Monday, November 12, 2007

Long-term beta carotene use may help aging brains, study suggests

By Elizabeth Cooney, Globe Correspondent

Older men in good health who took beta carotene for about 18 years had better memory skills than similar men who took a placebo for the same length of time, a Harvard study shows.

The antioxidant, found in carrots, showed no benefit when taken for only three years, pointing to long duration as a critical factor in possibly slowing cognitive decline, which is a strong predictor of dementia.

The improvement was modest: Brain aging was delayed by about a year in men who took beta carotene long-term, author Francine Grodstein of Brigham and Women’s Hospital said in an interview. The study appears in today’s Archives of Internal Medicine.

She cautioned that it was too soon to recommend that men take beta carotene supplements. Beta carotene also has risks: Previous research has connected beta carotene to increased rates of lung cancer in smokers.

“Even though the changes that we saw are relatively modest, it is known that even modest changes in your memory can have a pretty big impact on the risk of dementia over the long term,” Grodstein, an associate professor of medicine at Harvard Medical School, said. It's the first study, she added, to find something that may help healthy people's memory.

The study followed about 6,000 men enrolled in the Physicians’ Health Study II over two time periods. They were given either 50 milligram pills of beta carotene or a placebo every other day. The first group participated for an average of 18 years and the second group for up to three years. They took tests of memory over the phone.

There was no improvement in the men who took beta carotene for the shorter time. The men who were on long-term beta carotene treatment did better, showing delays in cognitive aging of one to one and a half years, the study says.

In an accompanying editorial, Dr. Kristine Yaffe of the University of California, San Francisco, says it's plausible that long-term treatment may be necessary to have an effect on a disease that takes a long time to develop. But she also suggests there may be other interpretations of the results. In particular, she notes that the study doesn’t consider whether the men who took beta carotene for 18 years, staying in the study until it's completion, might be somehow different from men who did not continue to participate in the trial.

“For the clinician, there is no convincing justification to recommend the use of antioxidant dietary supplements to maintain cognitive performance in cognitively normal adults or in those with mild cognitive impairment,” she writes.

Grodstein said being conservative is appropriate.

“We don’t want to tell people to run out and start taking it immediately,” she said. “If we keep doing the research and keep working at it, it should give people hope we are going to be able to find something to help them keep their memory.”

Posted by Elizabeth Cooney at 05:01 PM

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Friday, November 9, 2007

Open access, open debate

Making scientific articles free and available to all is only fair to the taxpayers who support research and the developing countries who need it, a Nobel laureate at the forefront of the open-access movement said at a forum today, but the editor of a prestigious journal likened that approach to vanity publishing.

Dr. Harold Varmus, head of Memorial Sloan-Kettering Cancer Center and former director of the National Institutes of Health, and Emilie Marcus, executive editor of Cell Press, took opposing positions at a conference on scientific publishing organized by graduate students at Harvard Medical School.

"The public pays a lot for the research that's published in this country," said Varmus, the keynote speaker. He shared the 1989 Nobel in medicine for his work with genes that cause cancer. "Why should they have to pay for it twice to see the results?"

During a later panel discussion, Marcus countered that having scientists pay journals to publish their work, which is the way open-access journals offset costs traditionally borne by subscribers, ignores the value that journals and editors bring.

"When journals derive money from readership, the pressure is on the journal to provide value important to the people who read it. I as editor focus on creating a journal you as readers want to read," she said. "The philosophy of publishing with the author paying can turn publishing into a vanity publishing model."

In opening remarks, Dr. Steven Hyman, provost of Harvard University, reminded the mostly young crowd of about 120 that when he was a student, he had to scramble to feed nickels into Xerox machines to copy papers from bound volumes of journals in the stacks of Countway Library.

Now scientists have the opportunity to make their work freely and immediately available online, with the same peer-review process in place, Varmus said. They pay a fee of up to $3,000 for publication in journals of the Public Library of Science.

Varmus also hopes for an encyclopedic and timely repository of all research, whatever journal publishes it originally, so people can search for all sorts of information without having to pay for it -- a concern for poorer nations around the world. PubMed Central was formed in 1999 with that idea in mind when Varmus was near the end of his tenure at NIH, but with only 5 percent of NIH-funded researchers contributing to it, and only several months after publication, the repository falls short of that goal, he said.

Marcus said articles published by Cell's parent company, Elsevier, are deposited on behalf of all NIH-funded authors into PubMed Central 12 months after publication at no charge.

Posted by Elizabeth Cooney at 07:24 PM

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Wednesday, November 7, 2007

Women at the top, families in training

Dr. Nancy Andrews, who earlier this year left Harvard Medical School to become the first female dean of the Duke University School of Medicine, asks why it’s still big news when a woman takes the top post in academic medicine.

Writing in tomorrow’s New England Journal of Medicine, she answers her own question. Only 14 of 124 US medical school deans are women, and the pipeline for leadership at the department chair level is almost empty, despite similar numbers of men and women graduating from medical school.

“If institutions are to accelerate the emergence of more female deans, then they will need to consider women who have not stepped on every rung of the traditional academic career ladder,” she writes.

The article that follows Andrews’ essay takes a look earlier in medical careers, focusing on family leave policies for male and female doctors during their residency programs.

Dr. Reshma Jagsi of the University of Michigan and Dr. Nancy J. Tarbell and Dr. Debra F. Weinstein, both of Harvard Medical School, say while federal law allows family leave, policies set by graduate programs and medical-specialty boards can make that unworkable if they require training to be completed within a fixed time frame.

“It is unrealistic and inappropriate to expect trainees to delay childbearing or to forgo spending critical time with their infants,” they write. “We therefore need new solutions.”

Posted by Elizabeth Cooney at 06:18 PM

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Wednesday, October 24, 2007

Patients and doctors struggle separately with medical errors, Journal authors say

Doctors aren’t the only ones who can become paralyzed by guilt, fear and isolation after medical errors occur.

Patients and families also struggle with these emotions, Dr. Tom Delbanco and Dr. Sigall K. Bell discovered when they made a documentary about the impact of medical errors. They write about the parallel experiences in tomorrow’s New England Journal of Medicine.

“I had no idea, frankly, and I’ve been a primary care provider for 36 years,” Delbanco said in an interview. He and Bell are both from Harvard Medical School and Beth Israel Deaconess Medical Center. “It had never entered my mind that family members could feel the same kind of guilt that we as doctors feel. It had never entered my mind they would say, ‘If only I’d been more assertive with the doctor before this happened’ or ‘If only I’d listened to my instincts.’ ”

Another surprise, Delbanco said, was how reluctant people are to speak up, afraid that they will get worse care, particularly if they are from disadvantaged immigrant groups.

Doctors don’t talk for three different reasons, he said.

“We tend to run away from people we hurt rather than get close to them, we just plain don’t know what to say, and we’ve been told by lawyers to keep our mouths shut and that someone will take care of this,” he said. “We drift away rather than reach out to the people who need us.”

Building bridges to injured patients would be a first step, after the taboo of mentioning mistakes is dispelled, the authors write. They also suggest teaching healthcare providers about preventing errors and how to respond when they do happen. Their 2006 documentary has been shown to third-year medical students at Harvard.

"Everyone involved needs an organized structure that restores communication and supports emotional needs," they write. "The yield from working in partnership could be enormous, both improving people's experience with medical errors and preventing harm from occurring in the future."

Posted by Elizabeth Cooney at 05:16 PM

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Boston group to share genetic data on autism

A Boston group is sharing genetic information from families affected by autism with other researchers to promote understanding of the developmental disorder.

The Autism Consortium, whose members include hospitals, medical schools and universities in the Boston area, will transfer profiles of 500,000 genetic variations found across the genomes of 700 families with two or more children who have autism. The data will be held by the Autism Genetic Resource Exchange, a program of the advocacy organization Autism Speaks. Scientists can apply to the exchange, which gathered DNA from the families. The samples have been scanned for sequences where there are deletions or extra copies of DNA segments. The consortium is sharing the genetic variations it found.

"We returned all of the raw data to AGRE so they can distribute it to any other investigtors who want to begin exploring what may be the genetic underpinnings of autism," Mark Daly, a consortium member from Massachusetts General Hospital and the Broad Institute of MIT and Harvard, said in an interview. "Understanding the genetics underlying a complex disease is not an easy problem to solve. So there's no excuse for hoarding your data when much more can be learned by sharing."

Only a small percentage of autism arises from a recognizable genetic cause, such as Fragile X syndrome, Daly said. Recent research suggests that some families with autism might have higher rates of genomic abnormalities, but very few of these abnormalities have been conclusively identified.

"There's very strong heritability to autism but very little of the heritability has been explained by specific mutations of specific genes," he said. "What we hope is that this data is a starting point. We need to perform collaborative research in the spirit of the Human Genome Project to deliver on the trust the public has placed in us."

Members of the Autism Consortium are Beth Israel Deaconess Medical Center, Boston Medical Center, Boston University, Boston University School of Medicine, the Broad Institute of MIT and Harvard, Cambridge Health Alliance, Children’s Hospital Boston, Harvard University, Harvard Medical School, Massachusetts General Hospital, Massachusetts Institute of Technology, McLean Hospital and Tufts-New England Medical Center.

Posted by Elizabeth Cooney at 11:37 AM

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Tuesday, October 23, 2007

Who needs sleep?

Just as weary but exhilarated Red Sox fans head into the World Series on two days' rest, the New York Times devotes its Science section to the subject of sleep.

“To do science you have to have an idea, and for years no one had one; they saw sleep as nothing but an annihilation of consciousness,” Dr. J. Allan Hobson, a professor of psychiatry at Harvard, told the Times. “Now we know different, and we’ve got some very good ideas about what’s going on."

Boston researchers are prominent in the story, beginning with cognitive neuroscientist Robert Stickgold of Harvard and Beth Israel Deaconess Medical Center. He and postdoctoral student Matthew Tucker are studying the effect of naps on memorized words. Matthew Wilson of MIT is investigating what happens to mice cells when they record memories. Subimal Datta of Boston University School of Medicine is looking at the chemicals that bathe the brain while we sleep.

“During waking we have a thousand things happening at once, the library is filling up, and we can’t possibly process it all,” Datta says in the Times story. “It’s during sleep that we have this special condition to clear away this overload."

Something to sleep on before tomorrow night's Game 1.

Posted by Elizabeth Cooney at 10:34 AM

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Wednesday, October 17, 2007

Mayor Bloomberg to receive Harvard public health award

By Stephen Smith, Globe Staff

New York Mayor Michael R. Bloomberg, who has championed bans on cigarette smoking in restaurants and bars and banished trans fats from restaurant menus, is receiving the highest award bestowed by the Harvard School of Public Health.

Bloomberg, a native of Medford, will receive the Richmond Award in a ceremony Oct. 29 at Harvard. The award is named for Dr. Julius Richmond, an emeritus professor at Harvard who served as US surgeon general from 1977 to 1981 and was the first national director of the Head Start program.

Along with his campaigns against smoking and fatty foods, Bloomberg has been lauded -- and, in some camps, vilified -- for his efforts to keep illegal guns off the street, a passion shared by Boston Mayor Thomas M. Menino. Most recently, the New York mayor has embraced aggressive measures to curtail pollution in the city, raising the specter of charging drivers who venture onto Manhattan's traffic-clogged streets.

Bloomberg is no stranger to schools of public health: He has one named for him. His financial backing led Johns Hopkins University in Baltimore to call its school the Bloomberg School of Public Health.

Posted by Karen Weintraub at 05:56 PM

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Harvard launches new website

Harvard Wednesday launched a new website – HarvardScience – to feature the scientific, medical, and engineering work done at the university’s schools and related hospitals.

The site has a snappy design, and includes profiles, breaking news and stories about topics from agriculture to zoology. Today’s headlines include Harvard chemists’ construction of nanowires that can carry and create electricity, as well as a study led by Massachusetts General Hospital researchers finding that the drug companies have increasingly cozy relationships with medical schools and teaching hospitals.

Posted by Karen Weintraub at 04:34 PM

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Tuesday, October 16, 2007

Community partnerships needed to recruit minority patients to cancer clinical trials

Higher cancer rates among ethnic and racial minority groups cannot be attacked without increasing their representation in clinical trials, community health workers and health care providers heard today.

"The solution is to build community-academic partnerships," Dr. Claudia Baquet, director of the University of Maryland Comprehensive Center for Health Disparities, told about 100 people at a conference at the University of Massachusetts - Boston also sponsored by the Harvard School of Public Health and community outreach organizations. "Notice I said 'community' first."

About 3 percent to 5 percent of all cancer patients participate in clinical trials that study ways to prevent, diagnose and treat cancer. Fewer than 1 percent of African-American patients do.

Historic barriers, including lack of trust or limited access to health care, aren't the only reasons, Baquet said. Patients need to hear from their health care providers that they might have the option of joining the studies, which are typically run by researchers at academic medical centers.

"It's a total myth that underserved communities have no interest in research," she said. "It's just that it has not been presented in a way that they can consider the benefits."

Groups like the Cherishing Our Hearts and Souls Coalition, which works to improve health among African-Americans in Roxbury, is an example of efforts to make research better reflect different populations, she said. The group is one of three pilot programs in the US funded by the Lance Armstrong Foundation with the goal of including more minorities in research.

Trust is still an issue, Tarma Johnson, director of clinical health services at Mattapan Community Health Center, said at a separate session for primary care practitioners. She was involved in recruiting patients for a clinical trial about vitamin D led by Boston University School of Medicine researcher Dr. Michael Holick. The patients were interested in what she told them, which could apply to cancer studies, too.

"The information came from the health center, not the hospital, because they trust us," she said.

Posted by Elizabeth Cooney at 02:37 PM

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Thursday, October 11, 2007

Second Harvard team heading to Congo to help women injured by rape

Physicians and public health specialists from Harvard will join their colleagues in Congo to care for women who have suffered rape-related injuries.

The Harvard Humanitarian Initiative has been working since May with Panzi Hospital in the eastern part of the Democratic Republic of Congo, where up to 70 percent of girls and women have been raped or sexually mutilated, the group said in a statement today. Their medical problems include pregnancy, sexually transmitted disease (including HIV), and traumatic fistula – a condition that leaves women incontinent. A story in Sunday's New York Times describes the brutal violence that brings about 10 women to the Panzi Hospital each day.

The Harvard surgeons and researchers will perform gynecologic surgery, begin training programs, and initiate research into the causes of the violence. Their efforts will be coordinated with Doctors Without Borders, United Nations Office for the Coordination of Humanitarian Affairs, the International Urogynecological Association, V-Day, Brigham & Women’s Hospital, and University of Illinois.

Posted by Elizabeth Cooney at 03:28 PM

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Boston-Denver team to lead study of COPD

A team of researchers from Boston and Denver will lead a large study of genetic factors and biological mechanisms involved in progressive lung diseases.

Brigham and Women's Hospital in Boston and National Jewish Medical and Research Center in Denver are the lead sites for the five-year, 16-center study of chronic obstructive pulmonary disease, which includes emphysema and chronic bronchitis. The two hospitals have received $37 million from the National Heart, Lung, and Blood Institute.

The researchers hope to enroll 10,500 participants, including 3,500 African-Americans. COPD is rising among African-Americans but risk factors in this population have not been adequately studied, according to the two hospitals' news release.

The Harvard School of Public Health, working with Johns Hopkins University, Brigham and Women's and the University of Colorado, will provide statistical analysis.

Posted by Elizabeth Cooney at 02:20 PM

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Wednesday, October 10, 2007

Children get recommended care less than half the time

Children get recommended care from their doctors less than half the time, leaving them even worse off than adults, concludes an analysis of medical care in 12 cities including Boston.

Researchers from the University of Washington, RAND and UCLA reviewed the medical records of more than 1,500 children and evaluated the quality of care they got as outpatients. They chose 175 quality indicators, from prescribing asthma medications to immunizing against childhood diseases to screening for sexually transmitted diseases.

To measure quailty, they divided the number of times the children's charts showed that recommended care was ordered or given by the number of times the care was warranted, based on national guidelines for screening, diagnosis, treatment and follow-up.

Overall, children received recommended care 46.5 percent of the time, they write in tomorrow's New England Journal of Medicine. That compares with a rate of 54.9 percent for adults.

When children had acute medical problems, they got the right services 67.6 percent of the time. For chronic conditions, they were given the indicated care 53.4 percent of the time. That falls to 40.7 percent for preventive care.

The authors note that research and policy devoted to children have concentrated more on expanding access to healthcare for children than on providing the right care.

"Deficits in the delivery of care must be identified if appropriate strategies to close the gaps are to be developed and implemented," they write.

Dr. James M. Perrin and Dr. Charles J. Homer of Harvard Medical School called the findings "shocking," while pointing out the study's limitations. Some of the data are 10 years old and failures in keeping accurate medical records may be a factor in the "dismal story," they write in an accompanying editorial.

"Services are not delivered when they should be, or they are delivered when they should not be," Perrin and Homer say in their editorial, also in tomorrow's journal. "Although one could challenge the precise 46.5 percent value for the percentage of overall care delivered, one cannot avoid the main observation that there exists a yawning chasm in the quality of health care provided to children."

Posted by Elizabeth Cooney at 06:45 PM

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WSJ blog: Harvard scientist devises way to bring vaccines to the poor, via China

Harvard scientist John Mekalanos (left) came up with a way to make vaccines much more cheaply, but to actually produce them, he had to fly to China, the Wall Street Journal's Health Blog reports.

Mekalanos struck a deal with Gerald Chan, a venture capitalist who is opening a vaccine factory on a tropical island called Hainan, one of the regions China has targeted for foreign investment, the blog says. Harvard will license Mekalanos’s method to Chan’s Morningside Group. The result will be a company with scientists working in Boston and on Hainan to develop a commercial vaccine.

The deal allows Harvard to license any vaccines the company creates to governments and humanitarian groups in the developing world, Isaac Kohlberg, the chief of Harvard’s technology development office, told the WSJ blog. Morningside would be able to sell the vaccine in the developed world.

Posted by Elizabeth Cooney at 08:51 AM

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Tuesday, October 9, 2007

Breast-feeding medical student to take licensing test tomorrow

By Elizabeth Cooney, Globe Correspondent

A Harvard medical student who went to court to get extra time to pump breast milk during a licensing exam will start taking the test tomorrow.

Sophie Currier, who is breast-feeding her 5-month-old daughter, sued the National Board of Medical Examiners on Sept. 5 when it refused to give her more than the usual 45-minute break allowed to students taking the nine-hour exam. Since then the case has gone through seven rulings.

Today the Supreme Judicial Court denied a request from the board for an expedited review of the case after a state Appeals Court ruling on Friday cleared the way for Currier to have the extra time. The examination board had also asked for a single justice to hear an appeal, but the court did not rule on that petition, board spokeswoman Carol Thomson said in an interview.

"Sophie Currier is scheduled to take the test tomorrow and the following day," Thomson said. "The board certainly will comply with the court's requirements and she will take the test with extra time."

Currier, who must pass the test before beginning her residency at Massachusetts General Hospital, has been granted permission to take the test over two days because of her dyslexia and attention deficit hyperactivity disorder. She will get an hour of extra break time each day.

The 33-year-old Brookline resident had argued that it would be uncomfortable and possibly harmful to her health if she could pump breast milk only during standard breaks.

Currier was unavailable to comment today, her spokeswoman Alex Zaroulis said.

"Sophie is looking forward to taking the test tomorrow. She's focused, she's prepared," Zaroulis said. "This has all been about Sophie being able to take this test and be able to express milk while she takes the test in a humane and sanitary way."

One of her lawyers said she found it troubling that the organization responsible for licensing doctors continues to take such an "anti-female approach."

"We took this case pro bono because we believed strongly in the legal positions that were set forth regarding a nursing mother's right in the workplace and by extension, a nursing mother's right to be able to become a doctor and take the medical exam without being at risk for physical harm," said Lauren Stiller Rikleen, who worked on the case with Christine Smith Collins of the law firm Bowditch & Dewey.

Posted by Elizabeth Cooney at 06:45 PM

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Monday, October 8, 2007

Howard Hiatt honored by Institute of Medicine

The Institute of Medicine today presented the 2007 Gustav O. Lienhard Award to Dr. Howard H. Hiatt, professor of medicine at Harvard Medical School, former dean of its School of Public Health and a senior physician at the Brigham and Women's Hospital.

The $25,000 award recognizes Hiatt's contributions to improving the performance of personal health services in the United States and around the world, the institute said in a news release.

"Throughout his professional life, Howard Hiatt brought compassionate and innovative approaches to health and medical care," said Harvey V. Fineberg, president of the Institute of Medicine. "He introduced fresh analytic methods to medical and public health education, fostered interdisciplinary approaches to complex health problems, cultivated a new generation of socially responsible physicians, illuminated key challenges to making the best use of limited health resources, pioneered in research on patient safety, and championed successful programs to reduce health disparities. Many of today's leaders in health can trace the roots of their accomplishments to the inspiration, example, and guidance of Howard Hiatt."

Hiatt was formerly chief of medicine at Beth Israel Hospital in Boston, led a pioneering study of medical malpractice, called the Harvard Medical Practice Study, and helped to create the Division of Social Medicine and Health Inequalities at the Brigham in 2001.

Posted by Gideon Gil at 01:09 PM

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Five Boston researchers named to Institute of Medicine

Five Boston researchers have been elected to membership in the Institute of Medicine, a prestigious group established by the National Academies of Science to analyze health issues and make recommendations on policy.

Among the 65 new US members, five are from Massachusetts (four from Harvard, one from MIT), three are from Connecticut (all from Yale) and one is from New Hampshire (Dartmouth). The current 1,538 active members chose new members from candidates nominated for achievement and commitment to service, the IOM said in its announcement of new members today.

The Massachusetts members are:

Dr. Emery N. Brown, professor of anesthesia, department of anesthesia and critical care, Massachusetts General Hospital; and professor of computational neuroscience, health sciences, and technology, Massachusetts Institute of Technology

Dr. William G. Kaelin Jr., investigator, Howard Hughes Medical Institute, and professor, Harvard Medical School, Dana-Farber Cancer Institute

Dr. David T. Scadden, professor of medicine and co-chair, department of stem cell and regenerative biology, and co-director, Harvard Stem Cell Institute; and director, Center for Regenerative Medicine, Massachusetts General Hospital

Jonathan G. Seidman, professor of genetics, Harvard Medical School

B. Katherine Swartz, professor of health economics and policy, department of health policy and management, Harvard School of Public Health

The three new members from Connecticut are:

Dr. Robert J. Alpern, dean, Yale University School of Medicine

Dr. Harlan M. Krumholz, professor of medicine and epidemiology and public health, and professor of internal medicine, Yale University School of Medicine

Dr. Mary E. Tinetti, professor of medicine, epidemiology and public health, and director, Yale Program on Aging, Yale University School of Medicine

New Hampshire has one new member:

Jonathan S. Skinner, professor of economics, Dartmouth College, and professor of community and family medicine, Dartmouth Medical School

Posted by Elizabeth Cooney at 11:44 AM

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Nobel for medicine honors gene targeting in mice

Mario R. Capecchi (from left), Sir Martin J.
Evans and Oliver Smithies

Three scientists who modified genes in mice using embryonic stem cells have won this year's Nobel Prize in physiology or medicine, the Swedish Academy announced this morning.

