Published by
Stanford Medicine

Category

In the News

Health and Fitness, In the News, Sleep, Videos

“Father of Sleep Medicine” talks with CNN about what happens when we don’t sleep well

"Father of Sleep Medicine" talks with CNN about what happens when we don't sleep well

Dement - smallA good night’s sleep is often the first thing to go when we have an important work deadline or health issue. I know this from firsthand (and recent!) experience: I let a foot injury kept me up until 4 a.m. today even though I know that cheating sleep – or getting a poor night of sleep – is bad for my health.

But is skimping out on sleep now and again really that bad? As Chief Medical Correspondent Sanjay Gupta, MD, and Stanford sleep expert William Dement, MD, PhD, explain in a recent CNN feature: yes. When we rest, our bodies go to work, Gupta explains: “When your head hits the pillow, your body doesn’t shut down. It uses that time to heal tissue, strengthen memory, even grow.”

Dement, who founded the Stanford Center for Sleep Sciences and Medicine in the 1970s and has devoted his career to understanding sleep, has lots of experience with patients who miss out on these benefits because they don’t sleep well – due to obstructive sleep apnea. (The disorder, he says, affects 24 percent of adult males in the U.S.) In the piece, he and Gupta discuss the risk factors, such as excess weight and large tonsils, linked to sleep apnea and what can be done to alleviate the problem.

If you have a few minutes, this video is worth a watch. Dement makes his first appearance at the 2.5-minute mark.

Previously: Stanford doc gives teens a crash course on the dangers of sleep deprivationWilliam Dement: Stanford Medicine’s “Sandman”Stanford docs discuss all things sleep, Why untreated sleep apnea may cause more harm to your health than feeling fatigued and What are the consequences of sleep deprivation?
Photo, which originally appeared in Stanford Medicine, by Lenny Gonzalez

In the News, Neuroscience, Research, Sleep, Stanford News

Stanford researcher’s work, which clarifies role of brain activity during sleep, featured on NPR

Stanford researcher's work, which clarifies role of brain activity during sleep, featured on NPR

ParviziMuch to my delight, I heard the voice of Josef Parvizi, MD, PhD, on NPR yesterday afternoon. He was discussing the results of his latest study, which showed that the brain’s activity during sleep is far from random.

“There is something that’s going on in a very structured manner during rest and during sleep,” Parvizi told NPR. “And that will, of course, require energy consumption.”

A Shots blog entry accompanying the segment describes the findings:

The team saw activity in two widely separated brain areas known to be involved in episodic memories. And the activity was highly coordinated — suggesting the different brain regions were working together to answer the questions…

“What we found,” he says, “was that the same nerve cells that were activated to retrieve memories… have a very coordinated pattern of noise.”

This explains, in part, why the brain consumes 20 percent of the body’s energy, although it constitutes only 2 percent of its weight. There are more details on the study in our press release.

Previously: New findings on exactly why our “idle” brains burn so much fuel, The brain whisperer: Stanford neurologist talks about his work, shares tips with aspiring doctors and How epilepsy patients are teaching Stanford scientists more about the brain

Evolution, In the News, Research, Science

Chins make us human; new study examines why

Chins make us human; new study examines why

il-150226-ts-08When we think of what makes us human, it’s common to think of something like language or tool-making. Something that likely doesn’t pop into mind is the chin – but humans are the only species to have one! The bony prominence is missing from the skulls of Neanderthals, archaic humans, primates, and indeed all other animals. (In the photo, the skull on the left is human, and the one on the right is Neanderthal).

Scientists have puzzled for more than a century over why chins developed, and the dominant theory has been that they resulted from mechanical forces like chewing. Bones under pressure sustain tiny tears that then enable new bone to grow, much like weight lifting does to muscles. But a new study conducted by University of Iowa researchers suggests that mechanical forces have nothing to do with it: It’s more likely that chins resulted from shifting social dynamics.

