Here’s something that may interest those who adhere to the belief that food dropped on the floor is safe to eat if pick up within a few seconds. An LA Weekly blogger today offers an overview of scientific experiments done to determine if the three-second rule, or any variation of it, will prevent you from eating contaminated food. From the piece:

A few years ago, Harold McGee looked at tests conducted by Clemson University researchers in which slices of bologna and bread were placed onto salmonella-laced surfaces to determine how quickly each item picked up the bacteria. Suffice to say, the longer the items stayed in contact with the surface, the more bacteria they collected. More recently, researchers at Manchester Metropolitan University conducted their own experiment on behalf of household products company Vileda to test the three-second rule and found that certain foods were more likely to pick up the bacteria than others.

According to The Daily Mail, the university researchers went beyond bologna and bread for their study, choosing to test cooked pasta, ham, a biscuit, bread with jam and dried fruit because they’re commonly eaten and because they contain varying levels of water, a “key factor in whether items will sustain bacterial growth in the three seconds before they are picked up from the floor.” As it turned out, that water level, and high levels of salt and sugars, made a huge difference in how much bacteria collected on each food.

Although study results are mixed, another thing to consider is that some viruses seem to need little help spreading, as was the case with a recent norovirus outbreak that was traced back to a reusable grocery bag. In the end, any pleasure gained from eating a tasty morsel from the floor or countertop hardly seems worth the risk.

Previously: Slight decrease in food-borne illnesses, reports CDC, FDA introduces pilot programs to improve methods of identifying foodborne illness sources and Report shows high costs of foodborne illnesses
Photo by Eric Skiff

As reported here last week, two Stanford professors recently recommended making dramatic changes to the medical education format, including re-imagining the traditional lecture. An opinion piece published on TechCrunch further examines the proposal to adopt a flipped classroom model:

Students forget most of what they hear in lecture and then only recall 40% of the tested material two years later. Lectures do little for students actually enrolled in the school, let alone the millions of online users who will study part-time, without a supportive community or frequent feedback from a professor.

So, last week, two Stanford professors made a courageous proposal to ditch lectures in the medical school. “For most of the 20th century, lectures provided an efficient way to transfer knowledge, But in an era with a perfect video-delivery platform — one that serves up billions of YouTube views and millions of TED Talks on such things as technology, entertainment, and design — why would anyone waste precious class time on a lecture?,” write Associate Medical School dean, Charles Prober and business professor, Chip Heath, in The New England Journal of Medicine. Instead, they call for an embrace of the “flipped” classroom, where students review Khan Academy’s YouTube lectures at home and solve problems alongside professors in the classroom. Students seem to love the idea: when Stanford piloted the flipped classroom in a Biochemistry course, attendance ballooned from roughly 30% to 80%.

Skeptical readers may argue that Khan Academy can’t compete with lectures from the world’s great thinkers. In response, Prober and Heath point to a recent one-week study that compared the outcomes of two classes, a control class that received a lecture from a Nobel Prize-winning physicist and an experimental section where students worked with graduate assistants to solve physics problems. Test scores for the experimental group (non-lecture) was nearly double that of the control section (41% to 74%).

Previously: Stanford dean discusses changing expectations for medical students, Think medical education takes too long? So does Victor Fuchs and A quick primer on getting into medical school
Photo by Stanford EdTech

As part of the National Science Foundation’s “Big Data” initiative (.pdf) UC Berkeley was recently awarded a $10 million grant. There, researchers will create an open-source platform to collect, organize and make sense of vast amounts of data, including information recently made public by the Centers for Disease Control and Prevention and several other federal agencies.

In a new iHealthBeat report from Deirdre Kennedy, health-care experts, including Stanford’s Atul Butte, MD, PhD, discuss (.pdf) the UC Berkeley project and the opportunities and challenges of mining big data for health care and scientific research. About the potential of using electronic health-care records for research purposes:

Butte says it’s possible to mine EHR without violating patient privacy. Stanford did just that. The university released a widely publicized study this year that found women reported higher levels of pain than men. Researchers gleaned that information from thousands of patient records by just combing through one piece of data — how they rated their pain when nurses asked them.

