Author: Tom Ulrich

My work, my life: John Brownstein, PhD

Boston Children’s Hospital’s new chief innovation officer, John Brownstein, PhD, is an epidemiologist by training and a founding father of the growing field of digital epidemiology—the use of digital (especially social and mobile) data from a variety of sources to detect and track disease and promote health. As co-founder of HealthMap and director of the Computational Epidemiology Group in the hospital’s Computational Health Informatics Program, he infuses his work into many aspects of his life—along with a healthy helping of hot sauce.

Hover over the icons in the photo below to learn about the things in Brownstein’s phone, office and life that keep him going.

Brownstein will be one of four panelists discussing Patient Engagement in a Big Data World at Boston Children’s Global Pediatric Innovation Summit + Awards 2015. Learn more about the summit and register to attend.

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Daniel Kohane, MD, PhD, at TEDMED: “Smart vehicles for safer medications”

“The drugs that I take don’t just go to the places in my body they’re supposed to go to do the things they do. They actually go everywhere. And what they do in those other places can be whatever.”

With those words, Daniel Kohane, MD, PhD—director of the Laboratory for Biomaterials and Drug Delivery at Boston Children’s Hospital—launched into a TEDMED talk about technologies that get drugs to where they need to go with much greater precision, like:

“Progress in this field is limited only by the imagination of the investigators and, to some degree, by reality,” says Kohane, who also sees patients in Boston Children’s Department of Critical Care Medicine. “You can achieve really big things by thinking really small.”

Click the image above to watch his whole talk.

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So, what’s your digital phenotype?

Ideally, we’re all supposed to see our doctor once a year for a checkup. It’s an opportunity to see how we’re doing from a health perspective, address any concerns or issues that we may have and catch any emerging issues before they become true problems.

But those visits are really only one-time, infrequent snapshots of health. They don’t give a full view of how we’re doing or feeling.

Now, think for a moment about how often you post something to Facebook or Twitter. Do you post anything about whether you’re feeling ill or down, or haven’t slept well? Ever share how far you ran, the route you biked or your number of steps for the day?

Every time you do, you’re creating a data point—another snapshot—about your health. Put those data points together, and what starts to emerge is a rich view of your health, much richer than one based on the records of your occasional medical visit.

As John Brownstein, PhD—director of the Computational Epidemiology Group (CEG) in Boston Children’s Hospital’s Computational Health Informatics Program and the hospital’s new Chief Innovation Officer—explains in this episode of the Harvard Medical School (HMS) Labcast (click the image above to hear it), this view has a name: your digital phenotype.

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Targeting inflammation in sickle cell disease with fatty acids

sickle cell disease red blood cells
(OpenStax College/Wikimedia Commons)

Painful, tissue-damaging vaso-occlusive crises (a.k.a. pain crises) are one of the key clinical concerns in sickle cell disease (SCD). The characteristic C-shaped red blood cells of SCD become jammed in capillaries, starving tissues of oxygen and triggering searing pain. Over a patient’s life, these repeated rounds of oxygen deprivation (ischemia) can take a heavy toll on multiple organs.

There’s some debate as to why these crises take place—is the sickled cell’s shape and rigidity at fault, or are the blood vessels chronically inflamed and more prone to blockage? Either way, doctors can currently do little to treat vaso-occlusive crises, and nothing to prevent them.

The inflammation view, however, is leading some researchers to ask whether omega-3 fatty acids—which can alleviate inflammation—might be part of the solution. A recent mouse study in the journal Haematologica, led by Mark Puder, MD, PhD, of Boston Children’s Vascular Biology Program, and Carlo Brugnara, MD, of the hospital’s Department of Laboratory Medicine reveals some molecular clues and suggests that human trials of omega-3s might be a good next step.

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How our neutrophils might sabotage wound healing in diabetes

When you get a cut or a scrape, your body jumps into action, mobilizing a complicated array of cells and factors to stem bleeding, keep the wound bacteria-free and launch the healing process.

For most of us, that process is complete in a couple of weeks. But for many people with type 1 and type 2 diabetes, delayed wound healing can have permanent consequences. For example, between 15 and 25 percent of diabetes patients develop chronic foot ulcers. Those ulcers are the root cause of roughly two-thirds of lower limb amputations related to diabetes.

Why don’t these wounds close? Blame a perfect storm of diabetic complications, such as reduced blood flow, neuropathy and impaired signaling between cells. According to research by Denisa Wagner, PhD, of Boston Children’s Hospital’s Program in Cellular and Molecular Medicine, a poorly understood feature of our immune system’s neutrophils may be one more ingredient in the storm.

