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Health and Fitness, In the News, Orthopedics

Walking tall: The challenge of correcting your gait

Walking tall: The challenge of correcting your gait


Thanks to a bum knee, in elementary school I had to choose between two styles of special Oxford shoes to help correct my gait; I hated those ugly shoes. Luckily these days I have many cute options, along with custom orthotics.

Despite good shoes though, my plantar fasciitis recently sent me back to my physical therapist. Of course the first thing she had me do is walk back and forth across the room, a common sight at any physical therapy office.


Now, everyone from doctors and physical therapists to yoga instructors are teaching people how to walk properly.

A recent story in Vogue chronicles one woman’s efforts to correct her bad habits at two walking and gait clinics — with a physical therapist in Santa Monica and with a yoga teacher in Brooklyn. Author Marisa Meltzer also checked in with Jessica Rose, MD, a professor of orthopedic surgery at Stanford University and director of the Motion & Gait Analysis Laboratory at Lucile Packard Children’s Hospital.

Meltzer received immediate feedback from the physical therapist, displeased with the uneven wear of her shoes. As Melzter describes:

Finally, she instructs me to walk back and forth across the room. Her diagnosis: I’m constantly leaning back like a Looney Tunes character approaching oncoming traffic.

Similarly, Melzter visits a well-known yoga teacher, learning to straighten her upper body, rotate her pelvis, and swing her arms as she walks. She describes her new gait near the end of the article: “It feels unnatural, yet when I catch my reflection in the mirror I see I’m moving elegantly and with confidence.”

Jennifer Huber, PhD, is a science writer with extensive technical communications experience as an academic research scientist, freelance science journalist and writing instructor.

Previously: Walking-and-texting impairs posture – and walking, and texting, Walking and aging: A historical perspective and Global survey highlights the need for people to keep track of walking distance
Photo by sean_hickin

Cancer, Complementary Medicine, In the News, Research

“We need a breakthrough”: Cancer researchers call for more effective, lower cost therapies

"We need a breakthrough": Cancer researchers call for more effective, lower cost therapies

1024px-Tripterygium_regelii_1Cancer is wily. Although drug developers are continually crafting hard-hitting drugs, a variety of factors, such as a tumor’s genetic heterogeneity, mean that cancer usually comes out on top.

Something else is needed.

And that something, writes a panel of 180 researchers in a special issue of Seminars in Cancer Biology, is an array of treatments that bombard a series of targets. These treatments can be based on substances found in nature that are lower in cost and toxicity than many current treatments, the researchers write. Some of these compounds stem from plants, such as the Chinese herb Tripterygium wilfordii (although that herb, like many treatments is not without a downside: it also suppresses the immune system).

The team identified 74 molecular targets deserving of investigation and set up a framework for researchers to pitch in. And the time is now, researchers Anupam Bishayee, PhD, and Keith Block, MD, write in the introductory paper: “We have a long way to go before oncology can offer true comfort to most patients.”

Stanford oncologist Dean Felsher, MD, PhD, was part of the project. “This is an area that merits considerable attention and where interdisciplinary and international collaboration is needed,” he said in a statement.  “Our approaches to therapy are improving, but we need a breakthrough that can helps us address the problem of relapse.”

Previously: Researchers develop molecular target for brain cancer, Kidney cancer secrets revealed by Stanford researchers and Tool to identify the origin of certain types of cancer could be a “boon to doctors prescribing therapies”
Photo by Qwert1234

Ethics, In the News, Parenting, Patient Care, Pediatrics, Stanford News

Parents now help doctors decide what care is right for the sickest babies

Parents now help doctors decide what care is right for the sickest babies

Today, NPR’s Morning Edition featured an in-depth story on the evolution of decision-making in neonatal intensive care units – hospital nurseries for the sickest infants. Parents now have much more say in their babies’ care than in the past, and Stanford experts who were on the front lines of the change, including William Benitz, MD, chief of neonatology at Lucile Packard Children’s Hospital Stanford, explained how it happened.

As medical care for premature and other at-risk babies advanced in the 1970s and early 1980s, doctors gained the ability to save many infants who would once have died soon after birth. But some children in the new category of survivors had lifelong disabilities, with lasting implications for them and their families.

