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Aging, Stanford News, Technology

Stanford Center of Longevity announces dementia-care design challenge winners

Stanford Center of Longevity announces dementia-care design challenge winners

Winners have been announced for Stanford Center on Longevity‘s first Design Challenge, which launched last fall. As previously written about on Scope, 52 teams representing 31 universities in 15 countries submitted entries, all of them centered on improving the daily lives for people with dementia as well as their families and caregivers.

Stanford News reports:

There were seven finalists, including one student team from Stanford.

Sha Yao from the Academy of Art University in San Francisco won the $10,000 first place prize for her project, “Eatwell,” which involved the design of tableware specifically for people with Alzheimer’s.

For example, blue was chosen as the color of the insides of bowls because dementia sufferers can become confused when food and bowl have similar colors, according to Smith. As spills are common when bowls are tipped to get the final bits out, Yao designed a slanted bottom that eliminates the need to tip. The cups have low centers of gravity and are difficult to knock over.

The piece describes runner-up prize winners and the center’s new design contest, themed “enabling personal mobility across the life span.”

Previously: Finalists announced for Stanford Center on Longevity’s Design Challenge and Soliciting young minds to help older adults

Cancer, Genetics, Research, Stanford News, Technology

Gene panel screens for dozens of cancer-associated mutations, say Stanford researchers

Gene panel screens for dozens of cancer-associated mutations, say Stanford researchers

Stanford scientists have shown that it’s possible to simultaneously screen for dozens of cancer-associated mutations from a single blood sample using a multiple-gene panel. The research is published today in the Journal of Clinical Oncology (subscription required).

As I describe in my release:

Gene panels allow researchers to learn the sequences of several genes simultaneously from a single blood sample. It stands to reason that screening for mutations in just a few select genes is quicker, easier and cheaper than whole-genome sequencing. The technique usually focuses on fewer than 100 of the approximately 21,000 human genes. But until now, few studies have investigated whether homing in on a pre-determined panel of suspects can actually help people.

The researchers, medical oncologists and geneticists James Ford, MD and Allison Kurian, MD, used a customized 42-gene panel to investigate the presence of cancer-associated mutations in 198 women with a family or personal history of breast or other cancers. The women had been referred to Stanford’s Clinical Cancer Genetics Program between 2002 and 2012 to undergo screening for mutations in their BRCA1 or BRCA2 genes. They found that the panel was  a useful way to quickly screen and identify other cancer-associated mutations in women who did not have a BRCA1/2 mutation. From our release:

Of the 198 women, 57 carried BRCA1/2 mutations. Ford and Kurian found that 14 of the 141 women without a BRCA1/2 mutation had clinically actionable mutations in one of the 42 genes assessed by the panel. (An actionable mutation is a genetic variation correlated strongly enough to an increase in risk that clinicians would recommend a change in routine care — such as increased screening — for carriers.)

Eleven of the 14 women were reachable by telephone, and 10 accepted a follow-up appointment with a genetic counselor and an oncologist to discuss the new findings. The family members of one woman, who had died since giving her blood sample, also accepted counseling. Six participants were advised to schedule annual breast MRIs, and six were advised to have regular screens for gastrointestinal cancers; many patients received more than one new recommendation.

One woman, with a history of both breast and endometrial cancer, learned she had a mutation that causes Lynch syndrome, a condition that increases the risk of many types of cancers. As a result, she had her ovaries removed and underwent a colonoscopy, which identified an early precancerous polyp for removal.

The study shows that gene panels can be a useful tool that can change clinical recommendations for individual patients. It also indicates that patients are willing and eager to receive such information. As Ford explains in the release:

Gene panels offer a middle ground between sequencing just a single gene like BRCA1 that we are certain is involved in disease risk, and sequencing every gene in the genome. It’s a focused approach that should allow us to capture the most relevant information.

Previously: Whole genome sequencing: the known knowns and the unknown unknowns,  Assessing the challenges and opportunities when bringing whole-genome sequencing to the bedside and Blood will tell: In Stanford study tiny bits of circulating tumor DNA betray hidden cancers.

Global Health, Infectious Disease, Technology

Health workers use crowdsourced maps to respond to Ebola outbreak in Guinea

Médecins Sans Frontières and other international aid organizations are furiously working to contain an outbreak of Ebola in Guinea and nearby African countries. Latest reports estimate that the virus has infected 157 people and killed 101 in Guinea alone.