Mario R. Capecchi of the University of Utah, Sir Martin J. Evans of Cardiff University and Oliver Smithies of the University of North Carolina will share the prize for discoveries that made gene targeting possible. Their work led to creation of "knockout mice," or animals whose genes have been modified so scientists can study development, physiology or disease.

Capecchi, born in Verona, Italy, in 1937, earned a doctorate in biophysics at Harvard in 1967 and is now a US citizen. Evans was born in Great Britain in 1941. Smithies was born in Great Britain in 1925 and is now a US citizen.

At Harvard, Capecchi's Ph.D. advisor was James D. Watson, a previous Nobel winner for his co-discovery of the DNA double helix. Capecchi, a Howard Hughes Medical Institute investigator, credits Watson for inspiring his development as a scientist and his pursuit of big questions, according to the institute's website.

"He taught me not so much about how to do science but rather provided me with the confidence to tackle any scientific question that fascinated me, regardless of its complexity," Capecchi is quoted on the site. "He also taught me the importance of communicating your science clearly and to pursue important scientific questions."

Capecchi told the journal Nature in 2004 that his relationship with Watson was not always smooth. He recounted a disagreement they had about the results of an experiment. Capecchi was unconvinced by the data and wanted to repeat the experiment while Watson wanted to publish the results. Capecchi then threw away glass plates containing crucial bits of data, ensuring that the results could not be published and prompting Watson to explode in anger. Capecchi recalled: "I came that close to being thrown out of the lab."

Capecchi's childhood was disrupted by World War II in Italy, according to the Nature article and the Hughes website. When he was 4 years old, his mother, a poet, was taken by the Gestapo to a concentration camp, and he lived on the streets, begging and stealing, until they were reunited five years later. After the war, they emigrated to the United States, where Capecchi began school at age 9, knowing no English and unable to read or write.

"It is not clear whether those early childhood experiences contributed to whatever successes I have enjoyed or whether those achievements were attained in spite of those experiences," he said.

Posted by Elizabeth Cooney at 07:47 AM

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Friday, October 5, 2007

Breast-feeding medical student wins break time

A Harvard medical student battling for extra time to pump breast milk during a licensing exam plans to take the test as soon as she can after a court ruling in her favor today.

The state Appeals Court declined to reverse a ruling made by a single justice last week that cleared the way for Sophie Currier to have extra time.

"I'm going to take the test as soon as possible," Currier said in a phone interview before referring other questions to a spokeswoman so she could return to studying.

The 33-year-old Brookline mother of a five-month-old girl sued the National Board of Medical Examiners when it refused to give her more than the standard 45-minute break allowed to students taking the nine-hour exam. Currier, who must pass the test before beginning her residency at Massachusetts General Hospital, has been granted permission to take the test over two days because of her dyslexia and attention deficit hyperactivity disorder.

Joseph Savage, the board's attorney, argued that granting Currier extra time would not be fair to other test-takers. Savage did not immediately return phone calls seeking comment.

Today's ruling did not consider the merits of the case. Instead it was based on whether the single justice whose decision overturned a superior court's denial of Currier's claim showed abuse of discretion or a clear error of law. The court found neither.

Posted by Elizabeth Cooney at 01:53 PM

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Ig Noblesse oblige

Nobel laureates (seated, from left) William Lipscomb,
Robert Laughlin, Craig Mello, Roy Glauber and Dudley
Herschbach taste Ig Nobel-prize winning ice cream
flavored by vanillin derived from cow dung.
(Kees Moeliker / Annals of Improbable Research)

You had to be there.

At last night's Ig Nobel prize ceremony, paper airplanes, pointless chicken references and acceptance speech poems sailed through Harvard's Sanders Theatre. The mood was part Mardi Gras, part Marx Brothers as the Annals of Improbable Research induced real Nobel laureates to play along with real scientists whose published work first made people laugh, and then think, journal editor and master of ceremonies Marc Abrahams said.

There was sword-swallowing, natch, from the Tennessee winner Dan Meyer, who studied sword swallowing's side effects. There was ice cream from Toscanini's made, so the real laureates were told, using Japanese Ig Nobel winner Mayu Yamamoto's formula for deriving vanillin from cow dung. Craig Mello, last year's Nobel winner in medicine, was the first to dip his spoon into his dish as the crowd chanted "Eat it!"

There was 2005 physics Nobelist Roy Glauber, wearing a Chinese straw hat and wielding a twig broom, sweeping paper airplanes off the crowded stage as he has done for 10 years of Ig Nobel celebrations.

And there were chicken and/or egg costumes made out of black garbage bags that Mello, Glauber, and their good-natured peers Dudley Herschbach (chemistry 1986), William Lipscomb (chemistry 1976) and Robert Laughlin (physics 1998) climbed into and burst through on cue.

You had to be there.

But there's another chance to enjoy the merriment: At 1 p.m. tomorrow, the Ig Nobel winners will make presentations in MIT Building 10, Room 250. Check out their prizes and real references.

Posted by Elizabeth Cooney at 11:46 AM

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Thursday, October 4, 2007

Ig Nobels pop tonight

By Elizabeth Cooney, Globe Correspondent

Bottomless soup bowls, vanilla made from cow dung, a net that drops on bank robbers and "gay bombs." And don't forget discriminating rats listening to Japanese and Dutch. Backwards.

Must be time for the Ig Nobel Prizes again, when the science humor magazine Annals of Improbable Research recognizes scientists with a sense of humor from around the world for achievements that made the judges laugh and think.

Harvard's Lakshminarayanan Mahadevan is the only local laureate this year. He took the prize in physics for studying how sheets become wrinkled. Seems a little mild, next to the soup bowl that refilled itself in an experiment measuring people's appetites. But that sounds more appetizing than the vanillin, which really did come from livestock excrement.

The robber-nabbing net? Its Taiwanese inventor seems to have vanished, the Ig Nobel organizers report.

Gay bombs, however, were found at an Air Force research lab in Ohio that developed a chemical weapon to make enemy soldiers sexually irresistible to each other. The technical term is "Harassing, Annoying and 'Bad Guy' Identifying Chemicals."

And those rats? Turns out, sometimes they can't tell the difference between Japanese and Dutch spoken backwards. Huh.

This year's ceremony, at which real live Nobel laureates give out prizes to the winners -- 7 of the 10 were expected to show up at their own expense -- was webcast tonight from Harvard's Sanders Theatre.

Here's the list of winners:

MEDICINE PRIZE
Brian Witcombe of Gloucester, UK, and Dan Meyer of Antioch, Tenn., for their penetrating medical report "Sword Swallowing and Its Side Effects."
REFERENCE: "Sword Swallowing and Its Side Effects," Brian Witcombe and Dan Meyer, British Medical Journal, December 23, 2006, vol. 333, pp. 1285-7.

PHYSICS PRIZE
L. Mahadevan of Harvard University, and Enrique Cerda Villablanca of Universidad de Santiago de Chile, for studying how sheets become wrinkled.
REFERENCES:
"Wrinkling of an Elastic Sheet Under Tension," E. Cerda, K. Ravi-Chandar, L. Mahadevan, Nature, vol. 419, October 10, 2002, pp. 579-80.
"Geometry and Physics of Wrinkling," E. Cerda and L. Mahadevan, Physical Review Letters, fol. 90, no. 7, February 21, 2003, pp. 074302/1-4.
"Elements of Draping," E. Cerda, L. Mahadevan and J. Passini, Proceedings of the National Academy of Sciences, vol. 101, no. 7, 2004, pp. 1806-10.

BIOLOGY PRIZE
Johanna E.M.H. van Bronswijk of Eindhoven University of Technology, The Netherlands, for doing a census of all the mites, insects, spiders, pseudoscorpions, crustaceans, bacteria, algae, ferns and fungi with whom we share our beds each night.
REFERENCES:
"Huis, Bed en Beestjes" [House, Bed and Bugs], J.E.M.H. van Bronswijk, Nederlands Tijdschrift voor Geneeskunde, vol. 116, no. 20, May 13, 1972, pp. 825-31.
"Het Stof, de Mijten en het Bed" [Dust, Mites and Bedding]. J.E.M.H. van Bronswijk Vakblad voor Biologen, vol. 53, no. 2, 1973, pp. 22-5.
"Autotrophic Organisms in Mattress Dust in the Netherlands," B. van de Lustgraaf, J.H.H.M. Klerkx, J.E.M.H. van Bronswijk, Acta Botanica Neerlandica, vol. 27, no. 2, 1978, pp 125-8.
"A Bed Ecosystem," J.E.M.H. van Bronswijk, Lecture Abstracts -- 1st Benelux Congress of Zoology, Leuven, November 4-5, 1994, p. 36.

CHEMISTRY PRIZE
Mayu Yamamoto of the International Medical Center of Japan, for developing a way to extract vanillin -- vanilla fragrance and flavoring -- from cow dung.
REFERENCE: "Novel Production Method for Plant Polyphenol from Livestock Excrement Using Subcritical Water Reaction," Mayu Yamamoto, International Medical Center of Japan.

LINGUISTICS PRIZE
Juan Manuel Toro, Josep B. Trobalon and Núria Sebastián-Gallés, of Universitat de Barcelona, for showing that rats sometimes cannot tell the difference between a person speaking Japanese backwards and a person speaking Dutch backwards.
REFERENCE: "Effects of Backward Speech and Speaker Variability in Language Discrimination by Rats," Juan M. Toro, Josep B. Trobalon and Núria Sebastián-Gallés, Journal of Experimental Psychology: Animal Behavior Processes, vol. 31, no. 1, January 2005, pp 95-100.

LITERATURE PRIZE
Glenda Browne of Blaxland, Blue Mountains, Australia, for her study of the word "the" -- and of the many ways it causes problems for anyone who tries to put things into alphabetical order.
REFERENCE: "The Definite Article: Acknowledging 'The' in Index Entries," Glenda Browne, The Indexer, vol. 22, no. 3 April 2001, pp. 119-22.

PEACE PRIZE
The Air Force Wright Laboratory, Dayton, Ohio, USA, for instigating research & development on a chemical weapon -- the so-called "gay bomb" -- that will make enemy soldiers become sexually irresistible to each other.
REFERENCE: "Harassing, Annoying, and 'Bad Guy' Identifying Chemicals," Wright Laboratory, WL/FIVR, Wright Patterson Air Force Base, Ohio, June 1, 1994.

NUTRITION PRIZE
Brian Wansink of Cornell University, for exploring the seemingly boundless appetites of human beings, by feeding them with a self-refilling, bottomless bowl of soup.
REFERENCE: "Bottomless Bowls: Why Visual Cues of Portion Size May Influence Intake," Brian Wansink, James E. Painter and Jill North, Obesity Research, vol. 13, no. 1, January 2005, pp. 93-100.
REFERENCE: Mindless Eating: Why We Eat More Than We Think, Brian Wansink, Bantom Books, 2006, ISBN 0553804340.

ECONOMICS PRIZE
Kuo Cheng Hsieh, of Taichung, Taiwan, for patenting a device, in the year 2001, that catches bank robbers by dropping a net over them.
REFERENCE: U.S. patent #6,219,959, granted on April 24, 2001, for a "net trapping system for capturing a robber immediately."

AVIATION PRIZE
Patricia V. Agostino, Santiago A. Plano and Diego A. Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that Viagra aids jetlag recovery in hamsters.
REFERENCE: "Sildenafil Accelerates Reentrainment of Circadian Rhythms After Advancing Light Schedules," Patricia V. Agostino, Santiago A. Plano and Diego A. Golombek, Proceedings of the National Academy of Sciences, vol. 104, no. 23, June 5 2007, pp. 9834-9.

Posted by Elizabeth Cooney at 10:30 PM

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Breast-feeding student to reschedule exam, wait for court ruling

(Michele McDonald/Globe Staff)

Sophie Currier with her white coat and her baby.

By Globe Staff

Sophie Currier, the Harvard medical student who sued because she wanted time to pump breast milk during a licensing exam, will postpone taking the exam, her lawyer said Wednesday.

Currier had planned to take the exam this week after Massachusetts Appeals Court Judge Gary Katzmann ordered that she should get the extra time. But a three-judge panel of the court on Tuesday stayed Katzmann's order, promising a ruling by next Wednesday.

Carol Thomson, a spokeswoman for the National Board of Medical Examiners, said, "The next step for us is to await their conclusion."

She noted that Currier could take the exam under normal conditions or reschedule.

Christine Collins, Currier's lawyer, said Currier planned to reschedule so she could see how the court ruled.

"We're fairly confident that the judges are going to affirm Judge Katzmann's decision and order," she said.

Posted by Karen Weintraub at 11:06 AM

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Wednesday, October 3, 2007

Harvard's Allston science complex approved

Harvard University won final approval today from the Boston Redevelopment Authority for a four-building science complex that will be the first major project in the university's new Allston campus.

The complex, with an estimated cost of $1 billion, will house Harvard's Stem Cell Institute and the Department of Stem Cell and Regenerative Biology. The project will face Western Avenue, across the street from the old WGBH-TV studios.

Posted by Gideon Gil at 05:49 PM

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New anesthesia method blocks pain without numbness or paralysis

By Colin Nickerson, Globe Staff

The world's hottest work in anesthesiology is being done at Harvard, where researchers are pouring pepper on pain.

Scientists at Harvard Medical School and Massachusetts General Hospital today described a new "targeted" approach to anesthesia that uses the active ingredient in chili peppers as part of an ingenious recipe for blocking pain neurons. Most critically, the technique doesn't cause the numbness or partial paralysis that is the unwelcome side effect of anesthesia used for surgery performed on conscious patients.

If approved for use in humans, the method could dramatically ease the trial of giving birth -- by sparing women pain while allowing them to physically participate in labor. It could also diminish the trauma of knee surgery, for instance, or the discomfort of getting one's molars drilled. Not only would there be no "ouch," there would be none of the sickening wooziness or loss of motor control that comes from standard forms of "local" anesthesia.

In time, the process might even be employed for major surgery on the heart and other organs, the researchers said. More prosaically, the work might also represent a breakthrough cure for the common itch.

The work on lab rats, described in the scientific journal Nature, breaks from the standard approach to local anesthesia, which usually involves anesthetics delivered by catheter tubes or injections that silence all neurons in a given region of the body, not just those that sense pain. Shutting down just the pain neurons means that patients could still feel a light touch and other non-hurtful sensations.

"This could really change the experience of, for example, knee surgery, tooth extractions, or childbirth," said Dr. Clifford Woolf, senior author of the study and a researcher in anesthesia and pain management at Mass. General. "The possibilities are almost endless."

Woolf collaborated with Bruce Bean, professor of neurobiology at Harvard Medical School, in research that employed surprisingly basic scientific principles as well as some unlikely ingredients -- capsaicin, the stuff that imparts "hot" to chili peppers, as well as an all-but-forgotten variation of a standard anesthesia, long dismissed as clinically useless.

"We plucked a little of this and little of that off the shelves," Bean said. "The project is really a great illustration of how basic biological principles can have very practical applications."

Indeed, scientists with no involvement in the Harvard study were most surprised by its simplicity.

"It's a really clever piece of work, based on one of those 'I wish I'd thought of that' ideas," said Dr. Stephen G. Waxman, head of the department of neurology at Yale University's School of Medicine. "This is an important piece of research."

There's also sweet historic symmetry to the discovery.

Boston, after all, is the city that invented feeling no pain -- at least in surgery.

Modern anesthesia was first successfully employed in surgery in October 1846, one of the greatest moments in medicine. In Boston's Public Garden, the second-largest statue -- after that of George Washington on his horse -- is a soaring pillar, adorned with roaring lions and bas-relief depictions of 19th Century surgeons, that celebrates the "discovery that the inhaling of ether causes insensibility to pain. First proved to the world at the Massachusetts General Hospital."

Not far away, modern Mass. General's original "ether dome" still stands, a national landmark and popular pilgrimage point for anesthesiologists from around the world.

The work undertaken by Woolf, Bean and post-doctoral researcher Alexander Binshtok exploits well-known concepts of how electrical signals in the nervous system depend on ion channels -- proteins that make passageways through the membranes of nerve cells. Pain-sensing neurons possess a unique channel protein, TRPV1, but one that is usually blocked by a molecular "gate."

Medicine for more than 150 years has relied on general and standard anesthetics that penetrate and suppress sensation in all neurons, not just those nerve cells dedicated to sensing pain. That's why an epidural or a simple shot of Novocain leaves a whole region of the body numb or paralyzed, because all nerves cells are affected.

Enter the hot chili pepper, in the form of capsaicin.

Enter, too, a failed derivative of the common anesthetic lidocaine, invented in the 1940s. The derivative, known as QX-314, was deemed useless because it couldn't penetrate cell membranes to block sensation. In non-pharmaceutical terms, that's a bit like having a power shovel that can't cut earth.

In experiments, the Harvard researchers found that the chili pepper ingredient generated heat that opened the gate to pain neurons, but had no similar effect on other nerve cells. Then, when they introduced the lidocaine derivative, it charged through the open channels to block pain in those neurons, but was still unable to enter other nerve cells, such as "motor" neurons that control coordination and mobility.

Thus, in rat experiments, there appeared to be a total shutdown of pain, with no apparent numbness or paralysis.

The rats received injections near nerves leading to their hind feet, and lost the ability to feel pain in their paws. But they continued to scamper about their cages normally and showed sensitivity to touch and other stimulation.

"We introduced a local anesthetic selectively into specific populations of neurons," said Bean. "Now we can block the activity of pain sensing neurons without disrupting other kinds of neurons that control movements or non-painful sensations."

Experimentation will likely move on to to sheep, then humans. One problem that needs to be addressed is whether the capsaicin might cause such a burning sensation when first injected -- before the lidocaine derivitive shuts down the pain -- that it may be too uncomfortable for use as an anesthetic. But the researchers are confident they can find a more practical "warming" chemical to open the gateways to the pain neurons.

"This method could really transform surgical and post-surgical analgesia. Patients could remain alert without suffering pain. But they also wouldn't have to cope with numbness or paralysis," Woolf said.

Noting that itch-sensitive neurons are similar to nerves that sense pain, he added: "We may have even found a good treatment for the common itch."

Posted by Gideon Gil at 01:43 PM

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Tuesday, October 2, 2007

Mass. law slows stem cell research, Harvard scientist says

By Colin Nickerson, Globe Staff

One of Harvard’s best and brashest used a major conference on stem cells to lambaste the policies of a commonwealth that takes huge pride in medical research

"In Massachusetts, we have a law meant to support stem cell research, but it creates restrictions that are more onerous than in states" where religious fundamentalists, conservative legislators and other opponents actively fight medical research involving human embryos, Kevin Eggan said today at the Stem Cell Summit, a two-day conference that brought some of the world’s top stem cell researchers to Boston.

Eggan, a Harvard molecular biologist and leading stem cell scientist, was voicing deepening frustration that the Harvard University Stem Cell Institute's research into one of medicine’s most promising, if controversial fields, has been slowed by lack of raw materials – human eggs. More than a year after Harvard vowed to create cloned human embryonic stem cells for research, the institute has not been able to persuade a single eligible woman to donate a single egg.

Eggan blames a Massachusetts law that forbids researchers from paying women to donate eggs. The law is meant to prevent researchers from exploiting poor women who might be willing to undergo the lengthy and occasionally painful procedures for a cash pay-off. Eggan considers it hypocritical that women can be paid to "donate" eggs for use in fertility treatments, but not for stem cell research that, many scientists believe, holds enormous promise for combating degenerative diseases, cancer, and spinal injuries.

"Despite an advertising campaign to find donors, we have yet to have a woman donate an egg to our cause," Eggan said. Only women age 25 to 35 are eligible as donors.

"We’ve had hundreds of calls" from women expressing interest, Eggan said. But none, so far, is willing to take the time, effort, and slight medical risk purely for altruism.

The question of paying individuals to donate tissue -- whether a kidney or an egg -- is complex and bitterly controversial. And while most stem cell scientists share Eggan’s frustration with the pace of research, not all agree with his notion that money is the answer.

"This is a tremendously contentious issue," said George Q. Daley, a blood specialist at Children's Hospital Boston and president of the International Society for Stem Cell Research.

Many stem cell researchers, Daley told the same panel discussion at the conference, believe that paying "market rates" for donated eggs is morally unacceptable. But he indicated that there is more support for the idea that women should be paid something in compensation for undergoing a process that typically takes two months.

The Stem Cell Summit, at the Hynes Convention Center, attracted almost everyone who is anyone in the stem cell world, including researchers from Australia, South Korea, Japan, Great Britain, Canada, Italy and the Netherlands. The conference, sponsored by Harvard, the Genetics Policy Institute, and Burrill Life Sciences Media Group, ends Wednesday.

Along with physicians, scientists, and eager venture capitalists, the conference attracted people suffering from conditions that might eventually be cured by stem cell advances.

Among them was Brooke Ellison, author of the book "Miracles Happen," based on her struggles after a 1990 accident left her paralyzed from the neck down and dependent on a ventilator for breathing.

"The potential of cures that may arrive out of stem cells represent the most powerful manifestation of hope in the world today," said Ellison, a Harvard graduate who raises money for stem cell research.

Posted by Gideon Gil at 03:23 PM

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Monday, October 1, 2007

Back and neck pain, depression take toll in 'lost days'

Mental and physical illnesses have "staggering" costs that are measured not only directly in health care dollars but also indirectly, in days lost when people are unable to carry out their usual activities, a new study reports.

More than half of American adults suffered from one or more of 30 conditions that kept them from their typical functions at work or at home for an average of 32.1 days a year, according to a survey analyzed by researchers including Ronald C. Kessler and Minnie Ames of Harvard Medical School. That translates into a total of 3.6 billion days a year, with mental disorders accounting for 1.3 billion days lost.

Chronic back and neck pain led to the most days of disability (1.2 billion), followed by major depression (387 million), the researchers found. The national survey’s results, funded by the National Institute of Mental Health, appear in the October issue of the Archives of General Psychiatry.

"The staggering amount of health-related disability associated with mental and physical conditions should be considered in establishing priorities for the allocation of health care and research resources," the authors conclude.

Posted by Elizabeth Cooney at 04:00 PM

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Thursday, September 27, 2007

Notables

Researchers from Boston and Cambridge have won two of three prizes for young cancer investigators.

Angelika Amon (left) of MIT and Dr. Todd R. Golub of Dana-Farber Cancer Institute and the Broad Institute of Harvard and MIT will receive the 2007 Paul Marks Prize for Cancer Research from Memorial Sloan-Kettering Cancer Center. The prize recognizes contributions to understanding the treatment of cancer made by scientists under the age of 45.

Amon studies how chromosomes segregate during cell division and Golub uses genomic approaches to classify subtypes of cancer. They will share a $150,000 prize with the third winner, Gregory J. Hannon of Cold Spring Harbor Laboratory, who studies the biology and biochemistry of RNA interference. All three winners are also Howard Hughes Medical Institute investigators.

