By Lisa Brown
SPH Welcomes New Global Health Chair
Patricia Hibberd wants to leverage technology to save young lives
When Patricia Hibberd looks at her smartphone, she sees a chance to save young lives.
Hibberd, the new chair of the School of Public Health’s Department of Global Health, has been working in Malawi, India, and Pakistan to develop a low-cost thermal imaging system for smartphones that would help to detect bacterial pneumonia in children in countries where standard chest X-rays are not available. The prospect of giving resource-strapped clinicians a way to diagnose the world’s leading cause of death of children under age 5 marks a new chapter in her 25-year quest to stem childhood pneumonia, sepsis, diarrhea, and other illnesses.
“X-ray machines are not going to magically appear in the health clinics of poor countries. We can’t wait for that,” Hibberd says. “Smartphones are everywhere. This is about giving clinicians the tools they need to save lives, now.”
A physician and epidemiologist, Hibberd came to SPH this summer from Harvard University, where she has been a professor of global health at the Harvard T.H. Chan School of Public Health and professor of pediatrics at Harvard Medical School. She also has headed the Division of Global Health in the Department of Pediatrics at Massachusetts General Hospital (MGH).
A native of Liverpool, England, who earned her PhD from the University of Leicester and her MD from Harvard in 1986—six years after coming to the US—Hibberd has spent much of her research career tackling the alarming rates of morbidity and mortality among women and children in the developing world. Over the last 15 years, she has collaborated with researcher Archana Patel in India on ways to reduce the rates of neonatal sepsis and pneumonia, as a leader of the National Institutes of Health’s Global Network for Women’s and Children’s Health Research at MGH. The group’s most important contributions have included the early recognition of severe hypoxemia and treatment with oxygen for children with pneumonia in resource-constrained settings, and the development of point-of-care diagnostics for neonatal sepsis.
Hibberd also is a Paul G. Rogers Society Ambassador for Global Health Research and chair of the Data and Safety Monitoring Board for the Centers for Disease Control and Prevention’s STRIVE Trial, which is testing a vaccine to prevent Ebola in Sierra Leone.
The author of more than 250 scientific articles, many on pediatric health, Hibberd says she plans to continue her own research work at BU, while supporting the many projects underway in the global health department. She cites as one of her reasons for coming to BU SPH Dean Sandro Galea’s commitment to “leverage new technologies, such as bioinformatics, to drive a new agenda for public health.”
She recently spoke with BU Today about her research interests and what excites her about the new position.
BU Today: You’ve had a long career focused on preventing and treating childhood diseases. How did you become interested in that area of research?
Hibberd: As an infectious diseases physician and epidemiologist, my main interest has always been to make a real difference in childhood mortality. To do that, I have to follow the reasons why children unacceptably keep dying. Today, in 2016, babies die in the first month of life, mostly because of infections, or sepsis, and between two and 59 months, because of pneumonia. This was true in the 1990s—and unfortunately, it’s still true now. To me, that is just not OK.
There are vaccines that prevent pneumonia in children, as long as they survive to age two months. These vaccines are available for all babies in the US, Europe, and Australia, but they’re not widely available in resource-limited settings.
I keep asking the doctors in these places, “Don’t people donate vaccines for the babies here?” Sometimes, the answer is yes. They’ll say, “I got a gift of 100 vaccines—so what I am supposed to do? Save the lives of 33 babies, as each baby needs three doses of the conjugate pneumococcal vaccine and three doses of the Haemophilus influenzae [type] b vaccine? Or should I try and save 50 babies who get two doses of each vaccine, even though that is not recommended?” That’s a terrible decision for a clinician to have to make. In the developed world, these are not decisions that any doctor faces.
You’ve focused on the diagnosis side, more than the vaccine side. Why?
While we figure out how to make sure vaccines are available for all babies, we still need to find and treat babies who are sick and can be treated for the infections that vaccines should prevent.