A New Scientist story published today explains how health workers from Médecins Sans Frontières were initially at a disadvantage when they arrived in Guinea to combat the deadly virus because they only had topographic charts to use in pinpointing the source of the disease. Desperately in need of maps that would be useful in understanding population distribution, the organization turned to Humanitarian OpenStreetMap Team, which coordinated a crowdsourcing effort to produce the first digital map of Guéckédou, a city of around 250,000 people in southern Guinea. Hal Hodson writes:

As of 31 March, online maps of Guéckédou were virtually non-existent, says Sylvie de Laborderie of cartONG, a mapping NGO that is working with MSF to coordinate the effort with HOT. “The map showed two roads maybe – nothing, nothing.”

Within 12 hours of contacting the online group, Guéckédou’s digital maps had exploded into life. Nearly 200 volunteers from around the world added 100,000 buildings based on satellite imagery of the area, including other nearby population centres. “It was amazing, incredible. I have no words to describe it. In less than 20 hours they mapped three cities,” says de Laborderie.

Mathieu Soupart, who leads technical support for MSF operations, says his organisation started using the maps right away to pinpoint where infected people were coming from and work out how the virus, which had killed 95 people in Guinea when New Scientist went to press, is spreading. “Having very detailed maps with most of the buildings is very important, especially when working door to door, house by house,” he says. The maps also let MSF chase down rumours of infection in surrounding hamlets, allowing them to find their way through unfamiliar terrain.

Previously: Using crowdsourcing to diagnose malaria and On crowdsourced relief efforts in Haiti

Genetics, In the News, Research, Science, Stanford News, Technology

Policing the editor: Stanford scientists devise way to monitor CRISPR effectiveness

Policing the editor: Stanford scientists devise way to monitor CRISPR effectiveness

edited paperAs a writer, I think a lot about editing. Will this sentence work here? Maybe I should change this word. Argh – a typo! But I’m not alone. Biologists also appreciate the power of editing, particularly when it comes to modifying genes in cells or organisms.

Recently a powerful new technology has emerged (called CRISPR) that allows researchers to make small, precise and permanent changes in the DNA of animal and human cells. It builds on the concept of genome editing that is key to generating cells, cell lines or even whole animals such as laboratory mice, containing specific genetic changes for study. With CRISPR, however, researchers can generate in days or weeks experimental models that usually take months or years. As a result, they can quickly assess the effect of a particular gene by deleting it entirely, or experiment with repeated, tiny changes to its DNA sequence.

According to a recent New York Times article, scientists roundly agree that CRISPR is revolutionary. At least three companies have been launched in the mere 18 months since the first results were reported by researchers at the University of California, Berkeley and Umea University in Sweden, and more than 100 research papers based on the technique have been published. But, although it’s highly specific, it’s (sadly) not perfect. According to the New York Times piece:

Quick is not always accurate, however. While Crispr is generally precise, it can have off-target effects, cutting DNA at places where the sequence is similar but not identical to that of the guide RNA.

Obviously it’s important to know when (and how frequently) this happens. Unfortunately, that’s been difficult to assess.

Enter researchers in the laboratory of pediatric cancer biologist Matthew Porteus, MD, PhD. Porteus’s lab is interested in (among other things) learning how to a particular type of genome editing called homologous recombination to treat diseases like sickle cell anemia, thalassemia, hemophilia and HIV. They’ve devised a way to monitor the efficiency of genome editing by CRISPR (as well as other more-traditional genome editing technologies) that could be widely helpful to researchers worldwide. Their technique was published today in Cell Reports. As postdoctoral researcher Ayal Hendel, PhD, told me:

We have developed a novel method for quantifying individual genome editing outcomes at any site of interest using single-molecule real-time (also known as SMRT) DNA sequencing. This approach works regardless of the editing technique used, and in any type of cell from any species.

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Events, Medical Education, Medical Schools, Stanford News, Technology

Using technology and more to reimagine medical education

Using technology and more to reimagine medical education

Over on The Health Care Blog, Michael Painter, MD, JD, shares his thoughts from a recent meeting at Stanford’s medical school inviting medical education leaders to debate big questions in their field. Painter, a senior program officer at the Robert Wood Johnson Foundation, explained that meeting participants discussed ways that educators can use technology and other tools “to help create a durable culture of health for all.”

