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Medical Education, Medical Schools, Stanford News, Videos

Stanford students design “enrichments” for lions, giraffe and kinkajou at the San Francisco Zoo

Stanford students design "enrichments" for lions, giraffe and kinkajou at the San Francisco Zoo

My job took me to the zoo.

It was a rather unorthodox assignment for a medical writer, but one of our faculty at Stanford medical school was teaching a rather unorthodox class at the San Francisco Zoo. A dozen Stanford sophomores signed up to spend two intensive weeks there learning about animal welfare and behavior and designing “enrichments” to make life more interesting for the lions, a giraffe and a kinkajou at the zoo.

These included a “Poop Shooter” to lob animal poop into the lion’s cage, a urine-soaked scratcher for a lone giraffe and a “Robo-Flower” to automatically dispense smoothies to the kinkajou, a tree-dwelling rainforest mammal that looks like a cross between a squirrel and a raccoon.

“Zoo animals have pretty good welfare already,” said Stanford’s Joseph Garner, PhD, an associate professor of comparative medicine who helped design and lead the class. “So it’s not about fixing things. It’s about how we can turn this animal on a little. How can we help the keepers manage the animal and improve the experience for guests.”

“It’s like if you lived in the same room your whole life. We want to change it up, keep it fresh and interesting – something novel,” said student Jennifer Ren.

For Floyd the giraffe, the students shook things up a bit by building a scratcher soaked in female giraffe urine to make it appealing to him. Instead of lurking in a corner of his paddock near the female enclosure, Floyd ventured out into his large pad to explore his new toy, where he was a lot more visible to zoo-goers.

“The giraffe is one of the largest and strongest animals on the planet, so building something that he is not going destroy in 30 seconds is a real challenge,” Garner said.

For the lions, the students adapted a conveyor-belt system to periodically shoot giraffe poop into the lion’s cage, where the male lion in particular found the aromatic pellets extremely interesting.

“Lions lie around all day watching and waiting. But when the zoo put the enrichment in, it was like somebody just flipped a switch,” Garner said. “The male lion was up and about and smelling and searching for the giraffe droppings, and performing all of this wonderful lion behavior.”

The students took their assignments very seriously, videotaping the animals’ responses and designing charts and graphs to measure the results, which they presented at a zoo ceremony last Friday in which they were celebrated for their contributions.

The students said they came away with a whole new perspective on zoos and wildlife behavior, as well as a gratifying sense of having designed something to improve the animals’ lives.

Previously: How horsemanship techniques can help doctors improve their art
Photo in featured entry box by Norbert von der Groeben

Science, Stanford News, Videos

Science is like an ongoing mystery novel, says Stanford neurobiologist Carla Shatz

Carla Shatz

We all know that Carla Shatz, PhD, director of the interdisciplinary institute Stanford Bio-X, is a pioneering scientist — her work in early brain development and in Alzheimer’s disease has earned her many accolades. Now she’s being featured in a videos series celebrating women pioneers in science.

I want to say first that it always rankles a bit when people are celebrated as being “pioneering women in XXX”. That makes it seem like if they weren’t women they wouldn’t have made the pioneer cut. Carla is a pioneer period. And also a woman. And gave a great interview.

One interesting point she made had to do with what she wished she’d known before starting a career in science. She said, “If you really like science and you like research, that is the joy and the easy part. The hard part is managing the teams and the research itself – the people.”

She went on to talk about the people who influenced her (her dad) and her first scientific experiment (it had to do with Siamese cats, and initially didn’t work).

When it comes to women in science, her answer was straightforward. She said we need talented people working on critical problems, and women are half the population. Without them, there are fewer people working on these important questions. She also said that she worries about the diminished funding for science driving the best minds (male and female) into other fields.

Her answer to what gets her up in the morning should help lure at least a few of those potential best minds into a scientific career, even with weak funding. She said:

Every day when I come to work I am so excited to be here and go to my lab and do experiments and be with my students. It’s part of an ongoing mystery. I can hardly wait to see the next part of the mystery that is going to be solved.

