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Events, Neuroscience, Stanford News

Open Office Hours: Stanford neurobiologist taking your questions on brain research

Open Office Hours: Stanford neurobiologist taking your questions on brain research

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Last year Stanford launched the new Stanford Neurosciences Institute, led by visionary neurobiologist William Newsome, PhD. Part of his job over the past year has been to inspire faculty to think beyond their own labs and to dream about what they could accomplish if they work together. He called this the Big Ideas in Neuroscience.

This week, Newsome will be taking questions about your Big Ideas (or Big Questions) in brain research as part of a Stanford Open Office Hours event on Facebook. Are you curious how we learn and remember? What technologies might allow us to peer into the brain and even manipulate its function? How a deeper understanding of the brain could influence public policy, education and the law? Go to the Facebook page for the event and submit your questions by tomorrow (Oct 1).

Previously: “Bold and game-changing” federal report calls for $4.5 billion in brain-research fundingDinners spark neuroscience conversation, collaborationBrain’s gain: Stanford neuroscientist discusses two major new initiatives and Co-leader of Obama’s BRAIN Initiative to direct Stanford’s interdisciplinary neuroscience institute
Photo from Stanford News Service

Events, Medicine and Literature, Stanford News

For group of Stanford doctors, writing helps them “make sense” of their experiences

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At a Stanford Pegasus Physician Writers Forum last week, psychiatrist Shaili Jain, MD, told the 40-or-so attendees that writing and practicing medicine are synergistic. Medicine and motherhood: not so much.

“As one of my mentors once said, it’s called ‘juggling the joy,’” Jain said. “People who don’t think it’s a challenge are either in denial – or someone else is doing all the hard work.”

Jain was one of five authors who shared their work. She read an essay, called “The Trimesters,” that she had written ten years earlier about her initial struggles coping with her duel roles as doctor and to-be mother. During her pregnancy, Jain suffered from intense all-day sickness. “Panic set in; was this what life was going to be from now on? I feared I had entered a no-man’s land of perpetual dissatisfaction,” Jain wrote. She had to tell her patients, some who suffered from severe mental disorders, she would be off work — a situation that left her uncomfortable with the blurring of roles. Pregnancy was personal, yet it impinged on her professional life.

Yet patients have no choice but to share their inner secrets, fears, goals, what medical school alum Ward Trueblood, MD, called their “heart songs” in the poem, “Cancer Doctor.”

It started when he slowed
to ask about a grandson’s picture
or fetched a cup of ice
for the bed-bound, listened to
talk of a fishing hole, heard about a dog
that licked a woman’s morning eyes…

They were sharing heart
songs rarely whispered.
He grew softer, invited
in this open window
of each one’s brave longing.

Medicine is a privilege, Trueblood went on to say. “As a cancer doctor, one shares soul with their patients… so here I am, 76, and I’m still going into the hospital,” he said.

And for Jain, writing is an essential part of her job as a physician. “I have a compulsion to make sense of what I’m experiencing,” she said.

The Pegasus Physicians Writers group meets regularly.

Becky Bach is a former park ranger who now spends her time writing about science or practicing yoga. She is an intern at the Office of Communications and Public Affairs. 

Previously: On death and dying: A discussion of “giving news that no family members want to hearWhen death comes rapping at the chamber door: Writers inspired by crises and medical emergencies and “How cancer becomes us”: A conversation with author and anthropologist Lochlann Jain
Photo by annazuc

Applied Biotechnology, Bioengineering, Events, Medical Education, Stanford News, Technology

Stanford physicians and engineers showcase innovative health-care solutions

Stanford physicians and engineers showcase innovative health-care solutions

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A “breathalyzer” that noninvasively determines if patients have unsafe levels of ammonia in their blood. The discovery of a previously approved drug that also fights the Dengue virus. A smartphone-based eye-imaging system that can be used to diagnose vision problems remotely.

These are a few of the 40-plus inventions and clinical solutions presented at the first annual Spectrum Innovation Research Symposium, held last Friday at the Stanford School of Medicine. The event demonstrated the power of bringing together teams of physicians, bioinformaticists and engineers to apply new technologies and ideas to challenging medical problems. Also showcased were budding physician-scientists supported by the Spectrum KL2 and TL1 clinical research training awards. (In the photo above, Colleen Craig, MD, an endocrinology fellow, describes a novel treatment that she’s developing for gastric-bypass patients who suffer from severely low blood sugar.)

The buzz is that it’s going to be a good year for health-care breakthroughs

Spectrum, the recipient of Stanford’s NIH Clinical and Translational Science Award, annually gives up to $50,000 to investigator teams for year-long projects in the areas of drug discovery, medical technologies, predictives/diagnostics, population health sciences and community engagement. This program also provides these teams with training and mentoring to help them move their ideas rapidly from bench to bedside and into the community.