From the post:

In 2013 we extended a $312,000 grant to Stanford Medical School that will support work by five medical schools, Stanford, Duke, University of Washington, UCSF and University of Michigan, as they create a consensus knowledge map of the critical things medical students should learn.

Why a knowledge map? The simple answer: because there isn’t one, and we need one if we’re going to build massive core online medical education content.

Why change now? There’s building pressure on fortress academia: pressure to push health care toward high value, pressure for health care to center itself on the patient rather than the professional, and pressure from technology, specifically the ability to move previously closely held knowledge of the expert more efficiently to the learner.

Here’s where this mapping effort also starts to get interesting. It wouldn’t be that surprising if these education leaders ticked through all the reasons why change is too hard—why it can’t or won’t happen. Instead something marvelous is happening: they’re challenging each other to examine the time they spend with their students—asking if they ignite the kind of passion in their learners that others ignited in them.

An even more hopeful sign—these leaders want to connect the teaching of new healers—from the beginning—with the key partner: the patient. Their early reimagining is fixed on patient and story.

Previously: A closer look at using the “flipped classroom” model at the School of MedicineCombining online learning and the Socratic method to reinvent medical school courses, Using the “flipped classroom” model to re-imagine medical education and Stanford professors propose re-imagining medical education with “lecture-less” classes

Events, Genetics, Stanford News, Technology

Euan Ashley discusses harnessing big data to drive innovation for a healthier world

Euan Ashley discusses harnessing big data to drive innovation for a healthier world

Euan_AshleyElectronic patient records, clinical trials, DNA sequencing, and medical imaging and disease registries are a sampling of the sources contributing to the exponential growth of public databases housing biomedical information. Researchers hope mining this vast reservoir of data will accelerate the process of understanding disease while driving down the costs of developing new therapies.

But the challenge of harnessing big data to transform scientific research and improve human health is one that is so complex that it can’t be solved alone by a single person, institution or company; collaboration among government, academia and industry is imperative. To foster such partnerships, Stanford and Oxford University are sponsoring the Big Data in Biomedicine conference from May 21-23.

The conference is part of a big data initiative launched by Stanford and Oxford to solve large-number problems at a global scale to improve health worldwide. Euan Ashley, MD, who directs the effort at Stanford, has been involved in several major projects over the past few years to link an individual’s genome sequence to possible increases in disease risk. In the following Q&A, he shares insights about the upcoming conference program, provides an update on the initiative, and discusses how big data can drive innovation for a healthier world.

A collaborative effort between Oxford and Stanford aims to accelerate discovery from large-number data sets to provide new insight into disease and to apply targeted therapies on an unprecedented scale. In what ways are the universities currently working together to achieve this goal?

The Global Institute for Human Health Initiative is a very exciting new venture between these two universities. Catalyzed by the Li Ka Shing Foundation, the initiative draws on the complementary strengths of each institution. Stanford excels in innovation, technology and data management and analysis. Oxford has global reach through its School of Public Health. So it makes sense to work together.

One of our primary goals will be to build “bridges” between the largest databanks of health information in the world. These individual large-scale efforts are remarkable in their own way, but each one has by definition to focus primarily on its own data. This means that limited bandwidth is available to develop mechanisms of secure sharing and analysis. That bandwidth and expertise are things we hope to provide through the initiative. The seed grants awarded through our program in Data Science for Human Health are another way we have started to collaborate. Each one has an Oxford-Stanford collaboration at its heart.

Tell us more about those seed grants. How many have you awarded, and for what kinds of projects?

We received 60 applications and were able to award 12 grants totaling $807,171.48. Among the projects receiving funding were new methods for analyzing accelerometer data in smartphones, approaches to imaging data, and ideas for large scale data analysis, point of care testing for infectious disease and mobile application development. It was an amazing group of applications and I wish we could have funded more projects. At the conference, there will be a brief satellite meeting for the recipients to interact.

Let’s talk more about the upcoming conference. What else can attendees expect from it?

We have an exciting program with a number of high-profile speakers. I’m particularly pleased this year with the broad representation of presenters across sectors. There will be speakers across government, industry and academia, including representatives from the National Institutes of Health, Google, Intel, Mount Sinai and Duke.