The series is sponsored by Scientista, which supports women in math and science, The Scientist magazine, Lab Manager and Mettler Toledo.

Previously: They said “Yes”: The attitude that defines Stanford Bio-X and Pioneers in science
Photo be Steve Fisch

Biomed Bites, Research, Science, Stanford News, Videos

Studying the drivers of metastasis to combat cancer

Studying the drivers of metastasis to combat cancer

Today we’re launching Biomed Bites, a weekly series created to highlight some of Stanford Medicine’s most compelling research and introduce readers to promising scientists from across the basic and clinical sciences.

One might not think there’s much of a connection between grapes and cancer cells, but Amato Giaccia, PhD, has found some similarities. “The tumor microenvironment is very analogous to the microenvironment you would have in Napa Valley, where different types of grapes grow in different areas depending on the richness of the soil and the different climate and weather that exist,” explains the Stanford radiation oncologist and cancer biologist in the video above. “In a similar matter, tumors require different environments for them to be able to grow and… metastasize.”

Giaccia and his colleagues study the genetic and epigenetic regulators of metastasis, and their work could lead to the development of therapeutics that inhibit or eradicate the process, which contributes to 90 percent of cancer-related deaths. “Understanding the drivers of metastasis and how to best target them is going to have a major impact on cancer survival and mortality in the future,” Giaccia says.

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

Previously: Cellular culprit identified for invasive bladder cancer, according to Stanford study, Potential anti-cancer therapy starves cancer cells of glucose and Nomadic cells may hold clues to cancer’s spread
Photo in featured entry box by Lee Coursey/Flickr

Cancer, Men's Health, Stanford News, Videos

Stanford experts talk new diagnostic technology for prostate cancer

Stanford experts talk new diagnostic technology for prostate cancer

This month is National Prostate Cancer Awareness Month, and Stanford urologic oncologists are sharing their knowledge about prostate cancer diagnosis and treatment, both online and in person. This Saturday, at a free community talk hosted by the Stanford Cancer Center, several experts will be on hand to answer questions and discuss prostate cancer screening, “watchful waiting,” diagnostic advances, and treatment options. In an online Q&A and the video above, Eila Skinner, MD, chair of urology, and James Brooks, MD, chief of the urologic oncology division, and others provide more insight on the disease. And during the month of September, more information about prostate cancer, including the benefits of targeted prostate biopsy, will be offered on Twitter via @StanfordHosp.

Previously: Managing a prostate cancer diagnosis: From leader to follower, and back again, New technology enabling men to make more confident decisions about prostate cancer treatment, Six questions about prostate cancer screening, Ask Stanford Med: Answers to your questions on prostate cancer and the latest research and Making difficult choices about prostate cancer

Patient Care, Pediatrics, Stanford News, Videos

Pediatric patients create vibrant mural with help from Hewlett-Packard and DreamWorks Animation

Pediatric patients create vibrant mural with help from Hewlett-Packard and DreamWorks Animation

Here’s a feel-good story that will lift your spirits. Over at Lucile Packard Children’s Hospital Stanford, patients are working with volunteers from Hewlett-Packard and DreamWorks Animation to construct a unique piece of artwork designed digitally or drawn by hand. As described in the above video, the DreamWorks team worked with children in the hospital’s onsite school to create imaginary creatures, and next built a background and composited the patients’ art into a large mural. Then, Hewlett-Packard printed the custom designs onto PVC-free wallpaper. The final mural now hangs in Hewlett-Packard’s Palo Alto headquarters.

Previously: Ensuring young dialysis patients make the grade

Medicine X, Stanford News, Technology, Videos

Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation

Medicine X symposium focuses on how patients, providers and entrepreneurs can ignite innovation

A special Medicine X event on Sept. 4 will explore how patients, providers and entrepreneurs can help ignite innovation in the health-care industry. During the daylong symposium, James Hereford, chief operating officer at Stanford Hospital & Clinics, will be presenting crucial opportunities for innovation in medicine today, and challenging physicians, patients and entrepreneurs to collaborate and build partnerships in an effort to create impact and change.

