Every year the Federation of American Societies of Experimental Biologists (FASEB) brings...
By Lisa Brown
Kenneth J.Rhodes, PhD, an alumnus of the Boston University School of Medicine (BUSM) Pharmacology Training program and vice president of Neurology Discover at Biogen Idec, led a group of researchers to discover Tecfidera, an oral medication to help treat relapsing Multiple Sclerosis (MS).
Rhodes, who earned his PhD and completed a post-doctoral fellowship under Dr. David H. Farb at BUSM, led a team at Biogen Idec responsible for developing the Food and Drug Administration approved Tecfidera. The drug, also known as dimethyl fumarate, treats relapsing Multiple Sclerosis (MS) by delaying progression of physical disability and slowing the development of brain lesions associated with MS.
In a Biogen Idec press release, Rhodes stated that, “these exciting results support further research, as the data suggest that neublastin may have the potential to promote sensory neuronal regeneration and functional recovery following injury. The neublastin program is part of Biogen Idec’s commitment to innovative neurological science and discover.”
Rhodes joined Biogen Idec in May 2007 after spending ten years in the Neuroscience Department at Wyeth, where he also led neurodegeneration drug discovery teams researching MS among epilepsy, stroke, Parkinson’s and Alzheimer’s disease. Dr. Rhodes has published over 50 research papers in peer-reviewed journals, and most recently was the Keynote speaker for the 2013 BU-Pfizer Symposium on “Therapeutic Innvoation: Oxidative Stress and the Next Generation of Discover.”
Submitted by Ravi Lakdawala, MD
Faculty members in BUSM’s program in Forensic Anthropology recently wrote a technical paper “Relaxation of Clenched Digits in Cadaveric Hands to Facilitate the Recovery of Postmortem Friction Ridge Impressions” that will appear in the January/February 2014 issue of Journal of Forensic Identification that demonstrated a simple technique to more easily obtain finger or palm print impressions of deceased individuals. This technique is particularly useful when determining identities resulting from mass casualty incidents.
Assistant Professor Donald Siwek, PhD and Instructor Gary W. Reinecke, retired FBI, detail how an incision placed at the crease of the wrist to sever the flexor tendons allows for access to the palmar surface of the hands in order to record postmortem fingerprint or palm print impressions for identification purposes. This technique will be proven to be helpful to the Medical Examiner community as well as law enforcement in general. Learn more about the Program in Forensic Anthropology at http://www.bumc.bu.edu/gms/forensicanthro-masters-program/
BUSM’s Domenic A. Ciraulo, MD, co-edited the recently published Second Edition of the “Clinical Manual of Addiction Psychopharmacology.”
The Second Edition provides a thorough update on the pharmacology of drugs and abuse, as well as the medications used to treat dependence on those substances. This manual delves into the broad range of addictive substances and covers the areas where significant advances have been made since the publication of the first edition.
“This book is an invaluable reference for clinicians, including psychiatrists, psychiatric residents and fellows, as well as other mental health practitioners who encounter individuals with substance-related disorders in the course of their clinical work,” said Dr. Ciraulo. “The material is presented in an organized fashion with the most up-to-date information on psychopharmacology.”
Dr. Ciraulo is the chairman of psychiatry and a professor at BUSM and the chief of the Department of Psychiatry at BMC. He co-edited the manual with Henry R. Kranzler, MD and Leah R. Zindel, RPh, MALS.
The BU Advocacy Training Program (BUATP) is a student-led, faculty-mentored program at BUSM that provides training in medical advocacy. Founded as a student-led elective class called “The Spectrum of Physician Advocacy” in 2005, the BUATP grew into a multi-year curriculum that currently trains approximately 15 percent of each incoming class.
Recognizing that the health of patients is often tied intimately to social, economic, and other non-biomedical circumstances, and that medical students and future physicians may in many cases have an opportunity to influence these circumstances, the BUATP trains medical students in the theory and practice of advocating for the health and well-being of patients and the communities that they serve.
Michael Dukakis, the former governor of Massachusetts and an expert on health care reform visited the Spectrum of Physician Advocacy second year elective class on Wednesday, Nov. 6. Governor Dukakis shared his experiences, spoke about the history of health care reform, answered questions about health care reform and the affordable care act and urged students to get involved in public policy.
Learn more about BUATP at http://blogs.bu.edu/buatp/about/
According to a new study, many Boston-area military veterans diagnosed with post-traumatic stress disorder (PTSD) experienced flashbacks, unwanted memories and other psychological effects as a result of the Boston Marathon Bombing in April 2013. The study raises awareness of the effects that tragic events such as terror attacks and mass shootings have not only those directly affected but also on those with PTSD and other preexisting psychological conditions. The researchers urge healthcare systems to be prepared in the future to treat individuals who were either directly or indirectly affected by such tragedies.
