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Events, Medical Education, Medicine X, Patient Care, Precision health, Technology

“No ordinary conference”: The magic that is Medicine X returns to the stage

"No ordinary conference": The magic that is Medicine X returns to the stage

Larry Chu welcoming attendeesMedicine X, Stanford’s popular conference on emerging technologies and medicine, returned to the stage today.

The conference, which was proceeded by the first-ever Medicine X | Ed, is now in its fourth year, and the momentum and magnitude of the event has steadily increased since it began.

Last year, more than 4,000 participants in 69 countries took part in the Medicine X experience via Twitter, making it the most-discussed academic conference in the world. Its past successes were reflected in the theme for Medicine X 2015: “Great Xpectations.”

After executive director Larry Chu, MD, welcomed attendees with a reminder that they “all belong here,” Lloyd B. Minor, MD, dean of the medical school, officially opened the conference with remarks that encouraged this engaged audience to take action and seize opportunities to improve health care. “This is no ordinary time in our history, and Medicine X is no ordinary conference,” he said. “We are here today to have discussions and generate ideas about how to leverage the power of information and the latest technology to improve health for people in our own communities and across the globe. Health care is truly the opportunity of our lifetime.”

Minor talking“Since last year’s Medicine X conference, Stanford Medicine has launched a bold new initiative — our vision to lead the biomedical revolution in precision health,” he said. “Precision health as the next generation of precision medicine: Precision medicine is about sick care, precision health is about health care.” Everyone participating in this event is an important part of moving this conversation forward, he explained.

Eric Topol, MD, chief academic officer at Scripps Research Institute and bestselling author, went on to give an opening keynote on ways we can use new technologies to democratize medicine and involve the patient in his or her own care. “We have views of the human being that we never had before,” Topol said, referencing smartphones and other technologies that people use to monitor their health metrics.

These new technologies are important because they’re interactive and easy for patients to use, and they allow patients to become more involved in their health care, Topol explained. He showed an image of the iconic black doctor’s bag. “These are vintage tools,” he said. “This is my bag,” he explained, pointing to an image of a several digital tools.

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Media, Medical Education, Medical Schools, Medicine X, Technology

Integrating digital literacy into medical education

Integrating digital literacy into medical education

21474271319_dc2d63f449_zBertalan Mesko, MD, PhD, has cracked the code on convincing medical students that digital literacy skills are equally as important as clinical knowledge. Seats in his Social MEDia course fill up within 45 seconds of registration opening. Former students report a 100 percent satisfaction rate with the class, and 80 percent of those enrolling in the course heard about it from a classmate. How does Mesko do it? As it turns out: daily educational challenges promoted on Facebook, an arsenal of high-tech gadgets and lots of chocolate.

On Thursday at Stanford Medicine X|ED, Mesko shared his secrets with medical educators on how to develop a digital literacy curriculum that will engage millennial learners and keep pace with the ever-changing landscape.

A self-describe medical futurist, Mesko launched his class on social media in medicine in 2008 when Facebook and Twitter were still in their infancy. “I wanted to design the curriculum for students to prepare them for the future that is coming toward us,” he said. “My goal was to help them understand how to use these tools to be more productive and stay up to-date.”

Early on, the curriculum centered on his experience with social media tools, such as blogging, Twitter and Facebook. But as the field of digital media and medical devices has evolved, so has the class. These days, he’s constantly updating the coursework to the point where he never gives the same lecture twice. “Platforms come and go, but it’s the concepts and practices that really matter,” said Mesko, who teaches at Semmelweis University in Hungary. “Whenever I talk about these topics, I do everything live.”

Most students have been active on Facebook, Twitter, Instagram, Snapchat and other social media accounts, long before they enroll in Mesko’s class. However, he still believes it’s important to provide an introduction to social media; discuss search engines and the Google story; and provide instruction on medical blogging, crowdsourcing and mobile health.

“Students need some fundamental digital knowledge before diving into the topics of e-patients and how to empower patients,” said Mesko, author of the recently released book My Health: Upgraded . “Additionally, many students don’t fully understand the privacy polices of these services. I tell them to remember that there is no difference between offline or online conduct.”