“These modest pilot awards have been immensely successful in stimulating innovative ideas across the spectrum of translational research,” said Spectrum’s director, Harry Greenberg, MD. “They have lead to new inventions that promote individual’s health, new ways of improving the health of the populations and new efforts to assist our surrounding community on health issues.”

As this year’s grantees were rolling up their poster presentations, next year’s scholars were rolling up their sleeves to finish their 2014-15 Spectrum grant proposals, which are due in a few days.

It’s been a pivotal year in medical technology, with the launch of an unprecedented number of game-changing inventions, such as the Mini-ION, a $900 USB-powered DNA sequencer, and Apple HealthKit, a health-and-fitness dashboard and developer kit. In the coming year, these will provide Stanford scholars with amazing technology platforms from which to launch medical solutions that are better, faster and cheaper.

“We are in the middle of amazing biomedical innovation here in Silicon Valley,” said Atul Butte, MD, PhD, and faculty director of the diagnostics/predictives program. “Spectrum enables us to fund the earliest of early technologies, more risky than even the usual angel investments, but with higher potential impacts. In the end, this gets technologies to patients and families that much sooner.”

Because of this, anticipation among the grant-approval committee members at the symposium was high — the buzz is that it’s going to be a good year for health-care breakthroughs.

Previously: Spectrum awards innovation grants to 23 projects, Stanford awarded more than $45 million to spur translational research in medicine, As part of annual tradition, budding physician-scientists display their work, and New class of physician-scientists showcase research
Photo by Kris Newby

Big data, In the News, Patient Care, Pediatrics, Stanford News

Examining the potential of big data to transform health care

Examining the potential of big data to transform health care

Back in 2011, rheumatologist Jennifer Frankovich, MD, and colleagues at Lucile Packard Children’s Hospital Stanford used aggregate patient data from electronic medical records in making a difficult and quick decision in the care of a 13-year-old girl with a rare disease.

Today on San Francisco’s KQED, Frankovich discusses the unusual case and the potential of big data to transform the practice of medicine. Stanford systems-medicine chief Atul Butte, MD, PhD, also weighed in on the topic in the segment by saying, “The idea here is [that] the scientific method itself is growing obsolete.” More from the piece:

Big data is more than medical records and environmental data, Butte says. It could (or already does) include the results of every clinical trial that’s ever been done, every lab test, Google search, tweet. The data from your fitBit.

Eventually, the challenge won’t be finding the data, it’ll be figuring out how to organize it all. “I think the computational side of this is, let’s try to connect everything to everything,” Butte says.

Frankovich agrees with Butte, noting that developing systems to accurately interpret genetic, medical or other health metrics is key if such practices are going to become the standard model of care.

Previously: How efforts to mine electronic health records influence clinical care, NIH Director: “Big Data should inspire us”, Chief technology officer of the United States to speak at Big Data in Biomedicine conference and A new view of patient data: Using electronic medical records to guide treatment

CDC, Events, Global Health, Stanford News, Videos

Video of Stanford Ebola panel now available

Video of Stanford Ebola panel now available

Last week, a group of Stanford and CDC experts came together to address the health, governance, security and ethical dimensions of Ebola, the virus that is spreading rapidly in West Africa. Video of the lengthy and timely talk, courtesy of the Freeman Spogli Institute, is now available.

Previously: Ebola panel says 1.4 million cases possible, building trust key to containmentInterdisciplinary campus panel to examine Ebola outbreak from all angles, Expert panel discusses challenges of controlling Ebola in West Africa, Should we worry? Stanford’s global health chief weighs in on Ebola and Biosecurity experts discuss Ebola and related public health concerns and policy implications

Imaging, Research, Science, Stanford News

Stanford researcher details structure of sugar transporter called SWEET

Stanford researcher details structure of sugar transporter called SWEET

SemiSWEETSugar fuels life. But to power our cells, sugar molecules have to slip in and out of cells. And in humans, the sugar sometimes needs to travel deep into tissues such as the intestines or the brain, far removed from the bloodstream.

Thanks to technological advances, scientists are still making new discoveries about these basic processes. And now, a team led by Stanford molecular biologist Liang Feng, PhD, and Carnegie Institution/Stanford biologist Wolf Frommer, PhD,  has unraveled the molecular structure and function of a type of protein that straddles cell membranes, allowing sugar to pass.

