional review board, went into effect for the National Institutes of Health (NIH) on January 25, 2018. For other federally funded research, including that funded by the Department of Health and Human Services (HHS), the sIRB mandate was implemented on January 20, 2020
A4 Study Clinical Trial Results Released

The A4 Study clinical trial results were announced in March 2023, and published in the New England Journal of Medicine in July 2023. https://www.a4studydata.org/

Enrollment for the AHEAD 3-45 Study Begins
On July 14th, 2020, the first infusion of an investigational drug that aims to delay or help to prevent the earliest memory loss due to Alzheimer’s disease took place in September at Butler Hospital in Providence, R.I., researchers announced.

Funded by the National Institutes of Health (NIH) and Eisai Inc., a US subsidiary of Eisai Co., Ltd. (Headquarters: Tokyo), the AHEAD Study is the first Alzheimer’s disease trial to recruit people as young as 55 years old who are at risk of developing symptoms of Alzheimer’s disease as they get older. It introduces a personalized medicine approach that will tailor treatment dose levels to a participant’s particular risk of memory loss related to Alzheimer’s disease.
Two new ACTC studies are funded
In 2020, two new Alzheimer's Clinical Trials Consortium (ACTC) studies were funded by the NIA:

1.CT1812 (collaboration with Cognition Therapeutics) was announced on June 8th.


2.Life’s End Benefit of Cannabidiol and Tetrahydrocannabinol (LiBBY) was announced on September 10th.
Key initiatives kicked-off for ACTC’s aim of a well-trained workforce:

1. The Institute on Methods and Protocols for Advancement of Clinical Trials in ADRD (IMPACT-AD) course took place September 14 – 17. Even with the added challenge of meeting virtually, it was a huge success.

2. The Early-Career Project Evaluation Committee is committee which ensures input from the ACTC’s newest investigators on proposals while providing a key training opportunity and platform to develop experience evaluating study proposals.

ACTC forms its first Research Participant Advisory Board

The Alzheimer’s Clinical Trials Consortium (ACTC) formed its first Research Participant Advisory Board, with quarterly meetings throughout the year. This group has been integral in providing feedback on the approach to conducting ACTC studies.

ACTC launches the Site Metrics Reporting initiative
The Alzheimer's Clinical Trials Consortium (ACTC) launched the Site Metrics Reporting initiative, starting with the AHEAD study, which includes quarterly report cards and surveys capturing two-way feedback between the Alzheimer’s Therapeutic Research Institute which serves as the Coordinating Center and the clinical trial sites.
Aducanamab receives accelerated FDA Approval in a controversial decision

Aduhelm receives FDA approval via the accelerated pathway, becoming the first Alzheimer’s treatment targeting the disease’s underlying pathology.

Lecanemab receives the first full FDA approval for a disease-modifying (slowing) therapy

Lecanemab is approved by the FDA, representing another significant advancement in treatments that target Alzheimer’s core pathology.

ATRI Expands Scope

The Alzheimer’s Therapeutic Research Institute (ATRI) successfully recruited our long-term collaborator Robert Rissman, Director of ATRI Biomarker Laboratory and Biorepository to establish a Neuroscience Translational Research Division. This change greatly expands the scope of ATRI to include basic science translational research in models of disease that can serve as preclinical work for future therapeutics.

Donanemab's Phase 3 Success

Donanemab demonstrates effectiveness in slowing cognitive and functional decline in Alzheimer’s patients in the TRAILBLAZER-ALZ 2 trial.

Dr. Aisen Honored with Epstein Alzheimer’s Disease Director’s Chair

USC’s Alzheimer’s Therapeutic Research Institute (ATRI) in San Diego hosted the chair installation ceremony, which recognized and honored Dr. Aisen’s decades of work leading teams toward more effective treatments for Alzheimer’s disease. The Director’s Chair was endowed by the Epstein Family Foundation as another generous gift in a series of significant donations catalyzing Alzheimer’s research in Southern California.

