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Biomed Bites, In the News, Research, Stem Cells, Technology, Videos

“It gives me the chills just thinking about it”: Stanford researcher on the potential of stem cells

"It gives me the chills just thinking about it": Stanford researcher on the potential of stem cells

Welcome to the last Biomed Bites of 2014. We’ll be continuing this series next year — check each Thursday to meet more of Stanford’s most innovative biomedical researchers. 

If you watch this video and aren’t moved by the passion and conviction of Stanford biologist Margaret Fuller, PhD, then email me. Seriously, I’ll try to talk some sense into you. Because Fuller’s enthusiasm for biomedicine is downright contagious. This is a professor who you want to teach biology.

Fuller, a professor of developmental biology and of genetics, works with adult stem cells, and she’s palpably gleeful about their potential to improve the health of millions.

“I was really struck and inspired by a recent article in the New York Times,” Fuller says in the video above. She’s talking about “Human Muscle Regenerated with Animal Help,” a 2012 piece that told the story of Sgt. Ron Strang, a Marine who lost part of his quadriceps in Afghanistan. Yet here is Strang, walking, thanks to the donation of a extracellular matrix from a pig. This paper-like sheet secreted signals instructing his stem cells to come to the rescue and build new muscle. “It was amazing,” Strang told the Times reporter. “Right off the bat I could do a full stride, I could bend my knee, kick it out a little bit…”

“This is really amazing,” Fuller agrees. “It gives me the chills just thinking about it. This is the kind of knowledge and advances of the basic work that I do… The hope is that understanding those underlying mechanisms will allow people to design small molecules and other strategies that can be used to induce our own adult stem cells to be called into action for repair.”

Learn more about Stanford Medicine’s Biomedical Innovation Initiative and about other faculty leaders who are driving biomedical innovation here.

Previously: Center for Reproductive and Stem Cell Biology receives NIH boost, Why the competition isn’t adult vs. embryonic stem cells and Induced pluripotent stem cell mysteries explored by Stanford researchers

Mental Health, Research, Technology

Reducing your stress level could be as simple as checking email less frequently

Reducing your stress level could be as simple as checking email less frequently

4329363938_26522735d1_zAs the end of 2014 approaches, many of us are thinking about what changes we’re going to make come Jan. 1 to be healthier and happier. Those looking for ways to reduce their stress level in 2015 may want to consider adopting a New Year’s resolution to limit how often they check their email throughout the day.

A study (subscription required) recently published in Computers in Human Behavior suggests that there are psychological benefits to easing up on the number of times you click your inbox. For the experiment, researchers at the University of British Columbia instructed half the participants to read emails no more than three times a day for a week, while a second group was allowed to check their inbox as often as they wished. The groups’ instructions were then reversed the following week. New York Magazine reports:

Overall, “limiting the number of times people checked their email per day lessened tension during a particularly important activity and lowered overall day-to-day stress,” the researchers write, and was associated with various other positive measures of psychological well-being. Those who checked their email a lot also didn’t perceive themselves as any more productive than those who were on an email diet.

…This study, combined with a lot of prior research into things like the distractions imposed by task-switching, paint a pretty clear picture: Ceaselessly checking your email probably isn’t making you more productive, and it probably is making you more stressed.

Previously: What email does to your brain
Photo by Ian Lamont

Parenting, Pediatrics, Pregnancy, Technology, Women's Health

Stanford alumni aim to redesign the breast pump

Stanford alumni aim to redesign the breast pump

2014-11-21 15.02.36

Three Stanford graduates have an idea that could dramatically impact the daily life of active breastfeeding women: They plan to design and build a breast pump that is discreet, intuitive, and supportive of mothers. This may sound obvious, but nothing like it currently exists. In August of this year, Cara Delzer, MBA; Gabrielle Guthrie, MFA; and Santhi Analytis, PhD, founded Moxxly, “a consumer products company designing for women.” They’re in the final stretch of their 16-week incubation with Highway 1, which helps hardware startups move from a concept to a prototype ready for production.

“We’ve talked to women, hundreds of women, who have told us things like ‘pumping makes me feel like a cow,'” shares Delzer, Moxxly’s CEO, who I interviewed in late November. So she and her colleagues are aiming to re-imagine the pumping experience.