“It was the largest study ever for pain. That data was just sitting there in the repository waiting for someone to do something with it,” [says Butte.] “It didn’t even have to be publicly available. Data is on its way to getting more and more public. I actually think the new challenge is what do we want to ask of that data?”

Previously: New project will help people donate their data to research and Women report feeling more pain than men, huge EMR analysis shows

Dog owners often make inferences about what their four-legged companions are thinking or feeling. But how correct are such assumptions? A recent study by Emory University researchers aimed to answer this question and others about the minds of man’s best friend.

During the study, researchers spent eight months training two canines to sit motionless inside a functional magnetic resonance imaging (fMRI) machine. They then analyzed the animals’ brain activity while using hand signals indicating the dogs would either receive or not receive a hot dog. Results showed the appropriate brain regions lit up in anticipation of a treat.

In the above Emory video, researchers discuss their findings and their motivation for embarking on the study.

Via Healthland

In 2010, a study published in the Lancet concluded that a substantial portion of the money provided to developing countries for administering health-care services wasn’t used as intended. The findings raised questions and sparked debate about whether international aid could, in some cases, actually harm health systems.

But the evidence underlying the argument that foreign aid for health may lead to a diversion of government funds from that country’s health sector is unreliable and should not be used to guide policy, according to a paper by two Stanford researchers published in PLoS Medicine.

Rajaie Batniji, MD, PhD, and Eran Bendavid, MD, decided to re-analyze the data used in the Lancet study after meeting with policymakers who pointed to the findings as a cautionary tale of foreign governments that waste and mismanage money earmarked for health programs. As described in a recent article in the Stanford Report:

Taking a fresh look at the same numbers used for the 2010 study – public financing data culled from the World Health Organization and the International Monetary Fund – the researchers saw a different story emerge about the use of foreign aid in the health sector.

Once Batniji and Bendavid excluded conflicting and outlying data, such as huge discrepancies between WHO and IMF estimates and information about countries that were getting very small amounts of money from other countries, “There was no significant displacement of foreign aid,” Bendavid said.

The Stanford researchers’ findings are poised to influence a debate among policymakers and donors over whether it’s more efficient to give international assistance slated for health spending to government agencies or NGOs.

“We want to free donors of feeling that if they give money directly to governments, the money will be offset and used for an unintended purpose,” Batniji said. “The concern about displacement really amplifies the demands we make on governments for how they use the money. And that is at odds with a recent movement to let foreign governments set their own agendas for how to spend money.”

Photo by UK Department for International Development

In March, sculptor Alyson Shotz visited Stanford as the annual Sterling Visiting Professor in the Department of Chemical and Systems Biology. While here, she collaborated with students for a week of creativity building. Among the activities, Shotz and students visited a studio to stress glass in various ways, including enclosing foods in it, and then returned to campus to examine and photograph the samples microscopically.

The above video captures snippets from the experiments and features Shotz discussing the relationship between empirical research and experimentation in art.

Previously: Image of the Week: Kiwi under glass and Stanford’s explosive exercise in creativity

Much has been written about measures being taken to prevent and better diagnose concussions among athletes. Now findings published in the latest issue of American Journal of Sports Medicine show that age and gender may be important factors in how players recover from head injuries.

In the two-year study (subscription required), researchers monitored nearly 300 athletes from multiple states who had suffered a concussion. All of the participants completed a baseline test before taking three different post-concussion tests, the same ones used in professional sports following a head injury. According to a university release:

The study… found females performed worse than males on visual memory tests and reported more symptoms postconcussion.

Additionally, high school athletes performed worse than college athletes on verbal and visual memory tests, and some of the younger athletes still were impaired up to two weeks after their injuries.

