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Biomed Bites, Microbiology, Research, Videos

Long a mystery organelle, the primary cilium is giving up its secrets

Long a mystery organelle, the primary cilium is giving up its secrets

Welcome to Biomed Bites, a weekly feature that introduces readers to some of Stanford’s most innovative researchers.

Picture a bacterium or a sperm cell — it has a flapping flagella, a hair-like structure that some species, and cells, use to move. There’s a different type of structure that protrudes out of the cells of many mammals called a primary cilium. Unlike flagella, this structure doesn’t move. Instead it receives mechanical and chemical signals from surrounding cells.

The primary cilium and its function is the focus of Max Nachury, PhD, an assistant professor of molecular and cellular physiology. His team is applying research on the cilium to learn more about a group of hereditary diseases characterized by a malfunctioning cilium such as Bardet-Biedl syndrome. Patients with BBS are often obese, have extra fingers or toes and have poor vision.

“These multi-symptomatic disorders caused by a defect in cilium function are really things we understand very poorly,” Nachury says in the video above. “We hope that our basic research can then feed back into the basic understanding of this disorder.”

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

Previously: Clues about kidney disease from an unexpected direction, Parent details practical ways to get care and support for your child’s rare disease and New search engine designed to help physicians and the public in diagnosing rare diseases

Events, Global Health, Health Policy, Pediatrics, Stanford News, Videos

Rajiv Shah discusses efforts to end preventable child deaths worldwide at Childx

Rajiv Shah discusses efforts to end preventable child deaths worldwide at Childx

The inaugural Childx conference was held here this month, and video interviews featuring keynote speakers, panelists and moderators are now on the Stanford YouTube channel. To continue the discussion of driving innovation in maternal and child health, we’ll be featuring a selection of the videos this month on Scope.

More than six million children under the age of five die from preventable diseases each year. During this year’s Childx conference, Rajiv Shah, MD, the former administrator of USAID, told the crowd, “I do think it’s possible to end preventable child death.”

In the video above, he explains how innovations in drug development, diagnostics and vaccines are among the solutions that are effectively reducing child mortality rates around the world. But there is still more that can be done. Using global health data to see in real-time where children are dying because of a lack of vaccines and places children are suffering as a result of poor health care, Shah said, could assist in more efficiently directing resources to these areas and other pockets of need. Watch the full interview with Shah to hear more about why he thinks ending preventable child death is achievable in the next 20 years.

Previously: Childx speaker Matthew Gillman discusses obesity prevention, Pediatric health expert Alan Guttmacher outlines key issues facing children’s health today, “It’s not just science fiction anymore”: Childx speakers talk stem cell and gene therapy and Global health and precision medicine: Highlights from day two of Stanford’s Childx conference

Aging, Medicine and Society, Pain, Palliative Care, Patient Care, Stanford News, Videos

“Everybody dies – just discuss it and agree on what you want”

"Everybody dies - just discuss it and agree on what you want"

Earlier this week, my colleague pointed to a New York Times essay penned by VJ Periyakoil, MD. In it, Periyakoil calls for a role-reversal in talking about end-of-life issues and encourages patients to take the lead in starting such conversations with their doctors. “Without these conversations, doctors don’t know what the patients’ goals are for living their last days,” she writes. “What are their hopes, wants, needs and fears? Do they want to die at the hospital connected to a machine? Do they want to die at home? The current default is for doctors to give patients every possible treatment for their condition, regardless of its impact on the patient’s quality of life, the cost or the patient’s goals.”

Periyakoil goes on to describe a letter that she and her colleagues created to help facilitate these patient-doctor conversations. The video above expands upon the Stanford Letter Project, which helps patients map out what matters most to them at the end of life, and includes the candid thoughts of numerous older adults.

“If I’m brain-dead, unplug me,” one woman says matter-of-factly. “And I want to die painless. No pain – just put me to sleep and don’t let me wake up.”

