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Behavioral Science, Complementary Medicine, Neuroscience, Videos

This is your brain on meditation

This is your brain on meditation

For years, friends have been telling me I should try meditation. I’m embarrassed to admit it’s mostly because of (how can I put this delicately?) a temper that flares when I’m anxious or stressed out. But, as it is for many people, it’s one of those things I haven’t gotten around to. This video by AsapSCIENCE, though, describing the things scientists have discovered about meditators has me thinking about it again.

Meditation is linked to a decreased anxiety and depression, and increased pain tolerance. Your brain tunes out the outer world during meditation, and on brain scans of meditators, scientists can see increased activity in default mode network – which is associated with better memory, goal setting, and self-awareness. The part of the brain that controls empathy has also been shown to be more pronounced in monks who are long-time meditators. From the video:

“[Meditation] also literally changes your brain waves, and we can measure these frequencies. Medidators have higher levels of alpha waves, which have been shown to reduce feelings of negative mood, tension, sadness and anger.”

Much like hitting the gym can grow your muscles and increase your overall health, it seems that meditation may be a way of working out your brain—with extra health benefits.”

Other demonstrated benefits include better heart rate variability and immune system function. I’m glossing over a lot of the information that’s packed into this entertaining little video, but if you’re curious, check out this less-than-three-minute video yourself.

Previously: Study shows benefits of breathing meditation among veterans with PTSDResearch brings meditation’s health benefits into focusUsing meditation to train the brainCan exercise and meditation prevent cold and flu? and How meditation can influence gene activity
Video by AsapSCIENCE

Cardiovascular Medicine, Emergency Medicine, In the News, Research, Women's Health

New test could lead to increase of women diagnosed with heart attack

New test could lead to increase of women diagnosed with heart attack

12192161504_34544b2f38_zSimilar numbers of men and women come to the emergency room complaining of chest pain, and similar numbers of men and women die from heart disease each year (in fact, slightly more than half are women), so why are only half as many women being diagnosed with heart attacks?

A study recently published in the BMJ and funded by the British Heart Foundation suggests that the reason for the difference lies in the diagnostic methods: blood tests. Researchers at the University of Edinburgh found that if blood tests are administered with different criteria for each gender, women’s heart attack diagnoses are much higher. Better tests could limit under-diagnosis and prevent women from dying or suffering from future heart attacks. (And women are more likely than men to die after suffering an attack; twice as likely in the few weeks afterward!)

Blood diagnostic tests measure the presence of troponin, a protein released by the heart during an attack. Previous research showed that men produce up to twice as much troponin as women, so Anoop Shah, MD, and fellow authors hypothesized that if different thresholds of troponin levels were used for men and women, it would correct the disparity.

The researchers administered two tests on patients complaining of chest pain, once using methods that are standard around the world, and then again using a highly sensitive troponin test and gender-specific thresholds. MNT reports:

When using the standard blood test with a single diagnostic threshold, heart attacks were diagnosed in 19% of men and 11% of women. However, while the high-sensitivity blood tests yielded a similar number of diagnoses in men (21%), the number of heart attack diagnoses in women doubled to 22%.

In addition, the researchers observed that participants whose heart attacks were only diagnosed by the high-sensitivity test with gender-specific diagnostic thresholds were also at a higher risk of dying or having another heart attack in the following 12 months.

This research included a little more than 1,000 subjects; the BHF is now funding a clinical trial on more than 26,000 patients to verify the results.

Photo by MattysFlicks

Applied Biotechnology, In the News, Patient Care, Technology

Building bodies, one organ at a time

Building bodies, one organ at a time

bioprinting muscle. jpg

If you’ve been to a geek or tech event like the annual Maker Faire that happens every spring here in the Bay Area, you’ve probably seen demonstrations of 3D printers that can spit out toys or jewelry.