The study, published in the Journal of Anatomy, capitalized on the fact that children don’t have chins either – the bone underneath their lower lip is smooth, and the prominence develops with age. The study examined nearly 40 people ranging from 3-20 years old, correlating their chin development with various forces exerted by their cranio-facial anatomy (during chewing, for example), and concluded that mechanical forces don’t play a role in chin development. In fact, those with the most mechanical force had the smallest chins.

Nathan Colton, PhD, professor of orthodontics at the UI College of Dentistry and lead author of the study, is quoted in a UI press release:

In short, we do not find any evidence that chins are tied to mechanical function and in some cases we find that chins are worse at resisting mechanical forces as we grow. Overall, this suggests that chins are unlikely related to the need to dissipate stresses and strains and that other explanations are more likely to be correct.

Instead, the researchers think that the chin results from the facial structure being rearranged as faces got smaller – human faces are 15 percent smaller than those of Neanderthals. This reduction resulted from a decrease in testosterone levels, which happened as males of the species benefitted more from interacting socially with other groups rather than fighting other males.

Robert Franciscus, PhD, professor of anthropology at UI and a contributing author on the study, also comments:

What we’re arguing is that modern humans had an advantage at some point to have a well-connected social network, they can exchange information, and mates, more readily, there’s innovation. And for that to happen, males have to tolerate each other. There had to be more curiosity and inquisitiveness than aggression, and the evidence of that lies in facial architecture.

Previously: Humans share history – and a fair amount of genetic material – with Neanderthals
Photo by Tim Schoon, University of Iowa

In the News, Mental Health, Research, Sleep

The importance of screening soldiers for sleep problems to combat mental-health conditions

The importance of screening soldiers for sleep problems to combat mental-health conditions

Watching over

A new report from the RAND Corporation suggests that treating military members’ sleep disturbances early on may be an important step in preventing serious mental-health conditions, including post-traumatic stress disorder, depression, and traumatic brain injury.

The two-year multi-method study examined sleep-related policies and programs across the U.S. Department of Defense and surveyed almost 2,000 veterans from various branches of the military to evaluate their sleep habits. The findings emphasized the negative effects of poor sleep on soldiers’ mental health, daytime impairment and perceived operational readiness; and it outlined interventions for helping identify and prevent sleep problems for service members.

The Huffington Post reports:

The researchers recommended that the military improve screening for sleep disturbance, and develop guidelines for doctors on how to identify and treat sleep disorders in the military. Apps on mobile phones might be one new way to identify and monitor sleep problems so they do not become chronic and debilitating, the researchers said.

Although the new report focused on activity-duty troops, studies show that sleep problems are often missed in veterans as well, [Wendy Troxel, PhD, co-author of the report] said, so there is also a need to develop guidelines for treating this population. In a previous survey of 3,000 veterans, 74 percent had symptoms of insomnia, but only 28 percent had talked with their doctor about it, Troxel said.

The researchers also recommended improving policies and programs to educate military personnel about the importance of sleep, and provide guidance on how to help military members get better sleep.

Previously: Study shows benefits of breathing meditation among veterans with PTSD, The promise of yoga-based treatments to help veterans with PTSD and Using mindfulness therapies to treat veterans’ PTSD
Photo by DVIDSHUB

In the News, Pediatrics, Sleep, Stanford News, Videos

Stanford doc gives teens a crash course on the dangers of sleep deprivation

Stanford doc gives teens a crash course on the dangers of sleep deprivation

Numerous studies, including a big one published in Pediatrics earlier this year, have shown that adolescents are getting less sleep than ever before. But most teens are unlikley unaware of the dangers of sleep deprivation – and that’s something that a group of Stanford clinicians is trying to change. Rafael Pelayo, MD, with the Stanford Center for Sleep Sciences and Medicine, and colleagues recently gave a “crash course” on sleep, and the importance of getting enough, to students at nearby Menlo-Atherton High School. ABC7 captured the story in the video above.