What everyone forgets is that pneumonia and sepsis in babies are among the most difficult diagnoses to make—even here in Boston, never mind in remote rural villages in sub-Saharan Africa and Asia. The way I think about this is that we need to improve diagnosis of serious infection in babies everywhere, in Boston and beyond. And, at the same time, we need to get lifesaving vaccines to that beyond.
I’m delighted that I will be moving our NIH-funded Global Network grant to BU and continuing the work on early detection and treatment of pneumonia and sepsis. We’re going to continue looking for the best ways to recognize infants at risk as early as possible—in the home—so that they are brought for treatment as quickly as possible.
How promising is the thermal imaging technology you’ve been piloting?
We have some very impressive results here at home, and some exciting preliminary data from India and Malawi. Basically, the technology allows us to diagnose children who have pneumonia caused by bacteria by identifying asymmetric hot spots of high temperatures in the lungs, caused by localized inflammation.
We are studying how to use this technology in urgent-care outpatient clinics and emergency departments in our own backyard, while also conducting rigorous studies to determine whether thermal imaging can be used by first-level health care workers in developing countries to diagnose and start treatment with antibiotics as early, and as appropriately, as possible. This is work we will continue with collaborators across BU, including Muhammad Zaman, a College of Engineering professor of biomedical engineering on the Charles River Campus.
What excites you most about being at SPH?
There is a palpable excitement about public health, in Boston and in the broader community, since Dean Galea arrived. This is a time when the public health agenda is coming to a kind of crossroads: concern over communicable diseases is being overshadowed by attention to noncommunicable, chronic diseases. But we are not done with communicable diseases, by any means. Zika and Ebola remind us of that. So we have to do more, and get more right fast.
Dean Galea and the SPH faculty are focused on pushing the public health community to pursue this dual agenda in innovative ways. I so want to be part of that.
This BU Today story was written by Lisa Chedekel.
A Conversation: Race and Violence
If you were unable to attend the Conversation: Race and Violence, watch the video.
July 13 A Conversation: Race and Violence
The BUSM Office of Diversity and Multicultural Affairs invites all members of the BUMC/BMC community to participate in an open and candid dialog about race and violence. The targeted police shootings in Dallas at a peaceful protest in response to videos showing two African-American men shot by police in Louisiana and Minnesota has sparked ongoing contention across the country.
This event will be co-moderated by Associate Dean of Multicultural Affairs and Professor of Anesthesiology Rafael Ortega, MD, and Chief & Chair of Psychiatry and Assistant Dean of Multicultural Affairs David Henderson, MD.
Please join us for the conversation.
Wednesday, July 13
5-6 p.m.
BUMC Instructional Building, L112
Slone Epidemiology Center Leadership Changes
After 18 years as Director of the Slone Epidemiology Center, Allen A. Mitchell, MD, professor of Epidemiology and Pediatrics, has decided to step down, effective Sept. 1. Mitchell was a founding member of the Drug Epidemiology Unit (now known as the Slone Epidemiology Center) led by Drs. Dennis Slone and Samuel Shapiro that came to BU in 1975. He became the director in 1998, when Slone was elevated to a Medical Campus Center. An internationally recognized leader in the epidemiologic study of drug safety in pediatric and pregnant populations, Mitchell founded and led the Birth Defects Study for 39 years. . He also developed risk management assessments for Accutane/isotretinoin and thalidomide in pregnancy and a large-simple trial of ibuprofen safety involving 84,000 children recruited through a pediatric office practice-based research network. In addition to bringing major studies to Slone, Mitchell promoted rigorous science to serve the public health and provided a supportive environment with the sense of comity, friendship, and family that characterize Slone. He will continue his research activities at Slone as Director Emeritus.
David W. Kaufman, ScD, professor of Epidemiology, has been appointed the next Slone Director. Kaufman came to BU in 1975 as a research associate at Slone and was ultimately promoted to professor of Epidemiology at SPH and Associate Director of Slone in 1998. His early career focused on studies of drugs in cancer and heart disease and other conditions. In the 1980s Kaufman was co-investigator of the International Agranulocytosis and Aplastic Anemia Study, which enrolled several hundred cases in seven countries with these rare but often drug-induced blood dyscrasias.