Full FDA Approval for Lecanemab

The FDA grants full approval to Leqembi for Alzheimer’s treatment, marking it as the first traditionally FDA-approved therapy to slow disease progression and improve patient outcomes.

A4 Study Data Released

The A4 Study clinical trial results were announced in March 2023, and published in the New Journal of Medicine in July 2023

Featured News

Will Alzheimer’s disease become preventable within a decade? Researchers from USC Alzheimer’s Therapeutic Research Institute say ‘yes’

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OUR PODCAST EPISODES

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faculty + Staff Insights

ROBERT RISSMAN, phd – biomarker laboratory and biorepository
“The past 10 years have been unprecedented for AD therapeutic development, both in terms of new treatments but also in terms of plasma biomarkers for detection. ATRI has had a major role in these new developments, and I look forward to the next 5-10 years which will be more incredible as we advance the field by identifying new targets for treatment and complete our asymptomatic and tau trials. ”
MICHAEL RAFII, MD, PHD – MEDICAL SAFETY
“This is an incredibly exciting time in Alzheimer’s research. For the first time, we have treatments that slow the disease. We are now targeting the earliest stages of the disease—before symptoms even begin. New study designs are accelerating progress and, importantly, allowing us to bring these advances to individuals with genetically defined forms of Alzheimer’s, including people with Down syndrome.”
REMA RAMAN, phd – Biostatistics, Participant Recruitment & Retention
“As ATRI marks 10 years of advancing Alzheimer’s research, we honor the ATRI team, our partners, and the participants who brought us here. We remain committed to rigorous science, training future researchers, and advancing a future where prevention, early detection, and equitable access to approved treatments are within reach for all.”
Michael Donohue, PhD — Biostatistics
“It has been an immensely rewarding honor to contribute to ATRI’s growth and accomplishments over the past 10 years. I am especially proud of our commitment to open science and data sharing, particularly through ADNI and A4/LEARN. ADNI data has likely informed the design of nearly every Alzheimer’s trial in the past decade, and A4/LEARN will help shape the next generation of prevention studies.”
GUSTAVO JIMENEZ-MAGGIORA PHD, MBA – INFORMATICS
"I am proud to be part of an exceptional team of scientists dedicated to advancing the frontiers of Alzheimer’s disease research. Through rigorous testing of novel diagnostics and therapies, we are working to transform the future of care and prevention. Since its founding over a decade ago, the Alzheimer’s Therapeutic Research Institute (ATRI) has been at the forefront of many groundbreaking innovations in the field. Our progress has been made possible through the steadfast support of USC, our sponsors and partners, and the vibrant Southern California community. Together, we are making a meaningful global impact."
Alison Belsha - Clinical Operations
“It is an honor to be part of ATRI’s decade of dedication, scientific discovery, and an unwavering commitment to advancing the field of Alzheimer’s research. Collaborating with colleagues whose pursuit of bold science and compassionate purpose is both a privilege and an inspiration.”

OUR PARTNERS

Scientific Awareness Task Force

Sandrine Andrieu
MD, PhD
Karen Bell
MD
Adam Boxer
MD, PhD
Maria Carrillo
MD
Suzanne Craft
PhD
Jeffrey Cummings
MD, ScD
Bonnie Davis
MD
Michael Donohue
PhD
Phyllis Barkman Ferrell
DrPH MBA
Lawrence Honig
MD
Takeshi Iwatsubo
MD
Gustavo Jimenez-Maggiora
PhD, MBA
Nancy Lynn Keach
Doris Molina-Henry
PhD
Ronald Petersen
MD
Michael S. Rafii
MD, PhD
Robert Rissman
MD
Laurie Ryan
PhD
Marwan Sabbagh
MD
Heather M. Snyder
PhD
Reisa A. Sperling
MD
Arthur W. Toga
PhD
Bruno Vellas
MD, PhD
Michael Weiner
MD

Awareness Events Task Force

Carrie Aisen
MD
Mindy Aisen
MD
Dinh Albright
Shelly Atkinson
Lisa Bilotti
Josephine Chen-Habibi_
Katherine Foster
Cini Gannon-Robb
Candace Leeds-Sears
Shelley Moore
Sally Oxley
Zandra Rhodes
Pamela Spain
Muffy Walker
MSN, MBA
Hanaa Zahran

Join Us

The more information you provide below, the better we can tailor our engagement to what matters most to you.