What’s really interesting is how researchers and doctors are harnessing that technology to help their patients by making prosthetics for amputated arms, or replacements parts for damaged bones. A recent article in the San Jose Mercury News highlights this new frontier and features Stanford cardiologist Paul Wang, MD, who describes one of the biggest advantages of 3D printing:

“You can make things for tens of dollars rather than thousands of dollars,” said Stanford University professor Dr. Paul Wang, a cardiovascular and bioengineering expert who is among those studying the printers’ potential for prosthetics, replacement bones and other applications. “It’s totally opened up what’s possible.”

Printing prosthetics or bone substitutes using inorganic materials is just the beginning of how scientists hope to use 3D printing; many are trying to use the technology to print living tissue and organs. Doing so is a challenging endeavor – for starters, even relatively simple organs need networks of blood vessels that can constantly feed its cells – but several research teams are betting they can solve the puzzle:

University of Pennsylvania researchers say they’ve designed a way to print those [blood vessel] networks and a Russian company, 3D Bioprinting Solutions, has vowed this year to 3D-print a transplantable thyroid gland, which is laced with blood vessels.

Still other researchers are 3D-printing insulin-producing pancreatic tissues to help manage diabetes, viruses that can attack cancer cells and organ models that surgeons can practice on or that can be used to help design medical devices.

Stanford’s Wang, for example, has made a 3D-printed model of the heart along with a prototype of a tiny gadget he envisions one day could crawl though real hearts to gather information on the organ’s health or kill cells that damage it.

The field has the potential to be a financial windfall for companies that can bring a viable medical product to market, but one of the biggest hurdles is the regulatory process, which can stretch out over a decade or more for new devices. Still, as detailed in the article, proponents are “encouraged by the impact 3D printing already is having on health care” and remain optimistic about the future.

Previously: Countdown to Medicine X: 3D printing takes shapeCreating organ models using 3D printing3D printer in China makes tiny ear and 3D printer uses living cells to produce a human kidney
Photo of researcher printing muscle tissue by U.S. Army Materiel Command

Big data, Cardiovascular Medicine, Chronic Disease, Research, Stanford News

Big data used to help identify patients at risk of deadly high-cholesterol disorder

Big data used to help identify patients at risk of deadly high-cholesterol disorder

Familial hypercholesterolemia is not exactly a catchy name. But Stanford cardiologist Josh Knowles, MD, is determined to make it easier to remember. This little known, high-cholesterol disease is a silent killer. If you don’t know you have it, it can strike suddenly – and years before most people ever start worrying about heart attacks.

Knowles and fellow researchers at Stanford have launched a new research project aimed at identifying people at-risk of having FH. Using “big data” research methods and software that “teaches” a computer how to recognize patterns, researchers plan to comb through electronic medical records at Stanford hospitals and, if successful, pinpoint those who might have the disease and not know it.

In a story I wrote on the new project, Knowles described how this innovative technology could potentially be used to transform health care:

Machine learning, in which computer algorithms learn to recognize patterns within data, is widely used by Internet businesses such as Amazon and Netflix to improve customer experience, get information about trends, identify likes and dislikes and target advertisements. These techniques have not been widely applied in medicine, but we believe that they offer the potential to transform health care, particularly with the increased reliance on electronic health records.

Using these methods to help identify patients with FH is a good place to start, Knowles said, since there are currently few systematic approaches to finding people with FH, and many doctors are unfamiliar with the disease. As he told me:

This disorder certainly leads to premature death in thousands of Americans each year … Less than 10 percent of cases are diagnosed, leaving an estimated 600,000 to 1 million people undiagnosed. If found early enough and treated aggressively with statin-based regimens, people can live longer, healthier lives.

The project is part of a larger initiative called FIND FH (Flag, Identify, Network, Deliver), a collaborative effort involving Stanford Medicine, Amgen Inc., and the nonprofit Familial Hypercholesterolemia Foundation to use innovative technologies to identify individuals with the disorder who are undiagnosed, untreated, or undertreated.

