Stories about: Innovation

Science Seen: Using Twitter to map hospitals’ stance toward LGBT patients

Hswen Y et al. Social Science & Medicine Oct 2018. DOI: 10.1016/j.socscimed.2018.08.031  

How sensitive are hospitals to the needs of lesbian, gay, bisexual and transgender (LGBT) patients? In a 2010 survey by Lambda Legal, 70 percent of transgender patients and 56 percent of gay/lesbian/bisexual patients reported discrimination from health care providers. Clinicians refused to provide needed care, refused to touch them or used excessive precautions, blamed them for their health status, were verbally abusive or were physically violent.

A new exploratory study, published in the October issue of Social Science & Medicine, turned to social media for a view from the ground. The researchers, Yulin Hswen of Harvard T.H. Chan School of Public Health and Jared Hawkins, PhD, MMSc, of Boston Children’s Hospital’s Informatics Program, analyzed 1,856 publicly available tweets from 2015-2017.

“Information from social media and other online sources can help us gain authentic and unsolicited accounts from vulnerable patient groups, like LGBT individuals who are not typically represented,” says Hswen.

Based on the tweets, the team determined which hospitals were more supportive of LGBT patients (the blue dots in the above map) and which were less supportive (the red dots).

The identified tweets included Twitter handles from 653 hospitals and contained LGBT-related terms: LGBT, transgender, trans, intersex, sex change, transisbeautiful, tranny, drag queen, preferred pronoun, transhealth, genderodyssey, cis, gay, lesbian, queer, rainbowhealth, gender fluid, homosexual, bisexual, homo, homophob and transphobe. A tweet classed as supportive might read, “@Hospital is hosting a LGBT resource fair;” a negative tweet might read: “Having sex with men does not mean I deserve less @Hospital.”

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In zebrafish, a way to find new cancer therapies, targeting tumor promoters

A new study suggests the power of zebrafish as tools for cancer drug discovery (PHOTO: KATHERINE C. COHEN)

The lab of Leonard Zon, MD, has long been interested in making blood stem cells in quantity for therapeutic purposes. To test for their presence in zebrafish, their go-to research model, they turned to the MYB gene, a marker of blood stem cells. To spot the cells, Joseph Mandelbaum, a PhD candidate in the lab, attached a fluorescent green tag to MYB that made it easily visible in transparent zebrafish embryos.

“It was a real workhorse line for us,” says Zon, who directs the Stem Cell Research Program at Boston Children’s Hospital.

In addition to being a marker of blood stem cells, MYB is an oncogene. About five years ago, Zon was having lunch at a cancer meeting and, serendipitously, sat next to Jeff Kaufman, who was also interested in MYB. Kaufman was excited to hear about Zon’s fluorescing MYB zebrafish, which can be studied at scale and are surprisingly similar to humans genetically.

“Have you ever heard of adenoid cystic carcinoma?” he asked Zon.

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Genomic sequencing for newborns: Are parents receptive?

BabySeqCasie Genetti, MS, CGC is a licensed genetic counselor with the Manton Center for Orphan Disease Research at Boston Children’s Hospital. She is first author of a recently published paper on the BabySeq Project.

The idea of genomic sequencing for every newborn has many in the scientific community buzzing with excitement, while leaving others wary of the ethical and social implications. But what do the parents think? The BabySeq Project has been exploring parental motivations and concerns while assessing their willingness to participate in a pilot newborn sequencing study.

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‘See through,’ high-resolution EEG recording array gives a better glimpse of the brain

Transparent microelectrodes allow EEG recording at the single-neuron level, with simultaneous 2-photon optical imaging of calcium activity.
Transparent microelectrodes allow EEG recording at the single-neuron level, with simultaneous 2-photon optical imaging of calcium activity. (CREDIT: Yi Qiang et al. Sci. Adv. 4, eaat0626 (2018).)