We’ve also expanded our international reach, and one of the keynote speeches will be delivered by Ewan Birney, director of the European Bioinformatics Institute. Additionally, this year’s program includes two new topic areas: computing and architecture, which will be chaired by Hector Garcia Molina, PhD, and infectious disease genomics, a particular strength at Oxford. Another addition is the Big Data Corporate Showcase, where companies ranging from industry giants to start-ups will share their achievements and innovations related to big data. So, lots to look forward to!

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Health and Fitness, Mental Health, Technology

A bike helmet that doubles as a stress-o-meter

A bike helmet that doubles as a stress-o-meter

bike_riderMany of those who ride their bike to work do so because of the health, financial and psychological benefits. While it’s clear that commuting on two wheels can help you stay fit and save money, a new high-tech helmet that measures brain activity shows bicycling may not be as stress-free as you believe.

The helmet, developed by the MIT MediaLab, is equipped with an LED display that lights up  green when you are calm, yellow when you are slightly irritated, and red when you are sleepy or anxious. If your stress level turns to panic, the lights flash red. The display is powered by built-in sensors and an electrode that translates electroencephalogram (EEG) feedback.

Dubbed MindRider, the latest version of the helmet maps your stress level to your route. Fast Company reports:

The first prototypes of the helmet just had colored lights, but the GPS adds new potential. “Now that it is a connected device, we definitely see its power in yielding insights over time,” [Arlene Ducao, a master's candidate at MIT's MediaLab] explains. “Urban and transportation planners can look at the data of many people and use that for transportation planning–things like bike lanes or bike-share programs.”

As a large group of people start to use the device, it can also be used for navigation. “You can access the data of others to help navigate you in a way that’s potentially less stressful, potentially more relaxing and more safe,” she says.

Previously: Now that’s using your head: Bike-helmet monitor alerts emergency contacts after a crash, University leaders raise awareness about the importance of bike helmets and Modest increases in bike ridership could yield major economic, health benefits
Photo by Roland Tanglao

Imaging, Ophthalmology, Research, Stanford News, Technology

Instagram for eyes: Stanford ophthalmologists develop low-cost device to ease image sharing

Instagram for eyes: Stanford ophthalmologists develop low-cost device to ease image sharing

eye-phoneThis probably won’t grab as many headlines as the news of a smartphone that wakes you up with the sizzle and smell of bacon, but it should!

A team of Stanford scientists is using 3D printing to create inexpensive adapters that make it easy to use a smartphone and an ordinary examination lens to capture high-quality images of the front and back of the eye. And – what seems to me as just as important – providing a nearly effortless way to share those images.

“Think Instagram for the eyes,” said one of the developers, assistant professor of ophthalmology Robert Chang, MD.

This is a big deal because most primary-care doctors have no good way to see into patients’ eyes, and no easy way to share the images. The usual eye-imaging instruments are expensive and hard to use, and even ophthalmologists who have the equipment and know-how find capturing and sharing the images slow going.

As one of Chang’s fellow developers, Stanford ophthalmology resident Dave Myung, MD, PhD, told me when I interviewed him for an article in Inside Stanford Medicine:

“A picture is truly worth a thousand words… Imagine a car accident victim arriving in the emergency department with an eye injury resulting in a hyphema – blood inside the front of her eye. Normally the physician would have to describe this finding in her electronic record with words alone. Smartphones today not only have the camera resolution to supplement those words with a high-resolution photo, but also the data-transfer capability to upload that photo securely to the medical record in a matter of seconds.”

The scientists describe the adapters, currently dubbed the EyeGo, in two articles in the new issue (volume 3, issue 1) of Journal of Mobile Technology in Medicine. And you can read my story to learn more about the development process, including how Myung pieced together the first prototype (with plastic bits he ordered from the Internet and a few Legos), how mechanical engineering graduate student Alex Jais created the first printed model on his own 3D printer, and how residents Lisa He, MD, and Brian Toy, MD, are leading studies to test them out.

Those interested in using an EyeGo adapter for research or beta-testing can e-mail the team at eyegotech@gmail.com.

Previously: Image of the Week: Sigmoid volvulus and Treating common forms of blindness using tissue generated with ink-jet printing technology
Photograph by Dave Myung

In the News, Sleep, Technology

Exploring the benefit of sleep apps

Exploring the benefit of sleep apps

man sleeping in bedCan sleep-related apps be of benefit to the bleary-eyed masses? That’s the question explored today by the New York Times’ Molly Young, who sought the advice of one of our sleep experts for her story:

Browse the iTunes store or Google Play and you’ll find them by the dozen: offerings with names like SleepBot and eSleep, represented by icons of placid sheep or glowing moons. The offerings fall into two basic categories. One tracks sleep patterns through the smartphone’s accelerometer (the doodad that recognizes when your phone is upside-down), giving users a blueprint of their time in bed. The second promises to lull users to sleep with music, hypnosis or guided meditation.

