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Big data, Events, Science

At TEDMED 2015: Using data to maximize human potential

This year’s TEDMED was held Nov. 18-20 in Palm Springs, Calif. Stanford Medicine is a medical research institution partner of TEDMED, and a group of MD and PhD students who represented Stanford at the conference will be sharing their experiences here. 

A tall, striking woman walked out onto the TEDMED stage. Energetically and confidently, Vivienne Ming, PhD, a theoretical neuroscientist and entrepreneur, went on to tell us about her passion for optimizing human potential utilizing big data.

There are many examples where Ming has used data for social good, such as matching refugees to their families with image-recognition software, but here at TEDMED she discussed personalized education. By looking for trends and patterns in classroom data, she has built an educational tool that predicts a child’s grade trajectory in the class and then chooses the highest impact personalized intervention for each individual student. Using data-science techniques to study society and education, Ming dazzles us with the possibilities of data in improving our capacity to reach our individual potentials.

Ming completely upended my view on data science in social issues

As a graduate student applying these same techniques to the field of genomics, I was intrigued. My understanding of data science applied to the social sciences, such as in the field of economics, was that the modeling remained fairly straightforward and simple: Understandable models were very important for the social sciences, and complex data-science models were not very interpretable. As a medical student, I found this frustrating – my interests lay both in cutting-edge computational advances as well as empathy for human suffering, and I couldn’t figure out how to apply my data-science skills beyond the world of science to answer questions of social and health inequalities.

Ming completely upended my view on data science in social issues. I was fortunate enough to have the chance to chat with her the next day, and I asked her about the computational work, as I was curious how complex her models really could be. She displayed a wonderful technical capacity and a deep understanding of how to choose the right algorithms for the social problems at hand. Granted, it’s still not common to find such imaginative interdisciplinary work combining cutting-edge computer science work and social science work. But Ming showed me a world of possibility around bringing data skills into improving everything from hiring to education to gender equality. I came away impressed, inspired, and excited about the possibilities of utilizing my own skills in the world beyond genomics.

Working at the intersection of two fields can be extremely challenging to impossible. And it’s particularly tricky to apply the latest data-science methods to societal questions. As such, to be able to intelligently and thoughtfully do the two together is an art – and Ming is a master of the important intersection where computation meets humanity.

Daniel Kim is a fifth-year MD/PhD student at Stanford. He studies biomedical informatics and genomics and is interested in all things data-related.

Events, Research, Science, Technology

At TEDMED 2015: Thinking about “breaking through” the valley of death in science

At TEDMED 2015: Thinking about "breaking through" the valley of death in science

This year’s TEDMED was held Nov. 18-20 in Palm Springs, Calif. Stanford Medicine is a medical research institution partner of TEDMED, and a group of MD and PhD students who represented Stanford at the conference will be sharing their experiences here. 

“I am #BreakingThrough the ‘valley of death.’”

That’s what I wore on my nametag last week at TEDMED. The theme of this year’s conference was “Breaking Through,” and every delegate was asked to write a brief statement that illustrates an area of health care that they’re most passionate about.

The “valley of death” refers to the vast gap in the landscape of biomedical therapeutic development between academia and industry. Traditionally, an academic institution and industry have played two separate but equally important roles in the lengthy and expensive process of bringing new medical innovations to the patient. Academic researchers investigate new mechanisms, pathways and methods, making discoveries that yield promise. Industry then takes these experimental innovations and conducts product development, safety profiling, clinical trials, and manufacturing and distribution, ensuring that extensively tested, safe and efficacious products are widely made available.

However, this transition between academia and industry is not always a smooth one. The pharmaceutical industry is notorious for its extreme risk aversion with new products – and with an average cost of $1B, a 10-year path to FDA approval, and a failure rate north of 95 percent, who can blame them? Meanwhile, most academic labs are neither equipped to nor interested in spending the resources to conduct important yet labor-intensive preclinical work (which, quite frankly, won’t help a scientist graduate, secure tenure, or win a Nobel Prize). And so, because of this, potentially beneficial therapeutics are liable to languish in the valley of death between discovery and human trials.