“While previous research suggests younger athletes and females may take longer to recover from a concussion, little was known about the interactive effects of age and sex on symptoms, cognitive testing and postural stability,” said [Michigan State University researcher Tracey Covassin, PhD, who led the study.]

“This study confirms that age and sex have an impact on recovery, and future research should focus on developing treatments tailored to those differences.”

Previously: Report finds brain injuries rising among high school football players, Study suggests teens are more vulnerable to effects of sport-related concussions, Should parents worry about their kids playing football? and A conversation with Daniel Garza about football and concussions
Photo by Big West Conference

In an effort to automate early diagnosis of autism, researchers are testing a new system that combines Kinect motion sensors with computer-vision algorithms capable of detecting telltale signs of the behavioral disorder.

The experiment is underway at the University of Minnesota’s Institute of Child Development in Minneapolis. Inside the institute, five Kinect depth-sensing camera rigs installed in the nursery are used to monitor groups of roughly 10 children between the ages of 3 and 5 years old as they play. The New Scientist reports:

The cameras identify and track children based on their shape and the colour of the clothes they are wearing. The information is fed to three PCs, which run software that logs each child’s activity level – including how they move each of their limbs – and plots it against the room’s average. The system can flag up children who are hyperactive or unusually still – both possible markers for autism.

Medical staff can then decide whether the child requires closer attention from a specialist for a one-on-one diagnosis

…

Ultimately, the team hopes to merge the Kinect work with another project it is working on. By studying video footage of children interacting with a psychiatrist, computer-vision algorithms learn to identify behavioural markers as designated on the Autism Observation Scale for Infants (.pdf). The system measures traits like a child’s ability to follow an object as it passes in front of the eyes, as well as noting certain mannerisms or postures that are classified as being early signs of a possible [autism spectrum disorder].

Researchers say that automating diagnosis of autism could result in children beginning speech therapy sooner and getting help learning social and communication skills, which can have a significant impact on treatment outcomes. Long-term, researchers hope to develop a video game for Kinect capable of testing a child as they played with a parent, meanwhile identifying any concerns.

Previously: Mobile app being developed to help people with autism and Could the iPad be an effective learning tool for children with autism?

Can large groups of public non-experts be trained to recognize infectious diseases with the accuracy of a trained pathologist? Findings recently published in PLoS ONE suggest the answer may be “yes.”

In the study (.pdf), UC Los Angeles researchers developed an online gaming system in which users distinquish malaria-infected red blood cells from healthy ones by viewing digital images obtained from microscope. Prior to playing the game, users were required to complete a short tutorial describing the rules and explaining how to identify malaria-infected red blood cells using example images. Gamers then completed a training module and were required to achieve greater than 99 percent accuracy in order to continue playing the game. If they failed to meet this standard, gamers were asked to replay the practice game until achieving greater than 99 percent accuracy.

According to a university release:

The UCLA team found that a small group of non-experts playing the game (mostly undergraduate student volunteers) was collectively able to diagnosis malaria-infected red blood cells with an accuracy that was within 1.25 percent of the diagnostic decisions made by a trained medical professional.

The game, which can be accessed on cell phones and personal computers, can be played by anyone around the world, including children.

…

Crowdsourcing, the UCLA researchers say, could potentially help overcome limitations in the diagnosis of malaria, which affects some 210 million people annually worldwide and accounts for 20 percent of all childhood deaths in sub-Saharan Africa and almost 40 percent of all hospitalizations throughout that continent.

Typically, malaria diagnosis involves a time-consuming process during which a trained pathologist uses a conventional light microscope to view images of cells and count the number of malaria-causing parasites. Using a crowdsourcing method, such as the UCLA game, to train non-professionals to identify malaria could be an affordable option to speed up diagnosis.

Previously: Video: Crowdsourcing your health, Crowdsourcing cost of drug development and On crowdsourced relief efforts in Haiti
Via Medgadget

The Stanford University Medical Center Alumni Association (SUMCAA) is partnering with Doximity, a social networking service for physicians and health-care professionals, to test a new application for iPhone and Android devices.