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Events, Medical Education, Medicine X, Research, Stanford News, Technology

Medicine X 2015 kicks off this week with a focus on the theme “Great eXpectations”

Medicine X 2015 kicks off this week with a focus on the theme “Great eXpectations”

15146055376_5600a69df1_zThought-leaders and innovative thinkers will gather on campus this week for Medicine X. Stanford’s premier conference on emerging health-care technology and patient-centered medicine, the three-day event will be held at the Li Ka Shing Center for Learning and Knowledge and focus on the theme “Great eXpectations.”

Eric Topol, MD, chief academic officer at Scripps Research Institute, will kick off the conference on Friday with a keynote on democratizing medicine. Additional keynote speakers include Robert Pearl, MD, executive director and CEO of The Permanente Medical Group; and Peter Bach, MD, director of Memorial Sloan Kettering’s Center for Health Policy and Outcome. The program will also feature panels and presentations exploring the topics of precision medicine, aging, health and community and misconceptions and misperceptions in health care.

This year, Medicine X will be preceded by the first-ever Medicine X|ED conference. The two-day event, which begins on Wednesday, will examine the role of technology and networked intelligence in shaping the future of medical education. Digital media pioneer Howard Rheingold; Abraham Verghese, MD, vice chair for the theory and practice of medicine for Stanford’s Department of Medicine; and Sarah Stein Greenberg, executive director of the Stanford, will deliver keynote speeches at the conference. Medicine X|ED will focus on five core themes: Engaging millennial learners, opportunities and challenges for innovation in medical education, interdisciplinary learning, and how digital media and massive open online courses are redefining the educational landscape. Participants will also have the option to participate in a range of interactive and educational opportunities.

Those unable to attend the conferences in person can participate in the plenary sessions virtually through a high-quality streaming webcast; registration for the Global Access Program webcast is free. We’ll also be live tweeting the keynotes and other proceedings from the conference. You can follow our tweets on the @StanfordMed feed or follow the hashtag #MedX.

More news about the conference is available in the Medicine X category.

Previously: Medicine X conference to focus on the theme of “Great eXpectations”, Registration now open for the inaugural Stanford Medicine X|ED conference and Stanford Medicine X: From an “annual meeting to a global movement”
Photo by Medicine X

Global Health, Health Disparities, Pediatrics, Stanford News, Technology

Sunshine solves a life-threatening newborn health problem — with a little help from Stanford experts

Sunshine solves a life-threatening newborn health problem — with a little help from Stanford experts

jaundice-greenhouseWhen pediatrician Tina Slusher, MD, began caring for newborns in Nigeria in 1989, she saw two big threats to the babies’ health: severe jaundice and tetanus.

“I thought, ‘Tetanus will go away with immunization, but nobody really seems to understand this jaundice problem,'” Slusher, a global pediatrics expert at the University of Minnesota, told me recently. In developing countries, well over 150,000 babies a year currently die or suffer severe brain damage from jaundice. “They still aren’t getting treated,” Slusher says.

But now, thanks to Slusher and her colleagues, that is set to change. She is the lead author on a scientific paper in the New England Journal of Medicine that evaluated a low-tech, inexpensive method for treating jaundice with filtered sunlight. The technology was conceived and built at Stanford, by a team led by neonatal jaundice expert David Stevenson, MD.

Newborn jaundice is caused by a delay after birth in development of the baby’s ability to metabolize compounds released in the breakdown of red blood cells. In the U.S. and other developed countries, most cases are treated with phototherapy. But putting a baby under a blue-light-emitting lamp isn’t feasible in places that lack steady electricity. The team members, who also included doctors and researchers at the Massey Street Children’s Hospital in Lagos, Nigeria, wondered if they could safely use filtered sunshine instead.

From our press release about the new study:

Some mothers and babies sat under outdoor canopies that filtered out harmful wavelengths from sunlight, but still allowed jaundice-treating blue wavelengths to reach the babies’ skin. The filtered-sunlight treatment was as safe and effective as the blue-light lamps traditionally used to treat infant jaundice.