Delzer experienced the current, poorly-imagined pumps firsthand after the recent birth of her child: “I just remember watching my husband take piece after piece out of the pump box for the first time thinking, how in the world am I going to put this together? All those pieces, and clean them? I was already overwhelmed as a new mom, but completely overwhelmed by the pump.” Once she went back to work, she found that she was spending 25 percent of her day dealing with the logistics of pumping – mentally integrating it into her schedule, worrying about having all the parts. The experience is similar for many of today’s busy, mobile moms.

Meanwhile, Guthrie was at Stanford developing her passion for designing for women, Delzer recounts. “A lot of things that have been designed for women and girls in the past have followed this ‘shrink it and pink it’ trope where you literally make it smaller and bright pink and think, ‘Oh, now the girls will buy it.’ Well, Gabrielle doesn’t buy it.” For her masters’ thesis, Guthrie interviewed working moms, and the breast pump kept coming up as something that needed to be redesigned. She spent much of her last year at Stanford working on just that. At a hackathon, she and Analytis worked together to put the new designs into practice, and Analytis, whose PhD is in mechanical engineering, was hooked on solving this problem as well.

The three women “got together, looked one another in the eyes and said, ‘Do we believe this is a problem? Do we believe we can solve it? Do we believe the time is now?’ And it was yes, yes, yes,” said Delzer. They took on the challenge despite the fact that the breast pump is an FDA-regulated medical device and they will face a lengthy review process. They invented the name “Moxxly” with the intent of conveying spunkiness and strength, and incorporated XX to signify women.

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Imaging, Patient Care, Stanford News, Technology

Every foot has a story: Why communication is key in radiology

Every foot has a story: Why communication is key in radiology

11739904364_92e702bc65_zBack in the day, radiology departments were simpler. After obtaining an x-ray, the technologist would hand off the images to the radiologist. In the process, the radiologist might ask about the technologist’s family, how Aunt Lucy was faring or how that day’s commute had been. Maybe a senior technologist would walk by, glance at the pinned up images and offer the junior technologist some advice on how to improve the positioning of the patient. The primary care doctor and the junior radiologist might chat about the patient over their lunchtime tennis game.

Not to say it wasn’t busy — it was. But in a smaller, simpler environment, informal relationships were easier to maintain. Despite their informality, these relationships, and the communication that went with them, served as a powerful means to improve patient care, according to Stanford radiologist David Larson, MD.

Fast forward to today. At a busy, top-tier hospital, radiologists might not know their colleagues, much less the technologists or referring physicians. All images remain on computers — no need to pin anything up for public viewing, or to receive unsolicited comments, or advice.

The many technological improvements, as well as the scale and speed of modern radiology, have inadvertently thwarted communication, Larson and colleagues write in a paper recently published in the American Journal of Roentgenology. Here’s Larson:

In radiology, we’re in the business of information. Everything we do from the time that somebody even thinks of a question, to the time they ask for an imaging study, to when we then interpret the images, is really all about information.

So we need to be really good at moving that information efficiently and effectively, which means we need to be good at communicating… But in many ways, we’re thinking as if we still operate in a small, simple environment, even though we’re operating in a large, complex environment.

For example, Larson said, in addition to having the images, it’s also important for radiologists to know about a patient’s history. He said information that someone runs 20 miles a week, for example, makes a big difference when interpreting an image of a foot. “I have been in the situation where I looked at the study and was about to call it normal. Then I looked at the history, looked back at the study, and found the very subtle stress fracture,” Larson said. “A good history makes that possible.”

Larson pointed out that Stanford is continuously improving its own communication processes. For example, the hospital recently hired a reading room assistant, what Larson referred to as an “air traffic controller,” to direct queries and facilitate communication among physicians.

Previously: Despite genetic advances, detection still key in breast cancer, Using 3-D technology to screen for breast cancer and Better communication between caregivers reduces medical errors, study finds
Photo by Jill Carlson

Medicine and Society, Patient Care, Technology

Advice for young doctors: Embrace Twitter

Advice for young doctors: Embrace Twitter

9093733888_79ccacf171_zYoung doctors have to juggle a huge workload, so it’s not surprising that many don’t use Twitter or other social media. But Brian Secemsky, MD, an internal medicine resident at the University of California, San Francisco recently wrote a story on Huffington Post outlining the benefits of the twitter-verse for young physicians. He notes that Twitter can serve as a good source of medical knowledge and writes:

By choosing a good mix of these medical profiles, especially those that tweet links to high-yield content, you are able to create an individually tailored and constantly updated curated source of medical information, freely available at any time.