In the doctor’s office, one man shares his reason for writing a letter and expressing his wishes: “One of the worst things in the world that you can have happen [is you’re on] your deathbed and you’re putting the burden of life-altering decisions on a family member that has no clue of what you really want or don’t want.”

Advises another older man: “Don’t be ashamed of it – everybody dies. Just discuss it and agree on what you want.”

Previously: How would you like to die? Tell your doctor in a letter, In honor of National Healthcare Decisions Day: A reminder for patients to address end-of-life issues, Study: Doctors would choose less aggressive end-of-life care for themselves, On a mission to transform end-of-life care and The importance of patient/doctor end-of-life discussions

Cancer, Neuroscience, Pediatrics, Research, Stanford News, Videos

Brain tumor growth driven by neuronal activity, Stanford-led study finds

Brain tumor growth driven by neuronal activity, Stanford-led study finds

Nerve activity in the cerebral cortex can drive the growth of deadly brain tumors called high-grade gliomas, new research has found. The finding, from a study of mice with human brain tumors, provides a surprising example of an organ’s function driving the growth of tumors within it, according to Michelle Monje, MD, PhD, the Stanford neuroscientist who led the work. The work appears online today in Cell.

High-grade gliomas include tumors that affect children, teens and adults. They are the most lethal of all brain tumors, and their survival rates have scarcely improved in 30 years. Monje’s team and others around the world are trying to learn how the tumors arise and grow, with the hope that this understanding will enable development of new drugs that specifically attack the tumors’ vulnerabilities.

From our press release about the research:

Monje’s team identified a specific protein, called neuroligin-3, which is largely responsible for the increase in tumor growth associated with neuronal activity in the cerebral cortex. Neuroligin-3 had similar effects across the different types of high-grade gliomas, in spite of the fact that the four cancers have different molecular and genetic characteristics.

“To see a microenvironmental factor that affects all of these very distinct classes of high-grade gliomas was a big surprise,” Monje said.

The identity of the factor was also unexpected. In healthy tissue, neuroligin-3 helps to direct the formation and activity of synapses, playing an important role in the brain’s ability to remodel itself. The new study showed that a secreted form of neuroligin-3 promotes tumor growth.

“This group of tumors hijacks a basic mechanism of neuroplasticity,” Monje said.

Blocking the tumor-stimulating effects of neuroligin-3 might be an effective treatment for high-grade gliomas, Monje added.

In the video above, Monje describes some of the earlier work that led her team to ask whether nerve activity could drive tumor growth. In the healthy brain, it’s important for neuronal activity to be able to modify how the brain grows and develops, she explains – this is how experience changes our brains. But: “The growth-inducing effects of neuronal activity are very robust and it made me wonder if a similar physiology was being hijacked by glioma cells,” she says in the video.

Previously: Emmy nod for film about Stanford brain tumor research — and the little boy who made it possible, Big advance against a vicious pediatric brain tumor and New Stanford trial targets rare brain tumor

Biomed Bites, Imaging, Neuroscience, Research, Science, Videos

Vrrrooom, vrrrooom vesicles: A Stanford researcher’s work on neurotransmission

Vrrrooom, vrrrooom vesicles: A Stanford researcher's work on neurotransmission

Welcome to Biomed Bites, a weekly feature that introduces readers to some of Stanford’s most innovative researchers.

When one neuron wants to communicate with another neuron, it doesn’t talk, make gestures, or perform an interpretive dance. Instead, it ejects a vesicle filled with chemical information. That vesicle travels like an interstellar ship to the next neuron, which sucks it up, receiving the message.

And this isn’t a slow, hmm, maybe-I-should-send-this-out-sometime-today kind of message.

“The process of effusion of synaptic vesicles is very fast,” says Axel Brunger, PhD, in the video above. “It occurs on the order of a millisecond. It’s one of the fastest known biological processes, so we’re trying to understand this process at a molecular level and how it actually works is a big mystery at the moment.”

Brunger, the chair of the Department of Molecular and Cellular Physiology, and his team use a variety of optical imaging methods and high-resolution structural methods to examine the transmission of synaptic vesicles:

We’re now using our [in vitro] system to study the effect of a number of factors, including factors involved in a number of diseases.