The name of the compound — oh, those scientists and their senses of humor — is SWEET, which stands for “Sugars Will Eventually be Exported Transporters.” SWEETs are found in all sorts of creatures, including humans, and plants; bacteria have semiSWEETs that are about half the size of a SWEET.

To determine the structure of these super-small proteins, Feng and his team used powerful X-ray equipment at the Argonne National Laboratory in Illinois and the Stanford Synchrotron Radiation Lightsource on campus. “Before our study, we had no idea what the protein looked like and how it could function,” Feng told me.

As described in a paper published earlier this month in Nature, Feng and his colleagues learned that SWEET actively changes shape to swallow sugar, unlike a fixed channel such as a train tunnel. SWEET swings open jaws like a crocodile, clamps them shut, then shoots the sugar into the cell interior.

SWEETs, and the two other types of sugar transporters found in humans, could play a prominent role in a variety of human diseases, including diabetes, although most research now has been done in plants. The project produced what Feng calls “snapshots” of SWEET transporting sugar. Next, he plans to develop a moving “video” of the protein.

“We need to understand the blueprint of this machinery,” Feng said. “What we learn could be used to improve crop yield or to design drugs that can help with sugar-related diseases such as diabetes.”

Becky Bach is a former park ranger who now spends her time writing about science or on her yoga mat. She is a science-writing intern in the Office of Communications and Public Affairs. 

Previously: Civilization and its dietary (dis)contents: Do modern diets starve our gut-microbial community?, Joyride: Brief post-antibiotic sugar spike gives pathogens a lift, Short and sweet: Three days in a sugar solution, and you’ve got your see-through tissue sample 
Image courtesy of Liang Feng

Stanford News, Surgery, Videos

The importance of human connection as part of the patient experience

The importance of human connection as part of the patient experience

When I first heard Tim Engberg describe the feeling of intense loneliness and separation from humanity he felt as he was being wheeled on a gurney into surgery, I immediately pictured myself in a hospital bed staring at the ceiling, desperate for the touch of a familiar hand, afraid.  When you’re well, you forget so quickly how lonely and scary it is to be sick, and in Engberg’s case, with enormous pain in his neck, an infection threatening to render him paralyzed, and the enormity of the looming surgery, the sense of aloneness was overwhelming.

Engberg just so happens to be the vice president of Stanford Health Care’s Ambulatory Care. Most of his days he spends as an executive of a hospital, thinking about how to ensure that patients are being taken care of in the best possible way. Like many of us, it took being a patient himself to fully understand what a difference our nurses and doctors make and how they can pull someone back from the brink of despair to full recovery, or as Engberg puts it, “back into the human race.”

Engerb’s story is captured in the video above.

Evolution, In the News, Research, Stanford News

Blond ambition: Delving into the work of Stanford biologist David Kingsley

Blond ambition: Delving into the work of Stanford biologist David Kingsley

Thanks to a tiny fish called the stickleback, Stanford developmental biologist David Kingsley, PhD, and his team uncovered the genetic basis for blond hair earlier this year.

Kingsley’s research caught the eye of the team at HHMI Bulletin, which featured his discovery in their fall issue. As described in the piece, Kingsley and fellow researcher Catherine Guenther, PhD, discovered the change in a single point in the genetic sequence outside the gene itself. The discovery prompted a question because the gene, known as KITLG, is involved in many other key processes in developing organisms. Yet Kingsley found the control for hair color acted alone.

“The genetic mechanism that controls blond hair doesn’t alter the biology of any other part of the body. It’s a trait that’s skin deep, and only skin deep,” Kingsley told HHMI.

The HHMI feature also includes a video of Kingsley – above – that provides glimpses into his lab and reveals the sources of his inspiration (as well as his penchant for purchasing telescopes).

And for a Friday giggle, check out his lab members spelling his name with their bodies here.

Becky Bach is a science-writing intern at the Office of Communications and Public Affairs. 

Previously: It’s a blond thing: Stanford researchers suss out molecular basis of hair color, Something fishy: Threespine stickleback genome published by Stanford researchers and Hey guys, sometimes less is really more

Cardiovascular Medicine, Genetics, Research, Science, Stanford News, Stem Cells

Stem cell study explains how mutation common in Asians affects heart health

Stem cell study explains how mutation common in Asians affects heart health

10011881004_d5ab6d7cd9_zMany Asians carry a mutation that causes their faces to flush when they drink alcohol. The affected gene is called ALDH2, and it also plays a role in cardiovascular health. Carriers are more susceptible to coronary artery disease and tend to recover more poorly than non-carriers from the damage caused by a heart attack. Now Stanford cardiologist Joseph Wu, MD, PhD, and postdoctoral scholar Antje Ebert, PhD, have learned why.