Electroencephalography (EEG), which records electrical discharges in the brain, is a well-established technique for measuring brain activity. But current EEG electrode arrays, even placed directly on the brain, cannot distinguish the activity of different types of brain cells, instead averaging signals from a general area. Nor is it possible to easily compare EEG data with brain imaging data.

A collaboration between neuroscientist Michela Fagiolini, PhD at Boston Children’s Hospital and engineer Hui Fang, PhD at Northeastern University has led to a highly miniaturized, see-through EEG device. It promises to be much more useful for understanding the brain’s workings.

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A life-saving adjustment in IV nutrition cleared by the FDA

Fourteen years after Charles Rolfe received an experimental IV fish-oil solution, Omegaven has been approved by the FDA. (PHOTOS: WEBB CHAPPELL/ROLFE FAMILY)

In 2004, a surgeon and a hospital pharmacist went against the prevailing dogma. They began revising the IV nutrition formula being given to children unable to take food by mouth. In doing so, they saved many lives. Yet, it wasn’t until last month that their intervention, a new fat emulsion called Omegaven, gained formal approval from the Food and Drug Administration.

Children with intestinal failure due to gastroschisis, necrotizing enterocolitis or other diseases are typically placed on parenteral nutrition, an intravenous method of feeding. Without it, they would die. But prolonged use of IV nutrition — using the traditional formula — had a massive side effect: injury to the liver. The majority of children either died from liver failure or required a liver transplant.

By 2001, surgeon Mark Puder, MD, at Boston Children’s Hospital was tired of watching babies slowly die from liver disease that should be preventable. He suspected something needed to be adjusted in the IV nutrition formula — particularly the fat component, derived from soybean oil and known as Intralipid.

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A tissue engineered heart ventricle for studying rhythm disorders, cardiomyopathy

a tissue engineered heart ventricle
(Luke MacQueen and Michael Rosnach/Harvard University)

While engineered heart tissues can replicate muscle contraction and electrical activity in a dish, many aspects of heart disease can only adequately be captured in 3D. In a report published online yesterday by Nature Biomedical Engineering, researchers describe a scale model of a heart ventricle, built to replicate the chamber’s architecture, physiology and contractions. Cardiac researchers at Boston Children’s Hospital think it could help them find treatments for congenital heart diseases.

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Vessel-lengthening technique offers game change for a rare vascular condition

TESLA concept for midaortic syndrome

Tissue expanders — small balloons that can be filled with saline solution or other fluids to grow skin — have long been used in plastic surgery, most commonly breast reconstruction. They’re based on the simple idea that the surrounding skin will stretch as the device expands over time. That extra skin can then help repair injuries or congenital anomalies or accommodate implants.

Now, a novel approach extends tissue expansion to blood vessels. It is transforming the way that surgeons treat a rare but serious condition called midaortic syndrome, report Heung Bae Kim, MD, Khashayar Vakili, MD and their colleagues at Boston Children’s Hospital.

Midaortic syndrome occurs when the middle section of the aorta is narrowed and typically affects children and young adults. It can cause severe hypertension and can be life-threatening if left untreated. The surgical approach to this condition would be to replace the damaged portion of the aorta with nearby healthy blood vessels. However, this usually isn’t possible because these vessels tend to be too short to adequately fill in.

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Forecasting the convergence of artificial intelligence and precision medicine

Image of artificial DNA, which in combination with other artificial intelligence could contribute to an artificial model of the immune system
Will an artificial model of the immune system be the key to discovering new, precision vaccines?

This is part I of a two-part blog series recapping the 2018 BIO International Convention.

At the 2018 BIO International Convention last week, it was clear what’s provoking scientific minds in industry and academia — or at least those of the Guinness-world-record-making 16,000 people in attendance. Artificial intelligence, machine learning and their implications for tailor-made medicine bubbled up across all BIO’s educational tracks and a majority of discussions about the future state of biotechnology. Panelists from Boston Children’s Hospital also contributed their insights to what’s brewing at the intersection of these burgeoning fields.