Sandrine Andrieu

Dr. Sandrine Andrieu is a professor of public health and Chair of the Clinical Epidemiology and Public Health Department at Toulouse University Hospital. She leads the aging research team at the Center for Epidemiology and Research in Population Health (CERPOP) and has published over 300 works on aging and Alzheimer’s disease. Dr. Andrieu specializes in Alzheimer’s prevention, age-related functional prevention, and healthy aging. She is actively involved in major European studies and serves as the scientific committee president for France Alzheimer.

Karen Bell

Dr. Karen Bell, Professor of Neurology at Columbia University Medical Center, in the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain and the GH Sergievsky Center, specializes in neurodegenerative cognitive disorders. As Director of the Education Core at Columbia’s Alzheimer’s Disease Research Center, she develops physician and community education programs. Dr. Bell is active in professional organizations, serves on multiple advisory boards, and mentors students through the Harlem Children Society.

Adam Boxer

Dr. Adam L. Boxer, Endowed Professor in Memory and Aging at the University of California, San Francisco, directs the Neurosciences Clinical Research Unit and the Alzheimer’s Disease and Frontotemporal Degeneration (FTD) Clinical Trials Program. He serves as the Principal Investigator of the Advancing Research and Treatment for FTLD (ARTFL) Rare Disease Clinical Research Consortium and has led major studies including the Four Repeat Tauopathy Neuroimaging Initiative (4RTNI).

Maria Carrillo

Dr. Maria Carrillo, Chief Science Officer of the Alzheimer’s Association, leads the world’s largest nonprofit research program for Alzheimer’s and dementia. She oversees global initiatives, including the Alzheimer’s Association International Conference (AAIC) and is a co-principal investigator for the Alzheimer’s Network for Treatment and Diagnostics, tracking outcomes of FDA-approved therapies. An internationally recognized expert, Dr. Carrillo has received numerous awards for advancing Alzheimer’s clinical trials and serves on prominent boards in the field.

Suzanne Craft

Dr. Suzanne Craft is a Professor of Medicine at Wake Forest School of Medicine and is the Founding Director of the NIA-funded Alzheimer’s Disease Research Center. Her research focuses on metabolic disorders in Alzheimer’s development, leading innovative clinical trials on treatments such as intranasal insulin and dietary intervention. Craft is a recipient of the National Institute of Health MERIT Award and the Alzheimer’s Association Zenith Award. She has served on prestigious advisory groups, including the NIA Board of Scientific Counselors and the Alzheimer’s Clinical Trial Consortium (ACTC).

Jeffrey Cummings

Dr. Jeffrey L. Cummings, a renowned Alzheimer’s researcher and clinical trial leader, is a research professor at the University of Nevada, Las Vegas Department of Brain Health. Previously, he founded the Cleveland Clinic Lou Ruvo Center for Brain Health and directed Alzheimer’s research centers at the University of California, Los Angeles. Ranked among the top Alzheimer’s scientists globally, Dr. Cummings focuses on embracing clinical trials, developing therapies for brain diseases, and the interface of neuroscience and society. He has received numerous awards, including the Alzheimer’s Association’s Bengt Winblad Lifetime Achievement Award and the Society for Behavioral and Cognitive Neurology’s Lifetime Achievement Award. He also serves as Director of the National Institute of General Medical Sciences-funded Center for Neurodegeneration and Translational Neuroscience.