Subsequently he directed the largest epidemiological investigation to date of aplastic anemia (with more than 500 cases enrolled in Thailand), as well as studies of Stevens-Johnson syndrome and toxic epidermal necrolysis in four European countries, and of anaphylaxis in Spain, Hungary, India and Sweden. He has also published studies of analgesics and upper gastrointestinal bleeding and of end-stage renal disease in three regions of the U.S.
More recently, Kaufman and Mitchell led the Slone Survey, a US population-based survey of medication use. Kaufman also studied Oxalobacter formigenes (an oxalate-metabolizing bacterium found in about 40 percent of the normal population) and calcium oxalate kidney stones, and developed a nationwide registry that followed patients with myeloma and myelodysplastic syndromes through the course of their illness. Currently, he is co-PI for a large-scale, behavioral surveillance program of acetaminophen users, focusing on patterns and correlates of overdose.
Kaufman earned his MS and ScD in epidemiology from Harvard TC Chan School of Public Health. He has served on the Medical Campus IRB since 2000, and as Chair of the Orange Panel since 2011.
Vote for BUSM’s Jane Mendez!
Jane Mendez, MD
BUSM’s Dr. Jane Mendez, surgery, is in the running as one of People’s (en Espanol) 25 Most Influential Latina Women! Nominated by her sister Laura Posada, wife of former major league baseball player Jorge Posada, Mendez is highlighted for her years of service as a breast cancer surgeon at BMC and associate professor of surgery at BUSM. “It’s a privilege to heal others,” says Mendez. “I love helping other women.”
Your vote decides who deserves to be a part of this list! Click and VOTE for DR. MENDEZ today!
Slone Awarded Grant to Better Understand Breast Cancer Among African-American Women
Why do African-American women die at a higher rate and experience more aggressive breast tumors than white women? Researchers from Boston University’s Slone Epidemiology Center (SEC) have received funding from the National Cancer Institute (NCI) to explore this question. The new grant is based on the premise that having a better understanding of the biology of breast cancer in African-American women will lead to better prevention and treatment.
Julie Palmer, ScD
“Identifying genetic variants related to breast cancer in African-American women will further our knowledge of the disease and may ultimately lead us to better treatments and opportunities for prevention,” said Julie R. Palmer, ScD, senior epidemiologist at BU’s SEC and professor of epidemiology at BUSPH, who is leading the study at BU.
Breast cancer is not a single disease, but a combination of distinct disease subtypes, with varying risk factors and clinical outcomes. However, the reasons for differences in breast cancer biology and disparities in incidence and mortality rates between white and African-American women are not well understood, and existing studies have not been large enough to provide sufficient statistical power to elucidate genetic factors associated with how breast cancers develop. The size and power of this new study could help address the current lack of scientific understanding.
“Health disparities are a problem of great concern for the NCI and one that we are zeroing in on as evidenced by this grant,” said acting director of the NCI, Douglas Lowy, M.D.
This study will seek to identify novel genes and gene pathways that influence breast cancer in African-American women.
This multicenter study will pool data, bio-specimens, and expertise from 18 previous studies of breast cancer among women of African ancestry. The investigators will determine whether genetic variants may be associated with increased risk. Specifically, they will examine:
- The association between genetic variants and the risk of estrogen receptor-negative breast cancer and estrogen receptor-positive breast cancers
- How genetic variants affect major breast cancer biological pathways and whether the effects may differ between African-American women and white women
In addition to Palmer, the research team is being led by Wei Zheng, MD, PhD, from Vanderbilt University, Nashville and Christopher Haiman, ScD, from the University of Southern California, Los Angeles. Experts from five other institutions will join them in gathering information and biospecimens from 20,000 breast cancer cases
Palmer’s major research interest is the etiology of breast cancer, with a particular focus on African American women. She was instrumental in designing and implementing the Black Women’s Health Study, a cohort study of 59,000 women, and has served as co-investigator of the study since its inception in 1995. She is the director of genetics research in the Black Women’s Health Study and has spearheaded efforts to use DNA from study participants in studies of the genetics of breast cancer, other cancers, lupus, uterine fibroids, type 2 diabetes, and sarcoidosis.