Led by researchers at Boston University School of Medicine (BUSM) and the U.S. Department of Veteran’s Affairs National Center for PTSD in Boston, this study is published online in the Journal of Traumatic Stress.
PTSD is a psychiatric disorder defined by serious changes in cognitive, emotional, behavioral and psychological functioning that can occur in response to a psychologically traumatic event. Previous studies have estimated that approximately eight percent of the U.S. population will develop PTSD in their lifetime. That number is significantly greater among combat veterans where as many as one out of five suffer symptoms of the disorder.
Using data from an ongoing study of Boston area veterans diagnosed with PTSD, the researchers conducted 71 telephone interviews within one week of the bombing. Because the researchers had symptom data from participants approximately two months before the bombing, they were able to compare those levels with results from the interview one-week after the bombing.
Of those interviewed, 38 percent reported that they were emotionally distressed by the bombing and the subsequent lockdown of Boston and other communities. A majority of those participants said that the bombing caused them to experience flashbacks and the re-emergence of unwanted memories relating to their own past traumas.
“The effects felt by the veterans were likely due to thematic similarities between the Marathon explosions and the veterans’ own traumatic combat experiences, especially for those deployed to recent conflicts characterized by attacks involving improvised explosive devices,” said Mark Miller, PhD, associate professor at BUSM and a clinical research psychologist in the National Center for PTSD at the VA Boston Healthcare System who served as the study’s principal investigator.
There was not a significant change of symptoms between the pre and post-event data across the sample as a whole. However, for those who reported being personally affected, there was a strong correlation between distress at the time of the bombing and change in the severity of PTSD symptoms. According to the researchers, this change was primarily attributable to increases in intrusion and avoidance symptoms.
“This study highlights the fact that tragic local and national events of this type can have a significant impact on the health and wellbeing of individuals already suffering with PTSD,” said Miller. “It is crucial that relevant healthcare organizations understand this phenomenon and be prepared in the wake of tragedy to care not only for those who are directly impacted, but also for those with preexisting psychological conditions, including our nation’s veterans with PTSD.”
This study was funded by the U.S. Department of Veterans Affairs.
MED’s Holick will discuss the sunshine nutrient and why we need it
“Vitamin D chose me,” says Michael Holick, who has been an outspoken advocate worldwide for awareness of the ravages of vitamin D deficiency. As tonight’s 2013 University Lecturer, the School of Medicine professor of medicine, physiology, and biophysics will speak about his long career studying what he dubs the “D-Lightful” nutrient and share the story of how he became consumed by a subject he once considered boring.
Director of Boston Medical Center’s Bone Health Care Clinic and of MED’s Vitamin D, Skin and Bone Research Laboratory, Holick is a winner of the Linus Pauling Institute’s Linus Pauling Prize for health research and the author of The Vitamin D Solution: A 3-Step Strategy to Cure Our Most Common Health Problem (Plume, 2011). He believes the world is in the throes of a vitamin D defiency pandemic, which is causing bone disease and osteoporosis in adults as well as increasing the risk of a range of diseases, including some cancers, tuberculosis, influenza, diabetes, stroke, heart disease, and schizophrenia. About a third of all Americans are at risk for vitamin D deficiency, he says, and that the risk is higher for young children. It’s estimated that vitamin D deficiency affects nearly two billion people worldwide, making it, he says, one of the world’s leading medical problems.
Vitamin D regulates insulin production in the pancreas as well as in genes that control cell growth, and it helps the immune system, says Holick, who has been studying how skin makes vitamin D for more than 30 years. “Every tissue and cell has a vitamin D receptor. We estimate that as many as 2,000 genes—up to one-sixth of the total human genome—are directly or indirectly regulated by vitamin D.”
Holick’s zeal for the “sunshine vitamin,” which has earned him some detractors, has its roots in his early research as a resident at Massachusetts General Hospital, which shed light, so to speak, on the elegant way that our bodies synthesize the vitamin in our skin during sun exposure. His research resulted in what he calls “the concept of sensible sun exposure” coexisting with protection from skin cancers and other damage. Recently he worked with a California-based software engineer to develop an app that he says “not only tells you how much Vitamin D you are producing anywhere at any time of the year, but also provides a warning when you’ve made enough Vitamin D and that further sun exposure can increase the risk of skin damage.”
“The major cause of the vitamin D deficiency epidemic is the lack of appreciation that sun exposure has been, and continues to be, the major source of the vitamin worldwide,” says Holick, who in his lecture will elaborate on his three-step strategy to treat and prevent vitamin D deficiency.