Posted by Elizabeth Cooney at 03:31 PM

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Wednesday, September 26, 2007

Journal asks: After a patient dies, how do doctors deal with their emotions?

It was more than 30 years ago, but Dr. Katharine Treadway (left) vividly remembers answering her first "code" call to revive a hospital patient.

The resuscitation attempt failed, and in this week’s New England Journal of Medicine she recalls what it felt like, as a freshly minted intern, to simply walk away from a life that had just ended.

“Someone had just died. But we all behaved as though that was not at all what had happened,” she writes. “We learned to bury our fear of death in an avalanche of knowledge. … And for good reason. We could not do what we do – take responsibility for the lives of our patients – if we were aware, minute to minute, of the true significance of what we were actually doing.”

The journal is publishing Treadway's essay to spark an online discussion, which the Boston-based publication calls Perspective Forum. Its physician readers are invited to write about how they cope with the emotions they put away while meeting clinical challenges.

Treadway, a Harvard Medical School faculty member and primary care doctor at Massachusetts General Hospital, writes that many doctors have private rituals they observe whenever a patient dies -- she says aloud, "May choirs of angels greet thee at they coming" -- but they rarely share them.

White Coat Notes asked Treadway what she would like to hear from readers, why she chose this topic, and what she teaches medical students about it.

What do you hope to hear in the forum?
What I hope is people will in fact share some of their experiences and write what it was like to be at a code the first time, or other experiences. I hope doing that is just the beginning of 'well, gee, if I write into the New England Journal, maybe I can talk to the doctor I share an office with.' I really believe that we’re all hungry for this.

What do you teach medical students about emotions?
I try to get them to recognize early how powerful they will become in the lives of their patients. I don't mean this in a hierarchical way. I mean when someone is ill, the emotional need that is there is so profound, if they don't recognize how powerful they are, they won't know how to use this in a positive fashion.

What about situations like the code call?
When you focus so intently on the problem you are trying to solve, (it’s) easy to forget about the person. I want them to remember to experience the experience and be aware of what’s taking place, not just the task.

There’s this tremendously fine line that we have to walk in terms of dealing with acute life-threatening situations in which you absolutely have to stifle your emotions. You can’t fling your hands into the air and say, 'Oh my god.' That wouldn’t help anyone.

At the same, time, if you completely shut that off, then you lose something.

How do you find that middle ground?
Part of the message I teach is being honest with yourself about what you have done well or not so well, and being aware of your emotions in a way that allows you to continue and come back another time.

How about your own work?
I love being a doctor. To me it's the combination of the intellectual demands and the fascination of how our bodies work, mixed with dealing with people and all of the interactions that take place in this human drama. I still feel like I have to pinch myself to believe I’m doing this, more than 30 years into it.

Being a primary care doctor, I take care of my patients’ children, or their children’s children, or in one case, the great-granddaughter of my original patient. In addition to teaching medical students who are so eager and idealistic, it’s just so renewing. I feel very lucky.

Posted by Elizabeth Cooney at 05:20 PM

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Judge orders extra break time for breastfeeding medical student

By Felicia Mello, Globe Correspondent

A Harvard medical student and nursing mother won an appeal today in her lawsuit for extra break time to pump breast milk during her doctor-licensing exam. A state appeals court judge ruled that the National Board of Medical Examiners must grant Sophie Currier of Brookline an additional 60 minutes of rest periods on each day of the exam, which Currier must pass to graduate and begin her residency at Massachusetts General Hospital.

Currier sued the board September 6, arguing that it violated her constitutional rights by denying her more than the 45 minutes of rest periods allotted to all test takers. She also accused the board of gender discrimination.

Last week, a state superior court judge denied her claim, saying Currier could still find a way to expel her milk during the test or on regularly scheduled breaks.

But Appeals Court Judge Gary Katzmann overturned that decision. “In order to put the petitioner on equal footing as the male and non-lactating female examinees, she must be provided with sufficient time to pump breast milk and to address the same physiological and other functions to which those examinees are able to attend,” he wrote.

Currier, who has a 4-month-old daughter, originally planned to take the exam this week, but postponed it until October 4 in hopes of winning her appeal. She already has received permission from the board to take the test over two days instead of one, because she has dyslexia and attention deficit hyperactivity disorder. The board also offered to allow her to bring a breast pump into the exam room and to provide her with a private room in which to express milk during breaks.

Lactating women can experience pain and risk developing infections of their breasts if they don't express milk at least once every three hours, breastfeeding experts say.

Posted by Gideon Gil at 01:43 PM

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Mass. General scores on two workplace lists

Massachusetts General Hospital has landed on two lists of best places to work.

One is the Working Mother magazine's 100 Best Companies, which considers compensation, child-care and flexibility programs, and leave policies. Harvard University also made the non-ranked list, along with Arnold Worldwide, The Boston Consulting Group and Massachusetts Mutual Life Insurance.

The other list is AARP's ranking of Best Employers for Workers Over 50, where it came in 10th. No other Massachusetts-based company made the list of 50 workplaces. The AARP considered recruiting practices; opportunities for development; and work options, such as flexible scheduling, job sharing, and phased retirement, in addition to health and retiree benefits.

Posted by Elizabeth Cooney at 09:56 AM

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Monday, September 24, 2007

Value of annual physicals debatable, study says

Annual physicals get a checkup in today's Archives of Internal Medicine.

Adult preventive health exams and women's gynecologic exams are among the most common reasons to see a doctor, but most preventive services other than Pap smears take place outside those visits, according to researchers from the University of Pittsburgh School of Medicine and Harvard Medical School.

"There's clearly a role for the type of preventive services we studied -- cancer screening, cholesterol testing and counseling about quitting smoking, losing weight and exercise," Dr. John Z. Ayanian of Harvard said in an interview. "It's a question of what's the best approach to get those provided."

Looking closely at the exams, the authors found that checkups including gynecological exams accounted for 1 in 12 adult visits to doctors. Annual exams are more common in the Northeast than in the West, according to previous research. Physicians in Boston, for example, are more likely to say they perform the annual exams than their counterparts in San Diego. People with insurance are more likely to go for physicals than people without coverage.

Annual physical exams "fill a very important role in the US healthcare system," but it wouldn't be feasible to recommend that all adults have annual physicals because there aren't enough primary care physicians or gynecologists, said Ayanian, who practices at Brigham and Women's Hospital. People get most of their preventive services when they come for an acute problem or receive care for chronic conditions, according to the authors' analysis of data from national surveys done from 2002 to 2004.

The study may help guide policy about who should be having preventive exams and what they should include, Ayanian said. People's expectations for blood tests or EKGs during checkups may increase healthcare costs without adding value, the authors found.

"We need to be very selective about what tests we recommend on a routine basis and limit them to those that are likely to have value in affecting people's health rather than reflexively ordering tests out of some sense of tradition," he said.

Posted by Elizabeth Cooney at 06:33 PM

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Friday, September 21, 2007

Appeals judge will hear nursing med student's plea for more break time

By Felicia Mello, Globe Correspondent

A nursing mother will take her request for extra break time on a medical licensing exam to a state appeals court judge Tuesday, after a lower court denied her claim.

Sophie Currier, 33, says she needs more than the standard 45 minutes of rest periods in order to pump breast milk for her four-month-old daughter.

Currier has finished an MD-PhD program at Harvard but must pass the test in order to graduate and begin her residency at Massachusetts General Hospital.

Last week, Norfolk Superior Court Judge Patrick Brady dismissed Currier’s lawsuit against the National Board of Medical Examiners, saying the board’s offer to let Currier express milk while taking the test and in a separate room during scheduled breaks was sufficient.

The appeal will be heard at 9 a.m. in Boston’s John Adams Courthouse.

Posted by Gideon Gil at 07:37 PM

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Wednesday, September 19, 2007

Judge rules against breastfeeding medical student

By Felicia Mello, Globe Correspondent

A Harvard medical student and new mother will not be permitted to take extra break time to pump breast milk during her exam to become a doctor, a judge ruled today.

Sophie Currier of Brookline sued the National Board of Medical Examiners Sept. 6, arguing the board violated her constitutional right to breastfeed by denying her more than the 45 minutes of rest periods allotted to all test takers.

Currier, who has a four-month-old daughter, must pass the exam before she can graduate and begin a residency program at Massachusetts General Hospital later this fall.

In a three-page opinion, Norfolk Superior Court Judge Patrick Brady said Currier could still find a way to expel her milk during the test or on regularly scheduled breaks.

"The plaintiff may take the test and pass, notwithstanding what she considers to be unfavorable conditions," Brady wrote. "The plaintiff may delay the test, which is offered numerous times during the year, until she has finished her breast-feeding and the need to express milk."

Currier’s lawyer, Christine Smith Collins, said she will appeal the decision to a state court of appeals judge, who could still issue a ruling before Currier takes the exam next Monday.

"Basically the judge decided it’s okay to tell women to wait until they are done being moms to become professionals, which as far as I’m concerned is not acceptable in this day and age,” Collins said.

The board has offered to allow Currier to bring her breast pump into the exam room, and to provide her with an extra room in which to expel milk during her breaks. Currier will be allowed to take the test over two days, instead of the normal one, because she has dyslexia and attention deficit hyperactivity disorder, and the board has agreed to give her 45 minutes of break time each day. Currier wants an additional hour of break time each day.

But the board argued that it would be unfair to other test takers to allow Currier more time for a condition not recognized as a disability under the Americans with Disabilities Act.

"The national board thinks that breastfeeding is a fine thing to do but it also thinks that having a standardized examination for licensure is also really important," said board spokesperson Ken Cotton.

He said the board periodically reviews its testing policies and will consider increasing break time for all examinees, a solution he said would be more consistent than making an exception for Currier.

Posted by Gideon Gil at 02:08 PM

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Monday, September 17, 2007

Breastfeeding medical student gets day in court

By Felicia Mello, Globe Correspondent

A state judge heard arguments today in the case of a Harvard medical student who is suing for extra break time to pump breast milk during her exam to become a doctor, but postponed a ruling until later this week.

The hearing set the stage for a last-minute decision in the suit filed by Sophie Currier of Brookline, who plans to take the clinical knowledge exam -- the last hurdle she must clear before she can begin her residency program at Massachusetts General Hospital -- next Monday and Tuesday.

Currier's lawyer today asked Judge Patrick Brady of Norfolk Superior Court to issue an injunction forcing the National Board of Medical Examiners to grant Currier, who has a four-month-old daughter, two hours of extra rest periods over the course of the exam. The lawyer accused the board of violating Currier's rights under the state constitution and discriminating against her based on her gender.

"What you're doing is screening out women because they are unable to take care of their dual roles as mothers and professionals," Currier's lawyer, Christine Smith Collins, told the court. "It's unfair, it's unjust, and it's not in the public's interest."

But a lawyer for the board said that making Currier follow the same rules as other test-takers didn't prevent her from breastfeeding, but just made it less convenient.

"One thing we cannot do is change the format for the test, because then we've failed all 50 medical boards that are relying on this and we've failed every other student who takes this test," said board lawyer Joseph Savage.

The board has offered to allow Currier to bring her breast pump into the exam room, and to provide her with an extra room in which to expel milk during her breaks -- though it's unclear whether that room would be monitored. Currier will be allowed to take the test over two days, instead of the normal one, because she has dyslexia and attention deficit hyperactivity disorder, and the board has agreed to give her 45 minutes of break time each day -- the daily amount granted all test-takers.

The case had been moved to federal court last week but was sent back to state court after a federal judge said he could not hear the case until mid-October.

Holding her baby outside the Dedham courthouse after the hearing, Currier, who has started a blog to reach out to mothers in similar situations, said she hoped her case would help them, too.

"It's really about whether women should be protected under the law to breastfeed their children," she said.

Posted by Gideon Gil at 07:06 PM

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Children's group building online medical records for major employer group

A group from Children's Hospital Boston has been hired by a corporate consortium to develop online medical records for their employees.

Dossia, a group of eight major employers including Wal-Mart and Intel, chose the Children's Hospital Informatics Program to adapt its own program called Indivo to provide secure health records for 5 million employees and their dependents and retirees.

The Children's program, which also has ties to Harvard and MIT, has been working for 10 years to create Web-based records for patients that include a lifetime of health information across different doctors and care sites. The Dossia goal is to allow its workers to have access to their medical records, to communicate with their doctors, and to pull together information from different sources, the group said.

Dossia does not disclose details of its contracts, Colette Cote, a spokeswoman for member Pitney-Bowes and Dossia, said when asked about the financial terms of the agreement with Children's. The other companies in Dossia are AT&T, Sanofi-aventis, Applied Materials, BP America Inc. and Cardinal Health.

Indivo will be introduced at Children's this fall and Dossia plans to roll out its version to some members by the end of the year, its statement said.

Posted by Elizabeth Cooney at 05:06 PM

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Wednesday, September 12, 2007

Hearing put off in nursing mother's suit against medical exam board

By Felicia Mello, Globe Correspondent

The case of a Brookline woman who is suing for extra break time to pump breast milk during the licensing exam to become a doctor has been removed to federal court, meaning a previously scheduled state court hearing this afternoon will not take place.

A hearing has been set for tomorrow at 2 p.m. to decide whether the federal court will hear the case before Sophie Currier, 33, is scheduled to take the test September 24 and 25.

Currier, a Harvard Medical School student who is breastfeeding her 4-month-old daughter, filed suit against the National Board of Medical Examiners in state court last week, saying the 45 minutes of free time allowed over the course of the nine-hour exam was not enough for her to expel milk in addition to eating and using the restroom.

The board has refused to grant Currier the extra time but has offered to supply her with a private room in which to pump the milk during scheduled breaks.

The case was transferred to the US District Court at the request of lawyers for the medical board.

Christine Smith Collins, Currier’s attorney, said the removal "could be viewed as a delay tactic by the board trying to push off a decision until after she's taken the exam, so she can’t get the relief that she’s seeking."

But medical board attorney Joseph Savage said he made the request because Currier’s major argument was that her civil rights had been violated, a claim more appropriately heard by a federal judge.

Currier, a Brookline resident, has started a blog, called Support Nursing Moms, in hopes of reaching other women in similar circumstances.

"I am fighting because I don't have a choice," she said today, "but I feel passionate about it because I feel I could influence how other nursing mothers are treated as well."

Posted by Gideon Gil at 01:10 PM

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Berwick and Herr win Heinz awards

Two Cambridge innovators are among five winners of $250,000 awards from the Heinz Family Foundation for their achievements in medicine and science, the foundation said today.

Dr. Donald Berwick (left), co-founder of the Institute for Healthcare Improvement and a professor of pediatrics at Harvard Medical School, won in the public policy arena. His organization has been central in the movement to increase patient safety through efforts to make healthcare systems work better. The 100,000 Lives campaign, followed by the 5 Million Lives effort, set goals to improve care in hospitals.

Hugh Herr (left), MIT professor and director of biomechatronics at the MIT Media Lab, won in the technology, the economy and employment category. He studies human movement, how it is controlled and how to engineer human-like structures, including prostheses for amputees and wrap-around devices for people who have suffered strokes.

"My philosophy is that there are no disabled people in the world. There are only technologies that haven't been invented yet or technologies that don't work," Herr said in an interview yesterday. He calls himself an end-user because both his legs were amputated. "We should not accept disability and society should always continue to work toward technological interventions that bring us closer to being sure no one has to live with a disability, whether cognitive or physical."

Yesterday Berwick said he might use his grant to advance IHI's work in developing countries, where the organization has been applying the same principles that work to reduce infections in hospital ICUs to ways that keep women from dying in childbirth in remote villages in Malawi.

"We take very good science around public health and then empower local groups to implement that science," he said. "The same improvement methods that are getting traction in wealthy countries can have tremendous effects in developing countries."

The other winners of the Heinz awards, named for Senator John Heinz of Pennsylvania and selected by the foundation chaired by his widow, Teresa Heinz, are:

Dr. David L. Heymann of Geneva, assistant director general of the World Health Organization, in the human condition category

Dave Eggers, San Francisco author and founder of the 826 Valencia writing laboratories, in the arts and humanities category

Bernard Amadei of Boulder, Colo., founder of Engineers Without Borders -- USA and -- International, and Susan Seacrest of Lincoln, Neb., founder of the Groundwater Foundation. They are co-recipients in the environment category

Posted by Elizabeth Cooney at 07:35 AM

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Monday, September 10, 2007

Nursing mother files suit against medical exam board

By Carey Goldberg, Globe Staff

Sophie Currier, the Harvard MD-PhD and nursing mother who was denied extra time to pump her breasts during an all-day exam of medical knowledge, has filed suit against the board that administers the exam.

Her case is currently scheduled to be heard this Wednesday at 2 p.m. in Norfolk Superior Court in Dedham, said her lawyer, Christine Collins, but that timing is still under negotiation.

Collins is asking the judge for an immediate order requiring the National Board of Medical Examiners to provide extra time and an appropriate place for pumping. Currier plans to take the clinical knowledge exam on Sept. 24 and 25th.

The board of medical examiners, the non-profit group that runs national medical exams, has said that it can provide accommodations only for disabilities covered by the federal Americans with Disabilities Act, and breastfeeding does not qualify.

Currier, 33, is not claiming that breastfeeding is a disability. But it is a demanding biological reality, she argues, and one that -- medical authorities agree -- is important for the health of her 4-month-old daughter, who is still exclusively breastfeeding.

Nursing mothers who go for hours without breastfeeding or pumping risk painfully hard breasts, plugged milk ducts and possible infection, as well as a possible reduction in milk supply.

Collins argues that it is a woman's constitutional right to breastfeed, and that denying Currier extra time to pump amounts to discrimination on the basis of sex. A member of the firm Bowditch & Dewey of Boston, Worcester and Framingham, Collins has taken Currier's case pro bono.

Dr. Ruth Hoppe, chair of the governing board that oversees the tests, said she could not comment directly on Currier's case.

But she said that the board tries to keep the tests as fair and uniform as possible in order to safeguard the American public and ensure the competence of its doctors. At the same time, she said, it tries to accommodate test-takers with personal difficulties that do not qualify as full-fledged disabilities, such as breast-feeding, bone fractures, back pain and bowel problems.

"We try to do the best job we can do to balance those priorities," she said.

Given the questions raised about breastfeeding, she said, she expects the board to re-examine its policy on lactation within the next year.

Currier's case, which was first reported on the Globe's front page, is in the New York Times today.

Posted by Karen Weintraub at 04:00 PM

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Wednesday, September 5, 2007

UMass Medical School recruits two RNA stars

University of Massachusetts Medical School has hired two leading RNA researchers to join a group best known for Nobel Prize winner Craig C. Mello.

Victor R. Ambros (far left), who discovered molecules called microRNAs that are important in gene regulation, is leaving Dartmouth Medical School for UMass, and Melissa J. Moore, noted for her work with gene splicing and messenger RNA, is coming from Brandeis University.

"Wow, they got the A Team," Phillip A. Sharp, an MIT Nobel laureate, said in an interview today. Moore previously worked in his lab and Ambros worked in the lab next door.

Ambros, 53, earned undergraduate and graduate degrees at MIT, where he also did postdoctoral work. While at MIT he worked with two other Nobel winners: David Baltimore on the poliovirus genome, and H. Robert Horvitz on the genetic regulation of organ development and programmed cell death.

When Ambros joined the faculty of Harvard, Mello was a graduate student in his lab. Mello won the 2006 Nobel Prize in medicine or physiology with Stanford's Andrew Z. Fire for discovering RNA interference, a natural mechanism that silences genes.

It was Mello who called Ambros about coming to UMass, Ambros said in an interview.

"There's really a great convergence of bright people and exciting problems" at UMass, he said. "When I heard Melissa Moore was planing to move there, that was sort of the clincher."

Moore, 45, is a Howard Hughes Investigator who has made major contributions to understanding how RNA is edited by the cell to make sure it is intact, Sharp of MIT said.

Moore said she was recruited by UMass professor and RNA scientist Phillip D. Zamore, who also worked in the Sharp lab at MIT.

"I think UMass is just really at an exciting stage of its growth and there is a tremendous community already there for the kind of research I do in RNA and what Victor does as well," she said in an interview.

Posted by Elizabeth Cooney at 01:56 PM

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Tuesday, September 4, 2007

NIH grants focus on genes and the environment

Seven Massachusetts researchers have won grants from a new government program to study how genes and the environment interact, the National Institutes of Health announced today.

Through the Genes, Environment and Health Initiative, researchers will study the genetics of such diseases as diabetes, cancer, heart disease and tooth decay. To learn about the environmental component, scientists will develop ways to monitor personal exposure, whether to toxins or to physical activity.

The Broad Institute of MIT and Harvard, led by Stacey Gabriel, will receive $3.8 million to become one of two genotyping centers for the initiative. The other is at Johns Hopkins University in Baltimore.

Individual investigators and their projects are:

Dr. Frank Hu, Harvard School of Public Health, genes and environment initiatives in type 2 diabetes, $622,000;

Patty Freedson, University of Massachusetts, Amherst, development of an integrated measurement system to assess physical activity, $411,000;

Stephen Intille, MIT, enabling population-scale physical activity measurement on common mobile phones, $681,000;

Bevin Engelward, MIT, comet-chip high-throughput DNA damage sensor, $429,000;

Bruce Kristal, Brigham and Women’s Hospital, mitochondrial, metabolite and protein biomarkers of effects of diet, $454,000;

Dr. Avrum Spira, Boston University, a non-invasive gene expression biomarker of airway response to tobacco smoke, $643,000.

Posted by Elizabeth Cooney at 12:57 PM

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Wednesday, August 29, 2007

Update on Harvard physician-scientist's move to Arizona

Dr. Robert A. Greenes says it's hard to leave Harvard and Brigham and Women's Hospital, after 40 years, but the chance to build a new biomedical informatics program in Arizona is too good to pass up.

"Harvard and the Brigham have provided a wonderful environment for my professional activity," he said in an e-mail message last night. "My decision to leave Boston after many years of working closely with so many wonderful colleagues was not easy but became irresistible as I learned more about what the opportunity could be."

Greenes, a Harvard Medical School radiology professor and program director of a Harvard-MIT training program in medical informatics, is joining Arizona State University, whose faculty teaches medical students at the new Phoenix branch of the University of Arizona College of Medicine.

He is the second prominent biomedical informatics researcher to leave Harvard for a new program, following Stephen Wong, who took about 20 lab staffers with him to Methodist Hospital Research Institute in Houston.

"Besides the attractions of the new position in terms of the commitment of the participating institutions to it, and the generous budget, and space, ... I think the big attraction for me is the chance to raise the scale of informatics activity and commitment, " Greenes said.

Greenes singled out Dr. Steven Seltzer, chief of radiology at the Brigham, for his support of biomedical informatics as the field has matured. Yesterday Seltzer called the new opportunity for Greenes an exciting one.

The University of Arizona incorporated biomedical informatics into plans for its new medical school branch in Phoenix, Greenes said. Its 24 students have just begun classes, medical school spokesman Al Brava said yesterday.