Previously: Registration for Big Data in Biomedicine conference now open, Hope for patients with familial hypercholesterolemia and Born with high cholesterol
Photo by Dwight Eschliman

Cancer, Health Costs, In the News, Stanford News, Videos

An initiative to deliver more compassionate and affordable advanced cancer care

This 9-minute video report from Al Jazeera America’s “America Tonight” offers an intimate glimpse into the lives of veterans suffering from advanced cancer, as they discuss end-of-life issues with their care providers at the Veterans Affairs Palo Alto Health Care System.

More than 200 late-stage cancer patients are participating in this Stanford-designed pilot study. Its goal is to improve the quality of life of these patients, while simultaneously reducing the costs of 11th-hour treatments that might not offer life-extending or life-enhancing benefits.

The driving force behind this study is Manali Patel, MD, a young Stanford oncologist who designed the plan with three others during her fellowship year at the Stanford Clinical Excellence Research Center, called CERC. The Center’s mission includes tests of its innovative care concepts at diverse U.S. health-care sites, in order evaluate and refine them prior to advocating widespread adoption.

The video focuses on one of three major components of the new CERC-designed approach to cancer care. The first is earlier patient counseling and shared decision-making about treatment options, well before a patient is on the brink of death, when emotions overwhelm the decision-making skills of patients, families and clinicians.

These difficult discussions don’t happen as often as they should, as I wrote in a 2012 Stanford Medicine magazine article on topic:

According to a recent study, end-of-life discussions typically take place only 33 days before death. With Patel’s proposed cancer care model, patients would be thoroughly briefed on the survival odds and side effects before being rushed off to surgery or chemotherapy. Many months before the family is gathered around a loved one’s deathbed, a person’s final wishes – resuscitation, feeding tubes, assisted breathing and whether a person wants to die at home – would be well-informed and documented.

Other pilot sites tests are in the process of implementing various components of the new approach. Last week Patel provided an update on these new cancer-care pilots:

And finally, an update on the cancer patients featured in the video: former Army police officer Rafael Arias, who chose to skip a final round of chemotherapy, recently passed away peacefully at his home. Timothy Blumberg is still in remission.

Previously: Uncommon hero: A young oncologist fights for more humane cancer careTV spot features a more humane approach to late-stage cancer care, “Stop skipping dessert:” A Stanford neurosurgeon and cancer patient discusses facing terminal illness
Video courtesy of Al Jazzera America

Global Health, Immunology, Research, Stanford News

With a Gates Foundation grant, Stanford launches major effort to expedite vaccine discovery

With a Gates Foundation grant, Stanford launches major effort to expedite vaccine discovery

Mark DavisThe vaccine field got a major boost today with the announcement that the Bill & Melinda Gates Foundation will invest $50 million in a new collaboration with Stanford’s School of Medicine to speed the development of vaccines for some of the world’s major scourges. The funds will support the new Stanford Human Systems Immunology Center, a multidisciplinary effort led by immunologist Mark Davis, PhD.

In recent decades, efforts to develop vaccines for major killers such as HIV and malaria have been stymied in part by the expense and time involved in conducting large-scale trials, which have often proved disappointing. Through the new initiative, scientists will use advanced immunological tools to better understand how vaccines provide protection and identify the most promising candidates to pursue in clinical trials.

What we need is a new generation of vaccines and new approaches to vaccination

“What we need is a new generation of vaccines and new approaches to vaccination,” said Davis, director of the Stanford Institute for Immunity, Transplantation and Infection. “This will require a better understanding of the human immune response and clearer predictions about vaccine efficacy for particular diseases.”

The 10-year initiative will involve multiple faculty from diverse fields, including medicine, engineering and computer science. It will capitalize on a range of technologies, some of which have been pioneered at Stanford, which can rapidly analyze individual cells and provide a detailed profile of the human immune response, with all of its various components.