(@StanfordMed is one of those profiles, in our humble opinion)

He also points out that Twitter is a good way for up-and-coming physicians to interact with others in their specialty and a place to for them to voice opinions about topics important to them. Also, these days, doctors have a presence online whether they plan to or not, so it’s best to take control of that image. Secemsky writes:

Whether you like it or not, your professional image will likely end up on the Internet. It may be through the increasing patient use of physician rating websites or your own institution displaying your professional profile and accomplishments. It will be difficult to avoid the impact of the online community in your medical career.

Previously: How can health-care providers better leverage social media to improve patient care?More reasons for doctors and researchers to take the social-media plungeSubjects for doctors to avoid when using social media, How, exactly, can Twitter benefit physicians? and How can physicians manage their online persona? KevinMD offers guidance
Photo by Kooroshication

Genetics, NIH, Research, Science, Stanford News, Technology

Of mice and men: Stanford researchers compare mammals' genomes to aid human clinical research

Of mice and men: Stanford researchers compare mammals' genomes to aid human clinical research

Scientists have long considered the laboratory mouse one of the best stand-ins for researching human disease because of the animals’ genetic similarity to humans. Now Stanford researchers, as part of a consortium of more than 30 institutions, have confirmed the mouse’s utility in clinical research by showing that the basic principles controlling genes are similar between the two species. However, they also found some important differences.

From our press release on the work:

“At the end of the day, a lot of the genes are identical between a mouse and a human, but we would argue how they’re regulated is quite different,” said Michael Snyder, PhD, professor and chair of genetics at Stanford. “We are interested in what makes a mouse a mouse and a human a human.”

The research effort, Mouse ENCODE, complements a project called the Encyclopedia of DNA Elements, or ENCODE, both funded by the National Human Genome Research Institute. ENCODE studied specific components in the human genome that guide genes to code for proteins that carry out a cell’s function, a process known as gene expression. Surrounding the protein-coding genes are noncoding regulatory elements, molecules that regulate gene expression by attaching proteins, called transcription factors, to specific regions of DNA.

The Mouse ENCODE consortium annotated the regulatory elements of the mouse genome to make comparisons between the two species. Because many clinical studies and drug discovery use mice as model organisms, understanding the similarities and differences in gene regulation can help researchers understand whether their mouse study applies to humans.

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Parenting, Pediatrics, Stanford News, Technology

Using texting to boost preschool reading skills

Using texting to boost preschool reading skills

Stanford researchers find promising results from program that uses text messages, like this one, to support parents in helping their children learn to read.

A new program that sends weekly texts to parents to  remind them to engage in simple activities to boost their preschooler’s literacy skills appears to help children read. The program, called READY4K! and developed at the Stanford School of Education by education professor Susanna Loeb, PhD, and graduate student Benjamin York and tested at preschools at the San Francisco Unified School District, underwent an 8-month pilot conducted in 2013-2014. In a release describing the pilot program, Loeb described the challenges faced by parents:

The barrier to some of these positive parenting practices isn’t knowledge or desire, but it’s the crazy, busy lives… It’s difficult to have the time or focus to make all these choices as parents, and we’re helping parents do what they know they should do and what they want to do.

The program enrolled 440 parents, half of whom got literacy building tips by text and the other half got placebo announcements about the district. Parents who received literacy tips were more likely to engage in literacy activities such as reading to their children, reviewing rhyming words and playing word puzzles. Moreover, the authors note in a report that the preschool-age children scored higher on literacy assessment tests at the end of the pilot program than those whose parents had not gotten weekly texts. In the release, a representative of SFUSD notes:

I believe that all families want to be involved in their child’s learning, but many feel they don’t have the time or perceive that supporting their child’s learning might be labor intensive or something that the teacher is better at. The texting program offered some simple nuggets around literacy strategies and validated that families do want to be involved, if given information that is easy to receive and useful.