At first, doctors did not realize that this change would affect parents’ desire to participate in planning medical decisions for fragile infants:

“It never occurred to anyone that that might be a reasonable conversation to have,” Benitz says. “We were in unexplored territory.”

As technology improved and doctors tried to save sicker babies, and some born even earlier in gestation, there were new decisions to make: Should the health team put the tiny child on a ventilator? Attempt heart surgery? Those interventions helped many infants survive. Others did not fare as well.

“A lot of them ended up with significant impairments,” Benitz recalls. And doctors started to get pushback. “In the mid-80s we began to hear from families that maybe that wasn’t consistent with their goals for their children.”

As a result, neonatologists began having in-depth conversations with parents about the possible outcomes of different treatments for their infants. The practice is now widespread, and it means a lot to parents like Karin and Chris Belluomini, whose daughter, Joy, was born in May 2015 with Down syndrome, several heart defects and fluid around her lungs.

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Cancer, In the News, Pediatrics, Stanford News

“Earth angel” brings smiles to sick kids in hospital

"Earth angel" brings smiles to sick kids in hospital

6552156879_1cd906fbab_zHere’s a tale that will tug on your heart strings: It begins in a small town in Pennsylvania, in 1926, at the birth of Joe Manfrey, the fifth child in a family that would eventually grow to nine.

Like many his age, Manfrey served in World War II; his ship was part of the battle of Iwo Jima.

But unlike many of his peers, Manfrey, now 89, is still volunteering twice a week in the cancer unit in the Lucile Packard Children’s Hospital Stanford where he spreads good cheer, hope and sock monkeys. Manfrey was featured in a recent story in the San Jose Mercury News:

“Joe embodies the great values of the Greatest Generation,” said Leslie Griffith, a nurse in the Bass Center for Childhood Cancer and Blood Diseases. “He is funny, engaging and soothing to parents, who can be crying or overwhelmed by a surreal sadness. But just when they feel lost, someone kind and upbeat like Joe arrives — an Earth angel, a beautiful spirit.”

But there’s a twist to Manfrey’s story.

His own son, now 47, survived acute lymphoblastic leukemia as a child, at a time when its survival rates were much lower than they are now. He shows patients a photo of his son as a bald, 5-year-old, and then one as a healthy adult.

“By showing them the pictures together, it lets them know that I personally know what they are going through. It also gives them hope because they can see that Rob grew up to be healthy and strong,” Manfrey said in the article.

“This is not about me,” he emphasized in the story. “I do this for the kids and the parents, in order to take their minds off the difficulties they are going through. I try to make them feel a little more comfortable.”

Previously: California collaboration focuses on analyzing pediatric cancers, A look at the dramatic improvement in pediatric cancer survival rates and Children’s hospital volunteers snuggle infants to soothe tiny patients and reassure their parents
Photo by Clyde Robinson

In the News, Medicine and Society, Mental Health, Public Health

Turning loss into hope for others: New website teaches about mental health

Turning loss into hope for others: New website teaches about mental health


Suicide slices close to the heart for me, and I remember well the story of Shelby Drazan, a Woodside, Calif. 17-year-old who died by suicide last year.

Now, the Drazan family is going public with their efforts to help others suffering from mental illness. A recent article in the Almanac explains their efforts:

The Drazans say they hope talking publicly about what happened to Shelby will ease some of the stigma attached to mental illness.

“A lot of people are struggling,” Stacy Drazan says, “a lot of people especially in this area. We’ve got to help get rid of the stigma so that people can seek help, and earlier.”

Her daughter Mackenzie has created an online trove of resources, Teaching Everyone About Mental Health or TEAM. “Hopefully we can lower the learning curve for everybody else,” Mackenzie said.

At the same time, Stacy Drazan is working to expand the number of adolescent beds for psychiatric patients in the San Francisco Bay area. Stanford’s Steven Adelsheim, MD, a child psychiatrist, is among those working with the family to expand local mental-health resources.