In the above Medicine X film, Hereford discusses the importance of patient-centered care, the need to treat the whole person and not just the illness and how including patients in pivotal discussions is crucial to transform health care. “I don’t think the world should be defined around us,” said Hereford. “I think the world should be defined around our patients.”

The brief conversation offers a taste of the thoughtful commentary that attendees can expect at this event. Other speakers include: Robert Pearl, MD, executive director and chief executive officer of The Permanente Medical Group; Stanford radiologist Lawrence Hoffman, MD; Mark Tomaino, senior industry executive at Welsh, Carson, Anderson & Stowe; Vivian Lee, MD, PhD, chief executive officer of University of Utah Health Care; and Alexandra Drane, co-founder of Eliza Corp. For more information or to register for the symposium visit the conference website.

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

Previously: Medicine X spotlights mental health, medical team of the future and the “no-smartphone” patient, Medicine X Live! to host Hangout on design thinking for patient engagement and Quite the reach: Stanford Medicine X set record for most number of tweets at a health-care conference

Cardiovascular Medicine, Patient Care, Stanford News, Technology, Videos

“Liberated from LVAD support”: One patient’s story

“Liberated from LVAD support”: One patient’s story

One of the first things I noticed about Donna Jackson — 68 years old when I met her in 2011 — was her decisive nature. She had a schedule filled with activity, and regardless of how many people (many of her children, grandchildren, great-grandchildren, in-laws and friends live very near at hand) came to visit in her modest home in Central California, she was a certain force of calm. She was also someone who did not like restrictions on what she could do.

Back then, she was just a few months out from surgery at Stanford Hospital to implant a mechanical pump, a left ventricular assist device or LVAD, on her heart. She knew it had saved her life, but she chafed at the battery, back-up battery and controller she had to wear at all times. Before the surgery, she had been a regular at a water aerobics class, and she loved to swim with her grandchildren. Even in those early months, Jackson was leaning on her Stanford doctors to find a way to get her back in the water. She asked her cardiologist, Dipanjan Banerjee, MD, to consider allowing her to swim in a wetsuit.

Banerjee did her one better. It had become apparent to him that she could be one of that small percentage of LVAD recipients whose heart recovers after the rest that the LVAD gives it and who no longer need the device. (He had been waiting, he said, to find a patient “who can be liberated from LVAD support.”) By Spring 2013, a little less than three years after her LVAD implantation, Banerjee and Jackson’s surgeon, Richard Ha, MD, put Jackson in an even smaller percentage. She became the first person to have her LVAD deactivated by catheter in the most minimally invasive approach yet.

The challenge set by Jackson for her Stanford team — and its groundbreaking procedural response — appears today in the August issue of the Annals of Thoracic Surgery. The lead author of the paper is Sanford Zeigler, MD, a cardiothoracic surgery resident.  Ha, surgical director of the hospital’s Mechanical Circulatory Support Program is the paper’s senior author, and Banerjee, medical director of Mechanical Circulatory Support Program, is a co-author. As they explain in the paper, Jackson, nearing 71,  was a high surgical risk for complete removal of the implant — that would have required them to crack open her ribs again — a procedure that’s followed typically by a long and sometimes painful recovery.  So, her doctors instead threaded a slim plastic tube through a small incision to her femoral artery in the groin and up to her aorta, allowed them to plug the flow of blood to the LVAD. Then, they cut, cleaned and capped the wiring powering the LVAD so it no longer emerged from an opening in her abdomen. (The LVAD remains inside Jackson’s chest.)

The new catheter-based deactivation of the LVAD has value beyond Jackson’s way of life, as the paper explains. She inspired the team to begin research on how to predict which LVAD patients might be like her and reach a point where they no longer need the LVAD. “If we can find out which patients are going to recover sooner, we can be more aggressive with them so they can be liberated from the LVAD,” said Banerjee, “and many of these patients will not want or be able to tolerate a complete removal of the LVAD.”