“This research has the potential for global impact,” said the study’s senior author, David Stevenson, MD, the Harold K. Faber Professor in Pediatrics and senior associate dean for maternal and child health at Stanford. “All babies can get jaundice. In settings with no access to modern devices, we’ve shown we can use something that’s available all around the planet — sunlight — to treat this dangerous condition.” Stevenson also directs the Johnson Center for Pregnancy and Newborn Services at Lucile Packard Children’s Hospital Stanford.

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Genetics, In the News, NIH, Science, Technology

The quest to unravel complex DNA structures gets a boost from new technology and NIH funding

The quest to unravel complex DNA structures gets a boost from new technology and NIH funding

5232013153_7808b471a2_zIf you’ve ever tried folding a map, packing an overnight bag or coiling a string of holiday lights, you know that the way you arrange an object affects how much space it takes up and how easy it is to use in the future. This same principle is true of DNA.

As a recent article in Science News explains, the way a DNA double helix is folded, packed and coiled is known to have a big effect on how much space it requires and how easy it is to access the information stored within. But, until recently, researchers lacked the technology to fully explore these four-dimensional DNA structures.

Now, new technology and last year’s launch of the National Institutes of Health‘s five-year, $120 million, 4D Nucleome project is helping researchers reveal the complex architecture of DNA. William Greenleaf, PhD, assistant professor of genetics at Stanford, discusses the significance of a genome‘s arrangement in the Science News article:

Like the genetic text within it, the genome’s shape holds specific instructions. “The way it’s compacted forms this sort of physical memory of what the cell should be doing,” Greenleaf says.

Loops of DNA that aren’t needed by a particular cell are tucked away from the biological machinery that reads genetic blueprints, leaving only relevant genes accessible to produce proteins. Studies have shown that sections of the genome that are shoved toward the edges of a nucleus are often read less than centrally located DNA. Such specialized arrangements allow cells as diverse as brain cells, skin cells and immune cells to perform different jobs, even though each contains the same genome. “In different cell types, there are very large changes to the regions that are being used,” Greenleaf says.

Much more remains to be understood about how a genome’s shape directs its activity. Future maps might zero in on functionally interesting regions of the genome, Greenleaf says. But he cautions there is also a benefit to unbiased, general exploration. Focusing on one location in the nucleome might lead researchers to miss important structural information elsewhere, he says.

Previously: DNA origami: How our genomes foldPacked and ready to go: The link between DNA folding and disease and DNA architecture fascinates Stanford researcher – and dictates biological outcomes
Photo by: Kate Ter Haar

Bioengineering, Research, Stanford News, Technology

New Stanford-developed technology bypasses “virtual reality sickness”

New Stanford-developed technology bypasses "virtual reality sickness"

headset_newsResearchers in the Stanford Computational Imaging Group have developed a new virtual reality headset that takes into account how the human eye focuses and processes depth.

Current display technologies are essentially two-dimensional and don’t present images the way our eyes were designed to see them, which can cause “virtual reality sickness,” or VR sickness for short, after only a few minutes.

The new system involves two transparent LCD displays with a spacer in between, which is called “light field technology.” A Stanford News article describes a light field as creating “multiple, slightly different perspectives over different parts of the same pupil. The result: you can freely move your focus and experience depth in the virtual scene, just as in real life.”

Gordon Wetzstein, PhD, assistant professor of electrical engineering, developed the technology along with researchers Fu-Chung Huang and Kevin Chen. In the news piece, Wetzstein listed the variety of applications this advance could have, robotic surgery top among them: “If you have a five-hour [robotic] surgery, you really want to try to minimize the eye strain that you put on the surgeon and create as natural and comfortable a viewing experience as possible.”

But the applications aren’t limited to what has already been imagined. Wetzstein explains, “Virtual reality gives us a new way of communicating among people, of telling stories, of experiencing all kinds of things remotely or closely. It’s going to change communication between people on a fundamental level.”

You can access a short video on the new development here.