The app, which the parties say is the first of its kind for any U.S. medical school, is built on Doximity’s network of over 50,000 physicians. Using the app, alumni can quickly access a searchable directory of published articles, lectures, clinical trials and curriculum vitae, and converse in an alumni-only forum.

The app is being made available starting today to a limited population of medical school alumni. To request access to the test group, please e-mail Doximity’s Taylor Carrol. All SUMCAA members will be able to download the app for free at the end of the month.

Stanford medical student Matt Goldstein, PhD, who is a research fellow with Doximity, commented on the app’s potential to foster collaboration, saying, “Research has shown better communication leads to better care. But like many of my classmates, I’ve had to stop using Facebook. It will be interesting to see what impact this app has on sharing clinical expertise and improving patient care.”

Previously: Stanford-developed iPARS app available for download, Mercury News looks at how clinicians are using medical apps and Study finds more doctors are using smartphones
Photo courtesy of Doximity

A year ago, researchers raised the red flag on popular smoking-cessation drug Chantix, citing findings that taking the medication was associated with an increased risk of serious heart problems. Today, a San Francisco Chronicle article takes a look at a new UC San Francisco study that challenges the earlier research and found no significant difference in rates of heart attacks and other serious  problems between smokers who took Chantix and those who didn’t.

In the story, Sean David, MD, PhD, a clinical associate professor of medicine at Stanford, comments on what the findings may mean for physicians. He says:

[The previous work] hasn’t really changed whether or not I prescribe the medication that works the best for my patients. But I know that there are a lot of physicians that were alarmed and probably have stopped prescribing it… Hopefully this new study will help physicians reconsider.

It’s worth noting that both studies involved a large number of participants: 14 clinical trials and 8,200 patients in the 2011 study compared with the 22 trials and 9,200 patients in the UCSF study.

The article brought to mind an entry posted on Scope earlier this week about an Institute of Medicine report recommending ways to improve the U.S. Food and Drug Administration’s drug-approval and tracking systems. The report’s goal is to determine how best to identify unanticipated side effects prior to a drug reaching the market — an important issue in cases such as Chantix, a drug that has been shown to have high success rates in helping patients kick the nicotine habit.

Previously: New ideas to help FDA discover drug risks, Hey doc, got a light? Research highlights Big Tobacco’s long history with the medical community and Kicking the smoking habit for good
Photo by snailo86

Back in 2000, photographer Angela Strass­heim visited an undisclosed morgue and captured a series of images depicting hearts pierced by a gunshot wound, damaged by obesity, affected by cancer and weakened by a drug overdose. The photographs were published for the first time yesterday in a Scientific American piece (subscription required).

In the above video, which accompanied the article, a pathologist at the University of Ottawa Heart Institute examines photos of five heart autopsies and discusses what the images reveal about one of our most vital organs.

On a related note, Stanford interventional cardiologist Jennifer Tremmel, MD, is taking questions about the heart from Scope readers. Today is the last day to submit a question for her.

Previously: Ask Stanford Med: Cardiologist Jennifer Tremmel taking questions on women’s heart health, Lab-made heart cells mimic common cardiac disease in Stanford study and At new Stanford center, revealing dangerous secrets of the heart

Ever since I heard Stanford researcher BJ Fogg, PhD, speak at last year’s Medicine 2.0 conference about how creating tiny habits can result in lasting lifestyle changes, I’ve been working on incorporating small goals into my daily life. So I was interested to read an Atlantic article about a study showing that jogging at a “slow or average pace” for 15 minutes a day may increase your lifetime by more than five and a half years

The findings are from a jogging sub study completed as part of the Copenhagen City Heart study, a prospective cardiovascular population study of nearly 20,000 men and women aged 20 – 93 years that began in 1976.

In the study on jogging, researchers compared the mortality of 1,116 male joggers and 762 female joggers to the non-joggers in the main study population. Participants were surveyed about the amount of time they spent jogging each week and rated their own perceptions of pace. The data were collected four times between 1976 and 2003.