Biomedical informatics includes the role of informatics not only in genomics and molecular science, but also in imaging, clinical medicine and public health, Greenes said.

"These are heady times for informatics, and Arizona recognizes and is poised to take advantage of its potential," he said.

His wife, Carole Greenes, is also joining Arizona State University. A professor of mathematics education at Boston University, she will become dean of the School of Educational Innovation and Teacher preparation at ASU's Polytechnic campus in Mesa.

Posted by Elizabeth Cooney at 09:27 AM

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Wait for Botox shorter than for mole check, study says

Patients seeking an appointment with a dermatologist to ask about a potentially cancerous mole have to wait substantially longer than those seeking Botox for wrinkles, says a study published online today by The Journal of the American Academy of Dermatology and described in today's New York Times.

In Boston, the median Botox wait was 13 days, versus 68 days for a mole examination, the Times story said. In Seattle, the median Botox wait was seven and a half days, compared to 35 days for a changing mole.

Dr. Alexa B. Kimball, an associate professor of dermatology at Harvard Medical School, told the Times one reason could be that the demand for medical dermatologists outstrips the supply. She was not involved in the study but her research has shown that dermatologists nationwide spent an average of three to four hours a week on cosmetic treatments.

More people are seeking medical appointments with dermatologists because of increased awareness about such skin diseases as melanoma and psoriasis, Kimball said. Meanwhile, a wider array of doctors, including plastic surgeons and even some internists, offer Botox shots, she said.

"The study shows that the Botox needs of the United States are being met," Dr. Kimball told the Times. "If dermatologists stopped providing cosmetic care, it would not necessarily have an impact on medical dermatology patients."

Posted by Elizabeth Cooney at 08:31 AM

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Tuesday, August 28, 2007

Another Harvard bioinformatics leader leaving

By Elizabeth Cooney, Globe Correspondent

Another biomedical informatics leader is leaving Harvard to head a new department in the Sun Belt.

Dr. Robert A. Greenes (left), a Harvard Medical School radiology professor and program director of a Harvard-MIT training program in medical informatics, is joining Arizona State University, whose faculty teaches medical students at the new Phoenix branch of the University of Arizona College of Medicine.

He will chair the Phoenix-based department of biomedical informatics in ASU's School of Computing and Informatics, which was founded last year as part of the School of Engineering.

Greenes is leaving Brigham and Women's Hospital, where in 1980 he established the Decision Systems Group.

His departure follows the move in July by Stephen Wong, who took about 20 researchers with him when he left for The Methodist Hospital Research Institute in Houston to create a bioinformatics program there.

"Bob got a wonderful professional opportunity," Dr. Steven Seltzer, chief of radiology at the Brigham, said in an interview today. "They have money and they have space, so it's exciting."

The departures by Greenes and Wong are "bittersweet" transitions that Harvard monitors, he said.

"Our institution is blessed with more than its fair share of resources and part of our mission in life is to help populate the world with folks who are leaders in American medicine," Seltzer said. "Having said that, we still need to retain our highly qualified faculty and when we lose any faculty member, even if for a unique opportunity, it is a bittersweet outcome for us. We monitor as carefully as we can with any faculty attrition we have, how much is for, a 'good' reason, like moving to a nice opportunity, and how much is for a bad reason, that we are not competitive [in] either compensation or other resources."

In a statement from ASU announcing his appointment, Greenes said he was influenced by "the substantial planning efforts and resources already devoted to ASU's biomedical informatics program."

"I'm impressed by the eagerness at all levels of the university, especially its leadership, and among its partners, the University of Arizona, and other Arizona health and biomedical science institutions, to create a top-notch biomedical informatics program," Greenes said. He was traveling today and did not immediately return calls or e-mails seeking comment.

Greenes is not taking members of the Decision Systems Group with him to Arizona, Seltzer said. Dr. Lucila Ohno-Machado will succeed him as director of the group.

Posted by Elizabeth Cooney at 02:44 PM

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Monday, August 27, 2007

Harvard leader named dean of Duke medical school

A Harvard Medical School physician-scientist has been named dean of the Duke University School of Medicine, the North Carolina school announced today.

Dr. Nancy C. Andrews (left), dean for basic sciences and graduate studies at Harvard Medical School, is the first woman to fill the position, Duke said. She will succeed Dr. R. Sanders Williams, who was promoted to senior vice chancellor for academic affairs at Duke.

Andrews, 48, is a pediatric hematologist/oncologist at Children's Hospital Boston and the Dana-Farber Cancer Institute. She previously directed the Harvard/MIT MD/PhD program. A member of the Institute of Medicine of the National Academy of Sciences, she was a Howard Hughes Investigator from 1993 to 2006.

Andrews earned bachelor's and master's degrees in molecular biophysics and biochemistry from Yale University, a Ph.D. in biology from MIT, and an MD from Harvard Medical School. She completed her residency at Children's and a fellowship in pediatric hematology/oncology at Children's and Dana-Farber.

Posted by Elizabeth Cooney at 02:51 PM

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Wednesday, August 22, 2007

Notables

A Brown University neuroscientist has won Germany's top honor for basic neurological research for creating a device that translates thought into action.

John P. Donoghue, who developed a brain implant called BrainGate that allows paralyzed people to use their thoughts to move a computer cursor, control a wheelchair or operate a robotic arm, will receive one of two K.J. Zulch prizes next week. The other goes to University of Melbourne professor emeritus Graeme Clark, who invented the cochlear implant.

Dr. Robert Ian McCaslin of Children's Hospital Boston has been named director of Mo HealthNet, the Medicaid agency for the state of Missouri, Governor Matt Blunt said. He has been an attending physician in the pediatric emergency department at Children's and an instructor at Harvard Medical School.

Each year MIT's Technology Review names 35 innovators under 35 for its TR35. This year eight technologists and scientists from New England make the list.

David Berry, 29, Flagship Ventures, Cambridge: renewable petroleum from microbes
Adam Cohen, 28, of Harvard University: making molecules motionless
Ali Khademhosseini, 31, Harvard-MIT Division of Health Sciences and Technology: improving engineered tissues
Ivan Kristic, 21, One Laptop per Child (on leave from Harvard): making antivirus software obsolete
Christopher Loose, 27, SteriCoat, Cambridge: beating up bacteria
Anna Lysyanskaya, 31, Brown University: Securing online privacy
Kristala Jones Prather, 34, MIT: reverse-engineering biology
Mehmet Yanik, 29, MIT: stopping light on microchips

Posted by Elizabeth Cooney at 07:03 AM

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Monday, August 20, 2007

Patient safety leader applauds Medicare policy to not pay for hospital errors

By Elizabeth Cooney, Globe Correspondent

A leader of the patient safety movement supports Medicare’s decision to not cover hospitals' costs of treating preventable errors, saying it’s time to go beyond altruistic efforts at improving outcomes.

"I would have preferred it to have been positive rather than punitive, but the time has passed for that, I’m afraid," Dr. Lucian Leape of the Harvard School of Public Health said in an interview. "We’ve got a lot of solutions out there and the thing that is so frustrating is they haven’t been implemented."

Under the new regulations, Medicare will not pay the costs of treating patients harmed by errors, injuries and infections that occur in hospitals.

The list of conditions includes pressure ulcers (bedsores), injuries from falls, and infections, most commonly from the use of catheters in the bladder or lines inserted into blood vessels. Hospital-acquired infections lead to 99,000 deaths a year, according to an estimate by the US Centers for Disease Control and Prevention.

Leape was an author of the landmark Institute of Medicine report "To Err is Human" in 1998 that said as many as 98,000 people die each year from hospital medical errors. Since that time, the picture has improved, he said -- citing the Cambridge-based Institute for Healthcare Improvement's "100,000 Lives Saved" campaign -- but not enough.

"That progress has been made in the absence of any financial incentives or penalties," he said. "It has been done because a lot of good people –- doctors, nurses, administrators and others -– have wanted to do the right thing and reduce injuries. That just hasn’t been enough, so people are beginning to pull the other lever, pulling the financial incentives in."

The Medicare move wasn’t a surprise to hospitals, Karen Nelson, vice president of clinical affairs at the Massachusetts Hospital Association, said in an interview, calling it consistent with a trend toward pay for performance and public reporting of patient outcomes.

"This is sort of the flip side: non-payment for non-performance," she said. "The new angle to this is an implied causation. We hope that the final rules that come out are clear and easy for hospitals to apply in terms of documenting, to ensure that the attribution is correct."

That might mean getting urine samples before a patient is admitted to determine whether a patient already has a urinary tract infection, she said, a practice in place now but not used for every patient.

John Auerbach, commissioner of the state Department of Public Health, applauded the Medicare policy, but said it was only one part of a solution that will also involve the state and individual hospitals.

"I think it's an excellent policy and we need a range of different approaches in terms of eliminating these infections and injuries," he said in an interview. "Reimbursement is one of them, providing technical assistance and education is another one, and requiring public reporting of these infections and injuries is a third. If we employ them all, it will end up being the best thing for the patient."

Posted by Elizabeth Cooney at 06:21 PM

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Friday, August 17, 2007

On the blogs: faculty diversity in science

On Nature Network Boston, scientist Deanne Taylor offers her take on why women and members of minority groups are underrepresented in academic science.

The main obstacle to increasing faculty diversity could be the habit of self-identification, says Taylor, who does research at the Harvard School of Public Health and chairs the bioinformatics graduate program at Brandeis University. By that she means feeling more comfortable with someone who seems the same and then using that familiarity as a shortcut to social interaction.

"Although there are exceptions, in my experience, we scientists are not always known for deft socialization skills, which would allow for that kind of facility in finding common ground among diverse people," she writes, stressing that this is her opinion, not the result of data analysis. "Since scientists make decisions on everything from grants to departmental resources and tenure awards on ‘best fit,’ you can imagine the consequences of self-identification could be quite predictable."

Posted by Elizabeth Cooney at 12:40 PM

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Thursday, August 16, 2007

New physician-scientists win Howard Hughes awards

Seven Boston physicians who spent a year or more away from medical school doing research have won grants to continue their dual roles as scientists and clinicians.

The Howard Hughes Medical Institute has given Early Career Awards of $375,000 each over five years to 20 doctors to make sure they have the time and financial support for research early in their careers, it said in a statement. Their institutions agreed to allow these tenure-track physician-scientists to devote at least 70 percent of their time to research.

The winners are alumni of either HHMI's research scholars or training fellowship programs, which bring students to the National Institutes of Health or other institutions. They are:

Dr. Sarah Fortune, Harvard University School of Public Health
Dr. Aram Hezel, Massachusetts General Hospital
Dr. Farouc Jaffer, Massachusetts General Hospital
Dr. Eric Johannsen, Brigham and Women's Hospital
Dr. Sridhar Ramaswamy, Massachusetts General Hospital Cancer Center
Dr. Manish Sagar, Brigham and Women's Hospital
Dr. Sean Savitz, Beth Israel Deaconess Medical Center

Posted by Elizabeth Cooney at 01:49 PM

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What Canada can learn from US about health care

Discussions about healthcare often look north to the single-payer model in Canada. But the tables are turned, now that the Canadian Medical Association has recommended allowing private competition to enter its national healthcare system.

That way lies disaster, Dr. Arnold S. Relman contends. The Harvard emeritus professor and former editor of the New England Journal of Medicine warns of a US-style system failure in a commentary that appears on globeandmail.com, the online partner of The Globe and Mail in Toronto.

"If Canada were so unwise as to allow privatization to grow in its health-care system, it would sooner or later experience all of the problems driving the U.S. system toward collapse," he writes. "One thing is certain: When medical care and health insurance are allowed to become private businesses, costs go up and patients with little or no resources do not get the care they need. That is the lesson Canadians should learn from the United States."

Posted by Elizabeth Cooney at 08:55 AM

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Wednesday, August 15, 2007

Encouraging signs on drug reviews, critic says

The voices of independent scientists are more important than ever, according to a critic of drug-company influence on government regulation, and there are signs they are being heard more than before.

Writing in tomorrow's New England Journal of Medicine, Dr. Jerry Avorn of Brigham and Women's Hospital and Harvard Medical School warns that Congress's re-authorization of user-fee funding from pharmaceutical companies to support the Food and Drug Administration means unbiased outside experts are critical to proper drug evaluation. As an example, he compares the approval of Vioxx in 1999 to this year's rejection of Arcoxia. Renewed assertiveness by FDA's external advisers made the difference in reviews of the painkillers linked to cardiac risk, he writes.

"Though the quiet voice of science may often be no match for powerful vested interests or ideology, some encouraging signs may be in the air," he writes. "The same reauthorization bill, disappointing in so many respects, may tighten somewhat the conflict-of-interest rules for outside advisers."

Posted by Elizabeth Cooney at 07:05 PM

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Tuesday, August 14, 2007

This week in JAMA

Three studies by Boston authors appear in this week's Journal of the American Medical Association.

A study from Dana-Farber Cancer Institute found that a diet high in meat, fat, sweets and refined grains may be associated with a higher risk of colon cancer recurrence and death in people who had surgery and chemotherapy to treat stage III colon cancer.

Researchers from Brigham and Women’s Hospital report that people with diabetes have an increased risk of death in the first month and first year after they have a heart attack or unstable angina compared with people who have these acute coronary syndromes but do not have diabetes.

A new measure of a lipid protein ratio is no better at predicting coronary heart disease than traditional methods of measuring cholesterol, Boston University School of Medicine investigators from the Framingham Study say.

Posted by Elizabeth Cooney at 07:27 PM

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Monday, August 13, 2007

Antioxidants no magic bullet for heart disease, study says

Antioxidant pills do not protect high-risk women from cardiovascular disease, a Harvard study has found, adding to growing evidence that supplements can’t duplicate a healthy diet and lifestyle.

Taking vitamin C, vitamin E and beta carotene alone or together did not protect the women overall from heart attacks, coronary artery disease or stroke, Dr. JoAnne E. Manson of Harvard Medical School and colleagues report in today’s Archives of Internal Medicine.

"Antioxidants are clearly not the magic bullet for heart disease prevention," she said in an interview. "Supplements do not replace the more difficult lifestyle modifications that have been proven to lower the risk of cardiovascular disease, such as regular exercise, a heart-healthy diet, not smoking, and managing high blood pressure and high cholesterol."

The study of 8,171 women was the first large-scale randomized trial to look at the impact of vitamin C on the risk of cardiovascular events, and it was also the first to examine vitamin C, vitamin E and beta carotene individually and in combination, Manson said.

Previous randomized trials of antioxidants have been disappointing, failing to duplicate the promising results found in observational studies following people who ate high amounts of antioxidants in their food. Antioxidants have been the subject of much research because of the hope that they could limit the harm caused by compounds called free radicals.

The combination of vitamin C and vitamin E did appear to reduce the risk of stroke by 30 percent, but Manson, who is also chief of preventive medicine at Brigham and Women’s Hospital, said this result warrants further study before making a recommendation.

"It’s not ready for prime-time," she said. "People should not be going out and buying vitamin C and vitamin E for the express purpose of preventing stroke."

They shouldn’t throw away their multivitamins, either, if they take them to make up for not eating a balanced diet, she said. The trial used doses much higher than can be found in multivitamins.

"Everyone’s looking for a simple pill you cold pop that will improve health or lower the risk of heart disease," she said. "Any widespread use of these vitamins for cardiovascular disease prevention is just not warranted."

Posted by Elizabeth Cooney at 04:29 PM

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Wong's Texas state of mind

Stephen Wong (left), the bioinformatics leader who left Harvard for Houston and took nearly two dozen lab colleagues with him, talks about his new role in a Houston Chronicle story.

"Texas is a whole change in mind-set," Wong, 49, told the Chronicle. "We want to do something new. The whole idea is, we don't want to do something small. And this is the place to come and do that."

The exact place, as in lab space, is significant, too, according to the story:

"For decades, Houston has been known for its leading-edge heart research. Yet, it is a clear sign of the times that Wong, a star recruited by The Methodist Hospital from Harvard University earlier this summer, will claim a large chunk of the hospital's two floors of lab space formerly used by legendary heart surgeon Dr. Michael DeBakey."

Posted by Elizabeth Cooney at 10:28 AM

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Friday, August 10, 2007

Update on Harvard stem cell scientist

Here's an update from Harvard stem cell scientist Kevin C. Eggan on a report in today's New York Times –- denied earlier today by a Harvard spokesman -- that he is delaying a move to Kansas City because of political opposition in Missouri to human embryonic stem cell research.

The Harvard spokesman said Eggan has never had plans to leave Harvard. But Eggan said in an interview later this afternoon that a move to Kansas City was "always on the table" as part of his contract with the Stowers Medical Institute, which is based in Harvard Square and supports two investigators: Eggan and Chad Cowan at Massachusetts General Hospital.

"Our contracts say that advancement in the institute would be tied to moving to Kansas City if the political situation improved," Eggan said. "It was always very much on the table."

Even though Missouri voters approved a constitutional amendment in November to allow stem cell research, state legislators have proposed many bills that would limit any research on human embryonic stem cells.

"The political situation is anything but clear," Eggan said.

Jim and Virginia Stowers of Kansas City, who have delayed a $300 million expansion of their Stowers Institute for Medical Research there, started supporting Eggan and Cowan because they thought Missouri would ban stem cell research.

If the climate for stem cell research changes in Missouri, Eggan and his lab colleagues will have a decision to make.

"It's certainly something we would have to seriously consider," he said.

Posted by Elizabeth Cooney at 06:39 PM

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Stem cell scientist never planned to leave, Harvard says

Harvard Stem Cell Institute scientist Kevin C. Eggan (left) has no plans to move to a Kansas City, Mo., research center, a Harvard spokesman said today, despite a report in today's New York Times saying he has delayed leaving because of political opposition in Missouri to working with embryonic stem cells.

Eggan, whose Harvard lab is supported by the same Kansas City donors that built the Missouri research center, did not immediately return a phone call seeking comment, but a Harvard Stem Cell Institute spokesman said Eggan isn't going anywhere.

"There are not and there have not been any plans for Kevin Eggan to leave the Harvard Stem Cell Institute," B.D. Colen said in an interview. "He was making a general comment about anyone who was considering going to Missouri to do stem cell research."

The Times quoted Eggan in a front-page story about political and financial roadblocks to a $300 million expansion of the Stowers Institute for Medical Research, funded by Kansas City philanthropists Jim and Virginia Stowers. Even though Missouri voters approved a constitutional amendment in November that allows embryonic stem cell research, many new bills to limit research have been proposed in the state legislature, stalling the recruitment of scientists, the story said.

Eggan is a founding member and assistant investigator of the separate Stowers Medical Institute based in Cambridge, which supports researchers in an arrangement that follows the Howard Hughes Medical Institute model of funding scientists' work at their home institutions. Stowers is providing $5.9 million over five years to Eggan's lab, according to a 2005 Harvard statement.

The Stowers Medical Institute also supports Chad Cowan at the Center for Regenerative Medicine at Massachusetts General Hospital and the Harvard Stem Cell Institute.

Jim Stowers said in 2005 that he and his wife were supporting research at Harvard rather than in Missouri because of fears that the Missouri legislature would ban stem cell research, according to that Harvard statement.

Posted by Elizabeth Cooney at 01:46 PM

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Tuesday, August 7, 2007

Underinsured children fall into vaccine gap

By Elizabeth Cooney, Globe Correspondent

Children whose private health insurance does not pay for new recommended vaccines may not be eligible to receive them in public programs, leaving them more vulnerable than if they had no insurance, according to a Harvard study.

These gaps are occurring as the number and cost of new vaccines have escalated. New vaccines recommended for children have doubled in the past five years and the cost to fully vaccinate a child -- about $1,170 -- is 7.5 times higher in 2007 than it was in 1995, Dr. Grace M. Lee of Harvard Medical School and colleagues write in tomorrow’s Journal of the American Medical Association. They surveyed state immunization program managers in 48 states from January to June 2006.

"We assumed kids with health insurance would have coverage for vaccinations, but we found a group of children whose insurance didn’t cover the cost of vaccine. That to me was surprising," Lee said in an interview.

Those children were referred to public health clinics, but they were still unable to receive vaccine because funding to pay for it was not available, the researchers found. The work was funded by the US Centers for Disease Control and Prevention.

"To us that was alarming because we had always seen the public sector as a safety net for vulnerable children," said Lee, also of Children’s Hospital Boston and Harvard Pilgrim Health Care. "Now we find that with the newer, more expensive vaccines, a lot of states are unable to provide these vaccines to kids who can’t afford them."

Massachusetts covers all children for all vaccines recommended by the Advisory Committee on Immunization Practices, except the new vaccine against human papillomavirus. ACIP sets policy for the federal Vaccines for Children program, which pays for all vaccinations for children who are uninsured, eligible for Medicaid, of American Indian or Alaskan Native origin, or seen at a federally qualified community health center.

In July, Massachusetts began providing rotavirus and meningococcal conjugate vaccines for all children, Dr. Susan M. Lett of the state Department of Public Health and a co-author of the JAMA article said in an interview. The vaccines to protect against severe diarrhea in infants and meningitis in teenagers, respectively, were included in the state budget recommended by Governor Deval Patrick. The governor's budget had also proposed coverage for a vaccine for adolescent girls against HPV, the virus that causes cervical cancer, but the legislature requested a study on it instead.

The JAMA study did not attempt to find out how many families might pay out of pocket for vaccines. The HPV vaccine costs about $120 for each of three doses, the meningitis vaccine costs about $80, and the rotavirus vaccine costs about $60.

"I imagine that if a family can’t afford health insurance that covers vaccines, they probably wouldn’t be able to afford to pay for that," Lee said.

Based on a 2000 estimate by other researchers that 14 percent of children in the United States are underinsured, the JAMA authors estimate that 2.3 million children are unable to receive meningococcal conjugate vaccine from their private health care providers and 1.2 million children can’t get it from public health clinics.

In an accompanying editorial, Dr. Matthew M. Davis of the University of Michigan suggests a tiered approach to financing newly recommended vaccines for underinsured children where funding is not available.

"Vaccines that benefit more of the population per individual immunized would receive higher priority," he writes.

Lee and her co-authors suggest working with insurance plans to include coverage.

"Until those enhancements can be made to health insurance plans, I think we need to support our public sector safety net," she said. "We need to come up with funding for these kids who are falling through the cracks to bridge the gap until we can have all health insurance plans covering vaccines."

Posted by Elizabeth Cooney at 07:07 PM

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Thursday, August 2, 2007

Partners executive to lead New York foundation

By Elizabeth Cooney, Globe Correspondent

Dr. George E. Thibault (left), a leader at Partners HealthCare hospitals and Harvard Medical School, is leaving Boston to become president of a New York foundation devoted to improving health care.

Currently vice president of clinical affairs for Partners and professor of medicine and medical education at Harvard, he will become president of the Josiah Macy Jr. Foundation in January. The philanthropy supports programs to improve the education of health professionals and to increase the representation of minorities in medicine.

"It’s a very exciting opportunity to influence medical education nationally," Thibault said in an interview. "These are things that I’ve been interested in all my career, but now I can do them on a national scale."