The READY4K! program was developed with accessibility and scalability in mind. York and Loeb carefully parsed early childhood literacy standards from the state into text-size bites, with the aim that they would be helpful and not add another layer of stress to the already busy parents’ lives.

SFUSD has expanded the program this year to all preschool and kindergarten parents. Loeb and York have heard from other interested school districts and have also added early math skills into the weekly texts.

Previously: Reading, book sharing less common in immigrant families, Stanford study finds, Researcher shows how preschoolers are, quite literally, little scientists and This is your 4-year-old on cartoons
Photo by L.A. Cicero/Stanford News Service

Global Health, Immunology, Pregnancy, Public Health, Stanford News, Technology

Stanford-developed smart phone blood-testing device wins international award

Stanford-developed smart phone blood-testing device wins international award

When I worked as an epidemiologist, one of my jobs was with a program that prevented perinatal hepatitis B infections. That’s when a woman with a chronic hepatitis B infection passes it on to her baby. Babies are more likely than almost any other group to develop chronic infections that can cause them years of health problems and will most likely cut their lives short.

In the U.S., most states have comprehensive testing programs to detect pregnant women with infections and strict protocols that require delivery hospitals to treat babies born to them with vaccination and antibodies to prevent infection with the virus. But a program like this requires a huge administrative and laboratory investment – and in many poverty-stricken parts of the world, this simply isn’t possible. In fact, in California, the vast majority of cases identified by the prenatal testing program are women who were born outside the United States, including many from Asia.

So when I heard the recent news that a team of four Stanford graduate students had won the Nokia Sensing XCHALLENGE, an international competition to for diagnostic devices, for a mobile test that could detect hepatitis B infections, I was pretty impressed and curious about how it could be implemented in those places. The competition is run by XPrize, the same group that has run several competitions for space exploration, and others for super-fuel efficient vehicles and ocean clean-up efforts.

The mobile version of the winning test was one of five awarded top prizes among 90 entrants. It was developed by engineering PhD candidates Daniel Bechstein, Jung-Rok Lee, Joohong Choi and Adi W. Gani, building on work previously done by Stanford professor of materials science and engineering Shan Wang, PhD, and Stanford immunologist  Paul Utz, MD. The device works because magnetic nanoparticles are grafted onto two biological markers: the hepatitis B virus and the antibody that our bodies make in response to the virus. Current tests for hepatitis B requires a full laboratory facility. A Stanford press release describes the device:

The students used a diagnostic strip that takes a finger prick of blood. The patient’s blood flows into a tiny chamber where it mixes with magnetic nanoparticles to form magnetically tagged biomarkers.

The test strip is inserted into a small magnetic detector… The smartphone is plugged into the detector, and its microprocessor helps to perform the test. It takes only a few minutes.

If the test finds the hepatitis B antigen in the blood, the patient is infected and needs treatment. For a newborn with an infected mother, the child needs both vaccination and antibody therapy.

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Neuroscience, Research, Sleep, Stanford News, Technology

Cheating jet lag: Stanford researchers develop method to treat sleep disturbances

Cheating jet lag: Stanford researchers develop method to treat sleep disturbances

jets landing in sunset - 560

Last month, I went to a conference back East. It was a short trip, four days, and I was jet lagged the whole time. I spent my mornings gulping down hot coffee to help shake off the sleepy haze; in the evenings, when I should have been making up the lost sleep, I was wired, tossing and turning in bed. I could have tried adjusting to East Coast time in the days before I left by getting to bed a few hours earlier and getting up around 4 AM, but that would have required a level of coordination and planning that I’m unlikely to muster in the days before an out-of-town trip.

So I was curious when I learned that a team of Stanford researchers, led by neurobiologist Jamie Zeitzer, PhD, were working on a technique that helps people shift their sleep cycles by flashing light briefly at their eyes while they sleep. They recently published their findings in the Journal of Biological Rhythms.

Beyond the obvious job of vision, our eyes and brain are constantly processing information about the light around us. Light affects our moods and the daily ebb and flow of our biological clocks. It influences when we are sleepiest and most alert. Our brains do a lot of this work behind the scenes and because it happens unconsciously, we are rarely aware of these circadian rhythms – unless something disturbs them, like flying across several time zones.