Bonnie Davis

Michael Donohue

Phyllis Barkman Ferrell

Phyllis Ferrell is a global leader in brain health and longevity innovation. After three decades at Eli Lilly & Company, where she advanced Alzheimer’s therapeutics and diagnostics, she now advises organizations to transform health systems worldwide. As Chief Impact Officer for StartUp Health Alzheimer’s Moonshot, she champions innovation in Alzheimer’s care. Ferrell also supports global initiatives like the Davos Alzheimer’s Collaborative to prepare healthcare systems for aging populations. She holds leadership roles in numerous health and advocacy organizations and is passionate about improving brain health to support future generations.

Lawrence Honig

Dr. Lawrence S. Honig, Professor of Neurology at Columbia University Irving Medical Center, is a renowned expert in neurodegenerative diseases, including Alzheimer’s disease, Lewy Body Dementia, Frontotemporal Degeneration, and Progressive Supranuclear Palsy. He directs the New York State Center of Excellence for Alzheimer’s Disease and co-directs the Lewy Body Disease Research Center of Excellence and the Progressive Supranuclear Palsy Center of Care.  With board certifications in Behavioral Neurology, Neuropsychiatry, and Geriatric Neurology, Dr. Honig combines clinical expertise with groundbreaking research. He serves as a principal investigator for observational studies and clinical drug trials focused on advancing treatments for neurodegenerative conditions. A member of Columbia’s faculty since 2000, he has made significant contributions to understanding and addressing disorders of nervous system aging and degeneration.

Takeshi Iwatsubo

Gustavo Jimenez-Maggiora

Nancy Lynn Keach

Nancy Lynn Keach, Senior Vice President of Strategic Partnerships at BrightFocus Foundation, facilitates partnerships to advance research and awareness for Alzheimer’s, Macular Degeneration, and Glaucoma. She has worked on the acclaimed film Glen Campbell…I’ll Be Me and is Executive Producer for Turning Point, a documentary on Alzheimer’s research. Formerly Executive Director and Chief Operating Officer at the Alzheimer’s Drug Discovery Foundation, Lynn has also held leadership roles at the Arnold P. Gold Foundation for Humanism in Medicine and the American Museum of Natural History in New York. She is a founding member of WomenAgainstAlzheimer’s.

Doris Molina-Henry

Doris Molina-Henry is an Assistant Professor at the USC Keck School of Medicine Alzheimer’s Therapeutic Research Institute. She is part of the leadership of the Alzheimer’s Therapeutic Research Institute in San Diego. Her work is focused on the science of recruitment and retention of diverse participants into clinical trials. Currently, she works on evaluating strategies that promote participation of cognitively unimpaired, at-risk, diverse adults into studies that aim to help prevent the symptoms of Alzheimer’s well before they begin.

Ronald Petersen

Dr. Ronald C. Petersen, M.D., Ph.D., is a leading researcher in cognitive aging, focusing on conditions such as Alzheimer’s, frontotemporal lobar degeneration, and Lewy body dementia. He directs both the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging, where his team examines aging individuals over time using neuroimaging and biomarkers to understand cognitive changes and neurodegenerative disorders.

Michael S. Rafii

Michael S. Rafii, MD, PhD, is a Professor of Clinical Neurology at the Keck School of Medicine and Medical Director of the Alzheimer’s Therapeutic Research Institute (ATRI). His research focuses on developing treatments for Alzheimer’s disease, including its genetic form in individuals with Down syndrome. He is Principal Investigator for the NIH-funded Alzheimer’s Clinical Trials Consortium – Down Syndrome (ACTC-DS) and serves in leadership roles at ATRI and the Alzheimer’s Disease Neuroimaging Initiative (ADNI).

Robert Rissman

Dr. Robert Rissman is a Professor of Physiology and Neuroscience, the W.M. Keck Endowed Professor in Medicine, and the founding Director of the Neuroscience Translational Research Division (NTRD) at ATRI. He leads the ATRI Biomarker Laboratory and Biorepository and serves as the ACTC Biorepository Unit Lead. His research focuses on biomarker discovery in Alzheimer’s Disease (AD), aiming to understand how treatment parameters may impact these biomarkers.