Previously: Fear factor: Using virtual reality to overcome phobias, From “abstract” to “visceral”: Virtual reality systems could help address pain, Double vision: How the brain creates a single view of the world, Discover magazine looks at super human vision and Augmented reality iOS app for color vision deficiency
Photo by Vignesh Ramachandran

Autism, Behavioral Science, Medical Apps, Nutrition, Stanford News, Technology

Stanford grad students design new tools for learning about nutrition, feelings

Stanford grad students design new tools for learning about nutrition, feelings

2789442655_1f5c33ac51_zMushrooms and tomatoes, veggies that are often reviled by preschoolers, star in a new app designed by a Stanford graduate student that aims to involve children in preparing, and eating, healthy meals.

“Children are more likely to try food that they’ve helped cook,” explained Ashley Moulton, a graduate student in the School of Education’s Learning, Design and Technology Program, in a recent Stanford News story.

Moulton’s iPad app, Nomster Chef, is one of several student projects featured in the article and accompanying video:

Before cooking, children receive an educational video about a food they’ll be working with – for example, a video on how mushrooms grow. The app also incorporates food information in the recipe steps, like the fact that tomatoes are actually a fruit.

After user-testing the app prototype, “I heard from parents that they noticed differences in how their kids are eating,” Moulton said. The app also kept kids engaged throughout the cooking process.

For her project, fellow student Karen Wang developed an iPad app called FeelingTalk that helps children with autism interpret facial expressions:

…[I]n the first level of FeelingTalk, kids choose the one face that’s different (a sad face) from the three happy faces on the screen. The app will then label the different face “sad.”

“My app will be utilizing learning mechanics that directly work with the autistic brain to help them work on something that they’re having difficulty with,” Wang said. “By leveraging something they’re good at, we’re going to teach them to get comfortable looking at people’s faces, examining the key features, and eventually understanding emotions.”

Moulton, Wang and other students will present their work this afternoon at the LDT Expo at the Stanford Graduate School of Education.

Previously: A look at the MyHeart Counts app and the potential of mobile technologies to improve human health and No bribery necessary: Children eat more vegetables when they understand how food affects their bodies
Photo by Peter Weemeeuw

Autoimmune Disease, Genetics, Immunology, Science, Stanford News, Technology

Women and men’s immune system genes operate differently, Stanford study shows

Women and men's immune system genes operate differently, Stanford study shows

A new technology for studying the human body’s vast system for toggling genes on and off reveals that genes connected with the immune system switch on and off more frequently than other genes, and those same genes operate differently in women and men. What’s more, the differences in gene activity are mostly not genetic.

A couple of years ago, geneticists Howard Chang, MD, PhD; Will Greenleaf, PhD, and others at Stanford invented a way to map the epigenome – essentially the real time on/off status of each of the 22,000 genes in our cells, along with the switches that control whether each gene is on or off.

Imagine a fancy office vending machine that can dispense 22,000 different drinks and other food items. Some selections are forever pumping out product; other choices are semi permanently unavailable. Still others dispense espresso, a double espresso or hot tea depending on which buttons you push. The activity of the 22,000 genes that make up our genomes are regulated in much the same way.

That’s a lot to keep track of. But Chang and Greenleaf’s technology, called ATAC-seq, makes it almost easy to map all that gene activity in living people as they go about their lives. Their latest study, published in Cell Systems, showed that the genes that switch on and off differently from person to person are more likely to be associated with autoimmune diseases, and also that men and women use different switches for many immune system genes. That sex-based difference in activity might explain the much higher incidence of autoimmune diseases in women — diseases like multiple sclerosis, lupus and rheumatoid arthritis.

The team took ordinary blood samples from 12 healthy volunteers and extracted immune cells called T cells. T cells are easy to isolate from a standard blood test and an important component of the immune system. With T cells in hand, the team looked at how certain genes are switched on and off, and how that pattern varied from individual to individual. Chang’s team also looked at how much change occurred from one blood draw to the next in each volunteer.

Chang told me, “We were interested in exploring the landscape of gene regulation directly from live people and look at differences. We asked, ‘How different or similar are people?’ This is different from asking if they have the same genes.”