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Sun Hur, PhD: Overcoming barriers to reveal innate immunity’s secrets

Self-discovery is a theme that unites Sun Hur’s life and work. Growing up with a passion for physics, Hur pursued a scientific career in chemistry before launching her own research group in biology. Today, Hur, an investigator in Boston Children’s Hospital’s Program in Cellular and Molecular Medicine (PCMM), uses her considerable intellectual gifts to uncover how the immune system distinguishes self from non-self.

In the video above, produced by the Vilcek Foundation (which honors and supports foreign-born scientists and artists who have made outstanding contributions to society in the United States), Hur talks about her personal and scientific journey since coming to the U.S. from her native South Korea in 2000. Overcoming cultural and language barriers, she has turned her childhood fascination with order and chaos toward exploring how the innate immune system recognizes invaders, in particular disease-causing viruses that generate a double-stranded RNA during replication.

These studies, which could open doors to new treatments for cancer and inflammatory diseases, recently garnered her the Vilcek’s 2015 Prize for Creative Promise in Biomedical Science.

Adapted from announcements originally published by the Vilcek Foundation and the PCMM.

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What we’ve been reading: Week of May 25, 2015

paszczak000/Flickr https://www.flickr.com/photos/paszczak000/3311707373/
(paszczak000/Flickr)

The White House draws the line against CRISPR/Cas9-designed embryos (FierceBiotechResearch)

Responding to Chinese scientists’ attempt to use CRISPR gene editing technology to edit human embryos, the White House spoke up, saying, “altering the human germline for clinical purposes is a line that should not be crossed at this time.”

Smartphones put medical diagnostics in your hands (Chemical & Engineering News)

Could smartphones help monitor disease outbreaks? Screen patients for cancer? Diagnose HIV? With the right attachments and data, the answer could one day be yes.

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Clinicians and social media: Finding the right relationship

doctor_social_media_shutterstock_264246836_260x260I remember the day about 15 years ago when my doctor tentatively gave me his email address, telling me he trusted that I wouldn’t abuse it. (For the record, I’ve used that address maybe five times.)

Fast forward to today, where doctors and nurses are frequently on social media the same as the rest of us, usually behaving well, sometimes not.

What place do social media have in a physician or nurse’s career? And where do the boundaries lie?

Read the full story on Boston Children’s Hospital’s new blog for healthcare providers, Notes.

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Is that fever a problem? Ask Thermia

Thermia fever calculator HealthMap

Your child’s forehead is warm, and you just took her temperature. The next question is, what to do about it? We all know that an average normal temp is 98.6°F, but is 100° a problem? Should 102° be a concern?

This is where Thermia comes in. It’s an online fever calculator developed by the HealthMap team at Boston Children’s Hospital. Essentially, it’s an educational tool aimed at helping concerned parents interpret a child’s temperature and understand which steps they should consider taking.

“I’m a father of two, and I still wonder sometimes what a temperature actually means,” says HealthMap co-founder John Brownstein, PhD. “We realized that there really aren’t any fever calculators out there to help parents answer that question.

“Our idea with Thermia,” he adds, “was to arm families with information so they don’t panic when their child has a temperature.”

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The design world’s eyes are on organs-on-chips

Organs-on-chips Museum of Modern Art MoMA London Design Museum exhibit Wyss Institute Vascular Biology
Organs-on-chips on display in New York City’s Museum of Modern Art. (Photo: Wyss Institute at Harvard University)

[Update 5/18/15: According to a Wyss Institute press release, the Design Museum in London has selected the organs-on-chips as the winner of their 2015 Designs of the Year exhibition’s Product category.]

If you’re in New York City in the next few months, pop into the Museum of Modern Art (MoMA) and stop by the “This Is For Everyone: Design For The Common Good” exhibit. There—alongside displays dedicated to the “@” symbol, the pin icon from Google Maps and bricks made from living mushroom roots—you’ll find three small silicone blocks mounted on a wall panel.

Those blocks are actually three of the organs-on-chips developed in the lab of Donald Ingber, MD, PhD, founding director of the Wyss Institute for Biologically Inspired Engineering and a scientist in Boston Children’s Hospital’s Vascular Biology Program.

Earlier this month, MoMA announced its plans to include the chips as part of their exploration of contemporary design in the digital age. In the museum’s eyes, organs-on-chips are more than a way to model disease in a complex, living system—they’re also art.

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