Previously: Talking about teens’ “great sleep recession”, With school bells ringing, parents should ensure their children are doing enough sleeping, Study shows poor sleep habits as a teenager can “stack the deck against you for obesity later in life”, What are the consequences of sleep deprivation? and Want teens to eat healthy? Make sure they get a good night’s sleep

In the News, Media, Science

Science enthusiasts flock to #IAmAScientistBecause and #BeyondMarieCurie on Twitter

Science enthusiasts flock to #IAmAScientistBecause and #BeyondMarieCurie on Twitter

iamascientistbecause tweet - smallRecently, a friend of mine commented that scientists “don’t use Twitter much.” The statement may have been true in the past, but as evidenced by #IAmAScientistBecause and #BeyondMarieCurie, scientists and science enthusiasts are now driving some trending topics on Twitter.

Yesterday, a story on Nature.com explained how these two popular hashtags have encouraged scientists to speak out. The first was created by the NatureCareers team in summer 2014, and the hashtag’s popularity suddenly increased earlier this week after Jon Tennant (@Protohedgehog), a graduate student studying paleontology at Imperial College London, shared the hashtag with his 6,000 some followers on Twitter. By Tuesday, the hashtag was trending on Twitter.

The resulting flood of tweets rallied scientists like epidemiologist Chelsea Polis, PhD, (@cbpolis) who told Nature.com she spent a day following the IAmAScientistBecause Twitter campaign online. “Despite all of the negatives, there’s so much that’s beautiful about science,” Polis said.

Meanwhile, a separate empowering conversation began when science editor Melissa Vaught (@biochembelle) tweeted about Rachel Swaby’s (@rachelswaby) Wired.com story on scientific achievements made by women. In her story, Swaby states that one woman tends to dominate conversations of female scientists and that we need to open our eyes to the many contributions other female scientists have made, and are making, to science:

Today if you ask someone to name a woman scientist, the first and only name they’ll offer is Marie Curie. It’s one of the biggest obstacles to better representation of women in science and technology, and it’s time to cut it out. Stop talking about Marie Curie; she wouldn’t have wanted things this way.

Vaught told Nature.com that she created #BeyondMarieCurie as a response to Swaby’s article because “we need diverse stories of women in science.”

As I scrolled through the hundreds of Tweets aggregated by the two hashtags one post in particular stood out. As shown above, chemist Carina Jensen, PhD, (@Chem_Monkey) tweeted, “IAmAScientistBecause a professor said women don’t do well in Chemistry. I proved him wrong.” For me, this unites the sentiments of the two hashtags beautifully.

Previously: The power of social media: How one man uses it to help amputees get prostheticsA day in the lab: Stanford scientists share their stories, what fuels their workChipping away at stereotypes about older women and science, one story at a timeWhat’s holding women in the sciences back? and Women in science: A rare breed

In the News, Medicine and Literature, NIH, Research, Science

The value of exploring jellyfish eyes: Scientist-penned book supports “curiosity-driven” research

The value of exploring jellyfish eyes: Scientist-penned book supports "curiosity-driven" research

3920357743_1f31572c1a_z

As an academic, I often encounter variations of the question “And so… what are you going to do with that?” In other words, why should anyone care about insights, experiments, and questions that serve no obvious functional purpose?

A PNAS release published earlier this week spotlights a novel that tackles just this issue. Joram Piatigorsky, PhD, a retired scientist from the NIH’s National Eye Institute who now devotes his time to his passion for art and literature, went through the arduous process of writing and publishing a novel because he sees literature as an important way to make statements about society. And the statement that he wants to get across loud and clear is that basic research matters, and needs to be funded.

The book, called Jellyfish Have Eyes, is set in the near future and follows a scientist who gets into serious legal and professional trouble because he departs from research that is clearly related to a human disease in favor of researching jellyfish, and in a mix-up uses government funding to do so. Piatigorsky laments how in today’s tight funding environment, students who would otherwise pursue basic questions – such as whether jellyfish have eyes – are forced to do more routine, translational research that doesn’t make use of their creativity.