On Thursday, Stanford professor Daria Mochly-Rosen, PhD, took the TEDMED stage to describe her own experience crossing that valley on the TED stage. In the early 2000s her lab had discovered a novel class of compounds for reducing cardiac injury after heart attack. After receiving universal rejections from pharma companies that they hoped would license the compounds, Mochly-Rosen and one of her graduate students reluctantly took matters into their own hands, left the university, and started KAI Therapeutics to bring their compounds into clinical trials. Long story short, they were eventually wildly successful and acquired by Amgen after demonstrating efficacy in Phase II clinical trials. The experience drove Mochly-Rosen to start the Stanford’s SPARK program, which offers a variety of resources – including classes, industry mentors and grants – to help scientists here survive their own journeys through the valley of death.

As a scientist developing new potential tools for diagnosis and therapy, and as someone who works frequently with early-stage life science companies, I spend a disturbing amount of time thinking about the valley of death. But to me, the valley is much deeper and wider than what it means for pharmaceutical development. It spans similar challenges in medical devices, diagnostics, and even digital health solutions.

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Events, Genetics, Research, Science

At TEDMED 2015: How microbiome studies could improve the future of humanity

At TEDMED 2015:  How microbiome studies could improve the future of humanity

This year’s TEDMED was held Nov. 18-20 in Palm Springs, Calif. Stanford Medicine is a medical research institution partner of TEDMED, and a group of MD and PhD students who represented Stanford at the conference will be sharing their experiences here. 

TEDMED scholarsOne of the highlights at TEDMED for me was meeting and hearing from Chris Mason, PhD, a Weill Cornell Medical College researcher in epigenetics. This is my field of study, so I was excited to talk to someone deeply involved in the world of genomics. Mason was an engaging and fast talking speaker, with a great sense of humor. And I soon discovered that, while he was doing the same sort of work and analysis that I was doing, his samples are incredibly unique.

While I work on primary cell types across the human body, Mason has interesting questions about the microbiome surrounding our body. The cells that make up the microbiome actually outnumber human cells ten times over – and scientists are increasingly gaining an understanding of how the microbiome, individual and personal to each and every person, can have a unique impact on human health and wellness. Mason, knowing this, began to look for interesting and unique ones that could tell us about how these microbiomes could be enhanced and utilized for improving our human lives.

Mason sequenced microbial cells that were gathered from subway riders around the world, and he discovered that about half of the cells discovered were not known microbial species. Literally under our feet, as Mason puts it, there is a world of diversity to explore and the possibility of discovering new antibiotics and cures to disease. But then Mason also went in the other direction – up! – and collected samples from astronauts in space. Now he has access to more than 8,000 samples of astronaut samples (let your imagination wander on what they saved) for a study of the human body in extreme environments.

During Mason’s talk on the last day of the conference, provocatively described by TEDMED organizers as a discussion of how his work is being done “in the interest of humanity’s interplanetary survival,” he touched on the subway experiments as well as the astronaut work, and then tied it all together by talking about the future of humanity. For Mason, an understanding of biology, both microbial and human, is the natural next step in humans’ progress to the stars and beyond. Genetic engineering is already here and will continue to grow as a technology, and he suggested we use it to extend our reach to the moon and beyond. The microbiome could be altered to protect us from UV radiation in space or to help us adapt to new planets, for example. Think of it as an astronaut suit, but biological, he suggested.

Mason’s thoughts may be controversial, depending on what you think about genetics, but he has clearly thought very hard about what new biological technologies mean for humanity’s future. It’s unknown whether the future will develop as Mason has envisioned it, but his work will likely be influential nonetheless.

Daniel Kim is a fifth-year MD/PhD student at Stanford. He studies biomedical informatics and genomics and is interested in all things data-related.

Photo of the author (second from left) and three other TEDMED scholars, from Lichy Han

Chronic Disease, Events, Stanford News

A reminder before World Diabetes Day: “We need more people educated about the disease”

A reminder before World Diabetes Day: “We need more people educated about the disease"

Bay Area native Anna Simos had always been the healthy one in her family — never a candy eater, she said — but, at 15, she was diagnosed with what had been the traditional family illness: diabetes. “My grandmother and uncle had Type 1 diabetes and my father Type 2, so with that diagnosis, I knew what it meant,” she said. “It was sobering and I knew there was no easy way out.” She remembers that day quite clearly. “The doctor brought in a syringe with insulin and told me to give myself a shot. I asked him how many times do I do this every day? Probably four to six, he said. I was not happy.”

Over the years, and through a pancreas and two kidney transplants, Simos learned how to balance her diet, lifestyle, medications and essential medical equipment to live a life with Type 1 diabetes. “I had figured it out for myself, but I began meeting others with diabetes and I decided I would do something with this on-the-job training.” She also earned a master’s degree in public health and a master’s degree in the epidemiology of diabetes.