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Cancer, Health Costs, In the News, Stanford News, Videos

TV spot features a more humane approach to late-stage cancer care

Updated 8-4-14: The video is no longer posted on the Al Jazzera website, but the online story is still available.

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7-30-14: Is it possible to cut the costs of late-stage cancer care by 30 percent and provide a much better experience for patients?

That’s the question that recently brought an Al Jazzera America TV news crew out to the VA Palo Alto Health Care System, to interview patients enrolled in a new Stanford-designed pilot study on cancer care. You can watch their 9-minute video on this topic here.

The guiding principle behind this cancer-care program is this: Make sure that patients are fully informed about survival odds and treatment side effects well before they’re on the brink of death, when emotions overwhelm the decision-making skills of patients, their families and clinicians.

“Eighty percent of all cancer patients express a desire to die at home, yet only 10 percent do,” says Manali Patel, MD, the VA hospital oncologist running this study. “These end-of-life conversations, which typically take two hours in the beginning and require many follow-on conversations, are too hard, time-consuming and draining for a busy oncologist to do well.”

For these life-and-death discussions, patients are assigned personal care coaches who help them understand the big picture — treatment side effects, survival odds and pain-relief options. They also have access to a 24-hour symptom-management hotline and an option for in-home chemotherapy.

Architects of this new cancer care model, working with Arnold Milstein, MD, at Stanford’s Clinical Excellence Research Center, estimate that this program will lead to fewer unwanted treatments and expensive emergency room visits, saving the overall heath-care system money, while at the same time improving patient quality of life.

Previously: Communicating with terminally ill patients: A physician’s perspective, Identifying disparities in palliative care among cancer and non-cancer patients, Uncommon hero: A young oncologist fights for more humane cancer care, The money crunch: Stanford Medicine magazine’s new special report and New Stanford center to address inefficient health care

Cardiovascular Medicine, Research, Videos

Researchers capture detailed three-dimensional images of cardiac dynamics in zebrafish

Researchers capture detailed three-dimensional images of cardiac dynamics in zebrafish

The stunning video above depicts a reconstructed beating heart of a zebrafish embryo with the muscle layer shown in red and the endothelium highlighted in blue. Researchers at the Max Planck Institute of Molecular Cell Biology and Genetics in Germany created the video using a new three-dimensional imaging technique, which holds the promise of leading to a better “understanding of congenital heart defects as well in future experiments on cardiac function and development”. As explained in a release:

[Researchers] developed a high-speed, selective plane illumination microscope that manages to do just that. By gently illuminating the fish heart with a thin light sheet and observing the emitted fluorescence with a fast and sensitive camera the researchers have achieved fast, non-invasive imaging of labelled heart tissue. The process involves taking multiple movies, each covering individual planes of the heart (movie stacks), then using the correlations between the individual planes to generate a synchronised, dynamic 3D image of the beating heart.

“These renderings allow us to further follow characteristic structures of the heart throughout the cardiac cycle,” says Michaela Mickoleit, PhD student who performed the experiments in [Jan Huisken's] lab.

Via Medgadget
Previously: An advancement in optogenetics: Switching off cells with light now as easy as switching them on and New York Times profiles Stanford’s Karl Deisseroth and his work in optogenetics

Patient Care, Stanford News, Videos

More on the Navy pilot with mysterious symptoms – and the Stanford doctors who diagnosed him

More on the Navy pilot with mysterious symptoms - and the Stanford doctors who diagnosed him

Last week, we blogged about a Navy pilot whose mysterious symptoms were diagnosed by clinicians here. A just-published Stanford Hospital video shares more of Robert Buchanan’s compelling story.

Previously: Medical mystery solved: Stanford clinicians identify source of Navy pilot’s puzzling symptoms

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