Even in identical twins, he said, one twin could have an autoimmune disease and the other could be perfectly well. And, indeed, the team reported that over a third of the variation in gene activity was not connected to a genetic difference, suggesting a strong role for the environment. “I would say the majority of the difference is likely from a nongenetic source,” he said.

Previously: Caught in the act! Fast, cheap, high-resolution, easy way to tell which genes a cell is using
Photo by Baraka Office Support Services

Imaging, Microbiology, Research, Science, Stanford News, Technology

3-D structure of key signaling protein and receptor revealed

3-D structure of key signaling protein and receptor revealed

Using ultra-bright X-rays at SLAC National Accelerator Laboratory, a team of international researchers has captured the 3-D structure of a key signaling protein and its receptor for the first time.

The discovery provides new insight into the functioning of a common cell receptor called a G protein-coupled receptor or GPCR. Researchers estimate this protein, and its relatives, are the targets of about 40 percent of pharmaceuticals. From a SLAC release:

“This work has tremendous therapeutic implications,” said Jeffrey Benovic, PhD, a biochemist who was not involved with the study. “The study is a critical first step and provides key insight into the structural interactions in these protein complexes.”

Specifically, the researchers were able to illuminate the structure of the GPCR bonded with a signaling protein called arrestin. Arrestins and G proteins both dock with the GPCRs, however, researchers had previously only examined a bonded G protein. G proteins are generally the “on” switch, while arrestins usually signal the GPCR to turn off:

Many of the available drugs that activate or deactivate GPCRs block both G proteins and arrestins from docking.

“The new paradigm in drug discovery is that you want to find this selective pathway – how to activate either the arrestin pathway or the G-protein pathway but not both — for a better effect,” said Eric Xu, PhD, a scientist at the Van Andel Research Institute in Michigan who led the experiment. The study notes that a wide range of drugs would likely be more effective and have fewer side effects with this selective activation.

Previously: Why Stanford Nobel Prize winner Brian Kobilka is a “tour de force of science”, Funding basic science leads to clinical discoveries, eventually and Video of Brian Kobilka’s Nobel lecture
Video by SLAC National Accelerator Laboratory

Cardiovascular Medicine, Chronic Disease, Imaging, Research, Stanford News, Technology

DNA damage seen after CT scanning, study shows

DNA damage seen after CT scanning, study shows

16288548276_e155ec8843_zUsing new laboratory techniques, Stanford scientists have been able to get a closer look at what happens inside the cells of patients undergoing medical imaging techniques. In a study published today, their research clearly shows that there is cellular damage in heart patients after CT scanning.

The researchers explained to me in interviews for a press release on the study that this doesn’t link CT scans to cancer. But as Patricia Nguyen, MD, lead author said in the release, it is further indication for caution:

“Whether or not this (cellular damage) causes cancer or any negative effect to the patient is still not clear, but these results should encourage physicians toward adhering to dose reduction strategies.”

Due to an explosion in the use CT scans for heart patients over the past decade, public health concerns have been raised over whether there might be a causal link with cancer. But until now, little has been known about exactly what happens at a cellular level when patients undergo CT scanning, a type of medical imaging which exposes them to low-dose radiation. This study took advantage of new laboratory techniques that made it possible to look inside cells of patients after they underwent CT scanning. As Nguyen explained in my release:

“Because we don’t know much about the effects of low-dose radiation — all we know is about high doses from atomic bomb blast survivors — we just assume it’s directly proportional to the dose. We wanted to see what really happens at the cellular level.”

Researchers examined the blood of 67 patients undergoing cardiac CT angiography using such techniques as whole-genome sequencing and flow cytometery to measure biomarkers of DNA damage. The results:

… showed an increase in DNA damage and cell death, as well as increased expression of genes involved in cell repair and death, the study said. Although most cells damaged by the scan were repaired, a small percentage of the cells died, the study said.

“These findings raise the possibility that radiation exposure from cardiac CT angiography may cause DNA damage that can lead to mutations if damaged cells are not repaired or eliminated properly,” the study said.

Photo by frankieleon

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