She received so much of her medical care at Stanford Health Care, she began to dream about what she could do to help there, too. Today, Simos, now a certified diabetes educator and diabetes clinical research coordinator at Stanford, will see one of her combined personal and professional goals met: Stanford Health Care’s first Diabetes Prevention and Wellness Health Fair, being held today in recognition of the upcoming World Diabetes Day.

The fair is a free, public event, and Charlie Kimball, a Formula 1 Indy car driver who has diabetes, will be there to talk about how his experience living with diabetes. Among the other features of the event: Fifteen non-profits and vendors, clinicians from Stanford Health Care and Stanford Children’s Health, and other diabetes education experts will offer free risk assessments, updates on diabetes care technology, food demonstrations and nutrition education. “Everyone’s coming together for the first time,” Simos said. “You’re going to learn something if you come, because it’s not just about diabetes — it’s also about prevention.”

Simos is pushed by the numbers: The Centers for Disease Control and Prevention estimates that 387 million adults have a form of diabetes. About 86 million American adults— more than 1 in 3 are pre-diabetic. That condition, defined by blood sugar levels that are above normal but not high enough for a Type 2 diagnosis, increases the risk of heart disease, stroke and Type 2 diabetes. “Diabetes and pre-diabetes are at epidemic levels,” Simos said. She knows how much easier it is to make the dietary and behavior changes than to develop the disease and possibly suffer the worst of its consequences. “We want to help prevent the transplant, the amputation, the blindness — that we can turn around with care,” she said. “We need more people educated about the disease. If we can just get people to start thinking about their risk factors, we can take a different approach to diabetes: prevention.”

Previously: A conversation about the diabetes epidemic and The role of nutrition in diabetes prevention and management
Photo, of Anna Simos meeting with patient Ed Grey earlier this week, by Norbert von der Groeben

Education, Events, Science

To boost diversity in academia, “true grit” is needed

To boost diversity in academia, "true grit" is needed

photo (1)With evangelical fervor, Freeman Hrabowski, PhD, president of the University of Maryland-Baltimore County (UMBC), challenged the School of Medicine to tackle inequality throughout its ranks, an effort that — if successful — could spill out to benefit society at large.

“It takes effort, being proactive, not being defensive, and being honest and transparent,” Hrabowski told a packed crowd here yesterday. His talk was the part of the Dean’s Lecture Series, which is focused on diversity.

A mathematician, Hrabowski is a national leader in the field of science education and is author of the recently published book, Holding Fast to Dreams: Empowering youth from the Civil Rights crusade to STEM achievement. He was incarcerated during a Civil Rights march in the 1960s and currently campaigns for inclusiveness at all levels of academia.

Dean Lloyd Minor, MD, lauded Hrabowski: “Personally, I have found Freeman to be an enormous source of inspiration, advice and of wisdom in my leadership career. He is an exceedingly wise leader, who measures his leadership by the lives that he impacts.”

Confronting entrenched notions about race and gender and STEM fields (science, technology, engineering and math) won’t be easy, Hrabowski admitted. He said it requires “true grit,” which is also the name of his university’s retriever mascot, True Grit.

One of the most critical points is the first undergraduate science course that high-achieving students take, he said. At UMBC, staff have created a new chemistry center and reorganized the curriculum. It’s also important to upend the cutthroat atmosphere in STEM fields and promote teamwork and cooperation, he said.

As a top institution, Stanford has a responsibility to promote diversity and inclusiveness, Hrabowski told the audience.

“When people look back at Stanford Medicine 100 years from now, who will they say you are?” Hrabowski asked. “The problems we face are more difficult than ever. The challenge is to keep learning and struggling with the issues.”

Previously: Intel’s Rosalind Hudnell kicks off Dean’s Lecture Series on diversity, Former Brown University President Ruth Simmons challenges complacency on diversity and Diversity is initial focus of new Stanford lecture series
Photo by Becky Bach

Bioengineering, Events, Mental Health, Research, Stanford News, Videos

Stanford’s Karl Deisseroth talks about the work he was “destined to do”

Stanford's Karl Deisseroth talks about the work he was "destined to do"

Earlier this week we announced the exciting news that Stanford bioengineer Karl Deisseroth, MD, PhD, had won a $3 million 2016 Breakthrough Prize in Life Sciences. Before he took the stage to accept his award during a star-studded Academy Awards-like ceremony Sunday evening, the video above was shown to highlight the significance of his work. One of Deissoroth’s quotes:

There are deep questions about the brain that may never be answered, but we’re making headway with optogenetics… We’re headed down a path that gets us to understanding [questions like] why does one person feel the way they do and why does it create a disease when they do a particular way, and what can be done to correct it?