Thibault, 63, had previously been chief medical officer at Brigham and Women's Hospital and chief of medical services at Brockton/West Roxbury VA Medical Center. Earlier in his career he was the first director of the Medical Practices Evaluation Unit at Massachusetts General Hospital and director of the medical intensive care unit and coronary care unit at MGH.

"The integrity, wisdom, and experience that George has brought to this position have allowed him to play a very important 'honest broker' role in working with physicians across the Partners system," Partners president and CEO Dr. James J. Mongan said in a message to staff today. "During George's tenure as Vice President of Clinical Affairs, he has improved physician relationships and cooperation across Partners."

Posted by Gideon Gil at 04:46 PM

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Korean cloning fraud covered an accidental stem cell first, Harvard paper says

Harvard scientists have answered a question that lingered after Korean scientists retracted their fraudulent claim
that they had cloned the first human embryonic stem cells: Where did the stem cell line they created come from?

Kitai Kim, Dr. George Q. Daley (left) and their colleagues at Children's Hospital Boston and the Harvard Stem Cell Institute report today in Cell Stem Cell that the embryonic stem cells created by the Korean lab resulted not from somatic cell nuclear transfer, a technique in which a person's DNA is injected into a donor egg cell that has had its own DNA removed, but from parthenogenesis, the process of making an embryo from the donor egg alone.

Cells derived from parthenogenesis carry a distinct genetic fingerprint because they have a duplicate set of chromosomes from the egg. Most of the genetic sequences are identical, but some show differences from the donor egg. Investigators looking into the Korean claims last year said parthenogenesis could not explain these different patterns, the paper said.

Kim and Daley's group analyzed the cells further and found that the DNA differences were clustered at certain points, just as they are in experiments on parthenogenesis in mice.

The Koreans appear to have created the first human embryonic stem cells from a woman's egg alone, the paper says.

Daley's lab is studying parthenogenetic cells as another possible source of embryonic stem cells to treat disease.

A Children's Hospital interview with Daley is here.

Posted by Elizabeth Cooney at 12:40 PM

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Wednesday, August 1, 2007

Harvard-educated doctor named Joint Commission chief

Dr. Mark R. Chassin (left) of Mount Sinai Medical Center in New York, a Harvard-educated doctor and former commissioner of the New York State Department of Health, has been named president of The Joint Commission, a body that accredits US healthcare organizations.

Chassin graduated from Harvard College and Harvard Medical School and received a master's degree in public policy from the Kennedy School of Government at Harvard. He also holds a master's degree in public health from the University of California at Los Angeles.

Chassin succeeds Dr. Dennis S. O'Leary, who will conclude 21 years as president of the commission at the end of the year. O'Leary earned his bachelor's degree at Harvard.

Posted by Elizabeth Cooney at 01:23 PM

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Tuesday, July 31, 2007

Harvard researchers identify treatment target in Hodgkin lymphoma

By Elizabeth Cooney, Globe Correspondent

Hodgkin lymphoma tumors are a paradox. In tumors that can grow as large as baseballs, only a small fraction of the tumor is made up of cancer cells – about 5 percent – but they are surrounded by the patient’s normal immune cells. Something keeps the immune cells from attacking the cancer cells they vastly outnumber.

Harvard researchers will report later this week in the online Proceedings of the National Academy of Sciences that they have identified a protein that acts like the tumor’s bodyguard. Called galectin-1, it disables the immune cells, a discovery they believe will lead to better diagnosis and treatment of the blood cancer that usually strikes young adults.

"The reason we think this may turn out to be very important from a clinical perspective is it suggests if you could neutralize the galectin-1 that is being secreted by the Hodgkin lymphoma cells, then you would have a very good chance at re-regulating or reinstalling an effective immune response in Hodgkin lymphoma," Dr. Margaret A. Shipp of Harvard Medical School and the Dana-Farber Cancer Institute said in an interview. "We think this may have relevance in other tumors."

The protein is already showing promise as a way to identify tumors as Hodgkin lymphomas as opposed to other types of lymphoma, the paper suggests. Previous work in mice has shown that galectin-1 can also be produced by tumors in melanoma.

Shipp and her colleagues are working on generating an antibody to neutralize galectin-1 that would be an attractive alternative to the chemotherapy and radiation used to treat Hodgkin lymphoma.

"This is a fascinating paper from a big-picture perspective because we are increasingly learning that the immune system is often involved in cancer formation and it can be stimulated to be part of cancer treatment," said Deborah Banker of the Leukemia and Lymphoma Society, which is funding the research going forward. "It seems that in general none of us might ever get cancer if the immune system were better at finding the very first cancer cells and eradicated them before they had a chance to multiply."

Posted by Elizabeth Cooney at 04:52 PM

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Two Mass. scientists win Keck awards

Two Massachusetts scientists are in the 2007 class of the W.M. Keck Foundation's Distinguished Young Scholars in Medical Research.

The Los Angeles philanthropy awards grants of up to $1 million each to five junior faculty members in the United States. Institutions make nominations by invitation only.

Amy Wagers (right) of the Harvard Stem Cell Institute, Joslin Diabetes Center and Harvard Medical School will study how to slow down or reverse the natural process of aging, which has potential implications for treating such age-related diseases as diabetes, immune deficiencies, muscle weakness and cancer, the foundation said.

Job Dekker (left) of University of Massachusetts Medical School will study how chromosomes are regulated by comparing cancer cells to normal cells, which may uncover defects that cause malignancy, potentially leading to advances in treating cancer, the foundation said.

The three other winners are Wallace Marshall of the University of California, San Francisco, who will study blue-green algae to gain insights into human ciliary disorders such as polycystic kidney disease and retinal degeneration; Dr. Xander Wehrens of Baylor College of Medicine, who will investigate the mechanisms of specialized protein complexes in excitable cells, such as heart muscle; and Jennifer Zallen of Memorial Sloan-Kettering Cancer Center, who will focus on a fruit fly’s cell structure to develop approaches to analyze cell behavior and structure in living embryos, the foundation said.

Posted by Elizabeth Cooney at 09:54 AM

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Monday, July 30, 2007

Harvard leader named president of Texas Tech Health Sciences Center

Dr. John C. Baldwin (left), a Harvard professor of surgery and head of the CBR Biomedical Institute affiliated with Harvard Medical School, has been named president of the Texas Tech University Health Sciences Center in Lubbock, the university's chancellor announced today.

A fifth-generation Texan, Baldwin graduated from Harvard College and Stanford University School of Medicine and completed his internship and residency at Massachusetts General Hospital. He was chief of cardiovascular surgery at Yale University, head of surgical programs at Baylor College of Medicine, dean of Dartmouth Medical School and associate provost of Dartmouth College before returning to Harvard to become president and CEO of the CBR Institute for Biomedical Research, which is in the process of changing its name to the Immune Disease Institute.

Posted by Elizabeth Cooney at 02:37 PM

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Wednesday, July 25, 2007

Friendships may contribute to obesity epidemic

By Alice Dembner, Globe Staff

A study released today suggests that obesity spreads through social connections, particularly via close friendships.

This doesn’t replace the effects of genetics, failing to exercise or supersizing food. But researchers writing in the New England Journal of Medicine say it provides a possible explanation for the rapid increase in obesity over the last few decades. Nationally surveys show that nearly one-third of US adults are now obese.

The condition appears to spread though what researchers are calling “social contagion,” a tendency of people who become obese to influence the behavior of others and to convey -- perhaps subliminally -- the message that being overweight is okay.

"Obesity is not just an individual problem, but a collective problem," said Dr. Nicholas Christakis, a professor of medical sociology at Harvard Medical School and co-author of the report. To slow the epidemic, he said, "treating people in groups may be more effective than treating them individually."

Studying more than 12,000 people linked to a long-running study of heart disease based in Framingham, the researchers found that an individual's chances of becoming obese increased by 57 percent if someone they consider a friend grew obese.

If the friendship was close and mutual and one person became obese, the other's risk soared by 171 percent. The study found similar, but smaller influences between siblings and spouses, but neighbors who aren't friends had no effect.

Surprisingly, obesity seemed to spread even if friends were geographically distant.

"We were stunned to find that friends who are hundreds of miles away have just as much impact on a person's weight as those who are geographically close," said James Fowler, the paper's other author, who is an associate professor of political science at the University of California San Diego. This led researchers to suggest that the effect wasn't only due to sharing behaviors -- such as eating together -- but to sharing ideas about what constitutes an appropriate weight.

Because the study looked at relationships over time, the researchers were able to exclude cases in which obese people chose overweight friends, and therefore were able to make a stronger case for a causal effect.

Researchers have developed an illustration showing how relationships impact obesity.

Posted by Karen Weintraub at 01:36 PM

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HBS professor takes AMA to task

The American Medical Association, which received $286 million in revenue last year to protect the profession, has served physicians poorly, a Harvard Business School professor writes in today's Washington Post.

Regina E. Herzlinger (left), who is also a senior fellow of the Manhattan Institute, says doctors' professionalism and incomes have taken a terrible beating recently. Some physicians are switching occupations and showing up in her classes seeking MBAs, saying they can no longer practice medicine, she writes.

"You might expect that the AMA would fight the insurers, hospitals, government bureaucrats and ivory tower academics who have diminished physicians' incomes, besmirched their ethical reputations and compromised their professionalism -- but you would be wrong," she writes. "No, instead, at its annual meeting last month, the AMA declared war on retail medical clinics, located in places such as CVS and Wal-Mart."

"We and doctors deserve better advocates."

Posted by Elizabeth Cooney at 10:57 AM

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Telling all, genetically speaking

Technology consultant Esther Dyson writes about being one of 10 members of Harvard geneticist George Church's Personal Genome project in today's Wall Street Journal.

The project's goal is to recruit 100,000 volunteers whose information will be public for anyone to use, whether for research, their own healthcare or commerce, she says.

She worries about the thousands that will follow the first group willing to post not only their genomes, but also their medical records and answers to extensive questionnaires on the Internet for all to see.

"The 10 of us are fairly well informed, and we know whom to turn to for help if we get an anomalous result," she writes. "But what if the 99,999th person has something alarming in his medical records? This is a research project: We will be careful not to give clinical advice or diagnoses, which could subject us to additional regulation."

Despite that concern, she has faith in the project's goals.

"No one said it would be easy, but the knowledge from our project, and with luck from many others, will ultimately lead to better information that will be there for anyone to use," she concludes.

Posted by Elizabeth Cooney at 08:18 AM

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Tuesday, July 24, 2007

After Katrina, coastal residents reluctant to evacuate, Harvard survey finds

Almost two years after Hurricane Katrina, nearly a third of the people who live along the coastline from North Carolina to Texas say they would not evacuate if ordered to do so, according to a Harvard survey, up from almost a quarter of people who told researchers last year they would stay in their homes.

Fewer people who live in the New Orleans metropolitan area –- 14 percent –- said they wouldn’t leave. But 61 percent of the respondents in the New Orleans area said they didn’t know where the nearest shelter was, and 54 percent were sure they would be rescued if they stayed home.

"Public officials need to be concerned that the further we get from the severe hurricanes of 2005, the less willing people are to evacuate," Robert J. Blendon, professor of health policy and political analysis at the Harvard School of Public Health, said in comments released with the survey today. "Officials need to remind people that many homes are vulnerable to major storms. They also need to ensure safe evacuation routes are available and the public is aware of them."

The latest survey, conducted last month, asked 5,406 people who lived in counties within 20 miles of the Atlantic Ocean or the Gulf of Mexico how prepared they were for a hurricane. Almost half of them had lived in places that had already been hit by damaging hurricanes.

Three-quarters of residents who said they wouldn’t leave thought their homes would be safe during a hurricane. More than half were afraid that evacuation routes would be too crowded; about a third worried that leaving would be dangerous; and a third also were concerned about theft or damage to their homes. About a quarter didn’t want to leave their pets.

If they did have to leave their homes, about two-thirds said they were most concerned that shelters would be dirty, lack clean water and be too crowded. Almost two-thirds of respondents thought they would be exposed to sick people and have no medical care.

Posted by Elizabeth Cooney at 05:27 PM

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Friday, July 13, 2007

Harvard doctors will blog on Gather.com

By Liz Kowalczyk, Globe Staff

Harvard Medical School physicians will begin blogging under a new agreement with Gather.com, a social networking site for adults. Harvard Health Publications, which provides content from the medical school, announced this week that it is launching 35 online communities focusing on different chronic conditions, including depression, diabetes and insomnia.

Physicians will blog on each disease, offering expert advice and allowing for back and forth conversations with consumers, who also will be able to join online discussions with each other.

LifeMasters Supported SelfCare Inc., a leading provider of disease management programs, also is part of the venture.

Posted by Gideon Gil at 02:55 PM

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Wednesday, July 11, 2007

Covering people before 65 reduces health care costs later

Providing health care to uninsured adults before they qualify for Medicare coverage may not only improve their health but also reduce costs after they turn 65, a Harvard study says.

People who haven’t had insurance coverage are significantly more likely to report poor health before the age of 65, the authors report in tomorrow’s New England Journal of Medicine.

They looked at data from the national Health and Retirement Study to compare health care expenditures between insured and uninsured adults at age 59 and 60 and then again after 65. They concluded that expanding health insurance coverage for uninsured people before 65 might be offset by savings in health care costs that would come later, particularly for people who have cardiovascular disease or diabetes.

"It may be less costly than people thought," Dr. J. Michael McWilliams, a research associate at Harvard Medical School, said in an interview. "Earlier coverage improves health and reduces health care needs."

These findings are especially important as baby boomers reach 65, he said. The current generation of adults has higher rates of obesity and hypertension than their parents', pointing to more chronic disease and a greater need for preventive care, said McWilliams, who also practices general internal medicine at Brigham and Women’s Hospital.

When previously uninsured adults reach 65, they have significantly more doctor visits and hospital stays than adults who had coverage before. The uninsured patients also had more out-of-pocket expenditures after 65 that were not covered by Medicare, the authors found.

"Not only does providing coverage to these adults substantially reduce their health care needs after 65, but it also protects them financially," McWilliams said.

Posted by Elizabeth Cooney at 05:56 PM

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It's official: Flier is new Harvard medical dean

By Liz Kowalczyk, Globe Staff

It's official.

Harvard just announced that Dr. Jeffrey S. Flier, a prominent diabetes and obesity researcher at Beth Israel Deaconess Medical Center, has been named dean of Harvard Medical School.

Harvard University President Drew Gilpin Faust said in a telephone interview that Flier has wide ranging experience across the university, developed during his nearly 30 years there. She said she was impressed that Harvard leaders and faculty in vastly different roles -- basic science researchers, academic leaders, and physicians -- all spoke highly of him.

"All brought the same sense of deep respect," she said this afternoon.

Flier succeeds Dr. Joseph Martin, who stepped down as dean last month.

Flier was selected after the head of the National Heart Lung and Blood Institute, Dr. Elizabeth Nabel, a cardiologist, withdrew as a finalist, two Harvard officials said, citing a desire to stay in Washington where her husband works. Just as Faust is the first female president of Harvard, Nabel could have been the first female dean of the medical school.

"The timing was not right for her family, but Dr. Nabel congratulates Dr. Flier and wishes him great success in his new position as dean," said NHLBI spokeswoman Susan Dambrauskas.

Flier, 59, lives in Newton; his wife, Dr. Eleftheria Maratos-Flier, also is a leading diabetes researcher at Beth Israel Deaconess.

Flier, who is known for his research into the molecular mechanisms of insulin action and insulin resistance, has served for the past five years as chief academic officer of Beth Israel Deaconess. He has been closely involved in recent discussions of the future of Harvard-wide science, as a founding member of the Harvard University Science and Engineering Committee.

"It's pretty clear we're starting from a very high base line," said Flier, who begins as dean Sept. 1. "The challenge is finding areas where this incredible institution can be strengthened," he said in an interview.

He said that his areas of focus will include implementing Harvard Medical School's new curriculum, which pushes students to better understand patients' experiences in the health care system; helping plan the university's new Allston campus and the future of science at Harvard; and increasing collaboration among researchers across the system, particularly in the area of translating basic research into treatments for patients.

Asked how he pitched himself for the job, considering the dozens of candidates, Flier recounted, "I said that I've been in this system my whole career. I've seen the system on the patient care end, the researcher end, the teaching and the academic leadership end. I know I've been successful in those areas."

Dr. James Thrall, head of radiology at Massachusetts General Hospital and a member of the search committee, said "it was very clear in the proceedings that all of the people in the Harvard community who had worked with him (Flier) held him in very high regard. Given the nature of the academic world that is refreshing. People are pretty tough and judgmental. Having the right personality is important; trust and respect become very important when (people) have legitimate disagreements."

Posted by Gideon Gil at 05:21 PM

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Dr. Jeffrey Flier to be named Harvard medical dean

By Liz Kowalczyk, Globe Staff

Word is that Dr. Jeffrey Flier (left), chief academic officer at Beth Israel Deaconess Medical Center and a nationally known researcher on diabetes and obesity, will be named the new dean of Harvard Medical School, as early as today.

Two Harvard officials with knowledge of the search said today that Harvard University president Drew Gilpin Faust is close to making an announcement about Flier's appointment.

Dr. Elizabeth Nabel, a cardiologist who trained at Brigham and Women's Hospital and is director of the National Heart Lung and Blood Institute in Washington, D.C., dropped out of contention, the officials said. Just as Faust is the first female president of Harvard, Nabel would have been the first female dean of the medical school.

But Nabel did not want the job for family reasons; her husband, Dr. Gary Nabel, is heading the National Institutes of Health's search for an AIDS vaccine, also in Washington.

A search committee evaluated an initial list of several hundred candidates. Faust conducts the final interviews, makes the ultimate decision, and negotiates the new dean's salary, resources, and fund-raising responsibilities.

Posted by Gideon Gil at 01:47 PM

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Tuesday, July 10, 2007

A century's worth of sky

The Great Refractor, left, which captured the first
picture of a star in 1850, and an image of the
Large Magellanic Cloud taken in 1900.

More than half a million images constituting humanity’s only record of a century’s worth of sky exist on glass plates at the Harvard College Observatory, a story in today's New York Times notes.

"Besides being 25 percent of the world’s total of astronomical photographic plates, this is the only collection that covers both hemispheres," Alison Doane (left) told the Times. She is curator of the glass database, which weighs 165 tons and contains more than a petabyte of data, the story says. There is no backup.

For the last few months, Doane and a few colleagues, along with volunteers from the Amateur Telescope Makers of Boston, have been setting the stage for a mammoth attempt to convert the entire collection into a searchable online atlas, the story says.

Posted by Elizabeth Cooney at 10:55 AM

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Monday, July 9, 2007

Electronic records alone don't improve outpatient care, study says

Electronic health records, championed as a way to improve patient health and safety, don't by themselves lead to better care in doctors' offices, a study shows.

Researchers from Harvard and Stanford found that electronic records made no difference in 14 of 17 measures of quality for outpatient health care, according to today's Archives of Internal Medicine. They examined data from the National Ambulatory Medical Care Survey gathered from visits to doctors in 2003 and 2004.

Two categories showed better performance on recommended care in the 18 percent of visits in which electronic health records were used: not prescribing tranquilizers for depression and not ordering routine urinalysis in general medical exams. But in one area -- prescribing statins for patients with high cholesterol -- physicians using electronic health records performed worse than doctors who didn't have them.

The missing piece is information to guide clinical decisions, co-author Dr. David W. Bates of Harvard Medical School said in an interview last week. Prompts to order tests, prescribe medications or avoid harmful drug interactions can make the records more than just computerized charts, the study said.

"I was surprised," he said. "I expected we would find improvement with the use of electronic health records, especially because there's a lot of evidence that with good decision support, quality measures do improve."

The survey did not ask if doctors were using electronic records with decision support tools, said Bates, who is chief of general internal medicine at Brigham and Women's Hospital. But previous research has shown quality goes up when a physician is reminded to order a lab test to monitor a patient's diabetes, for example. Decision support is most helpful with preventive care and chronic disease management, he said.

"I hope this will emphasize the importance of including good decision support in electronic health records," he said.

Posted by Elizabeth Cooney at 04:00 PM

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Wednesday, July 4, 2007

Doctor advises how to resolve family-hospital disputes over ending life support

They’re called "medical futility" cases, when family members and hospitals disagree on whether to continue life support for very sick patients. Although rare, they raise questions about respect for others’ viewpoints, a Children’s Hospital Boston doctor says.

Writing in tomorrow’s New England Journal of Medicine, Dr. Robert D. Truog warns against laws that allow a hospital ethics committee to be "surrogate judge and jury."

He considers the recent case of 19-month-old Emilio Gonzales, whose mother went to court to prevent Austin Children’s Hospital from turning off his respirator. Emilio had a rare, fatal genetic disorder called Leigh’s disease that meant he was in intensive care for five months with declining neurological function. Under the Texas Advance Directives Act, the hospital’s ethics committee decided to withdraw life support despite the objections of his mother, Caterina Gonzales.

"I’m concerned that legislation like that in Texas makes it just too easy for people in the medical profession to override the desires of those who have unpopular views," Truog said in an interview. "We’ve got a beautiful system of laws designed to protect people from the tyranny of the majority. The Texas law just bypasses it."

Massachusetts has no law governing cases like these, Truog said. Director of medical ethics at Harvard Medical School, he wrote a policy for Children’s about medically futile care. Under that policy, if a hospital ethics committee were to conclude that medical treatment should be stopped and the family disagreed, it would assist the family in finding and sometimes paying for a lawyer to take the hospital to court so a judge would decide.

In Emilio’s case, his mother found legal help through right-to-life groups, Truog said, but the process should have included safeguards to make that recourse standard. Those safeguards also have the benefit of allowing time for more discussion between the family and the hospital, he said, rather than ending the argument with a unilateral decision. Emilio died before the judge ruled, an outcome that is common in cases like these, Truog said.

The beliefs of people providing care in cases like these should not be ignored, he said. Clinicians should be supported in the difficult job of giving care that they don’t agree is the right thing to do. But their concerns do not automatically win the day, he wrote.

"The claim that continued life support for Emilio was morally objectionable was nothing more than an assertion that the values of the clinicians were correct while those of Ms. Gonzales were wrong," Truog wrote. "I believe that in cases like that of Emilio Gonzales, we should seek to enhance our capacity to tolerate the choices of others, even when we believe they are wrong."

Posted by Elizabeth Cooney at 05:00 PM

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Monday, July 2, 2007

Scientists report win against bacterial biofilms

Two scientists from Boston University and a Harvard-MIT program have engineered an organism to fight bacterial biofilms.

Writing in the online Proceedings of the National Academy of Sciences, Timothy K. Lu and James J. Collins report that they created a bacteriophage -- a virus that infects bacterial cells -- that releases an enzyme to attack both the bacterial cells in the biofilm and to disperse the biofilm itself.

Bacteria commonly live in biofilms. They can be found in dental plaque or water pipes or on medical devices. A source of infection and contamination, biofilms pose a particular problem when they are resistant to antibiotics.