What we are hoping from these studies is to obtain a better understanding of how these factors and then secondly and importantly, to develop new strategies or therapeutics to combat these diseases.

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

Previously: New insights into how the brain stays bright, Revealed: The likely role of Parkinson’s protein in the healthy brain and Examining the potential of creating new synapses in old or damaged brains 

Cancer, Events, Pediatrics, Stanford News, Videos

Pediatric nephrologist Mary Leonard discusses bone health in children with chronic diseases at Childx

Pediatric nephrologist Mary Leonard discusses bone health in children with chronic diseases at Childx

The inaugural Childx conference was held here last month video interviews featuring keynote speakers, panelists and moderators are now on the Stanford YouTube channel. To continue the discussion of driving innovation in maternal and child health, we’ll be featuring a selection of the videos this month on Scope.

Stanford pediatric nephrologist Mary Leonard, MD, initially began her career as a physician-scientist by investigating the bone complications of pediatric kidney disease. One of her earlier findings was that a number of the risk factors for poor bone development were also associated with many other childhood diseases, such as inflammatory bowel disease and cancer.

In the above video, Leonard explains how advances in treating pediatric kidney failure, cancer and other diseases is creating a growing population of survivors who are entering adulthood facing other health risks, including poor bone health, insulin resistance and cardiovascular disease. Watch the full interview to understand the magnitude of the problem and learn about efforts to develop prevention methods.

Previously: Childx speaker Matthew Gillman discusses obesity prevention, Pediatric health expert Alan Guttmacher outlines key issues facing children’s health today, “It’s not just science fiction anymore”: Childx speakers talk stem cell and gene therapy and Global health and precision medicine: Highlights from day two of Stanford’s Childx conference

Big data, Events, Stanford News, Videos

Stanford bioengineer discusses mining social media and smartphone data for biomedical research

Stanford bioengineer discusses mining social media and smartphone data for biomedical research

During the 2014 Big Data in Biomedicine conference, Stanford bioengineer and geneticist Russ Altman, MD, PhD, spoke about the possibility of collecting data directly from patients, via social media or smartphones, and using it to compliment traditional methods of gathering medical information to give clinicians an unprecedented capability to assess individuals’ state of health.

“One of the most exciting things is the ability to combine data at multiple levels,” he says in the video above. “We have an amazing ability to collect molecular data, cellular data, organism data from electronic medical records and population data about what’s happening at the population and global scale. The beauty of informatics is we don’t have to be tied to one of those levels.”

At the upcoming Big Data in Biomedicine conference, Altman will moderate a discussion with Kathy Hudson, PhD, deputy director for Science, Outreach, and Policy at the National Institutes of Health. Hudson leads the science policy, legislation, and communications efforts of the NIH and serves as a senior advisor to the NIH Director Francis Collins, MD, PhD. She is responsible for creating major new strategic and scientific initiatives and was a key architect of the National Center for Advancing Translational Sciences and the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative.

Registration for the conference, which will be held May 20-22 at Stanford, is currently open. More details about the program can be found on its website.

Previously: Big data used to help identify patients at risk of deadly high-cholesterol disorder, Examining the potential of big data to transform health care and Registration for Big Data in Biomedicine conference now open

Health and Fitness, In the News, Sleep, Videos

“Father of Sleep Medicine” talks with CNN about what happens when we don’t sleep well

"Father of Sleep Medicine" talks with CNN about what happens when we don't sleep well

Dement - smallA good night’s sleep is often the first thing to go when we have an important work deadline or health issue. I know this from firsthand (and recent!) experience: I let a foot injury kept me up until 4 a.m. today even though I know that cheating sleep – or getting a poor night of sleep – is bad for my health.