“This grant will provide crucial support to Stanford’s world-class scientists as they collaborate with investigators around the globe to assess vaccines against some of the most formidable diseases of our time,” said Lloyd B. Minor, dean of Stanford’s medical school. “The Stanford Human Systems Immunology Center will help the most promising vaccine candidates to move quickly and efficiently from the lab to the front lines of treatment, impacting countless lives.”

Previously: Knight in lab: In days of yore, postdoc armed with quaint research tools found immunology’s Holy Grail
Photo of Mark Davis by Steve Fisch

Applied Biotechnology, Biomed Bites, Genetics, History, Research, Videos

Basic research underlies effort to thwart “greatest threat to face humanity”

Basic research underlies effort to thwart "greatest threat to face humanity"

Welcome to this week’s Biomed Bites, a weekly feature that introduces readers to Stanford’s most innovative researchers. 

Stanley Cohen, MD, isn’t a household name. But it probably should be. The Stanford geneticist was instrumental in the discovery of DNA cloning – the technology that underlies innumerable advances in biotechnology and medicine, and led to the founding of biotech giant Genentech.

It wasn’t always thought possible to snip out a gene, stitch it into a new stretch of DNA – often in a different organism – and have it produce a desired protein.

In the video above, Cohen emphasizes that striving to achieve a concrete – and profitable – goal didn’t enable the discovery of gene cloning. First, researchers had to work to understand the basic biological processes. “In order to apply knowledge, it’s necessary to get that knowledge somehow.”

These days, Cohen isn’t resting on his laurels. Instead, he’s striving to thwart what he considers perhaps the “greatest threat to humanity,” drug-resistent microbes.

“My lab is still interested in understanding microbial drug resistance and the way in which microbes exploit host genes to carry out microbial functions such as entering cells, reproducing in cells and exiting from cells,” he said. Scientists need that basic knowledge to develop strategies to thwart the process, he added.

Learn more about Stanford Medicine’s Biomedical Innovation Initiative and about other faculty leaders who are driving biomedical innovation here.

Previously: The history of biotech in seven bite-sized chunks, The dawn of DNA cloning: Reflections on the 40th anniversary and Why basic research is the venture capital of the biomedical world

Immunology, Infectious Disease, Public Health, Research

Is honey the new antibiotic?

Is honey the new antibiotic?

3535805377_807788e3e1_z…Well, not quite. But recent research shows that honey does have infection-fighting properties surprisingly similar to the common antibiotic ampicillin. And even more importantly, honey worked just as well against bacteria that had developed a resistance to ampicillin, which is good news as the medical community raises awareness about antibiotic resistance.

The study, which was recently published in PLOS ONE, compared the effects of Canadian honey and ampicillin on E. coli bacteria. The most common kind of antibiotics – beta-lactams, which includes ampicillin – work by destroying the cell wall of a bacterium. This prohibits the bacterium from surviving, growing, and reproducing. In the experiment, the researchers used scanning electron microscopy to visualize the changes in the bacterial cultures’ cell structures. They saw that honey and ampicillin had similar effects on the shapes of the E. coli, that they affected it to a similar degree, and that honey had equal effects on normal and antibiotic-resistant E. coli.

As reported on the PLOS blog:

While scientists have yet to confirm the exact compounds responsible, the results of the above study support the idea that honey and ampicillin may have similar antibacterial efficacies, with possibly different mechanisms of attack.

But before you start smothering your toast with gooey goodness each morning or adding heaping spoonfuls to your tea, keep in mind that more research is needed to better understand the potential for honey’s medicinal use.