Noting that the suffering of people with psychiatric disease “is a very, very serious and pervasive matter,” he also says “the nature of the illnesses – their complexity, the amount of suffering and the mystery – has made this what I was destined to do.”

Previously: Stanford bioengineer Karl Deisseroth wins 2016 Breakthrough Prize in Life SciencesInside the brain of optogenetics pioneer Karl DeisserothLightning strikes twice: Optogenetics pioneer Karl Deisseroth’s newest technique renders tissues transparent, yet structurally intact and An in-depth look at the career of Stanford’s Karl Deisseroth, “a major name in science”
Video courtesy of National Geographic Channel

Aging, Events, Stanford News, Videos

Former medical school dean discusses learning and longevity at Stanford 125 event

Former medical school dean discusses learning and longevity at Stanford 125 event

The year-long celebrations for Stanford University’s 125th anniversary are in full swing, and Philip Pizzo, MD, former dean of Stanford’s medical school, recently helped kick off the festivities. Earlier this month, he and experts in the fields of psychology, computer science, education, physics and the humanities drew a crowd of more than 550 people to Stanford’s Cemex Auditorium to discuss the theme “Thinking Big About Learning.”

In his talk, Pizzo, founding director of the Stanford Distinguished Careers Institute, explored the topics of learning, aging and longevity and how traditional views of education and career (learn when young and do the same job for life) no longer apply now that people are living and working longer than ever.

If you missed the event, you can watch video of Pizzo’s talk here. Other videos from the symposium, including talks from Stanford psychology professor Carol Dweck, PhD, and Jeremy Bailenson, PhD, director of the Virtual Human Interaction Lab, are available on the Stanford 125 website.

Previously: Living long and living well: A conversation on longevity at Medicine XA look at aging and longevity in this “unprecedented” time in history and Living loooooooonger: A conversation on longevity

 

Events, Global Health, Health Disparities, Health Policy, Podcasts

An optimist’s approach to improving global child health

An optimist’s approach to improving global child health

Globally, more than six million children die before their fifth birthday each year, most having been born into poverty. While great strides have been made over the last few decades in reducing global child mortality, some countries, like Pakistan, have lagged behind. Today, Pakistan has the third-highest infant mortality rate in the world and some of the worst child health and social indicators in the world.

In a new 1:2:1 podcast, Paul Costello, chief communications officer for the medical school, talks with Anita Zaidi, MD, an internationally renowned pediatrician and director of the Enteric and Diarrheal Diseases Program at the Bill & Melinda Gates Foundation, about the state of child health in her home country of Pakistan and what it takes to lift a nation up. The conversation was adapted from a recent global health seminar sponsored by the Center for Innovation in Global Health.

In speaking to an audience of Stanford students and faculty prior to her talk with Costello, Zaidi described herself as a “relentless optimist” who always takes the “glass half full” perspective. In looking back from 1990 to now, she said Pakistan has made some progress in reducing child mortality, but not as much as what it could have achieved.

Perhaps the biggest barrier to Pakistan’s progress stems from gender inequalities and the poor status of maternal health.

“Women are very marginalized in Pakistan, which affects their health and child mortality,” said Zaidi. “Unless we address those issues, [child health] is a tough problem to take care of… The citizens of Pakistan have a very big role to play.”

In 2013, Zaidi became the inaugural recipient of the $1 million Caplow Children’s Prize for her work in one of Karachi’s poverty stricken fishing communities, Rehri Goth, to save children’s lives. Through her work in Rehri Goth, she saw first hand the complex issues that impact whether a child will live to age five or not. In areas of extreme poverty, like Rehri Goth, improving primary healthcare is not enough.

“There’s no source of income. There are more than 10 kids in a family. Even if their newborn isn’t dying, the child dies at two or three months of age because there’s nothing to eat,” said Zaidi. “You realize there is this sub-population of extremely high-risk individuals, who need more than primary healthcare…They actually need some poverty alleviation types of interventions, food subsidies, to get them out of that.”