The researchers used a type of stem cell called an induced pluripotent stem cell, or iPS cell, to conduct the study. The stem cells are made from easily obtained tissue like skin, and they can be coaxed in the laboratory to become other types of tissue, like heart muscle cells. It’s one of the first times iPS cells have been used to examine ethnic-specific differences among populations. The research was published yesterday in Science Translational Medicine.

From our release:

The study showed that the ALDH2 mutation affects heart health by controlling the survival decisions cells make during times of stress. It is the first time ALDH2, which is involved in many common metabolic processes in cells of all types, has been shown to play a role in cell survival. In particular, ALDH2 activity, or the lack of it, influences whether a cell enters a state of programmed cell death called apoptosis in response to stressful growing conditions. [...]

The use of heart muscle cells derived from iPS cells has opened important doors for scientists because tissue samples can be easily obtained and maintained in the laboratory for study. Until recently, researchers had to confine their studies to genetically engineered mice or to human heart cells obtained through a heart biopsy, an invasive procedure that yields cells which are difficult to keep alive long term in the laboratory.

You’ve likely read about Wu’s previous work with heart muscle cells derived from iPS cells. Now he’s shown iPS cells are also a good way to compare the effect of genetic differences among populations, and he has big plans. More details about his plans from our release:

Wu is working to start a biobank at the Stanford Cardiovascular Institute of iPS cells from about 1,000 people of many different ethnic backgrounds and health histories. “This is one of my main priorities,” he said. “For example, in California, we boast one of the most diverse populations on Earth. We’d like to include male and female patients of major representative ethnicities, age ranges and cardiovascular histories. This will allow us to conduct ‘clinical trials in a dish’ on these cells, a very powerful new approach, to learn which therapies work best for each group. This would help physicians to understand for the first time disease process at a population level through observing these cells as surrogates.”

Previously: Induced pluripotent stem cell mysteries explored by Stanford researchers, A new era for stem cells in cardiac medicine? A simple, effective way to generate patient-specific heart muscle cells and “Clinical trial in a dish” may make common medicines safer, say Stanford scientists

Photo by Nicholas Raymond

Behavioral Science, Parenting, Pediatrics, Research, Stanford News

Families can help their teens recover from anorexia, new study shows

Families can help their teens recover from anorexia, new study shows

anorexia-appleA large new study comparing two treatments for anorexia nervosa offers a hopeful message to parents of teens affected by the eating disorder: Families can work with therapists to help their children recover.

The study, which appears today in JAMA Psychiatry and was led by Stanford’s Stewart Agras, MD, was the first large randomized clinical trial to compare two forms of family-based treatment for anorexia. The study included 167 anorexia patients, aged 12 to 18, at six medical centers in the United States and Canada.

In both treatments tested, a trained therapist met regularly with the patient and at least one other member of his or her family. One type of therapy focused on teaching parents how to get their child eating again at home, a method that Agras and Stanford eating disorder expert James Lock, MD, PhD, have researched extensively in the past. The other approach was broader, with the therapist and the family exploring problems in family dynamics and how to solve them. Patients and families in both treatment groups received 16 one-hour therapy sessions over a nine-month period, and patients’ recovery was assessed at the end of the therapy and again one year later.

Both therapies were equally effective in the long run, but the approach that focused on feeding was faster, and patients in that group were hospitalized fewer days during their treatment, which also made this method less expensive. The findings add to a growing list of scientific studies that are changing how physicians think about the families of patients with eating disorders, as our press release explains:

“For a long time, people blamed families for causing anorexia and thought they should be left out of treatment,” said Lock. “But this study suggests that, however you involve them, families can be useful, and that more focused family treatment works faster and more cost-effectively for most patients.” Lock directs the Comprehensive Eating Disorders Program at Lucile Packard Children’s Hospital Stanford.

The need for good treatments for anorexia in teens is bolstered by prior research demonstrating that the disease becomes more difficult to treat in adulthood, as Agras noted:

“The longer anorexia goes on, the more difficult it is to treat,” he said. “A great many people live chronically restricted lives because of this disease — they plan their days around undereating and overexercise — and quite a few die. The idea is to treat the disorder in adolescence to prevent more adults from becoming anorexic.”

Lock is the c0-author of the book Help Your Teenager Beat an Eating Disorder, which is designed to help parents conduct the feeding-based treatment examined in this study. Lock and Agras have both contributed to textbooks and manuals on eating disorder treatment for health care professionals.

Previously: Stanford study investigates how to prevent moms from passing on eating disorders, A growing consensus for revamping anorexia nervosa treatment and Possible predictors of longer-term recovery from eating disorders
Photo by Santiago Alvarez

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