The University Lecture was established in 1950 to honor faculty engaged in outstanding research and to offer an opportunity to hear a distinguished scholar discuss a favorite topic. All faculty members are invited each spring to nominate the subsequent year’s lecturer. University Lecturers from the previous five years act as the selection committee.
Michael Holick will give the 2013 University Lecture, titled The D-Lightful Vitamin D for Health, tonight, Wednesday, November 6, at 7 p.m. at the Tsai Performance Center, 685 Commonwealth Ave. Admission is free and open to the public.
This BU Today story was written by Susan Seligson. She can be reached at email@example.com.
Introducing: BUSM’s Finding Information Framework (FIF) – Conceptual Algorithm, Practical Web-based Tool
In this age of rapid information expansion, medical education no longer can be structured solely around information acquisition. Faculty need to teach the concepts and lifelong learning skills of information management and information mastery to be used both at the “point-of-learning” and later applied in the clinical setting at the point-of-care. Recognizing that these concepts can be difficult to teach, the Boston University School of Medicine (BUSM) Evidence-based Medicine (EBM) Vertical Integration Group developed the “BUSM Finding Information Framework” – a conceptual algorithm as well as a practical web-based tool – to structure how medical students ask and categorize their questions and link them directly to the most appropriate information resource to answer their question. This framework is the basis of its longitudinal EBM/Information Mastery curriculum, which is woven throughout the four years of medical school.
“This new approach emphasizes the principles of adult learning and highlights the continuously changing and growing nature of the body of medical information. BUSM is training our students to be lifelong learners who can perform accurate self-assessment of their own learning needs, and can use information resources both for their own education, and for application during patient care,” said BUSM’s Director of Medical Student Education, Department of Family Medicine Miriam Hoffman, MD.
How it works
The student-centered tool, the “Finding Information Framework” (FIF), starts with students generating a question (based in the concepts of adult learning).
The FIF takes learners through an algorithm, much like a mathematical factor tree, to define their question first by determining whether it is a foreground or a background question. Once they continue down the algorithm, background is split into basic science or clinical. Clinical background is further split into common and rare/academic interest. Foreground questions are defined as always being clinical, and are split into point of care, rare/academic interest, and resources/services. Once students are able to put their questions into one of these final categories, they are directed to the appropriate information resource group to answer them. Each information resource group has a list of recommended resources. The framework is housed on the BUSM library website, so students can use it with direct one-click links into the actual resources (e.g. e-textbooks, databases, point-of-care resources, websites, etc.).
This framework and its concepts are taught to students early in the first year, reinforced throughout the curriculum and builds on itself over the four years. It is used in multiple courses including the medical library curriculum, the EBM/biostats course, the problem-based learning course, and the Family Medicine clerkship. Feedback from students has been overwhelmingly positive, with an emphasis on how logical and relevant this to their learning needs.
“Traditional EBM curricula focus mainly on concepts of study design, evidence based medicine theory, and the primary literature, and less on effective application of evidence in real time at the point-of-care. This curriculum teaches these difficult concepts and skills to students throughout the four years of medical school in a way that builds on itself and is relevant to students. It can also be a powerful faculty development tool. It is simple, clear, and intuitive to both students and faculty alike and can serve to frame these concepts for both,” said Hoffman.
Learn more about BUSM’s Curricular Innovations at http://www.bumc.bu.edu/oaa/curricular-innovations/ including the Finding Information Framework http://medlib.bu.edu/busm/fif/.
BUSM Professor of Medicine Jeffrey H. Samet, MD and colleagues* recently authored a viewpoint commentary in the Oct. 23 issue of JAMA on physician education in addiction medicine. The commentary explained that there is a “…failure of medical education systems to train physicians in addiction medicine. Despite the enormous burden of disease attributable to addiction in North America, there have traditionally been exceptionally few opportunities for physicians to obtain advanced skills in this area outside of addiction psychiatry.”
The essay concluded, “Ultimately, through the greater incorporation of addiction medicine into the spectrum of medical training, patients will be better served by narrowing the health care quality chasm in addressing substance use disorders. The development of addiction medicine as a formal medical subspecialty also has the potential to begin the slow process of public education required to treat those who are alcohol- or drug-addicted with compassion and care, and to move away from over reliance on punitive approaches that have not served the interests of patients, public health, or taxpayers.”
In addition to serving as Professor of Medicine at BUSM, Samet is Professor of Community Health Sciences at BUSPH, and Chief and Chair of the Section of General Internal Medicine at BMC and BUSM respectively. He also serves as Medical Director of Addictions Prevention, Treatment and Recovery Support Services at the Boston Public Health Commission.
Samet’s research has focused on linkage of substance abuse treatment and primary medical care; addressing substance abuse issues in the primary care setting; the impact of alcohol and drug use in HIV-infected persons, the delay in establishing primary medical care for HIV infection; and HIV prevention strategies in Eastern Europe. He is the principal investigator on several current NIAAA and NIDA-funded studies. He is an internist and has been a primary care physician since 1983.