So, what does it take to lift a nation up? For Zaidi: “Girls getting educated will change the world, and more and more girls are getting education. We know that [education] one of the strongest predictors of improving child health outcomes.”

Rachel Leslie is the communications officer at Stanford’s Center for Innovation in Global Health.

Previously: Pediatric health expert Alan Guttmacher outlines key issues facing children’s health todayCountdown to Childx: Global health expert Gary Darmstadt on improving newborn survival and Training program helps dramatically reduce stillborn rates in developing countries

Events, Global Health, Health Policy, Public Health, Stanford News

Using innovation to improve health in the developing world

Using innovation to improve health in the developing world

Ramano RaoHow can Silicon Valley-style know-how help improve health and lift up the lives of the poor in the developing world? That question was the focus of a panel discussion among four distinguished speakers last week at a Stanford conference on global development and poverty.

Panelist Ramana Rao, MD, described one technologically-based solution he helped develop with colleagues in Hyderabad, India:  a 911-type emergency care system which now serves some 750 million people across the South Asian country.

Though the system, users can call a single number – 108 – to summon an ambulance and team of skilled providers who can provide treatment en route to the nearest hospital.  The system, a public-private partnership known as GVK EMRI (Emergency Management and Research Institute), uses advanced call center technology, in which trained operators typically respond to calls within the first ring and relay them immediately to paramedics and emergency medical technicians on ambulances in the field, Rao told an audience of more than 200 people at the Stanford Graduate School of Business.

The system uses Google maps to help quickly locate patients. And the designers have introduced a mobile device app, which can be easily downloaded to call the service and which can be used to track the location of a caller during the first hour, the critical “golden hour” for treating trauma patients, he said.

Panel moderator Paul Yock, MD, PhD, noted the system is far more effective than the fragmented, 911 emergency system in the United States. “It’s a marvelous example of technology leap-frogging what we do here in this country,” said Yock, founder and director of Stanford Biodesign.

The Indian system was made possible in part by the soaring popularity of cell phones in India, used by 950 million people, including the poor.

“The mobile phone has been the most transformational technological advance in the developing world in the last 15 years,” noted panelist Rajiv Shah, MD, administrator of the U.S. Agency for International Development.

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Addiction, Cancer, Events, Health Policy, Medicine and Society, Public Health

The devil you know: Experts discuss the public-health consequences of e-cigarettes

The devil you know: Experts discuss the public-health consequences of e-cigarettes

e-cigarettesHow do we reduce health risk in the face of harm that can’t be eradicated completely? That’s the question that the medical school’s dean, Lloyd Minor, MD, presented to the audience at Monday’s Health Policy Forum on e-cigarettes — a topic about which he said “intelligent and reasonable people can disagree.”

E-cigarettes are a heavily contested subject in the public-health community. Panelists at this event debated whether the recently developed devices hold promise to help long-time smokers move away from combustible cigarettes, or whether they carry the worrisome potential to re-normalize smoking.

All panelists agreed that those under 21 shouldn’t be using any nicotine delivery devices, and they shared a goal of minimizing general use of harmful health products. They disagreed, however, on what the advent of e-cigarettes means to the accomplishment of those goals.

David Abrams, PhD, a Johns Hopkins clinical psychologist specializing in health psychology, addictions, and tobacco-use behavior, described himself as a harm reductionist. He argued that as an alternative mode of nicotine delivery, e-cigarettes pave the way for saving lives by helping addicted smokers not use traditional cigarettes.

“I do think the evidence is very solid that they are dramatically less harmful than cigarettes…because they absolutely have very low, almost undetectable levels or trace amounts of the top eight carcinogens that are found in cigarettes and they have no carbon monoxide,” he explained.

But a lack of extensive research makes Stanford’s Robert Jackler, MD, and Bonnie Halpern-Felsher, PhD, question whether vaping is actually safe — and a prevalence of candy-flavored e-liquids leaves them concerned for the potential for harm to youth.

“Let me point out that you can smoke [combustible cigarettes] for many years before you get chronic destructive lung disease,” said Jackler, who leads a Stanford research team studying the impact of tobacco advertising, marketing, and promotion. “So while I agree… that they are safer, the presumption that they are safe for teenagers to adopt as opposed to combustible tobacco, we won’t know that for decades.”

In the meantime, he worries that “we’re experimenting with the lungs of teens.”

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