Laurie Ryan

Dr. Laurie Ryan is Chief of the Clinical Interventions and Diagnostics Branch Division of Neuroscience at the National Institute on Aging, overseeing clinical research programs focused on Alzheimer’s disease and related dementias. With a background in clinical neuropsychology, she previously worked at the Defense and Veterans Brain Injury Center (DVBIC) and became the Assistant Director for Research. Dr. Ryan joined the NIA in 2005 and has played a key role in Alzheimer’s clinical trials, eventually being promoted to the branch chief position in 2013.

Marwan Sabbagh

Dr. Marwan Sabbagh, M.D., is a behavioral neurologist and the Moreno Family Chair for Alzheimer’s Research at the Barrow Neurological Institute. A specialist in Alzheimer’s diagnosis and treatment, he also serves as the Vice Chair of Research at the Institute’s Department of Neurology. Dr. Sabbagh has led numerous national Alzheimer’s prevention and treatment trials and serves as editor-in-chief of Neurology and Therapy. He has authored several books and contributed to numerous scientific articles.

Heather M. Snyder

Dr. Heather M. Snyder, Ph.D., is Senior Vice President for Medical & Scientific Relations at the Alzheimer’s Association. She oversees the association’s global funding initiatives, including the International Research Grant Program. Dr. Snyder is also involved in strategic studies like the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER). As a leading expert in the field, Snyder has been prominently featured in tv, print, and online mediums including The New York Times, The Washington Post and The Wall Street Journal. 

Reisa A. Sperling

Dr. Reisa Sperling is a neurologist at Harvard Medical School and Director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital. She leads studies on Alzheimer’s detection, including the A4 study, and led the NIA-Alzheimer’s Association workgroup to develop guidelines for “Preclinical Alzheimer’s disease.” Dr. Sperling was awarded the American Academy of Neurology Potamkin Prize and recognized as one of the 2017 Most Disruptive Women in Healthcare.

Arthur W. Toga

Dr. Toga focuses on neuroimaging algorithms, developing new visualization techniques and statistical measurements. His research includes creating 3D digital neuroanatomic atlases for precise localization and multisubject comparisons. His work involves local deformation methods to equate brain data from various subjects and modalities and the development of electronic databases for archiving and sharing brain data.

Bruno Vellas

Dr. Bruno Vellas is the founder of Institut Hospitalier Universitaire (IHU) HealthAge in Toulouse. Vellas chairs the Gérontopôle & Department of Geriatric Internal Medicine, Alzheimer’s Disease Research and Clinical Center at the Toulouse University Hospital. He has been pivotal in the creation of major initiatives like European Alzheimer’s Disease Consortium (EADC), Clinical Trials on Alzheimer’s Disease (CTAD), and The Journal of Prevention of Alzheimer’s Disease (JPAD). He has authored over 500 publications, holds multiple leadership roles in international scientific advisory boards, and was elected to the French National Academy of Medicine in 2016.

Michael Weiner

Dr. Michael Weiner is a Professor Emeritus at the University of California, San Francisco and the Principal Investigator of the Alzheimer’s Disease Neuroimaging Initiative (ADNI), the largest observational study on Alzheimer’s disease. His research focuses on using MRI, PET, and biomarkers for diagnosing neurodegenerative diseases, particularly Alzheimer’s. He has pioneered the use of magnetic resonance spectroscopy (MRS) in clinical applications and leads several initiatives to identify and monitor Alzheimer’s disease progression.

Carrie Aisen

Dr. Carrie Aisen, a general urologist, blends her love of science with a dedication to patient care. She specializes in evidence-based medicine, combining the latest research and treatments with a personalized approach. Through shared decision-making, she helps patients address sensitive urological issues, improving their comfort and quality of life. Outside of work, she enjoys family time, the beach, and Southern California's sunny weather.