Read the entire JAMA article.
*Evan Wood, MD, PhD, FRCPC; Jeffrey H. Samet, MD; and Nora D. Volkow, MD, authored the viewpoint.
BUSM Professor, BMC Physician Receives Award for Advancing Research on Tobacco Smoke’s Effect on Lungs
Avrum Spira, MD, MSc, the Alexander Graham Bell professor of medicine and chief of the division of computational biomedicine at Boston University School of Medicine, is the recipient of the Alton Ochsner Award Relating Smoking and Disease. The award will be presented to Spira today at the Opening Session of the Annual Meeting of the American College of Chest Physicians in Chicago.
This award recognizes Spira’s seminal research contributions that have enhanced the understanding of the biological response of lung tissue to tobacco smoke, which can cause lung cancer and chronic obstructive lung disease (COPD). Spira has applied innovative approaches to measure gene expression in populations of lung cells damaged by tobacco toxins and was the first to define the reversibility and permanent impact of cigarette smoke on gene activity in the bronchial airway. Spira’s lab has leveraged this genomic response in the airway to develop an early detection biomarker that can enable physicians to diagnose lung cancer earlier among smokers at risk for disease. This has important scientific, clinical and therapeutic implications. More recently, his group has extended this genomic approach to develop molecular biomarkers that can guide treatment decisions in COPD and identify novel therapeutic opportunities for this chronic debilitating disease.
Spira, who also is a physician in the pulmonary, critical care and allergy department at Boston Medical Center, is a graduate of Vanier College, Montreal, Canada, the McGill University Faculty of Medicine, also in Montreal, and Boston University (BU). He also is the Director of the Translational Bioinformatics Program within the Clinical Translational Science Institute of BU.
The Award is named in honor of Doctor Alton Ochsner, co-founder of the Ochsner Clinic in New Orleans. In 1939, Ochsner was the first to publish evidence relating cigarette (tobacco) smoking as the primary cause of lung cancer.
(This video shows a bacterial ribosome docked onto the SecYEG protein translocation channel, then removes the ribosome as it zooms in to show the channel as a set of ribbons that represent alpha helices of the 3 different channel subunits. The SecY channel is viewed from the plane of the membrane and changes from a closed to an open form and then the nascent (newly forming) protein (in green) from the ribosome, which is not shown in later stages of the video, is modeled within the central pore of the open channel in a looped configuration and additionally, there is a loop of the new protein lying on the top of the channel, before it enters the central pore.)
Similar to passengers on an urban transit system, every protein made in the cell has a specific destination and function. Channels in cell membranes help direct these proteins to their appropriate target. Researchers at Boston University School of Medicine (BUSM) and their colleagues have now captured images of these channels as they open to allow proteins to pass through a membrane, while the proteins are being made. These findings are published as a Letter in Nature (Park, E. et al. 2013).
Christopher W. Akey, PhD, professor of physiology and biophysics at BUSM is a co-senior author of the Letter. In addition, the collaborating institutions include Harvard Medical School (HMS), Baylor College of Medicine (BCM) and Georgia Institute of Technology (GT).
Proteins, which are encoded by genes, are large molecules that perform specific functions. Many proteins such as hormones and growth factors are secreted by the cell and move into the bloodstream. These proteins are made in factories called ribosomes, which interact with a family of channels called Sec61/SecY that provide a path across the membrane. Initially, these nascent, or newly-made, proteins are inserted into channels as the proteins are being made. The channels also aid in inserting nascent proteins into the cell membrane where they function as receptors for drugs and form ion channels that function in vision and in transmitting nerve cell impulses.
In this study, researchers used samples made in E. coli bacteria to determine the structure of the highly conserved SecY channel. Using an electron microscope and computer analysis, researchers were able to capture images of the SecY channel opening when a nascent protein enters the central pore. In particular, the channel undergoes large movements that enlarge the central pore as a first step in allowing the nascent protein to cross the cell membrane and eventually travel to its destination.
“Similar to train cars that transport passengers through a tunnel, SecY/Sec61 channels help nascent proteins move across the cell membrane to reach their target in the body, and this study provides important insight about the function of these channels,” said Akey.
Funding for this study was provided in part by the National Institutes of Health’s National Institute of General Medical Sciences under grant award number NIH GM45377.
Tom Rapoport, PhD, professor of cell biology, HMS, is a co-senior author. Other collaborators include: Eun Yong Park, PhD, HMS; Jean-François Ménétret, PhD, BUSM; Steven J. Ludtke, PhD, BCM; and JC Gumbart, PhD, GT.