Previously: Advice and guidance on teen suicide, “Every life is touched by suicide:” Stanford psychiatrist on the importance of prevention and Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets
Photo courtesy of TEAM

Big data, Genetics, In the News, Precision health, Research

Personal proteins: Assembling a “‘complete parts list’ of the human body”

3597686581_389d7b3df2_zGeneticist Michael Snyder, PhD, is on the forefront of a global effort to catalog — and investigate — the presence and activities of proteins in the human body. The worker bees of cells, proteins are responsible for the actions — such as germ fighting, digestion, reproduction and more — that keep us alive.

The task of tallying proteins is daunting, as a recent Nature article lays out:

Proteins… vary over time, changing during exercise, disease and menstrual cycles, for example. Another complication is that the most abundant protein can be about 10 billion times as common as the least.

Snyder started with himself and watched how his protein expression changed when he became ill with an infection. He also discovered his unexpected predisposition for diabetes. “I had no idea I’d turn out to be so interesting,” Snyder told Nature.

The piece outlines the multiple global efforts to “create a ‘complete parts list’ of the human body,'” as described by Gilbert Omenn, MD, PhD, head of the Human Proteome Project. Those endeavors, including the HPP, are using a variety of methods and tackling different tasks. For example, one is looking at proteins involved in disease, while another is systematically probing proteins produced by each chromosome.

Ultimately, Snyder said he hopes he and others can assemble protein inventories on as many as a million people. A key challenge of this work is what to do with, and how to analyze, the enormous amounts of data generated.

Previously: Gene regulation controls identity — and health, You say “protein interactions,” I say “mosh pit:” New insights on the dynamics of gene expression and ‘Omics’ profiling coming soon to a doctor’s office near you?
Image by Jer Thorp

Ethics, In the News, NIH, Research, Science, Science Policy, Stanford News, Stem Cells

Stanford researchers protest NIH funding restrictions

penSeven Stanford researchers, including Irving Weissman, MD, who directs Stanford’s Institute for Stem Cell Biology and Regenerative Medicine, and David Magnus, PhD, director of Stanford’s Center for Biomedical Ethics, have joined with four other prominent scientists to urge the lifting of a recent and unexpected ban on funding by the National Institutes of Health for research that involves placing human stem cells into early-stage, non-human embryos. Their comments will be published tomorrow in a letter to Science.

As I describe in our release:

At issue is the growing field of research that seeks to understand how human pluripotent stem cells, which can become any cell type, may integrate and contribute to the development of a nonhuman animal, such as a laboratory mouse. Pluripotent stem cells can be isolated from human embryos or created in a lab from adult human cells, in which case they’re known as induced pluripotent stem cells. Once obtained, these versatile cells can be injected into an early-stage animal embryo and studied as the embryo develops into an adult animal.

Tracking where these cells go and how they function in the growing embryo and the adult animal can help researchers understand early stages of human development that can’t be studied any other way. (Although researchers can and do study the development of fertilized human eggs, the study period is restricted to only a few days after fertilization for ethical reasons.)

In addition to investigating human development, the research is expected to lead to significant advances in disease modeling, drug testing and even transplantation. As cardiologist and one of the co-senior authors of the letter, Sean Wu, MD, PhD, explains:

By eliminating federal funding for all aspects of this research, the NIH casts a shadow of negativity toward all experiments involving chimera studies regardless of whether human cells are involved. The current NIH restriction serves as a significant impediment to major scientific progress in the fields of stem cell and developmental biology and regenerative medicine and should be lifted as soon as possible.

Science recently published a great background article describing the ban, and its effect on researchers like Sean Wu and geneticist and stem cell researcher Hiromitsu Nakauchi, MD, PhD, who also signed the letter. Other signees include Joseph Wu, MD, PhD, professor of medicine and director of Stanford Cardiovascular Institute; Christopher Scott, PhD, director of Stanford’s Program on Stem Cells and Society; and Vittorio Sebastiano, PhD, assistant professor of obstetrics and gynecology and director of Stanford’s Human Pluripotent Stem Cells Core Facility.