If you’re the data-driven type, a sleep-tracking app surely appeals. By placing the phone next to you in bed and tapping a button, you record your movements and a sleep chart is created. But according to Dr. Clete Kushida, the medical director of the Stanford Sleep Medicine Center, these apps are hardly precise.

“Without EEG — brain wave activity — it’s very hard to tell different stages of sleep apart,” Dr. Kushida said. “People can stay still and the device will think the person’s asleep.” Still, “the advantage of these devices is that they can help individuals become more aware of a potential sleep problem,” Dr. Kushida said.

Previously: Why physicians should consider patients’ privacy before recommending health, fitness apps, A look at the “Wild West” of medical apps, Designing the next generation of sleep devices, Exploring the effect of sleep loss on health, Turning to an app to help your health and Stanford sleep expert offers evaluation of science behind one sleep device
Photo by dearoot

Events, Medical Education, Medicine and Society, Stanford News, Technology

Stanford-hosted AMA Medical Student regional conference focuses on health-care technology

Stanford-hosted AMA Medical Student regional conference focuses on health-care technology

AMA photoStanford med students Nuriel Moghavem and Trishna Narula co-chaired an AMA Medical Student Section Regional 1 conference last weekend at the Li Ka Shing Center for Learning and Knowledge. Ninety students, including 40 from Stanford, participated in the two-day event, which involved meetings, breakout sessions with industry leaders and social outings, plus an optional trip to a local winery the following day. Moghavem shared his thoughts on the weekend’s proceedings in the Q&A that follows.

How did you decide to focus on healthcare technology innovation?

When we were putting together the proposal, we thought a lot about what makes Stanford different from other schools that might host this conference, and how we could add educational and inspirational value to the trips of students coming from other states. Stanford obviously has many things that set it apart, but we thought that the energy of the health tech field would really capture the imaginations of our attendees.

What were some key takeaways from the sessions?

Our keynote speaker was Atul Butte, MD, PhD, a giant in the field of big data analytics and [someone who is] incredibly knowledgeable about the process of bringing a medical discovery to the market. Everyone in that room was rapt and half probably left wondering why we all weren’t millionaires already. We then had some breakout sessions from telemedicine and technology startups that again pushed our attendees’ understanding about the future of medicine. I think the main takeaways were that technology is changing health care, and the “visibility” – if you think about it like driving a car in the fog – probably isn’t more than two to three years ahead. Technology has the promise to entirely overturn our idea of how health is fundamentally defined and approached in ways that we simply can’t anticipate at this time. It’s big stuff.

What took place at the AMA Leadership School Workshop?

The Leadership School is a national initiative to put tools in the hands of emerging leaders to empower them to expand their efforts. The workshop they led during our conference was an excellent morning icebreaker – asking attendees to share media related to their own personal “brand” (a favorite image, a Google search of themselves, etc.). Through the exercise, we all shared interesting personal details about our lives, interests, passions and hobbies, and we learned a valuable lesson in controlling one’s brand and online presence.

You are a busy medical student. Why do you feel it’s important to participate in leadership opportunities in your field?

As medicine becomes increasingly driven by public policy, it’s important that we cultivate a generation of leaders in medicine with the tools to engage in policy. This conference was, for us, an opportunity to get 70 of the brightest future physicians in our region (which spans from Hawaii to South Dakota!) in one room to discuss that very issue and to develop those skills. We don’t just think it’s important for emerging physician leaders to participate in policy matters, we think it’s critical for the future well-being of our community and perhaps our country for them to do so.

Co-organizer Trishna Narula later shared with me, “while this was a great opportunity for the AMA to benefit from the health technology hub at Stanford, it was also another large step for Stanford Med to push to the forefront of health policy and advocacy.”

Previously: Top 10 reasons I’m glad to be in medical schoolFuture doctors have a lot at stake, even if they don’t know it: A student’s take on the Affordable Care Act and Stanford Medicine X seeking students for leadership program
Photo by James Pan

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