Previously: A look at our disappearing microbes
Photo by bionicgrrl

Addiction, Health Policy, Parenting, Pediatrics, Podcasts, Public Health

Discussing the American Academy of Pediatrics’ call to put the brakes on marijuana legalization

Discussing the American Academy of Pediatrics' call to put the brakes on marijuana legalization

A wave of changes in state laws on the use of marijuana for medicinal and recreational purposes has stirred the American Academy of Pediatrics. It’s taken 10 years for the AAP to update its policy on the legalization of marijuana, and they released its new one on Monday.

74381759_e5a563cf3d_zThe organization still opposes legalization but it has opened the door to reform in several ways. First, recognizing that minority kids bear the brunt of criminal penalties for pot use, they call for decriminalization. Second, they call for the U.S. Drug Enforcement Agency to reclassify marijuana from a Schedule 1 listing for controlled substances to a Schedule 2. This action would effectively allow more research to be conducted and in turn scientifically determine where marijuana is most effective as a treatment. A review by the federal government is currently underway.

I asked Stanford pediatrician Seth Ammerman, MD, the lead author of the statement, what the AAP was trying to achieve with its policy redo and why such a restrictive stance on legalization since the train for legalization – recreational and medicinal –  seems to have already left the “coffee house.”

In this 1:2:1 podcast, Ammerman cites major two concerns. First, if legalized and commercialized, marijuana will become a big business, and the same marketing efforts by tobacco companies that encouraged teens to take up cigarettes will lasso them to pot smoking. “Well, aren’t kids smoking pot already?” I asked. Ammerman fully realizes that any teen who wants pot can readily buy it – legalization, to the AAP, is an imprimatur. Secondly, Ammerman cited, as does the new policy statement, the compelling and growing scientific evidence that the brain in formation continues to gel through the teen years and into the 20s. Marijuana, just like alcohol and any other drug, is likely to play a lot of bad tricks as the prefrontal cortex solidifies.

As described in the policy paper:

New research has also demonstrated that the adolescent brain, particularly the prefrontal cortex areas controlling judgment and decision-making, is not fully developed until the mid-20s, raising questions about how any substance use may affect the developing brain. Research has shown that the younger an adolescent begins using drugs, including marijuana, the more likely it is that drug dependence or addiction will develop in adulthood.

Ammerman says that the AAP will follow closely what happens in states where marijuana has been legalized both for health and recreation, and it will look carefully at what future evidence suggests. Clearly, there’s still a lot of smoke around this issue.

Previously: To protect teens’ health, marijuana should not be legalized, says American Academy of Pediatrics
Photo by Paul-Henri S

Behavioral Science, Complementary Medicine, Mental Health, Parenting, Pediatrics, Research

Mindfulness and the fourth- and fifth-grade brain

Mindfulness and the fourth- and fifth-grade brain

Maths Homework

As a parent, this Time headline immediately grabbed my attention: “Mindfulness Exercises Improve Kids Math Scores.” But as I read the article, I learned that math scores were just one facet examined by the researchers and that mindfulness training was also shown to help children be less stressed and more caring.

The study, which was published in this month’s issue of Developmental Psychology, looked at a group of 99 fourth and fifth graders in British Columbia. For four months, half of the students were taught a pre-existing “personal responsibility” curriculum, while the rest learned about mindfulness through a program called MindUP that focuses on breathing exercises, mindful smelling and eating, and gratitude. The researchers then looked at cortisol levels, behavioral assessments, self-reports, along with those math scores. The article describes the results in more detail:

The results were dramatic. “I really did not anticipate that we would have so many positive findings across all the multiple levels we looked at,” says study co-author Kimberly A. Schonert-Reichl, a developmental psychologist at the University of British Columbia. “I was very surprised,” she says—especially considering that the intervention took place at the end of the year, notoriously the worst time for students’ self-control.

Compared to the kids in the social responsibility program, children with the mindful intervention had 15% better math scores, showed 24% more social behaviors, were 24% less aggressive and perceived themselves as 20% more prosocial. They outperformed their peers in cognitive control, stress levels, emotional control, optimism, empathy, mindfulness and aggression.

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