Previously: NIH intramural human embryonic stem cell research haltedSupreme Court decision on human embryonic stem cell case ends research uncertaintyUsing organic chemistry to decipher embryogenesis and The best toxicology lab: a mouse with a human liver
Photo by Fimb

In the News, Research, Science, Stanford News, Videos

Brain cell spheres offer new tool to study disease

Brain cell spheres offer new tool to study disease

Earlier this year my colleague reported on some pretty neat work from the labs of psychiatrist Sergiu Pasca, MD, and neurobiologist Ben Barres, MD, PhD. Researchers there figured out how to create spheres of neuronal cells resembling the cerebral cortex, making functional human brain tissue available for the first time to study neuropsychiatric diseases such as autism and schizophrenia. In an article today the Associated Press highlighted this work, with Malcolm Ritter writing:

It’s part of a larger movement over the past few years to create “organoids,” miniature versions of the body’s organs or key parts of organs. Goals include studying disease, testing possible treatments and perhaps supplying replacements for transplants. Scientists have made organoids representing the intestine, prostate, kidney, thyroid, retina and liver.

This overall organoid approach “is a major change in the paradigm in terms of doing research with human tissues rather than animal tissues that are substitutes. … It’s truly spectacular,” says Arnold Kriegstein, who studies the brain at the University of California, San Francisco.

Pasca talks more about the work in the AP video above; Stanford ethicist Hank GreelyJD, also weighs in.

Previously: Brain cell spheres in a lab dish mimic human cortex, Stanford study says

In the News, Research, Sleep

On narcolepsy, naps, the genetics of sleep (and chocolate?)

On narcolepsy, naps, the genetics of sleep (and chocolate?)

606739059_bff97744c2_zSomeone who studies sleep for a living surely sleeps soundly, right? Maintains a set bedtime and snoozes for a full eight hours?

Not necessarily, a recent interview with Stanford narcolepsy researcher Emmanuel Mignot, MD, PhD shows.

“[I] usually wake up once in the middle of the night. Usually, I go into the kitchen and eat something like a piece of chocolate — always dark chocolate,” Mignot said in an article from Van Winkle’s, a website focused on sleep.

Otherwise, Mignot characterizes his sleep as “a little boring. It’s not great, but it’s not traumatic.”

For his dog, the narcoleptic Chihuahua Watson, however, sleep is something that pounces suddenly, often during a rousing game of fetch. “He’ll go and get the toy and then I’ll try to take it from him — and he just falls asleep. I have to catch him as he falls over,” Mignot said.

Watson’s cataplexy, or a sudden episode of muscle paralysis, is one of the most common symptoms of narcolepsy, a disease characterized by almost constant sleepiness.

In the piece, Mignot also discussed his work to develop a treatment for narcolepsy and his plans to conduct study on the genetics of sleep problems.

Previously: How insufficient sleep can lead to weight gain, Watson, the narcoleptic Chihuahua, demonstrates symptoms on-air and Stumbling upon circadian rhythms
Photo by John Loo

Imaging, In the News, Microbiology, Stanford News

Stanford image takes big honors at 2015 Nikon Small World Photomicrography Competition

Stanford image takes big honors at 2015 Nikon Small World Photomicrography Competition


Small things seldom get big press, but once a year the microscopic world takes front and center stage at Nikon’s annual Small World Photomicrography Competition. This year, a Stanford Medicine team took second place in the competition, edging out more than 2,000 entries from 83 countries around the world.

Their award-winning photo is a cacophony of color that uses immunofluorescence to illuminate a mouse colon colonized with human microbiota.

Four Stanford researchers were responsible for this mosaic of microbes: photographer Kristen Earle, PhD; second-year graduate student Gabriel Billings; KC Huang, PhD, a bioengineer and microbiologist; and Justin Sonnenburg, PhD, a microbiologist and co-author of The Good Gut.

Earle told me she took this image while working on a study with Sonnenburg that explores how images, like this one, can help researchers count microbes and see how they’re organized in a cross-section of gut.

Previously: Why C. difficile-defanging mouse cure may work in people, tooDrugs for bugs: Industry seeks small molecules to target, tweak and tune up our gut microbes and Civilization and its dietary (dis)contents: Do modern diets starve our gut-microbial community?
Image courtesy of Kristen Earle, Gabriel Billings, KC Huang and Justin Sonnenburg

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