She is one of the three multiple principal investigators who organized a collaborative NCI Program Project AMBER (African American Breast Cancer Epidemiology and Risk) Consortium, which combines data, germline DNA and tumor tissue samples from four epidemiologic studies of breast cancer in African American women for identification of factors related to specific breast cancer subtypes.
Reference: Breast Cancer Genetic Study in African-Ancestry Populations. Grant Number 1R01CA202981-01
July 4 Transportation Services
SHUTTLES
No shuttle services, including the HealthNet patient shuttle.
The BUS (Boston University Shuttle) will NOT operate. Please visit www.bu.edu/thebus for additional information.
PARKING
All parking facilities will be open.
MBTA
All subway lines will operate on a Sunday schedule.
Buses will operate on a Sunday schedule except for the CT1 & CT3, which will not be operating.
Commuter rail will operate on a Saturday schedule.
Hull service will operate on a Saturday schedule.
Charlestown boats will operate on a weekend schedule.
Hingham boats will operate on Saturday schedule.
Beginning at 2 p.m., subway service on all lines will operate at rush hour levels to accommodate increased holiday ridership to the esplanade. Fares will be free after 9:30 p.m.
Customers are urged to take public transportation to and from July 4 events and advised to check http://www.mbta.com/events/ for the most up-to-date service information. Please call TranSComm at 617-638-7473 if you have questions.
Emelia Benjamin Receives AHA’s Highest Honor
Emelia J. Benjamin, MD, ScM, FAHA receives the American Heart Association 2016 Gold Heart Award. AHA past president, Elliott Antman, MD is behind her. Photo courtesy of AHA.
The American Heart Association presented its 2016 Gold Heart Award to Professor of Medicine and Assistant Provost for Faculty Development Emelia J. Benjamin, MD, ScM, FAHA. The Gold Heart Award is the highest honor the association gives in recognition of continued, distinguished service. The award was presented at the association’s 2016 Gold Heart Banquet in Dallas on June 21.
Benjamin also serves as a professor of epidemiology at BUSPH, an attending cardiologist and vice chair of faculty development/diversity within the department of medicine at BMC, and an investigator at the Framingham Heart Study. She was recognized by the association for outstanding contributions supporting the development and mentoring of early career investigators. An AHA volunteer since 1992, Benjamin is a member of the Council on Functional Genomics and Translational Biology and was the council’s 2010-12 chairperson. She also is an associate editor for Circulation and the 2015-17 chairperson of the AHA Statistics Committee.
New Cross-Campus Initiative: Biomedical Bridge BUilders
Biomedical Engineering and the Clinical and Translational Science Institute have established a new collaborative program, the Biomedical Bridge BUilders Initiative. It is designed to accelerate the commercialization of clinician-inspired medical device innovations by partnering with graduate engineering biodesign and product development teams.
Clinical care providers on the Medical Campus are invited to email short (one page or less) descriptions of a medical device clinical challenge. These descriptions may be an early product idea or a project that is already underway that could benefit from a team of graduate biomedical engineers (BME), trained in the biodesign product development process. Graduate engineers will work part-time under your clinical guidance while they complete their graduate studies at the College of Engineering. Applications may be submitted immediately with an official “Start Date” for the first projects of Sept. 2. Questions? Email bubridgebuilders@gmail.com.
Teams will consist of a BME faculty supervisor plus four BME students and graduate students from other BU Engineering Departments, if their specialty skills are required. All biomedical team members will have HIPAA training, and all necessary tests and inoculations to be approved as Clinical Observers at BMC. If your idea is selected, you will serve as the Primary Clinical Advisor to the team, meet with them on a regular basis, and serve as their sponsor for their Clinical Observership so that they can see the current Standard of Care firsthand.
Related IP resulting from inventions will be assigned to Boston University or BMC under current Patent Policies. Each initiative is expected to file at least one Invention Disclosure.