Bacteriophages work in a different way than antibiotics when they infect bacterial cells. The authors say that adding enzymes makes the bacteriophages much more effective than previous efforts that didn't incorporate enzymes.

Lu is from the Harvard-MIT Division of Health Sciences and Technology and Collins is from BU's Center for BioDynamics.

Posted by Elizabeth Cooney at 02:29 PM

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Thursday, June 28, 2007

Notables

Cambridge Health Alliance will accept an award today from the National Association of Public Hospitals and Health Systems for its role in medical school curriculum change.

CHA developed a program for third-year Harvard Medical School students to follow patients for a year at one hospital instead of traditional rotations in different settings. The hospital was chosen for the 2007 Chair Award from 64 submissions, NAPH said in a statement.

Dr. Samantha L. Rosman, a third-year resident in pediatrics in Boston, has been re-elected to the American Medical Association's board of trustees. She is a 2004 graduate of Columbia University College of Physicians and Surgeons. After completing her residency, she will begin a fellowship in pediatric emergency medicine at Boston Medical Center.

Dr. Karen Shedlack (left), medical adviser for the mental retardation division of Vinfen, has won a 2007 Distinguished Fellowship from the American Psychiatric Association.

Before joining Vinfen, a private, nonprofit human services organization based in Cambridge, Shedlack was medical director for the adult developmental disabilities program at McLean Hospital and worked in the department of psychology and brain science at the Massachusetts Institute of Technology.

Virgin Life Care has named three Boston academics to its science advisory board.

A subsidiary of the Virgin group headed by Sir Richard Branson, the Boston company develops activity-based health rewards programs.

The board members are Dr. I-Min Lee of Harvard Medical School and the Harvard School of Public Health, Kyle McInnis of UMass-Boston and Jessica Whitely of UMass-Boston and Brown Medical School.

Children's Hospital Boston has honored five doctors with Community Physician Awards for the care they give in pediatric practices and community health centers.

They are Dr. Anthony Compagnone of Hyde Park Pediatrics, Dr. Debra Ann Gfeller of Holliston Pediatrics, Dr. David Holder of the Martha Eliot Health Center, Dr. Richard Marshall of Harvard Vanguard Associates at Copley and Dr. Robert Michaels of Longwood Pediatrics.

Posted by Elizabeth Cooney at 11:05 AM

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Tuesday, June 26, 2007

Notables

Kitty Dukakis (left), wife of former Governor Michael Dukakis and author of books about her battles with addiction and depression, was honored by the National Alliance on Mental Illness at its conference in San Diego last week. Author of last year's "Shock: The Healing Power of Electroconvulsive Therapy" with former Globe medical reporter Larry Tye and the 1990 book "Now You Know" about addiction to alcohol and diet pills, she was recognized for sharing her struggles and reducing the stigma associated with mental illness.

Dr. Donald M. Berwick (left), a Harvard Medical School professor who heads the Institute for Healthcare Improvement in Cambridge, is among 15 finalists for an award honoring innovators over 60 for their work on social problems.

Five Purpose Prize winners will each receive $100,000 from the San Francisco think tank Civic Ventures in September. Berwick, 60, was nominated for his work to help hospitals improve care through the "100,000 Lives" patient safety campaign. Each finalist is awarded at least $10,000.

Posted by Elizabeth Cooney at 04:20 PM

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Friday, June 22, 2007

Harvard researcher wins MERIT Award from NIH

Xihong Lin (left), professor of biostatistics at the Harvard School of Public Health, has won a MERIT Award from the National Institutes of Health.

Lin will develop statistical methods for analyzing cancer research data, including long-term and family data as well as genomic and proteomic information in epidemiological studies and population sciences, NIH said in a statement.

Fewer than 5 percent of NIH-funded investigators are selected to receive the awards.

Current MERIT recipients in Massachusetts and their instituions are:

Beth Israel Deaconess Medical Center: Benjamin G. Neel
CBR Institute for Biomedical Research: Timothy R. Springer
Children's Hospital Boston: Michael Klagsbrun and Bruce R. Zetter
Dana-Farber Cancer Institute: Stanley Korsmeyer and David M. Livingston
Harvard: John Blenis, Stephen C. Harrison, Peter M. Howley and Andrew G. Myers
Massachusetts General Hospital: Daniel Haber
MIT: Michael R. Lieber, Stephen J. Lippard and Alexander Rich
Tufts: John M. Coffin
Whitehead Institute for Biomedical Research: Rudolph Jaenisch

Posted by Elizabeth Cooney at 11:05 AM

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Tuesday, June 19, 2007

Boston scientists named Pew biomedical scholars

Four Boston-area scientists are among the newest class of 20 Pew Scholars in the Biomedical Sciences, the program announced today.

Funded by the Pew Charitable Trusts through a grant to the University of California at San Francisco, the awards give each scientist $240,000 over four years to support research.

Past winners have included Craig C. Mello of the University of Massachusetts Medical School, who shared the 2006 Nobel Prize in medicine or physiology for the discovery of the gene-silencing mechanism know as RNA interference.

This year's Boston-area winners are:

Ekaterina Heldwein (left), an assistant professor at Tufts University, will study how herpes viruses enter human cells. A graduate of Oregon Health and Science University, she trained at Children’s Hospital Boston and Harvard Medical School.

Dr. Deborah T. Hung (right), an assistant professor at Harvard Medical School and an assistant molecular biologist at Massachusetts General Hospital, will search for ways to fight the infectiousness of Pseudomonas aeruginosa, a bacterium that harms people with compromised immune systems because they have such conditions as cystic fibrosis, HIV or traumatic burns. She earned a doctorate in chemistry and a medical degree from Harvard and did additional training at Brigham and Women’s Hospital and Mass. General.

Daniela Nicastro (left), an assistant professor at Brandeis University, will investigate the molecular interactions involved in the beating of flagella in sea urchin sperm, which are important to understanding defects that underlie such human disorders as polycystic kidney disease, chronic respiratory disease and infertility. She received a doctorate in biology from the Ludwig Maximilians University in Munich and did postdoctoral research at the Max Planck Institute for Biochemistry and the University of Colorado.

Thomas U. Schwartz (left), an assistant professor at MIT, will study the three-dimensional structure of the nuclear pore complex that regulates molecular traffic into and out of the cell nucleus, which could lead to antiviral therapies. He earned a doctorate in biochemistry from the Free University of Berlin and did postdoctoral research at Rockefeller University.

Posted by Elizabeth Cooney at 04:28 PM

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Thursday, June 14, 2007

Houston $3b, Boston $1b

Last week Houston won Harvard's Stephen Wong and his bioinformatics team of 20 when they said they were wooed to Methodist Hospital. Yesterday Texas Gov. Rick Perry (at left with cancer survivor and lobbyist Andrea McWilliams) signed a bill that will put on the November ballot a $3 billion bond issue to fund research in the fight against cancer, today's Houston Chronicle reports.

The initiative, modeled after a 2004 California measure in which voters approved $3 billion for stem-cell research, seeks to compensate for the federal government's declining funding for scientific research in recent years, the story says.

"There is no piece of legislation that could mean more to the future of this state than this cancer-research bill," Perry said at the University of Texas M.D. Anderson Cancer Center in Houston, where he was joined by Lance Armstrong, a cancer survivor and seven-time Tour de France winner.

Officials at the ceremony, the story said, expect no area to receive a bigger share than Houston's Texas Medical Center, which is home to M.D. Anderson Cancer Center and Baylor College of Medicine, two of the state's three federally designated cancer centers. The third is at the University of Texas Health Science Center at San Antonio.

Last month Massachusetts Governor Deval Patrick announced a plan to invest $1 billion in life sciences, including a new stem-cell bank, job training, biomedical research, and tax breaks for companies hiring new workers.

Posted by Elizabeth Cooney at 11:11 AM

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Tuesday, June 12, 2007

She calls it 'phenomena,' not art

First an artist in residence and now a research scientist at MIT and also a senior research fellow at the Institute for Innovative Computing at Harvard, Felice Frankel (left) helps researchers use cameras, microscopes and other tools to display the beauty of science, a story in today's New York Times says.

But she doesn't call it art.

"My stuff is about phenomena," she says in the story, referring to magnetism or the behavior of water molecules or how colonies of bacteria grow — phenomena of nature. "When it’s art, it’s more about the creator, not necessarily the concept in the image."

Frankel and George M. Whitesides, a Harvard chemist and her longtime collaborator, are finishing a book about "small things," Whitesides told the Times, things at the limit of what can be seen with light, even through the microscope.

"She has transformed the visual face of science," he said.

Posted by Elizabeth Cooney at 10:54 AM

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New Florida school's dean remembers Harvard scholarship

Dr. Deborah German (left) won a full scholarship to Harvard Medical School. Now the 1976 graduate wants to offer the same free ride to students at the new medical school where she is dean, according to a story in today's St. Petersburg Times.

The University of Central Florida's medical school isn't even built yet, but it plans to pay the full ride for its entire inaugural class of 40 medical students admitted in 2009, the story says. The four-year scholarship of more than $160,000 would cover tuition and living expenses, under a money-raising campaign to be announced at UCF's main campus in Orlando today.

German's full scholarship to Harvard "made all the difference," she told the Times. Before becoming dean, she held positions at Vanderbilt and Duke.

"I want to offer the same gift that others offered to me."

Posted by Elizabeth Cooney at 09:01 AM

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Monday, June 11, 2007

Harvard names acting medical school dean

Harvard has named an acting dean for the medical school in a move that means a permanent appointment will not be made before the current dean leaves.

Dr. Barbara J. McNeil (left), chair of health care policy and professor of radiology, will assume the interim position after retiring dean Dr. Joseph B. Martin steps down June 30. A 1966 graduate of Harvard Medical School, McNeil has been a member of the faculty since 1983.

In a statement from Harvard last week, incoming President Drew Gilpin Faust said it did not seem feasible for a permanent dean to be appointed or to start as dean by July 1.

"We have made good progress in the search for a new dean and identified some very promising candidates," Faust said in the statement.

The Globe reported on May 24 that nationally known cardiologist Dr. Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute, and leading Harvard diabetes researcher Dr. Jeffrey Flier were among the finalists, according to several Harvard doctors and officials with knowledge of the search.

Posted by Elizabeth Cooney at 11:11 AM

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The cost of health

People do put a price tag on their existence, a story in a special section on the business of health says in today's New York Times.

Studies of real-world situations produce relatively consistent results, suggesting that average Americans value a year of life at $100,000 to $300,000, Peter J. Neumann, director of a program at Tufts-New England Medical Center that measures the cost-effectiveness of new treatments, told the Times.

The story also quotes David Cutler, a professor of economics at Harvard and author of "Your Money or Your Life: Strong Medicine for America’s Health-Care System." He says such estimates have value, at least as guides to the diseases and conditions that people will spend the most to avoid.

Also in the Times section, Jon Kingsdale (left) of the Commonwealth Health Care Connector and John McDonough of Health Care For All describe the challenges of implementing Massachusetts' new healthcare law.

"We’ll try to be the test laboratory for the rest of the country," Kingsdale said.

Posted by Elizabeth Cooney at 08:25 AM

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Friday, June 8, 2007

Study suggests men at risk for heart attack should be evaluated before starting hormones for prostate cancer

Men who are at risk for a fatal heart attack should be evaluated by a cardiologist before beginning hormonal therapy to treat prostate cancer, researchers from Harvard Medical School report.

The article to appear Sunday in the Journal of Clinical Oncology follows a landmark paper by other Harvard doctors published last fall in the same journal (and reported in the Globe) that linked androgen suppression therapy to diabetes and heart disease.

Androgen suppression therapy is often prescribed for men with prostate cancer. Research has established that it improves survival rates in men with advanced stages of the disease when given with radiation therapy, but the benefits of the treatment are not as clear in men whose cancer is in earlier stages.

In the newer work, researchers led by Dr. Anthony V. D'Amico of Harvard and Brigham and Women's Hospital analyzed data from three randomized trials of 1,372 men in Australia and New Zealand, Canada and the United States. They report that nearly half of the men who were 65 and older and had heart disease risk factors suffered heart attacks sooner if they had received androgen suppression therapy for six months compared to men who had not been given the therapy.

Men who smoke or have diabetes, which put them at risk for heart attacks, should be referred for a cardiac evaluation before they start hormonal therapy to treat prostate cancer, D'Amico said in an interview.

"The study shows that a significant fraction of these men who are going to have heart attacks will have them on average 2 to 3 years sooner if the underlying heart disease is not addressed," he said.

D'Amico said his study's results "fit perfectly " with data produced by Dr. Nancy L. Keating of Brigham and Women's and Dr. Matthew R. Smith of Massachusetts General Hospital. They found that among 73,000 Medicare patients, men who received hormonal therapy significantly increased their risk of developing diabetes and also raised their risk of heart disease.

"The landmark study by Keating put on the map the issue of treatment-related diabetes and cardiovascular disease," Smith said. "Great care needs to be taken in interpreting the results of other trials because of the relatively small number of events and because the studies weren't designed to look at cardiovascular disease."

D'Amico said men can safely delay hormonal therapy to seek treatments for heart disease, which can range from taking aspirin to having stents placed to prop open clogged coronary arteries.

"Hormone therapy can cause a heart attack sooner than prostate cancer can progress," he said.

Posted by Elizabeth Cooney at 06:00 PM

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Wednesday, June 6, 2007

Harvard, Whitehead scientists report embryonic stem cell advances

By Colin Nickerson, Globe Staff

Scientists in Massachusetts and Japan say they have created embryonic stem cells using procedures that might overcome some of the ethical objections to the controversial research as well as a major scientific hurdle.

Most dramatically, three of the four research findings announced today used a highly experimental approach that avoids the destruction of embryos, which critics equate to taking a life. Instead, they used genes and retroviruses to coax adult cells back to an embryo-like state.

The other project, meanwhile, points to a new, readily available source of embryonic stem cells, which would allow researchers to bypass a bottleneck in current efforts at Harvard University to clone human stem cells genetically matched to a patient with a particular disease -- the inability to find women willing to donate unfertilized eggs for the research.

All of the research reported in today's Nature and Cell Stem Cell involved mice, but scientists say they believe the results could be replicated in humans.

"These new studies, done with mice cells, point the way to experiments that can be tried with human cells," said Douglas Melton, a Harvard stem cell scientist. "This represents some of the most exciting work in stem cell biology and genetic reprogramming."

In one of the papers, Melton's colleague at the Harvard Stem Cell Institute, Kevin Eggan, defied long-standing scientific dogma that fertilized eggs cannot be used to clone embryonic stem cell lines. Eggan carried out somatic cell nuclear transfer -- cloning -- by removing chromosomes from a one-cell fertilized egg and replacing it with DNA from another, mature cell. The modified cell began dividing, and he then harvested stem cells from the resultant embryo.

Although less razzle-dazzle than the techniques used in the other research, Eggan's work holds the best prospect of creating human embryonic stem cell lines in the near future.

The study by Eggan suggested that researchers could use the genetically-defective fertilized eggs discarded by the thousands daily at fertility clinics across the United States. Such one-cell embryos are treated as waste because they stand no chance of attaching to the womb and forming a healthy embryo.

"This represents a wonderful way of obtaining something good -- medical research that could lead to therapies for human disease -- out of something that would just be thrown away," Eggan said in an interview.

The findings by scientists from Harvard, the MIT-affiliated Whitehead Institute, Massachusetts General Hospital, and Japan's Kyoto University also represented the most successful attempts to date to find new ways to make embryonic stem cells that might overcome some of the ethical opposition from religious groups who oppose destruction of human embryos and from womens groups worried about the implications of female donors undergoing tricky hormonal therapy to produce eggs for research.

"All in all, this is encouraging, exciting progress that shows real willingness among scientists to weigh ethical concerns even as they pursue science objectives," said Dr. William Hurlbut, a neuroscientist and ethicist at Stanford University who serves on the President's Council on Bioethics. "The science is critical, of course. But so are many ethical concerns. We've got to calm down as a nation and stop the acrimony and misrepresentation flung by both sides."

Embryonic stem cells, considered crucial to medical science and eventual treatment for an array of terrible diseases, have the ability to form any of the 220 basic tissue types in the body -- from bone cells to brain cells.

But research on the cells has been slowed in the United States since President Bush, citing concerns about destruction of embryos, sharply limited federal funding of the science in 2001.

Work done by teams working independently of one another at Harvard, the Whitehead Institute, and Kyoto University involved the genetic manipulation of mouse skin cells back into an embryonic state. No eggs were used, no embryos destroyed -- a stunning advance, although perhaps difficult to replicate in humans.

"You can really turn back the clock from adult to embryonic stem cells," said Konrad Hochedlinger of the Harvard Stem Cell Institute and Massachusetts General Hospital's Center for Regenerative Medicine. "But success in humans might be much more difficult than in mice."

Posted by Gideon Gil at 01:37 PM

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Monday, June 4, 2007

Harvard bioinformatics team leaving for Houston

A leading scientist who directed research programs at Harvard Medical School and at Brigham and Women’s Hospital is leaving Boston and taking about 20 researchers with him to develop a bioinformatics program in Houston.

Stephen Wong (left) is leaving his posts as director of the Center for Bioinformatics in the Harvard Center for Neurodegeneration and Repair at Harvard Medical School and executive director of the Functional and Molecular Imaging Center at Brigham and Women’s. He has been an associate professor of radiology at Harvard Medical School and part of the neuro-oncology and cancer imaging programs at Dana-Farber Cancer Institute.

On July 1 he will become chief of medical physics and vice chair of radiology at The Methodist Hospital and director of the bioinformatics program at The Methodist Hospital Research Institute. He will join the faculty at Weill Cornell Medical College, which became the hospital’s academic affiliate after it dissolved ties with Baylor University three years ago.

"This was not an easy decision to make. I think Harvard is wonderful," Wong said in an interview today. "I do think the opportunity in Houston is big. It’s a fantastic opportunity to be in on the infrastructure."

Wong said he was drawn to Methodist by Dr. King Li, with whom he had worked on molecular imaging. Li was the chief of diagnostic radiology at the National Institutes of Health Clinical Center before becoming chair of radiology at Methodist last year.

At Methodist, Wong will build a program to use information that comes from imaging and other biomedical technologies to devise diagnostic tests and treatments. He said he envisions a sort of human GPS system for interventional medicine, in which imaging guides individualized treatments.

Wong has a background in business that includes working for computer company HP and developing the online trading arm of stock broker Charles Schwab. He also worked on a digital image archive system at the University of California at San Francisco. He was recruited from industry three years ago to create the functional and molecular imaging center at the Brigham, Dr. Steven Seltzer, chair of radiology, said in an interview today.

"Steve’s a very talented Ph.D. scientist," he said. "As disappointed as we are to lose him, it’s a very exciting opportunity for Steve and for them."

Seltzer said the number of people transferring with Wong is "on the large side," calling it a testament to the resources Methodist has been able to put together. He said all but one of the Brigham people leaving with Wong are graduate students or postdoctoral fellows. Wong said the total number of people moving south with him is about 20. He will also take with him $4 million in NIH grants.

"Our backfill strategy is that talented folks are still here and some will be promoted into positions of new responsibility," Seltzer said. "We will in turn be looking at graduate students and postdoctoral fellows. We have the richness of the intellectual capital in the Boston area."

Wong said he will maintain the collaborations he has with 25 different labs in Boston.

"Science has no boundaries, so physical location doesn’t matter," he said.

Posted by Elizabeth Cooney at 06:50 PM

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Friday, June 1, 2007

Harvard's Herzlinger a 'healthcare heretic'

Harvard Business School professor Regina Herzlinger (left) is trying to transform America's health-care system through her advocacy of consumer choice, an article in The Economist headlined 'health-care heretic' says.

Calling her America's leading advocate of market-driven, consumer-orientated health reform, the article quotes Ray Gilmartin, a former chairman of drug giant Merck, on her efforts in the 1980s: "She argued for a greater role for competition and choice when market forces and productivity were foreign concepts in this sector."

In the 1990s, when managed care was all the rage, the story says, she predicted correctly that such a cost-obsessed approach would alienate consumers while it failed to rein in cost inflation ("I said, ‘this fish stinks’," she recalls in the article).

Today, "the US health-care system is in the midst of a ferocious war. Four armies are battling to gain control: the health insurers, hospitals, government and doctors," the article quotes from her new book, "Who Killed Health Care?"

Then she moves in for the kill, the story continues: "Yet you and I, the people who use the health system and who pay for all of it, are not even combatants."

Posted by Elizabeth Cooney at 07:48 AM

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Wednesday, May 23, 2007

Harvard close to hiring medical school dean

By Liz Kowalczyk, Globe Staff

Harvard University's incoming president, Drew Gilpin Faust, is close to making a key hire, dean of Harvard Medical School, and the finalists include a nationally-known cardiologist and a leading Harvard diabetes researcher, according to several Harvard doctors and officials with knowledge of the search.

Dr. Elizabeth Nabel, a cardiologist who trained at Brigham and Women's Hospital and is director of the National Heart Lung and Blood Institute, is a top finalist for the position, according to two of the sources.

Nabel and the agency's spokeswoman did not return calls asking for comment. While at the University of Michigan during the 1980s and 1990s, she rose to chief of the Division of Cardiology and became known for her research into the molecular genetics of cardiovascular diseases, according to the institute's website.

The sources said that Dr. Jeffrey Flier, chief academic officer at Beth Israel Deaconess Medical Center and a nationally-known researcher on diabetes and obesity, also is a serious contender for the job. He said through a spokeswoman that he would not comment on the search.

Harvard University spokesman John Longbrake said the university would not comment on the search until it is completed.

The next dean of Harvard Medical School will replace Dr. Joseph Martin, who steps down next month, ending a 10-year tenure during which he oversaw dramatic changes to the school's curriculum. Martin, a neurologist, plans to take a sabbatical for one year and then increase his work with the Harvard Center for Neurodegeneration & Repair, a group that is trying to develop new drugs for Parkinson's and Alzheimer's disease and other neurological disorders.

Interim Harvard University president Derek Bok convened a faculty search committee to recommend potential replacements for Martin. But he left the final decision to Faust, partly because of the medical school's importance -- it has 11,000 faculty members and $1.2 billion in National Institutes of Health research grants awarded to the medical school and its affiliated hospitals. The medical school dean also will have a key role in the development of Harvard's new Allston campus, where a major stem cell research institute and other scientific laboratories will be located.

The search committee evaluated an initial list of several hundred candidates, the sources said, but the committee is advisory; Faust conducts the final interviews, makes the ultimate decision, and negotiates the new dean's salary, resources, and fund-raising responsibilities.

Posted by Gideon Gil at 06:50 PM

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Harvard study explains how aspirin might prevent some colon cancers

Taking aspirin regularly has long been known to prevent colorectal cancer in some people, but why that’s true has been unclear.

Researchers have suspected that blocking the enzyme COX-2 might be the mechanism involved. Dr. Andrew T. Chan and his Harvard Medical School colleagues confirm a connection to COX-2 in an article to appear in tomorrow’s New England Journal of Medicine.