From the Atlantic story:

[Researchers] found that an hour to two-and-a-half hours of jogging per week was linked to an increase in life expectancy among men by 6.2 years, and among women by 5.6 years.

Over the course of 35 years, the risk of death fell by 44 percent among joggers of both sexes. And more strenuous activity didn’t necessarily result in greater benefits, either.

“The relationship appears much like alcohol intake,” said Peter Schnor, chief cardiologist of the Copenhagen City Heart Study. “Mortality is lower in people reporting moderate jogging, than in non-joggers or those undertaking extreme levels of exercise.”

Considering how often my daily jogging plans are squashed by a busy schedule, I’m hoping the knowledge that even a little effort can be highly effective combined with Fogg’s tiny habits program can reinvigorate my running regimen.

Previously: How physical activity influences health, Exercise may reduce Alzheimer’s risk among those genetically predisposed to the disease and Midlife exercise linked to better aging in women
Photo by Ed Yourdon

On occasion, more than I like to admit, I indulge in a second helping of dessert despite being fully aware that I am not hungry. When I dig into my tasty bonus course, I know that satisfying my immediate craving will come at a price: either spending extra time at the gym or, painfully, having to decline sugary treats the next time around.

But research (subscription required) recently published in the Journal of Clinical Endocrinology & Metabolism shows that eating for pleasure, rather than to satiate hunger, could prove to be more costly than extended workouts and eschewing delectable dishes in the future. Giving into hedonic hunger, the researchers found, may alter our brain activity stimulating overeating, and possibly lead to obesity.

ABC News reports:

Italian researchers used cookies, cakes and tiramisu to find out why the food we love keeps us coming back for more. The reason: a bit like addictive substances, the taste activates reward signals in the brain.

“Our preliminary findings show that when a normal-weight healthy subject’s motivation to eat is generated by the availability of highly palatable food and not by food deprivation, a peripheral activation of two endogenous rewarding chemical signals is observed,” the researchers wrote in a study set to be presented at the 94th annual Endocrine Society meeting in Houston.

The researchers tracked plasma levels of the hunger hormone ghrelin and the marijuana-like brain chemical 2-AG in study subjects who dined on delicious or, well, disappointing meals. Those who ate from the “palatable” plate had higher levels of both.

The findings offer more evidence that drug addiction and obesity are based on similar underlying neurobiological mechanisms.

Previously: The brain’s control tower for pleasure and Better than the real thing: How drugs hot wire our brains’ reward circuitry
Photo by SuperFantastic

As we’ve previously written on Scope, researchers are developing new ways to use Twitter messages, Facebook interactions and Google queries to anticipate surges in influenza cases, gain insights into the spread of viruses and track other public health trends. Now researchers are turning to data on sales of over-the-counter medicines in an effort to quickly identify disease outbreaks.

The Atlantic reports:

Data from the [National Retail Data Monitor] show that sales of over-the-counter products like cough medicines and electrolytes actually spike before visits to the emergency room do. The lead time can be significant — in the case of respiratory and gastrointestinal illnesses, it was about two and a half weeks, according to one paper. Another study examined pediatric patients at a Pittsburgh hospital and found that over 40 percent of parents had bought over-the-counter meds an average 1.88 days before bringing their children into the ER.

Being able to identify a possible disease outbreak probably won’t do much to keep the pathogens from spreading, but it could help prepare first-responders and other health professionals. In 2010, it took weeks for official sources to report details of a cholera epidemic in Haiti that killed 7,000 and infected half a million others. But on Twitter, news of the disease traveled far more quickly, according to a study published in the American Journal of Tropical Medicine and Hygiene.

Previously: Study shows Google Flu Trends data, patient spikes at emergency departments closely correlated, Facebook app models how viruses spread through human interaction, Mining Twitter data to track public health trends and Following Google Flu Trends, researchers use queries to track MRSA
Photo by levanah