Zeitzer and his team recruited volunteers and had them get on a routine sleep-wake cycle, going to bed and waking up at the same time every day for about two weeks. The researchers then had the volunteers come sleep in the lab, where the experimental group was given a series brief flashes of light about two millisconds long – about as long as a camera flash – aimed at their eyes. A control group slept in complete darkness, and the volunteers didn’t know which group they were assigned to. The team then measured whether the subjects’ sleep cycle had been affected by measuring the amount of melatonin in their blood. The brain floods the body with melatonin a couple of hours before bedtime and continues releasing the hormone until about an hour after wake time.

The researchers found that the volunteers who got the light flashes were able to shift the sleep phase of their circadian systems. What was surprising was that the intervention did not noticeably disturb the subjects’ sleep. The volunteers in the experimental group didn’t report any less restful sleep than the controls. “This kind of treatment can help people adjust even before they leave for a trip,” says Zeitzer. “Leaving for Australia, the night before you leave, you can adjust a couple of hours. On the plane, you can adjust a couple more. By the time you arrive, you’re already half-way adjusted.”

Besides jet-lagged travelers, this technique could also help teenagers who have a hard time getting up at the right time (a clinical condition for many that goes beyond adolescent laziness) and shift workers. Current treatments for sleep disturbances include sitting in front of bright lights for sometimes hours at a time, which often means it’s only used in extreme cases.

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Cancer, Research, Science, Stanford News, Surgery, Technology

New molecular imaging could improve bladder-cancer detection

New molecular imaging could improve bladder-cancer detection

Joseph LiaoThey say a picture is worth a thousand words. For bladder-cancer surgeons, an image can be worth many lives.

That’s because a crucial method for detecting bladder cancer is to produce images that allow surgeons to identify abnormal-looking tissue, a method called cystoscopy. In a study published yesterday in Science Translational Medicine, Stanford researchers developed a new way to image the bladder that they say could detect bladder cancer with more accuracy and sensitivity than the standard methods. As described in our press release:

 The researchers identified a protein known as CD47 as a molecular imaging target to distinguish bladder cancer from benign tissues. In the future, this technique could improve bladder cancer detection, guide more precise cancer surgery and reduce unnecessary biopsies, therefore increasing cancer patients’ quality of life.

Identifying cancerous tumors can be challenging — some bladder cancer treatments cause inflammation, which looks very similar to abnormal, cancerous tissue. The only way to know for sure is to perform a biopsy, which can be stressful for the patient. As co-senior author Joseph Liao, MD, explained:

 Our motivation is to improve optical diagnosis of bladder cancer that can better differentiate cancer from non-cancer, which is exceedingly challenging at times. Molecular imaging offers the possibility of real-time cancer detection at the molecular level during diagnostic cystoscopy and tumor resection.

For their work, the researchers looked for a target that would distinguish cancer cells from benign cells and found it in CD47, a protein on a cell’s surface that cancer cells produce in higher quantities than normal cells. In previous work, co-senior author Irving Weissman, MD, developed a CD47 antibody that binds to the cancer cell’s surface and blocks the signal. They hypothesized it would be a good imaging target. More from our release:

 To test their hypothesis, the researchers added a fluorescent molecule to an antibody that binds to CD47. The modified antibodies were then introduced into intact bladders, which had been surgically removed from patients with invasive bladder cancer. Because they bladders were kept in good condition, the study’s imaging methods mirrored the way an urologist might use with a real patient.

After 30 minutes, they rinsed the bladder, so only the antibodies that bound to the CD47 protein remained. When they shine the tumor was exposed to with fluorescent light, the cancer cells “lit up” whereas normal or inflamed cells did not.

“Our goal through better imaging is to deliver a higher- quality cancer surgery and better cancer outcomes,” Liao told me. “I am very excited about the potential to translate our findings to the clinics in the near future.”

Previously: Healing hands: My experience being treated for bladder cancer, Drug may prevent bladder cancer progression, say Stanford researchers, Cellular culprit identified for invasive bladder cancer, according to Stanford study and Mathematical technique used to identify bladder cancer marker
Photo of Liao by Norbert von der Groeben

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