And when creativity gets stymied, important breakthroughs are simply missed. The release quotes the book’s main character, who is modeled after Piatigorsky:

I justify my research on delving into the mysteries of Nature because generally the experiments yield new insights that benefit people. There’s penicillin, recombinant DNA, genetic engineering… Bacteria provided the first models for gene regulation, which set the stage for gene therapy. Sea slugs—snails without shells—revealed mysteries of memory. Birds have taught us that it’s possible to rest half the brain at a time. Think how useful it would be if we could be asleep and active at the same time.

Piatigorsky worries about the current research climate, where “anti-science politicians” force cuts to basic research and pundits and the public insist on knowing what “cure” a research project aims to find, says the release. But Piatigorsky is optimistic about the power of storytelling: “I have a very strong feeling that science is not a collection of facts. You have to make the facts into a story of communication… The narrative aspect of science is very compelling.”

And, in case you were wondering, jellyfish do have eyes – “magnificent eyes. It depends on the species. They have lenses, corneas, retinas,” says Piatigorsky in the release. No one knows what they can see or how vision might affect their behavior, but such impractical questions might lead to the next breakthrough. In the meantime, they promote curiosity and wonder about our world.

Previously: Research in medical school: the need to align incentives with value, Can science journals have beautiful prose? and Science is like an ongoing mystery novel, says Stanford neurobiologist Carla Shatz
Photo by Lassi Kurkijarvi

Global Health, In the News, Medical Education, Pregnancy, Women's Health

Project aims to improve maternal and newborn health in sub-Saharan Africa

Project aims to improve maternal and newborn health in sub-Saharan Africa

5567854013_6bd1e2b76b_zIn sub-Saharan Africa, maternal and neonatal outcomes are some of the worst in the world. What would happen to those numbers if 1,000 new obstetrician/gynecologists were trained with state-of-the-art educational materials in the region over the next ten years? The 1000+OBGYN Project, a collaborative training effort between American and African universities, aims to do just that.

The University of Michigan’s Open.Michigan initiative, in partnership with the UM Medical School’s Department of Obstetrics and Gynecology and Department of Learning Health Sciences, just released four new collections into the 1000+OBGYN Project’s open-access database, thanks to a grant from the World Bank.

A UM press release published today describes the new contributions, which cover a diverse range of subjects, including abnormal uterine bleeding, pregnancy complications, vaginal surgeries, pelvic masses, newborn care, postpartum care and family planning. The materials are all free, publicly available, and licensed for students, teachers and practitioners to modify according to their own curricular context.

Frank Anderson, MD, MPH, associate professor in the UM Department of Obstetrics and Gynecology and director of the 1000+OBYGN Project, comments in the release:

There is an urgent need to train Obgyns [sic] in sub-Saharan Africa, but their institutions don’t always have access to the same body of educational materials as doctors in developed countries have… Many newborn and maternal deaths are preventable. We want to ensure that future Obgyns in low resource countries have access to the same high-quality learning materials available here so they are equipped to provide the best care possible for mothers and babies.

The project hopes to overcome local barriers to good education, such as availability of training materials, licensing costs, and unreliable internet access. To make the materials available offline, the initiative partnered with the Global Library of Women’s Medicine, which compresses research onto USB flash drives and distributes them globally, particularly to women’s health professionals in Africa.

Previously: Countdown to Childx: Global health expert Gary Darmstadt on improving newborn survival, Gates Foundation makes bold moves toward open access publication of grantee research, Improving maternal mortality rate in Africa through good design and Using family planning counseling to reduce number of HIV-positive children in Africa
Photo by DFID – UK Department for International Development

Cancer, In the News, Patient Care, Research, Women's Health

Breast cancer survivors shown to benefit from quality-of-life interventions

Breast cancer survivors shown to benefit from quality-of-life interventions

6223587547_f7418ef489_zHow do you bounce back after breast cancer? As outlined in a recent Dartmouth press release, a quarter to a third of breast-cancer survivors have trouble re-adjusting to life and “peak performance” once their health is stabilized. But new research shows that rehabilitation interventions can have a significant positive effect for these women.