Mindy Aisen

Dr. Mindy Aisen is a distinguished neurologist with a career spanning roles at the Keck School of Medicine of USC, Cerebral Palsy International Research Foundation, Georgetown University, and the Department of Veterans Affairs. She is an accomplished researcher with expertise in neurorehabilitation, spinal cord injury, and emerging neurological technologies. Dr. Aisen is a board-certified neurologist with multiple peer reviewed journal publications, editorials, and books.

Dinh Albright

Shelly Atkinson

Lisa Bilotti

Based in San Diego, CA, Lisa Bilotti serves as Senior Partnership Manager at San Diego Magazine.  After years of experience at MARCOA Media, World Triathlon Corporation, and Competitor Group, Inc., Lisa has leveraged her marketing communications expertise to build and maintain robust relationships at a local and national level.

Josephine Chen-Habibi_

Katherine Foster

Cini Gannon-Robb

Cini Gannon Robb, a resident of Rancho Santa Fe, is deeply passionate about animals, caring for 11 birds and 10 dogs. She supports numerous animal organizations, including the FACE Foundation, where she's served on the board since its founding in 2006. Committed to helping underserved pet parents, she also actively works in addiction recovery, serving on the Hazelden Betty Ford Center Board of Directors for 19 years. Gannon-Robb exemplifies dedication to community service and animal welfare.

Candace Leeds-Sears

Candace Leeds-Sears has been a prominent real estate professional in Rancho Santa Fe since 1987, working with esteemed firms such as Sotheby’s, Coldwell Banker, and Compass. Currently affiliated with Compass's Luxury Home division, she is both a Broker-Associate and a designated International Specialist. Her extensive experience and dedication to excellence have established her as a trusted expert in luxury real estate.

Shelley Moore

Shelley Moore, Program Administrator at USC Alzheimer’s Therapeutic Research Institute, focuses on fostering partnerships and awareness to enhance Alzheimer’s clinical trials. With a passion for bridging research and public education, she has contributed to landmark trials like the A4 Study and observational studies like the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Moore is an alumna of the IMPACT-AD program and is personally motivated by family experiences with Alzheimer’s and dementia. She strives for breakthroughs in treatment and prevention. A USC alumna, she embraces her Trojan heritage while driving innovation in her hometown of San Diego.

Sally Oxley

Zandra Rhodes

Dame Zandra Rhodes, a pioneering British designer known as the "Princess of Punk," launched her bold fashion brand in the 1960s. Celebrated for integrating prints into garment designs, she has dressed cultural icons like Freddie Mercury, Diana Ross, and Princess Diana. Rhodes founded London’s Fashion and Textile Museum in 2003 and launched the Zandra Rhodes Foundation in 2020 to preserve her extensive archives. Her influence spans five decades, including notable collaborations with brands like IKEA, Poppy Lissiman, and Happy Socks.

Pamela Spain

Muffy Walker

Muffy Walker, MSN, MBA, is a psychiatric nurse, mental health advocate, and founder of the International Bipolar Foundation. She earned her Master’s in Psychiatric Nursing from the University of Pennsylvania and an MBA in Marketing from UC Irvine. Over three decades, she has led public education efforts on mental illness, served on national advisory boards, and received numerous awards for advocacy. Now an author, Walker blends professional insight with storytelling. Her debut novel, Memory Weavers (Koehler Books, April 2024), explores friendship, trauma, and resilience—offering readers a powerful, engaging look at mental health through the lens of fiction.

Hanaa Zahran

Hanaa Zahran, Senior Vice President at U.S. Bank in the Wealth Corporate Investment Banking Group, brings over 20 years of banking experience in treasury management, advisory sales, and business development. She has held leadership roles at institutions like HSBC, Pacific Premier Bank, and Bank of America Merrill Lynch. Hanaa is deeply involved in community initiatives, including STEM education with the Fleet Science Centers STEM Ecosystem Initiative, and mentoring through the American Red Cross’ CFO office. Multilingual and tech-savvy, she combines her love for innovation with cultural insights to build trusted relationships.