Isaac Kohane, MD, PhD, former chair of Boston Children’s Computational Health and Informatics Program, spoke on a panel about how large-scale patient data — if properly harnessed and analyzed for health and disease trends — is a virtual goldmine for precision medicine insights. Patterns gleaned from population health data or electronic health records, for example, could help identify which subgroups of patients who might respond better to specific therapies.

According to Kohane, who is currently the Marion J. Nelson Professor of Biomedical Informatics and Pediatrics at Harvard Medical School (HMS), we will soon be leveraging artificial intelligence to go through patient records and determine exactly what doctors were thinking when they saw patients.

“We’ve seen again and again that data abstraction by artificial intelligence is better than abstraction by human analysts when performed at the scale of millions of clinical notes across thousands of patients,” said Kohane.

And based on what we heard at BIO, artificial intelligence will revolutionize more than patient data mining. It will also transform the way we design precision therapeutics — and even vaccines — from the ground up.

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Viral discussion: Epidemics experts sound off on the future of infection control

Image of flu virus, which experts think will eventually lead to future epidemics
Is the next flu pandemic around the corner?

During the 1918 influenza pandemic, the average life expectancy in the U.S. dropped below 40 years old. Today, public health and medical professionals need to be actively preparing for the next great pandemic, according to leaders of the Massachusetts Medical Society, The New England Journal of Medicine and Microsoft founder Bill Gates, who delivered the keynote address at a Boston-based meeting on April 27 called Epidemics Going Viral: Innovation vs. Nature. Here’s recap of what we heard from various panelists.

The five key drivers of epidemics are population growth/urbanization, travel, animals, environmental/climate changes and conflicts/natural disasters, according to Harvey Fineberg, MD, PhD, President of the Gordon and Betty Moore Foundation and former president of the Institute of Medicine. When it comes to predicting and preventing the next epidemic, Fineberg believes that data from a social media platform like Twitter isn’t going to help identify the next big outbreak.

But John Brownstein, PhD, an epidemiologist and Chief Innovation Officer at Boston Children’s Hospital, disagreed with that idea.

“I believe it’s possible for Twitter to find the next microbe,” Brownstein said. “This information comes in real time and at global scale.” Attendees who were live tweeting with the hashtag #epidemicsgoviral were quick to highlight this difference of opinion.

Uber flu shot, “a cool millennial thing to do”

Anne Schuchat, MD, deputy director of the Centers of Disease Control, busted the myth that non-vaccination rates are rising. She explained that media stories about anti-vaccination supporters can make it seem as though vaccination rates are falling when they actually aren’t.

“Less than one percent of kids aren’t vaccinated in the U.S.,” Schuchat said.

But some vaccinations, like the annual flu shot, still have big gaps to close. Brownstein described how a partnership with Uber — dispatching flu vaccines and nurses to people’s homes — was able to influence people to get their first-ever flu shot.

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Families and data scientists build insights on Phelan-McDermid syndrome

querying stacks of data

This is the third year that Jacob Works has made the trip down to Boston Children’s Hospital from Maine. With research assistant Haley Medeiros, he looks at pictures, answers questions, manipulates blocks and mimes actions like knocking on a door. His father, Travis, and another research assistant look on through a window.

“At first, we had to practically bribe him with an iPad with every task,” Travis says. “This year he’s more excited, because he understands more and is more confident and able to share more.”

Jacob, 11, was diagnosed in 2011 with Phelan-McDermid Syndrome, a rare genetic condition that typically causes children to be born “floppy,” with low muscle tone, and to have little or no speech, developmental delay and, often, autism-like behaviors. At the time, Jacob was one of about 800 known cases. But through chromosomal microarray testing, introduced in just the past decade for children with autism symptoms, more cases are being picked up.

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