The release goes on to say:

Almost one-third of breast cancer survivors experience difficulty after treatment when trying to resume previous levels of work, leisure, physical, and social activities. This is particularly true of women in young to middle adulthood. For them, cancer diagnosis comes at a time of high demands for peak performance at work and home, and correspondingly less flexibility in time and schedule.

The Dartmouth group’s rehabilitation intervention was designed to help women find ways to accelerate recovery and engage in health-promoting activities. The study considered feasibility, acceptability to survivors, and efficacy in helping women to meet their goals.

Women were highly satisfied with the telephone-delivered intervention and primarily used the program to set weekly goals regarding exercise, work, better nutrition, taking care of themselves and their homes, managing stress, and social activities. The women met 71% of their weekly goals and showed improvements in quality of life, active coping, planning, and reframing.

Studies on the intervention, published in the Journal of Psychosocial Oncology and in Occupation, Participation, and Health, were led by Kathleen D. Lyons, ScD, professor of psychiatry at Dartmouth’s Geisel School of Medicine and affiliated with its Norris Cotton Cancer Center, which funded the research. In total 48 women were enrolled, and the results were clear enough to warrant further research into similar recovery interventions that don’t focus on pain-management.

“It was a complete pleasure and privilege to work with the study participants and give them a structure and some support while they found ways to create healthy and productive routines and lifestyles,” Lyons says in the release.

Previously: Breast cancer patients are getting more bilateral mastectomies – but not any survival benefit, Red Sunshine: One doctor’s journey to surviving stage 3 breast cancer, Wellness after cancer: Stanford opens clinic to address survivors’ needs and A call for rehab services for cancer survivors
Photo by DixieBelleCupcakeCafe

Emergency Medicine, Health Costs, In the News, Research, Stanford News

Thinking twice before doing blood transfusions improves outcomes, reduces costs

Thinking twice before doing blood transfusions improves outcomes, reduces costs

7413610060_317879301e_zStanford Hospital has figured out that doing fewer blood transfusions saves lives – and millions of dollars annually. In two studies headed by Stanford’s Lawrence Goodnough, MD, professor of pathology and hematology, doctors were gently nudged by a computer program to think twice before performing a blood transfusion. The impressive results were discussed in a Nature news feature published Tuesday:

The number of red-blood-cell transfusions dropped by 24% between 2009 and 2013, representing an annual savings of $1.6 million in purchasing costs alone. And as transfusion rates fell, so did mortality, average length of stay and the number patients who needed to be readmitted within 30 days of a transfusion. By simply asking doctors to think twice about transfusions, the hospital had not only reduced costs, but also improved patient outcomes.

Transfusions are common procedures in industrialized countries, but scientists are finding that they’re overused. More research needs to be done to determine when, exactly, transfusions cross the line between helpful and harmful. They do save lives, but probably only for the most critically ill patients.

Decades of established practice and protocol are hard to change, though. Clinicians acting in the moment refer to their experience, not to guidelines. That’s one reason Stanford’s simple computer innovation is so important. Goodnough, quoted in Nature, speculates about why it succeeded: Not only did alerts remind doctors about the guidelines and provide links to the relevant literature, they forced them to slow down and think instead of running with the default. The alerts may have provided an opening for more individualized discussion among caregivers:

‘Maybe the intern, who was ordering the blood because they were told to, goes back to the team and says, “I have to give a reason”, and then they discuss it,’ Goodnough says. The clinicians might decide to order the blood anyway, of course. Or they might stop, consider the evidence, and come to agree with what Goodnough believes is its clear message. ‘The safest blood transfusion,’ he says, ‘is the one not given.’

Check out the article for more on the history of blood transfusions, other research into their optimal use, and new practices being pioneered around the world.

Previously: Fewer transfusions means better patient outcomes, lower mortality, Stanford Hospital trims use of blood supplies, Stanford test a landmark in the blood banking industry and Should the US create a national blood transfusion reporting system?
Related: Against the flow: What’s behind the decline in blood transfusions?
Photo by Banc de Sang i Teixits

Stanford Medicine Resources: