Stories about: John Brownstein

Scientists find link between increases in local temperature and antibiotic resistance

Image representing the rise of antibiotic resistance
Illustration by Fawn Gracey

Over-prescribing has long been thought to increase antibiotic resistance in bacteria. But could much bigger environmental pressures be at play?

While studying the role of climate on the distribution of antibiotic resistance across the geography of the U.S., a multidisciplinary team of epidemiologists from Boston Children’s Hospital found that higher local temperatures and population densities correlate with higher antibiotic resistance in common bacterial strains. Their findings were published today in Nature Climate Change.

“The effects of climate are increasingly being recognized in a variety of infectious diseases, but so far as we know this is the first time it has been implicated in the distribution of antibiotic resistance over geographies,” says the study’s lead author, Derek MacFadden, MD, an infectious disease specialist and research fellow at Boston Children’s Hospital. “We also found a signal that the associations between antibiotic resistance and temperature could be increasing over time.”

During their study, the team assembled a large database of U.S. antibiotic resistance in E. coli, K. pneumoniae and S. aureus, pulling from hospital, laboratory and disease surveillance data documented between 2013 and 2015. Altogether, their database comprised more than 1.6 million bacterial specimens from 602 unique records across 223 facilities and 41 states.

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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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Digital doctoring, big data and AI: Five takeaways

digital health

Big data and artificial intelligence are reshaping our world. Earlier this month, at Computefest 2018, organized by the Institute for Applied Computational Science at Harvard University, held the symposium, “The Digital Doctor: Health Care in an Age of AI and Big Data.” Speakers were:

  • Finale Doshi-Velez, PhD, Assistant Professor of Computer Science, Harvard University
  • Matt Might, Director, Hugh Kaul Personalized Medicine Institute, University of Alabama at Birmingham
  • John Brownstein, PhD, Chief Innovation Officer and Director, Computational Epidemiology Lab, Boston Children’s Hospital
  • Marzyeh Ghassemi, PhD, Visiting Researcher, Google’s Verily; Postdoctoral Fellow, Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology
  • Jennifer Chayes, Managing Director, Microsoft Research New England and New York City
  • Emery Brown, PhD, Professor of Medical Engineering and Computational Neuroscience, Massachusetts Institute of Technology

Here are Vector’s five takeaways from the symposium:

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Cellphone data reveals Hurricane Maria’s impact on travel in Puerto Rico

Residents evacuate Puerto Rico after Hurricane Maria made landfall
A U.S. Naval Aircrewman leads residents of Puerto Rico to a helicopter for evacuation following the landfall of Hurricane Maria. Photo credit: Sean Galbreath/Wiki Commons

Nearly two months after Hurricane Maria swept through Puerto Rico, the infrastructural damage remains evident — today, FEMA estimates that only 41 percent of the island has had power restored. But the impact on human behavior is just beginning to be understood.

Research collaborators from the Boston Children’s Hospital Computational Epidemiology Group, MIT Media Lab and Google, Inc., have shed light on the particulars of when people chose to move out of the hurricane’s path and how much travel has been hindered since destructive winds and flooding knocked Puerto Rico off the grid.

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What do hospitals want from prospective digital health partners?

how digital health startups can better approach hospitals
How digital health startups can better approach hospitals.

How can the growing number of digital health startups sell their products to large-scale healthcare enterprises? Earlier this year, Rock Health, a San Francisco-based venture fund dedicated to digital health, conducted 30-minute interviews with executives at multiple startups and a few large healthcare organizations. They identified several key sticking points: navigating the internal complexities of hospitals, finding the right buyer, identifying the product’s value proposition and relevance to the hospital and avoiding “death by pilot.”

Now, in a Rock Health podcast, John Brownstein, PhD, Chief Innovation Officer at Boston Children’s Hospital’s Innovation and Digital Health Accelerator and Adam Landman, MD, MS, MIS, MHS, Chief Information Officer at Brigham and Women’s Hospital and part of its Innovation Hub, offer further tips from the inside. They were hosted by Rock Health’s director of research, Megan Zweig.

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Predicting influenza outbreaks faster with a digitally-empowered wearable device

Influenza viruses. Outbreaks can be predicted using digital health tools like Thermia.The Thermia online health educational tool, developed at Boston Children’s Hospital, has enabled one-month-faster prediction of seasonal influenza outbreaks in China, via its digital integration with a commercially-available wearable thermometer. The findings appear in a new study published in the American Journal of Public Health.

 “The fact that we were able to predict influenza outbreaks faster than China’s national surveillance programs really shows the capacity for everyday, wearable digital health devices to track the spread of disease at the population level,” says the study’s lead author Yulin Hswen, who is a research fellow in Boston Children’s Computational Epidemiology Group and a doctoral candidate at the Harvard T. H. Chan School of Public Health.

China has 620 million mobile internet users who can theoretically access the standalone Thermia application from any computer, smartphone or even the Amazon Alexa assistant.

Although the Boston Children’s team has previously demonstrated that social media can be used to track disease, this is the first time they’ve shown that outbreaks can be predicted through an integrated wearable device and online tool.

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Plugging gaps in Zika surveillance with online news reports

Zika surveillance
Zika virus disease reports as of May 31, 2016 (click to enlarge)

As the Zika epidemic continues to unfold, most affected countries are flying blind: they have limited government disease surveillance systems in place to track new cases. That leaves public health officials unable to estimate how fast Zika is spreading, where the hotspots are and when the outbreak will peak — much less contain it and prepare for cases of microcephaly and Guillain-Barré syndrome, both now presumed to be caused by the Zika virus.

“One of the things we really struggled with in the early days of Zika was a lack of official data sources,” says research fellow Maia Majumder, MPH, of the Computational Epidemiology Group at Boston Children’s Hospital. “Surveillance has been really lagging. When we don’t know how many cases there are day to day, week to week, it’s really hard to characterize how bad an outbreak is.”

A study this week led by Majumder suggests a readily available data source for estimating actual case counts on the ground: online local news reports, adjusted using data from Google search trends.

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Ten child health innovations headed to SXSWi

Impact Pediatric Health child health innovation
(U.S. Army/Lori Yerden via Flickr)

Innovation in pediatrics is alive and well. On March 14, at the South by Southwest Interactive (SXSWi) festival in Austin, Tex., Impact Pediatric Health will run its second annual pitch competition for digital health and medical device startups. Based on the ten child health innovations to be pitched, it promises to be as inspiring as last year’s event.

Judges include representatives from the four founding hospitals — Boston Children’s Hospital, Cincinnati Children’s Hospital, Texas Children’s Hospital and Children’s Hospital of Philadelphia — and from Sesame Workshop, whose recently announced Sesame Ventures plans to support companies that “help kids grow smarter, stronger and kinder.”

John Brownstein, PhD, chief innovation officer at Boston Children’s and one of the judges on the panel, agrees with that mission. “When it comes to innovation, pediatrics is often a second thought or gets left out altogether,” he says. “I’m extremely impressed with the landscape this year and the breadth of startup ideas.”

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Digital health, innovation and partnerships: A Q&A with Boston Children’s Chief Innovation Officer

Brownstein
Brownstein

During the last decade or so, health care has been rapidly transforming from a reactive, paper-based system to a responsive digital model.

Massachusetts, under Gov. Charlie Baker’s leadership, has launched a comprehensive public-private partnership to accelerate the state’s digital health care sector. The partnership has identified multiple ways to drive investment and growth in the state.

Technology transfer from universities to private companies is just one example. In the past, each transfer required completely new agreements. Three new standardized templates for licensing, technology transfer and sponsored research will help facilitate these processes. In 2016, the partnership will expand its Mentorship Speakers Series with a stronger focus on digital health care. Finally, the Digital Healthcare Innovation Hub and Accelerator will provide a space to support and grow new digital health companies in Boston.

Vector visited with John Brownstein, PhD, Boston Children’s Hospital’s Chief Innovation Officer, to better understand the background and potential impact of this new initiative.

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Mapping antibiotic resistance near you: ResistanceOpen

antibiotic resistance mapping ResistanceOpen

At the moment, it would appear the bacteria are winning. Antibiotic resistance is on the rise globally (in part because much of the public may not really understand how antibiotics work), threatening doctors’ ability to treat bacterial infections and potentially making surgery, chemotherapy and other medical procedures whose safety depends on antibiotic prophylaxis more risky.

Mapping antibiotic resistance — which bacteria are resistant to which drugs, and where — can help clinicians and public health officials decide how best to focus their control efforts. The challenge to date has been compiling resistance data in geographically useful ways.

“The data about antibiotic resistance are fragmented across laboratories and hospitals globally,” says Derek MacFadden, MD, a doctoral student at the Harvard T.H. Chan School of Public Health who is working with the HealthMap team in Boston Children’s Computational Health Informatics Program. “Most of the data that are available are very high level, so you can’t get an understanding of regional-level antibiotic resistance.”

This is where ResistanceOpen could come in handy. This new tool, launched by HealthMap team this week during the World Health Organization’s World Antibiotic Awareness Week, provides a window into regional and local antibiotic resistance patterns across the globe.

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