Analyzing data from two large observational studies, they found that regular aspirin use — two or more tablets a week for more than 10 years — reduced the risk of developing colorectal tumors with high levels of COX-2 by 40 percent but did not have any effect on tumors without COX-2.

"That’s a pretty striking difference," Chan said in an interview.

It’s too soon to suggest taking aspirin to prevent colorectal cancer, he said. At this point no one knows how to predict who will develop COX-2 negative or COX-2 positive forms of the cancer. Further studies are needed to see if people who develop polyps that are COX-2 positive, or people who had COX-2 positive tumors and are concerned about recurrence, might benefit from aspirin.

"We’re on the right track," Chan said. "Ultimately, we may reach a point of making clinical recommendations for some subset of the population to improve the methods we already have to prevent colorectal cancer," such as screening, eating a balanced diet low in red meat and maintaining a low body weight, he said. "People can do that now."

In an editorial accompanying Chan’s article, Dr. Sanford D. Markowitz of Case Western Reserve University School of Medicine echoed the article’s call for more research into other ways to inhibit production of COX-2, noting that only one-third of the COX-2 positive colorectal cancers were prevented by regular aspirin use.

"We need to ask whether there are alternative strategies for targeting the COX pathway that have better efficacy or lower rates of adverse effects," Markowitz writes.

Posted by Elizabeth Cooney at 05:12 PM

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$1m cancer prize promotes sharing of ideas

Taking a page from an investors' club handbook, hedge fund managers and a Harvard scientist today introduced the Gotham Prize for Cancer Research, a $1 million annual award that will be given to a researcher who posts a promising idea on an online forum.

"As researchers who live and die by grant support, we want to hold on to our ideas," said prize co-founder Dr. Gary C. Curhan of Harvard Medical School and the School of Public Health. "But it's important to share the best ideas and also try to expedite their investigation."

To be considered, a scientist will have to send an essay of 500 to 1,000 words describing an idea for further research. If the idea is approved by a panel of cancer experts, the scientist will become a member of the online forum, where accepted ideas will be anonymously posted. Members will be asked to comment on these ideas in a spirit of collaboration the prize's founders hope will pave the way for progress in cancer research. Guests can also view the exchange.

The prize was created by New York hedge fund managers Joel Greenblatt and Robert Goldstein of the investment firm Gotham Capital and Curhan, a kidney specialist at Brigham and Women's Hospital. For the website, they took as their model the Value Investors Club, an online group where members share investment ideas.

The winner will be selected based on the quality of the idea, the feasibility of studying it, and on the comments it generates on the forum. The prize will be awarded in February. An additional $250,000 Ira Sohn Conference Foundation Prize in pediatric oncology will also be offered.

The scientific advisory board for the prizes includes Dr. Meir J. Stampfer of Harvard's medical and public health schools.

Joan S. Brugge, a cancer researcher at Harvard Medical School who is not involved in the prize, applauded the marketplace of ideas approach that the website will take.

"Since research money is really tight, any influx of support for cancer research is a good thing in general," she wrote in an e-mail. "'Experimentation' to evaluate new strategies to stimulate novel ideas and new approaches can't hurt cancer research and could indeed lead to important new breakthroughs."

Federal funding for cancer research has been flat in recent years, but still provides the foundation for basic knowledge, she said.

"These kinds of creative approaches ... should not be viewed as substitutes for continued robust/large scale support of investigator-initiated programs at NIH," Brugge wrote.

Posted by Elizabeth Cooney at 03:36 PM

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Tuesday, May 22, 2007

Eric Winer adds role at Susan G. Komen for the Cure

Dr. Eric P. Winer (left) today was named chief scientific adviser to Susan G. Komen for the Cure, the breast cancer advocacy group.

He will remain director of breast oncology at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School while taking on the new role at Komen. He explained in an interview why he is excited about the opportunity and about the future of breast cancer research.

Why did you agree to join Komen?
It’s a way of helping an organization that I view as a very strong organization to do even better in the future. Komen is about raising money for research and increasing those funds to answer the most appropriate questions as quickly as possible. This is now a way for me to have a slightly larger influence beyond the exam room, beyond my own institution and to work in an organization that is really trying to do good.

What are some of the questions that need answers?
We have new treatments that are better treatments, but one of the issues that arises is, the better the treatments get, the more important access to care gets. When you have a disease that is very poorly treated, it almost doesn’t matter whether people have access if they’re not going to get well. When you have a disease that can be more effectively treated, access to care — and this applies in the United States and worldwide — becomes increasingly important. Among the various goals that Komen has is trying to improve access to care.

What’s important on the research agenda?
This is a time when there really have been advances in our understanding of breast cancer biology that we need to translate into treatments in the clinic that will actually help patients with breast cancer and cure women with breast cancer. This is occurring at a time when federal funding for research has gone down, so organizations like Komen become even more important in terms of their ability to support research.

How will you influence the research that gets done?
Research funds will still be given out to investigators based on the peer review system. However, we can put out requests for applications in specific areas, as has always occurred with federal funds. It’s an important way to ask for proposals in areas where we think there can be the biggest bang for the buck.

What are the significant advances in breast cancer research over your 20-year career?
There are really two major areas: One is that we have finally understood that breast cancer isn’t one disease but a family of fairly distinct diseases that each requires different treatments. One-size-fits-all doesn’t work. And our understanding of that is paired with the increasing ability to identify treatments for each of those different subtypes. An example is the drug Herceptin for HER-2 positive breast cancer. HER-2 positive breast cancer is a distinct entity and we have treatments that work based on that.

What do you see for the future?
One of the exciting things about the work I’ve been able to do, by no means by myself but with hundreds of others, is that there really will have been a dramatic change in breast cancer. For a disease that was terrifying to women and that took many lives, I think that it will be a disease that takes very few women’s lives by the time I’m at the end of my career.

How old are you?
I’m 50. I don’t view this as preparation for retirement.

Posted by Elizabeth Cooney at 05:38 PM

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Monday, May 21, 2007

On the blogs: Swiss healthcare parallels, latest hospital infection rates

On WBUR's CommonHealth, Béatrice Schaad Noble, a Swiss journalist who is getting her master’s in public health at the Harvard School of Public Health, explains how Switzerland approached universal health insurance coverage.

"Switzerland has gone through the same problems Massachusetts is facing now. Eleven years ago, pockets of resistance were strong. Some people deeply disliked being forced to buy coverage," she writes. "Today resistance has completely disappeared. Last March Swiss have even refused in a vote to shift to a single payer system."

On Running a Hospital, Beth Israel Deaconess CEO Paul Levy posts the latest report on central line infection rates. In the past he has challenged other hospitals to do the same.

"The overall quarterly trend is in the right direction, but as you can see ..., there is troublesome variation from time to time," he writes. "The up's and down's, I guess, are normal, but we all wish they stay down."

Posted by Elizabeth Cooney at 11:22 AM

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Friday, May 18, 2007

Holzman to lead state psychiatry group

Dr. Todd F. Holzman (left), a pediatric psychiatrist at Harvard Vanguard Medical Associates, has been named president-elect of the Massachusetts Psychiatric Society. He is also an instructor in psychiatry at Harvard Medical School.

Posted by Elizabeth Cooney at 05:07 PM

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Thursday, May 17, 2007

Surgery with a 90-day warranty

Geisinger Health System in central Pennsylvania is offering what amounts to a 90-day warranty on elective bypass surgery, according to a story in today's New York Times.

That makes Geisinger stand out as a group that has transformed the way it delivers care, Dr. Donald M. Berwick told the Times. A professor of pediatrics and healthcare policy at Harvard Medical School, he is the chief executive of the Institute for Healthcare Improvement in Cambridge, a national nonprofit organization whose goal is better patient care.

In almost no other field would consumers tolerate the frequency of error that is common in medicine, Berwick said, and Geisinger has managed to reduce the rate significantly. "Getting everything right is really, really hard," Berwick said.

Posted by Elizabeth Cooney at 08:45 AM

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Wednesday, May 16, 2007

Finding a quicker route to vaccines

Harvard microbiologist Dr. Darren E. Higgins (left) wants to help your immune system in a hurry and on the cheap, a story in today's New York Times says.

The 40-year-old associate professor of microbiology and molecular genetics at Harvard Medical School is a co-founder of Genocea, a Cambridge start-up working on a novel method of vaccine development. His goal is to find the quickest way to make inexpensive vaccines that fight numerous complex and aggressive viruses and bacteria, the story says.

Students in his lab are trying to determine which proteins stimulate an immune system response, the story says. The idea is to administer these proteins, or combinations of proteins, to people in order to prepare their immune systems to resist attacks by the likes of tuberculosis, HIV or malaria.

"We are mimicking the human body immune response," he told the Times.

Posted by Elizabeth Cooney at 08:50 AM

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Tuesday, May 15, 2007

Harvard scientists to discuss stem cell research with Charlie Rose

Harvard scientists Dr. George Daley (at left in photo) and Doug Melton (center) will discuss embryonic and adult stem cell research on the fifth installment of the Charlie Rose Science Series on PBS. It airs at 11 p.m. tomorrow on Channel 2.

The other guests are Larry Goldstein of the University of California at San Diego and Story Landis of the National Institute for Neurological Disorders and Stroke. Sir Paul Nurse, president of Rockefeller University, will be the co-host.

Posted by Elizabeth Cooney at 12:18 PM

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Doctors flocking to books, blogs, columns

Dr. Jerome Groopman (far left) and Dr. Atul Gawande are Harvard clinicians who also write for The New Yorker. Each doctor has a well-received new book. But they are only two of many doctors telling their stories or sharing their views on the pages of books, on blogs or in newspaper columns, a story in today's New York Times says.

The last six months alone have seen the publication of a half-dozen volumes of memoir and opinion by doctors at every stage of professional life, the story says, from newbie ("M.D.: A Four-Year Journey Through Medical School" by Shani Stein-Ratzker) to emeritus ("Galileo’s Gout: Science in an Age of Endarkenment" by Gerald Weissmann).

Posted by Elizabeth Cooney at 09:23 AM

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Friday, May 11, 2007

Hollywood smoking rating scripted by Harvard

Scarlett Johansson in "The Black Dahlia," via
the New York Times.

Smoking will be weighed in movie ratings along with sex, violence and drug use, according to a new policy from a film industry panel influenced by the Harvard School of Public Health.

Before yesterday's announcement by the Motion Picture Association of America, only teenage smoking scenes were taken into account when its ratings board reviewed movies. Now all tobacco use will be evaluated, the MPAA said, taking into consideration whether the portrayals are historically accurate or otherwise appropriate to the film.

Smoking won't mean an automatic "R" rating, but new labels such as "glamorized smoking" or "pervasive smoking" will appear.

"The addition of tobacco smoking as a factor in determining a movie's rating marks an historic and important step by the film industry to protect children and adolescents from one of the most significant health concerns our nation and our children face today," HSPH dean Barry R. Bloom said in a statement.

Bloom, his Harvard colleague Jay Winsten, and Jonathan Samet of Johns Hopkins worked with the MPAA for more than a year to reduce the depiction of smoking in movies, bringing scientists to make presentions to the group.

"By placing smoking on a par with considerations of violence and sex, the Rating Board has acknowledged the public health dangers to children associated with glamorized images of a toxic and lethal addiction to tobacco," Bloom's statement said.

Posted by Elizabeth Cooney at 03:23 PM

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Thursday, May 10, 2007

Brandeis-led project targets lack of women leaders in medical schools

Relatively few women are department heads or full professors at the four medical schools in Massachusetts. And Dr. Karen Antman of the Boston University School of Medicine is the only female dean.

This lack of women in leadership roles in academic medicine is no longer a pipeline problem, now that medical schools admit equal numbers of men and women, says Dr. Linda Pololi of Brandeis University, who is leading a study of the issue.

The answer to women's persistent under-representation must lie elsewhere, she said in a recent interview. "Something in the system impedes their progress toward taking leadership positions."

Here are the percentages of women in leadership positions at Massachusetts medical schools and how they compare with all 125 medical schools nationwide, according to 2005 data from the Association of American Medical Colleges provided by Pololi:

Deans
BU 100%
Harvard 0%
Tufts 0%
UMass 0%
US 13%

Chairs of clinical science departments
BU 11%
Harvard 10%
Tufts 8%
UMass 7%
US 8%

Chairs of basic science departments
BU 0%
Harvard 33%
Tufts 29%
UMass 0%
US 13%

Full professors
BU 19%
Harvard 12%
Tufts 11%
UMass 19%
US 14%

Pololi, principal investigator of the National Initiative on Gender, Culture and Leadership in Medicine, brought deans from five US medical schools to a two-day retreat at Brandeis last week. The medical schools, which are demonstration sites for the project, are Tufts University, Duke University, George Washington University, the University of Minnesota and the University of New Mexico.

Project members are still trying to diagnose the problem before coming up with solutions, Dr. Michael Rosenblatt, dean of the Tufts school of medicine, said in an interview. The project will run five years and is supported by a $1.4 million grant from the Josiah Macy Jr. Foundation of New York.

"People might reflexively think that it's discrimination or a glass ceiling, and there may well be an element of that," he said. "It may be in some cases that women choose not even to apply for these positions or don't aspire to them because they are not appealing to women at that stage in life."

"It's an important problem," Rosenblatt said. "I hate to see that potential not being realized."

The five medical schools in the project will experiment with programs to deal with the issue. Those programs have not been defined yet, Rosenblatt said, but each school will report on its results and share what works with others.

Certain minority groups -- African-Americans, Hispanics, Native Americans, Pacific Islanders -- are also under-represented in academic medicine, but that does seem to reflect a pipeline problem at entry to medical school, Pololi and Rosenblatt said.

Posted by Elizabeth Cooney at 11:16 AM

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Psychiatrists, children and drug industry's role

Doctors maintain that payments from drug companies do not influence what they prescribe for patients, according to a story in today's New York Times.

But the intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care, the story says. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics.

Dr. Steven E. Hyman (left), the provost of Harvard University and former director of the National Institute of Mental Health, told the Times the growing use of atypicals in children is the most troubling example of this. The Times story was based on an analysis of records in Minnesota, which tracks drug company payments to doctors.

"There’s an irony that psychiatrists ask patients to have insights into themselves, but we don’t connect the wires in our own lives about how money is affecting our profession and putting our patients at risk," he said.

Posted by Elizabeth Cooney at 06:50 AM

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Tuesday, May 8, 2007

Cataloguing every species on earth

By Colin Nickerson, Globe Staff

Spurred by fears that thousands of animals, plants, and microbes will disappear from the planet before scientists can properly study them, a consortium of world-famous research institutions and funding foundations tomorrow will launch an effort to compile an enormous, computer-based "Encyclopedia of Life" to catalog every species known or found.

"For biologists, this is equivalent to the moon shot or mapping the human genome in terms of complexity and scope," said Gary Borisy, director of the Marine Biological Laboratory in Woods Hole, which along with Harvard University is among the top players in a project that will be overseen by biologists but undertaken mainly by software designers and computer engineers.

The aim of a project expected to take a decade at a cost of $100 million is to create a gigantic computer data base containing detailed descriptions of each of 1.8 million "named" species -- that is, forms of life that have been identified by scientists.

Some species, like Elephas maximus (the Asian elephant) or Lumbricus terrestris (a common earthworm), are familiar to everybody and well-studied by biologists. But hundreds of thousands of species -- from microscopic fungi, to bottom dwellers from the deepest seas, to obscure desert beetles -- have simply been preserved on slides or specimen pins, given a Latin name, and assigned a tentative place on the tree of life, then stashed in a sample drawer and all but forgotten.

In addition, biologists believe that untold millions of species -- mainly microorganisms, but also insects, flowers, trees, and even a few reptiles and mammals -- have never been noticed by humans, much less scientifically recorded.

"Our ignorance is dangerous," said Edward O. Wilson, a pioneering researcher of global biodiversity, professor emeritus of entomology at Harvard, and long-time crusader for creation of an accessible encyclopedia of all life. "Life forms with which we've shared the planet are going extinct at an alarming rate -- usually before we even determine what they are and what role they play in the ecosystem. "Our knowledge of biodiversity is so incomplete that we are at risk of losing a great deal of it before it is even discovered."

The Encyclopedia of Life -- to be formally launched tomorrow in Washington, where it will be headquartered -- is envisioned as a computer-based, ever-expanding roster of all life forms that will give scientists an unprecedented means to help decide when they've encountered a new species. It should also provide an invaluable, publicly-accessible trove for everyone from bio-entrepreneurs to birdwatchers.

The encyclopedia's website -- www.eol.org -- contains only a few samples, but within a few years will describe hundreds of thousands of species.

Sample demonstration pages of the polar bear show what the scientists hope to do. It offers pictures, maps, research and data on the molecular biology, genetics, reproduction diet of the polar bear.

The information can be accessed at the "novice" level, which says: "Polar bears inhabit Arctic sea ice, water, islands and continental coastlines." At "expert" level, it says: Polar bears occur in low numbers throughout their range and are most abundant in shallow water areas near shore or where current or upwellings increase biological productivity near ice areas associated with open water, polynyas or lead systems."

The entries will include detail that might range from the color of a buzzard's tail feathers to toxins contained in a toadstool. The interactive encyclopedia will include photographs, maps, links to scientific studies and DNA sequences, anecdotes from amateur naturalists (clearly separated from expert opinion), sound, and video, when available. Eventually, the work will hold the equivalent of about 300 million pages of information.

"Imagine scientists working in a rain forest somewhere who find an unusual plant or fungus," said Jonathan Fanton, president of the MacArthur Foundation, which has donated $10 million to the encyclopedia and pledged another $10 million if the project meets early goals. "They'll be able go on-line and tap into this huge data base to find similar species. They'll be able to know right on the spot if they've made a real discovery."

Today, that process might require culling through museum collections or sifting through mounds of material from various sources.

The Sloan Foundation, another major donor, has fronted $2.5 million for the encyclopedia, while the Marine Biological Laboratory has developed new software that will allow for sophisticated scientific comparisons to be made between species, a technology that didn't even exist a few years ago. Along with Harvard, institutions contributing money and expertise to the project include the Smithsonian Institution, Chicago's Field Museum, and the Missouri Botanical Garden.

"This will be an extraordinary science tool," said James Edwards, a global biodiversity expert named as the encyclopedia's executive director. "It will enable researchers to better understand the complicated relationships between organisms on both the macro- and micro-scale."

Some scientists believe that life is veering towards a sixth "great extinction" since emerging on earth 3.8 million years ago. Unlike the earlier mass extinctions -- most famously the disappearance of dinosaurs -- the looming die-off seems to be caused by human activity, mainly destruction of natural habitat and carbon dioxide emissions contributing to climate change.

Building the encyclopedia will fall mainly to software designers and computer engineers, with old-style field scientists -- like Harvard's Wilson, who won his reputation tracking down unknown species of ants in remote rain forests -- serving mainly to ensure the accuracy and quality of entered information.

"It's really more of a communications project than a discovery project," said Edwards. "It's integrating information so that anyone and everyone can access it, from a frontline scientist to a high school teacher to a farmer trying to figure whether a certain worm in the soil is friend or foe."

And that's just fine with Wilson.

"This effort is just so important to understanding life on our unknown planet," he said. "We are never going to have a mature science of ecology if we don't even know the species in the ecosystem."

Material from the Associated Press was used in this report.

Posted by Karen Weintraub at 07:54 PM

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Monday, May 7, 2007

Mass. doctors favorable toward pay for performance

Leaders of Massachusetts primary care physician groups look favorably on pay-for-performance incentives, and practices that have the programs also adopt quality improvement plans, a survey by Harvard researchers shows.

Skepticism has greeted these programs because of concerns that they undermine professionalism, Dr. Eric C. Schneider of the Harvard School of Public Health said in an interview. He is a co-author of the Robert Wood Johnson Foundation-funded study in this month’s American Journal of Managed Care.

In pay-for-performance programs, a portion of insurers' payments to doctors is based on how well they meet national standards for care, such as managing diabetes or encouraging mammograms. Schneider and his co-authors wondered what physicians thought about performance pay as a way to improve quality.

"The financial situation for primary care physicians is pretty challenging right now and these incentives are coming at a time when they’ve been given other incentives that relate directly to having them reduce access to care, such as imaging, formularies for medications, and some other things," Schneider said. "I do think the clinical view is those are related not directly to quality but more to cost control, so these other incentives directed at improving quality align well with their mission."

Another reason pay-for-performance initiatives might be well received is that they pay bonuses rather than take away compensation, Schneider said.

The researchers surveyed leaders of 100 primary care group practices in Massachusetts in 2005. Pay-for-performance accounted for an average of 2.2 percent of a practice’s total revenue, the article said, which one-third of the practice leaders thought was financially important. Eighty-nine percent of the leaders said their groups had pay-for-performance incentives in at least one of their health plan contracts.

These incentives were associated with a higher likelihood that a group had quality improvement initiatives in place, the paper said.

Dr. Kenneth Peelle, president of the Massachusetts Medical Society, said that since the survey was done, health plans have increased the amount of pay tied to performance. Blue Cross Blue Shield of Massachusetts, for example, said last year its performance bonus would be 10 to 13 percent.

"The problem we see is each of the health plans seems to come up with a different payment plan," said Peelle. "We look to government to put out some overall guidelines for this to work together."

Posted by Elizabeth Cooney at 05:00 PM

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CIMIT awards $5m to medical device researchers

Proposals to build new devices to help premature infants, to inject medicine without breaking the skin and to guide surgeons operating on the brain were among projects to win $5 million in grants from the Center for Integration of Medicine and Innovative Technology, the consortium announced today.

CIMIT, composed of Boston-area teaching hospitals and engineering schools, made 37 grants that range from $40,000 to $100,000. Twenty-two have military applications, acording to CIMIT, which receives support from the US Department of Defense as well as its members.

Dr. Riccardo Barbieri of Massachusetts General Hospital won a grant to develop a computational tool based on a premature infant's heartbeat to predict episodes when they stop breathing.

Mark Horenstein of Boston University will demonstate a way to inject medications through the skin using nanoparticles, leaving no wound behind.

Dr. Nobuyuki Nakajima of Brigham and Women's Hospital will work to improve how instruments can be navigated to diagnose and treat brain injury or disease.

"Our goal ... is to bring life-changing technology to patients as quickly as possible," Dr. John Parrish, CIMIT founder and director and Vietnam War battlefield surgeon, said in a statement. "We are especially aware of the needs of soldiers wounded on the battlefield."

Posted by Elizabeth Cooney at 06:56 AM

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Wednesday, May 2, 2007

Neurologists here for conference

Boston researchers are among neurologists and neuroscientists delivering more than 1,000 presentations and poster sessions at the annual meeting of the American Academy of Neurology at the Hynes Convention Center in Boston. The weeklong conference has drawn more than 10,000 people, the group said.

Local presenters include Dr. Miguel Hernan of the Harvard School of Public Health, who is presenting his study showing that depression may be an early symptom of Parkinson's disease.

Evan L. Thacker, also of the Harvard School of Public Health, was scheduled to describe research exploring how moderate to vigorous exercise might be associated with the risk of developing Parkinson's disease.