But is skimping out on sleep now and again really that bad? As Chief Medical Correspondent Sanjay Gupta, MD, and Stanford sleep expert William Dement, MD, PhD, explain in a recent CNN feature: yes. When we rest, our bodies go to work, Gupta explains: “When your head hits the pillow, your body doesn’t shut down. It uses that time to heal tissue, strengthen memory, even grow.”

Dement, who founded the Stanford Center for Sleep Sciences and Medicine in the 1970s and has devoted his career to understanding sleep, has lots of experience with patients who miss out on these benefits because they don’t sleep well – due to obstructive sleep apnea. (The disorder, he says, affects 24 percent of adult males in the U.S.) In the piece, he and Gupta discuss the risk factors, such as excess weight and large tonsils, linked to sleep apnea and what can be done to alleviate the problem.

If you have a few minutes, this video is worth a watch. Dement makes his first appearance at the 2.5-minute mark.

Previously: Stanford doc gives teens a crash course on the dangers of sleep deprivationWilliam Dement: Stanford Medicine’s “Sandman”Stanford docs discuss all things sleep, Why untreated sleep apnea may cause more harm to your health than feeling fatigued and What are the consequences of sleep deprivation?
Photo, which originally appeared in Stanford Medicine, by Lenny Gonzalez

Aging, Medicine and Society, Videos

In honor of National Healthcare Decisions Day: A reminder for patients to address end-of-life issues

In honor of National Healthcare Decisions Day: A reminder for patients to address end-of-life issues

When San Jose, Calif. residents Shirley and Eddie Jones wanted to discuss their end-of-life wishes, they encountered resistance from an unexpected source. As detailed in the video above, their beloved children refused to participate in the conversation.

As with the Jones, the people who love you the most may not be willing to help you because they care too much – and your doctors may be largely silent as they’re uncomfortable broaching this sensitive topic for fear of offending you. So, when it comes to end-of-life planning, you’re largely on your own. And it’s important that you take the first step and break this wall of silence.

Even as you’re reading this, you may be thinking that the topic of end-of-life decision making is not relevant to you right now – that it’s too early. Or it may be that you’re uncomfortable thinking about death. You may even be waiting for your doctor to broach this subject with you and lead the way. After all, as long as you do what the doctor tells you to do, you can get pretty good results with your health care. But, this ‘wait-for-your-doctor’ strategy isn’t going to serve you well when it comes to end-of-life decision making and planning.

Don’t believe me? Then just take a moment to review the evidence (link to .pdf): Eighty percent of people say that it’s important to have end-of-life wishes in writing, but only 23 percent say they have have done so. Eighty percent wish to have end-of-life conversations with their doctor but only 7 percent get to do this. Research also shows that most doctors have neither the training nor the time to skillfully conduct end-of-life conversations with their patients.

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Biomed Bites, Immunology, Research, Science, Technology, Videos

Not immune from the charms of the immune system

Not immune from the charms of the immune system

Welcome to Biomed Bites, a weekly feature that introduces readers to some of Stanford’s most innovative researchers.

Once upon a time, a researcher named Holden Maecker, PhD, met flow cytometry, a technique used to examine cells by suspending them in fluid and then passing them by an electronic detector.

A match that could only be made in a science lab, Maecker was hooked. Maecker tells the tale in the video above:

Flow cytometry is a great technique for looking at the immune system and it’s also a little bit of an art, which also attracted me. It’s something that not everybody can do perfectly well and I got a little bit good at it and decided it was a fun thing to do and a good way to look at the immune system.

Maecker and flow cytometry haven’t parted, yet he’s broadened his mastery of a variety of other techniques to study the immune system as the director of Stanford’s Human Immune Monitoring Center.

“It’s a very interesting position because it allows me to collaberate with a lot of different peopel doing projects that have to do wiht human immune responses — everything from sleep apnea and wound healing to flu vaccines and HIV infections,” Maecker said. “It’s amazing the breadth we have here [at Stanford].”

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

Previously: Knight in lab: In days of yore, postdoc armed with quaint research tools found immunology’s Holy Grail, Immunology meets infotech and Stanford Medicine magazine traverses the immune system

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