Dr. Jeffrey Ellenbogen of Harvard Medical School was slated to talk about his study's conclusion that sleep not only protects memories from outside interferences, but also helps strengthen them.

Posted by Elizabeth Cooney at 03:02 PM

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Tuesday, May 1, 2007

11 from area named to National Academy of Sciences

Eleven researchers from the Boston area are among 72 new members named today to the prestigious National Academy of Sciences, a private organization established by Congress in 1863 to advise the federal government.

Five are from MIT, four from Harvard and two from Brandeis. They are:

Tania A. Baker, Howard Hughes Medical Institute investigator and professor of biology, MIT
Moungi G. Bawendi, professor of chemistry and professor of energy, MIT
Michael B. Brenner, professor of medicine, Harvard Medical School
Kerry A. Emanuel, professor, program in atmospheres, oceans, and climate, MIT
Gerald Gabrielse, professor of physics, Harvard University
Eve E. Marder, professor of neuroscience, Brandeis University
Curtis T. McMullen, professor of mathematics, Harvard University
Silvio Micali, professor of computer science, MIT
Christopher Miller, Howard Hughes Medical Institute investigator and professor of biochemistry, Brandeis University
Peter H. Schiller, professor of medical engineering and medical physics, MIT
Jonathan G. Seidman, professor of cardiovascular genetics, Harvard Medical School

Posted by Elizabeth Cooney at 12:37 PM

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Friday, April 27, 2007

This week in Science

Two papers in Science, including one by Harvard researchers, were among four published yesterday in Science and Nature Genetics on genetic risk factors for developing diabetes. Alice Dembner describes them in today's Globe.

Reseachers from Massachusetts General Hospital, Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center and Brigham and Women's Hospital are part of an international team reporting on a new mechanism involved in resistance to "smart" cancer drugs Iressa and Tarceva that target lung cancer cell growth.

Scientists have identified a new gene that helps regulate the body's clock and Giulio F. Draetta of Merck
Research Laboratories in Boston and colleagues report on a molecular component of this clock involved in the
length of the circadian period.

A team that includes researchers from the CBR Institute for Biomedical Research and Harvard Medical School in Boston reveal how the influence of micro-RNAs, small RNA molecules that regulate gene expression, extends to the immune system.

Posted by Elizabeth Cooney at 02:24 PM

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On the blogs: high deductibles and hospitals

On WBUR's CommonHealth, Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program, asks if high-deductible insurance coverage is worse than being uninsured for patients but better for hospitals seeking payment for services.

"Forcing modest-income families to buy insurance policies with huge deductibles, co-payments and co-insurance may help hospitals, but leave patients even worse off than when they were uninsured," he writes.

Posted by Elizabeth Cooney at 11:17 AM

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Thursday, April 26, 2007

Genetic understanding of diabetes deepens

By Alice Dembner, Globe Staff

Four separate scientific teams, including one led by Harvard researchers, are today reporting progress toward unraveling the genetic basis of the most common form of diabetes.

They have identified three new genetic risk factors and confirmed five others that were discovered over the last few years. An additional risk factor identified by one group has not yet been confirmed by others.

Together, the genetic defects account for about 5 percent of the risk of getting the illness, said David Altshuler, associate professor of genetics and medicine at Harvard Medical School and a leader of one of the four teams that included the Broad Institute of Harvard and MIT.

"The picture that is emerging is of multiple genes, each with a modest effect" on diabetes, he said.

Overall, genetics account for about half the risk of getting type 2 diabetes, according to Altshuler. Environment and such behaviors as obesity and lack of exercise account for the remaining risk.

More than 20 million Americans now have type 2 diabetes and scientists estimate that about 54 million more are at risk of getting the illness. The disease harms the body's ability to control blood sugar and can lead to heart disease, blindness and early death.

The new research is expected to provide leads for development of new treatments and possibly ways to prevent diabetes.

"The pharmaceutical industry is absolutely salivating at all of these studies because they represent the best validation of a new drug target," said Dr. Francis Collins, director of the National Human Genome Research Institute and a leader of another of the teams. But Collins cautioned that it could be a decade before patients see any new drugs from the research.

The work is unusual because three of the four scientific groups collaborated to confirm their results, making the findings extremely solid. In addition, the results identified some genetic areas that are not connected to any known mechanism behind diabetes.

The results were published today in the online editions of the journals Science and Nature Genetics.

They are all based on a new research technique called genome-wide association studies, in which scientists compare genetic samples from thousands of individuals with a specific illness to those without it. Differences between the two are examined as possible genetic causes of the disease.

Posted by Karen Weintraub at 02:05 PM

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Aronson, Rosenbaum honored for career achievements

Dr. Mark D. Aronson of Beth Israel Deaconess Medical Center and Dr. Jerrold F. Rosenbaum of Massachusetts General Hospital are being honored for liftime contributions to their fields.

Aronson has won the Society of General Internal Medicine's Career Achievement in Medical Education Award. He founded Beth Israel's hospital medicine program, incorporating it into the residency curriculum and into continuing education and graduate medical education at Harvard Medical School.

Rosenbaum, chief of psychiatry at MGH, has won the C. Charles Burlingame Award from the Institute of Living in Hartford. He specializes in treatment-resistant mood and anxiety disorders, focusing on drug treatments for those conditions.

Posted by Elizabeth Cooney at 01:14 PM

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Wednesday, April 25, 2007

More than a quarter of doctors paid by industry, survey shows

Lunch in the doctor's office courtesy of pharmaceutical company reps and payments to physicians who speak at conferences aren't new, but the proportion of physicians reporting that they get money from industry and how that varies by specialty may be important for efforts to control these relationships, according to an article in tomorrow's New England Journal of Medicine.

Researchers at the Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School conducted a national survey of 3,167 physicians and found that 94 percent had some kind of relationship with the pharmaceutical or medical device industries. The respondents reported receiving drug samples (78 percent), gifts of food (83 percent) and sports or cultural event tickets (7 percent). More than a third (35 percent) received reimbursement for continuing medical education or meeting expenses.

More than a quarter (28 percent) got paid for consulting, serving on an advisory board or speakers bureau, or enrolling patients in clinical trials. This surprised the authors more than the 94 percent of doctors with some sort of tie, which could have been as little as a mug or pen, Dr. David Blumenthal said.

"I figured that direct payments went pretty much to people who were academic or opinion leaders, but it seemed to be far more common," he said in an interview. "The fact that more than a quarter of physicians are actually getting direct monetary payments tells me this remains an important phenomenon in American medicine and that the rules and regulations put into effect have not eliminated it."

In 2002, the Pharmaceutical Research and Manufacturers of America, the industry's trade group, put in place voluntary guidelines limiting certain gifts. Leading physician groups have also adopted similar rules.

Pediatricians were less likely than internists to receive payments or reimbursements. Anesthesiologists didn't get samples, reimbursements or payments as often as family practitioners, internists or cardiologists.

Cardiologists were more than twice as likely to be paid by industry as family practitioners were, perhaps because they are recognized as the ones who set standards for prescribing widely used heart drugs, the authors suggested.

Where the physician practiced also made a difference, they found. Group practice doctors were six times as likely to get samples, three times as likely to receive gifts, and almost four times as likely to receive payments for professional services such as consulting than doctors in hospitals, clinics or staff-model HMOS. Male doctors and those with fewer Medicaid or uninsured patients also were more likely to receive payments.

"Specialties, organizations and practice leaders with an interest in reporting and managing physician-industry relationships may need to develop guidelines and recommendations that are specific to the context of each specialty and setting," the authors wrote.

Posted by Elizabeth Cooney at 05:40 PM

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Tuesday, April 24, 2007

Gene variants tied to progression of eye disease

Age-related macular degeneration is the most common cause of vision loss in people over 60, but only some of the people who have the early or intermediate stages of the eye disease develop its more serious form, losing so much of their central vision that they can no longer drive or read.

Researchers led by Dr. Johanna M. Seddon of Tufts-New England Medical Center report in tomorrow’s Journal of the American Medical Association that people with variations in two common genes have a two- to four-times higher risk of developing advanced AMD. When combined with smoking and obesity, already known risk factors for advanced AMD, the gene variations pushed the risk of advanced AMD 19 times higher.

"We have shown how genetic variations do add to progression," Seddon said in an interview about the clinical trial, which followed 1,466 people for about six years. "Genetic factors, smoking and obesity are all independent factors related to progression of AMD and they seem to be additive."

But Seddon and her co-authors, who include Sarah George and Bernard Rosner of Harvard, say it's too early to call for genetic screening. Many, but not all, people with the gene variations progress to advanced AMD, but so do some people without the gene variation.

"The story is unfolding and we have a lot more to learn," Seddon said. "Genetic screening is premature at this point."

They do recommend that people exercise, eat a healthy diet and not smoke, based on previous work implicating the same risk factors for cardiovascular disease in AMD. Seddon showed in 1994 that diet is linked to AMD, and in 1996 that smoking is related.

Dr. Bruce P. Rosenthal of Lighthouse International, a non-profit organization established to help people with vision loss, said the study will be valuable as researchers continue to seek the root causes of the disease.

"While we have known for many years that smoking and being overweight contributes to the risk of macular degeneration, the findings of a genetic link for the progression of macular degeneration from early or intermediate stages to advanced disease are indeed significant and will have a major impact on future study and possible treatment of AMD," he said in a statement.

Rosenthal was not involved in the study, which was funded by the National Eye Institute and other grants.

Posted by Elizabeth Cooney at 05:27 PM

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Angina drug helps with symptoms but doesn't reduce risk of further heart problems, study says

The anti-angina medication ranolazine safely eased chest pain in a large clinical trial led by Brigham and Women's Hospital researchers, but the drug did not make a significant difference in whether people with coronary artery disease had another heart attack or died, according to a report in tomorrow's Journal of the American Medical Association.

"It does not prolong life, but it provides important relief of symptoms," lead author Dr. David A. Morrow said in an interview.

One of the purposes of the randomized trial, which followed 6,560 patients for almost a year, was to answer questions about whether ranolazine could lead to heart problems, based on differences in heart rhythm noted in the electrocardiograms of people who took it.

The researchers found no difference in the number of heart arrhythmias reported in people who took ranolazine compared to people who took placebos.

In an editorial, Dr. L. Kristin Newby and Dr. Eric D. Peterson of Duke University Medical Center said beta-blockers and nitrates should still be the first drugs to turn to because ranolazine does not improve a patient's prognosis.

"Ranolazine may offer a back-up option for intensification of antianginal treatment if these first-line agents fail," they wrote.

Ranolazine, approved for marketing by the Food and Drug Administration in 2006, is sold as Ranexa by CV Therapeutics, which funded the trial.

Posted by Elizabeth Cooney at 04:42 PM

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Friday, April 20, 2007

This week in Science

This week's Science includes a special section on germ cells -- the reproductive cells of an organism.

George Q. Daley of Children's Hospital Boston, Brigham and Women's Hospital and the Harvard Stem Cell Institute asks whether the cup is half empty or half full for embryonic stem cells.

David C. Page of the Whitehead Institute and MIT considers the mysteries of sexual identity from the germ cell's perspective.

Alexander F. Schier of the Broad Institute of Harvard and MIT writes about the death and birth of RNAs during the maternal-zygotic transition.

Also in Science, Rachael L. Neve of Harvard and McLean Hospital is an author of a new study in mice about neurons competing to encode a memory in the brain.

Posted by Elizabeth Cooney at 01:03 PM

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Wednesday, April 18, 2007

Medical PR move

John Lacey leaves his post as associate director of public affairs for media relations at Harvard Medical School today to become director of communications at the Massachusetts Biotechnology Council on April 30. No replacement has been named for Lacey, who held the Harvard job for 7 years.

John Lacey

Posted by Karen Weintraub at 02:47 PM

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Tuesday, April 17, 2007

On the blogs: life-threatening or not, vaccine costs, calling RNA labs

Flea, a Boston-area pediatrician-blogger, answers a vehement "no" to this article's title in Pediatrics: "Do All Infants With Apparent Life-Threatening Events Need to Be Admitted?"

But that doesn't mean they aren't.

"In the real world, evidence-based medicine often doesn't make a dime's worth of difference," he writes. "It doesn't matter to parents and it doesn't even matter to some of Flea's colleagues. This is especially true in the current climate of over-test, over-diagnose, over-treat, and over-admit."

On Kevin, M.D., Nashua pediatrician Dr. Kevin Pho posts a link to the American Academy of Pediatrics' concern about the cost of new vaccines Gardasil, against cervical cancer vaccine ($360), and RotaTeq, against diarrhea-causing rotavirus ($190).

Via Nature Network Boston, Alex Palazzo of Harvard Medical School and the Daily Transcript is putting out the word to 29 RNA labs in the Boston area to meet for a monthly informal data seminar to be called the Boston RNA Data Club. Something like the Boston Area Yeast Meeting at the Whitehead, Nature Network's Corie Lok notes.

Posted by Elizabeth Cooney at 02:16 PM

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Teaching doctors to teach patients about lifestyle

Two years ago, a group of doctors founded an organization with the goal of making lifestyle medicine -- how daily habits affect health -- a credentialed clinical specialty and a part of basic medical training, according to a story in today's New York Times. Now the group, the American College of Lifestyle Medicine, has a new publication, The American Journal of Lifestyle Medicine.

"We know lifestyle interventions can be very powerful," often more effective than drugs or surgery, said Dr. JoAnn Manson, a professor of epidemiology at Harvard’s School of Public Health and a member of the editorial board of the new journal. "But we need to provide the scientific evidence on how to incorporate that knowledge into practice."

Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a member of the lifestyle medicine college’s board of advisers, said primary caregivers should be trained in lifestyle medicine.
Dr. Thomas W. Rowland, chief of pediatric cardiology at Baystate Medical Center in Springfield, counters that the principles of lifestyle medicine should be at medicine's core and not a separate specialty.

Posted by Elizabeth Cooney at 09:52 AM

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Teaching doctors to teach patients about lifestyle

Two years ago, a group of doctors founded an organization with the goal of making lifestyle medicine -- how daily habits affect health -- a credentialed clinical specialty and a part of basic medical training, according to a story in today's New York Times. Now the group, the American College of Lifestyle Medicine, has a new publication, The American Journal of Lifestyle Medicine.

"We know lifestyle interventions can be very powerful," often more effective than drugs or surgery, said Dr. JoAnn Manson, a professor of epidemiology at Harvard’s School of Public Health and a member of the editorial board of the new journal. "But we need to provide the scientific evidence on how to incorporate that knowledge into practice."

Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a member of the lifestyle medicine college’s board of advisers, said primary caregivers should be trained in lifestyle medicine.
Dr. Thomas W. Rowland, chief of pediatric cardiology at Baystate Medical Center in Springfield, counters that the principles of lifestyle medicine should be at medicine's core and not a separate specialty.

Posted by Elizabeth Cooney at 09:52 AM

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Most doctors see religion as beneficial, study says

Most physicians in the United States believe that religion and spirituality have a positive effect on patients’ health, according to a survey published last week in The Archives of Internal Medicine, and that God at least occasionally intervenes on their behalf, a story in today's New York Times says.

Dr. Jerome E. Groopman, a professor of medicine at Harvard who was not involved in the study, told the Times he was surprised by how many doctors believe in divine intervention.

"The most striking finding is the perception that God is micromanaging clinical outcomes at the bedside," said Groopman, the author of the new book "How Doctors Think" (Houghton Mifflin).

Posted by Elizabeth Cooney at 08:56 AM

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Monday, April 16, 2007

Harvard, Michigan team share cancer research honor

Scientists from Harvard Medical School and Brigham and Women's Hospital have been honored with collaborators from the University of Michigan for their discoveries about the genetics of prostate cancer.

The American Association for Cancer Research chose the team from about 30 applicants, the organization said. The researchers will share a prize of $50,000.

The Harvard members are Dr. Mark A. Rubin, Charles Lee, Dr. Sven Perner and Francesca Demichelis.

Posted by Elizabeth Cooney at 03:19 PM

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New genetic risk factors for Crohn's disease identified

Researchers from Massachusetts General Hospital and the Broad Institute of Harvard and MIT are part of a team that has discovered new genetic risk factors for Crohn's disease.

Reporting in the online Nature Genetics, they identify new genes that are involved in the immune system's response to bacteria. Crohn's disease, which affects about half a million Americans, is a chronic inflammatory bowel disease.

The authors include John D. Rioux, who has moved from the Broad to the Universite de Montreal, Ramnik J. Xavier, Alan Huett and Petric Kuballa of MGH, Todd Green of the Broad, and Mark J. Daly of the Broad and MGH.

Posted by Elizabeth Cooney at 03:03 PM

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Eric Lander honored for work in genomics

Eric S. Lander (left), founding director of the Broad Institute of Harvard and MIT and a leader of the Human Genome Project, has won the 2007 Society for Biomolecular Sciences Achievement Award for his study of genes and how they function in health and disease.

He will receive the award, which carries a $5,000 honorarium, and present a talk called "Beyond the Human Genome" at this week's SBS meeting in Montreal. Past recipients have included Stuart L. Schreiber, also of the Broad, in 2004.

Posted by Elizabeth Cooney at 11:31 AM

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On the blogs: dogs and handwashing, dumb movie science

On Running a Hospital, Paul Levy says Beth Israel Deaconess Medical Center has joined Boston Children’s Hospital, Tufts-New England Medical Center and MGH in offering a pet therapy program. Trained dogs and volunteers visit patients who give written consent. A dozen comments include praise as well as concern about allergies, infection and fears, plus Levy's replies with hospital policies on screening for the therapy dogs.

In the next post down, Levy vents frustration over hand hygiene stats at the hospital that show some improvement but not enough.

"Trust me, the irony of putting these two posts next to each other was not lost on me," he writes.

On Nature Network Boston, Harvard virology graduate student Anna Kushnir lists her favorite dumb movie science moments and invites more.

"When I think about the fact that I have spent 23/28ths of my life in school, I have difficulty controlling my gag reflex," she writes. "However, the (exceedingly) rare swells of intellectual superiority I experience when watching really (really) dumb movies make those 23 years worth it."

Posted by Elizabeth Cooney at 11:00 AM

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Friday, April 13, 2007

This week in PLoS and JCI

Harvard researchers including Dr. Todd R. Golub report in PLoS Medicine, the online Public Library of Science journal, that, using a molecular biology technique called microarray expression profiling (an example of a detail is at left), they were able to identify compounds that could target genes involved in Ewing sarcoma, the second most common childhood cancer of bone and soft tissue.

In the Journal of Clinical Investigation, Dr. Alan D'Andrea and colleagues at Dana-Farber Cancer Institute show a new therapeutic target for the treatment of Fanconi anemia, which carries the risk of cancer and bone-marrow failure.

Also in the Journal of Clinical Investigation, Dr. Rong Tian and colleagues from Brigham and Women's Hospital report that in mice, mutations in a protein that triggers cells to generate more energy are associated with heart failure.

Posted by Elizabeth Cooney at 11:02 AM

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Thursday, April 12, 2007

Harvard team identifies protein from a dinosaur

By Colin Nickerson, Globe Staff

Scientists at Harvard Medical School have for the first time isolated and identified protein from a dinosaur -- a Tyrannosaurus rex that perished in Montana 68 million years ago and was partly preserved under tons of sandstone. Some of the protein identified in the Cretaceous era predator match that of modern-day chickens, the research revealed.

The findings, being published tomorrow in the journal Science, upset the long-held assumption that protein and other basic materials of life could not possibly survive in detectable amounts for more than a few hundred thousand years. They also raise the possibility that scientists might eventually recover DNA from prehistoric beasts, allowing for even more sophisticated analyses of ancient organisms and the processes of evolution.

"People are going to be looking differently at prehistoric bones because now we see they may carry tissue and information that nobody believed could still exist," said Mary H. Schweitzer, a paleontologist at North Carolina State University and a coauthor of both articles.

In all, scientists at Harvard were able to isolate seven tiny strips of collagen protein from soft tissue found in the thigh bone of a Tyrannosaurus rex recovered earlier in the decade from beneath 60 feet of sandstone ledge in Montana's Hell Creek formation.

"At the very least, this breakthrough shows we can look at [protein] sequences that are many, many millions of years old," said John M. Asara, director of the mass spectrometry core facility at Beth Israel Deaconess Medical Center and one of the authors. "That's a first."

Paleontologists not involved in the the T.rex protein research said it represented an astonishing piece of scientific sleuthwork.

"This research might be creating a whole new field of molecular paleontology," said Lawrence M. Witmer, a paleontologist at Ohio University. "This research has opened a door we didn't even suspect was there."

But some scientists doubted whether the experiment will have much practical effect on the study of prehistoric life. Many seemed to believe that the surviving soft tissue found in the Montana T. rex was a fluke -- and that there will never be enough material for the sort of fullbore scientific scrutiny that would allow large conclusions to be drawn about the animals.

"If there were regular opportunities for this kind of matching and comparison, [these] techniques might add important evidence to genuine conundrums -- outstanding questions about the origin and relationships of various vertebrate groups," said Farish A. Jenkins Jr., a Harvard professor of zoology and internationally-recognized expert in vertebrate paleontology. "But the reality remains that finding soft tissues preserved with actual soft tissue structure intact is outside the realm of common expectation, so the applicability of their techniques is very limited."

Similar skepticism was expressed by Mark A. Norell, a paleontologist with the American Museum of Natural History: "This is a very cool experiment. But I don't think curators are going to start grinding up their fossil bones to obtain the really minuscule bits of protein that might be available. There probably just isn't going to be enough of this material" to conduct major research.

"Science requires replication," he said. "You need thousands of comparisons. Not dozens."

Still, buzz surrounded the the mind-boggling findings that protein dating back tens of millions of years can be identified at all. Until now, the oldest positively-identified proteins were recovered from the bones of a wooly mammoth reckoned to be a couple hundred thousand years old, according to Schweitzer. DNA has been taken from the 38,000 year-old bones of a Neanderthal, believed to be a prehistoric relative of modern humans.

Several of the T. rex protein snippets captured at Harvard matched sequences in modern chickens, which the authors of the Science articles say lends more credence to the increasingly accepted view among paleontologists that birds are descended from dinosaurs. "We've added molecular evidence to evidence based on the architecture of bones," said Asara.

The research marked an unusual collaboration between field paleontologists -- famous for rough expeditions to remote places in search of rare fossils -- and medical researchers more familiar with finicky lab equipment and computer readouts than sharp pickaxes, smelly sleeping bags, and battered sifting trays.

Lewis Cantley, professor of systems biology at Harvard Medical School and one of the authors, said the techniques used in sequencing the dinosaur protein from minuscule amounts of material could be useful for researchers who need to find the tiny molecular changes that lead to cancer. "We're creating a cross-discipline of biomedical researchers and paleontologists."

The T. rex femur at the center of the research was found in 2003 by John Horner, a paleontologist with Montana's Museum of the Rockies and reknowned fossil hunter. Schweitzer, analyzing the bone, found evidence that the big bone still contained actual bone and vascular tissue. In most preserved dinosaur remains, minerals have replaced all organic matter, the process known as fossilization.

Scientists were quick to