BUSM Faculty Advocates for Increased Federal Funding for Basic Science Research
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SNAP Judgment
A week on food stamps shows MED students the program’s limits
- Dan McGrail (MED’16) (from left), Sam Miller (MED’17), and Fabian Chang (MED’16) prepare a meal with items purchased on a food stamp recipient’s budget as part of the SNAP challenge. Photo by Jackie Ricciardi
At 6 feet and 200 pounds, Fabian Chang must fuel an ample frame for the grind of medical studies. Yet for one week in December, he ate only what he could buy for $30. That’s the average weekly benefit paid nationally under the federal food stamps program, says the School of Medicine student, whose week was an odyssey in belt-tightening.
Chang (MED’16) conceived this “SNAP challenge” (SNAP—Supplemental Nutrition Assistance Program—is the food stamps program’s formal name) for himself and others on the Medical Campus, and during last month’s weeklong regimen, he didn’t go hungry. But he discovered, as have families on food stamps, that fending off an empty stomach means making do with a malnourishing menu. His fresh food ran out by day five, leaving him to end the week subsisting on eggs, bread, rice, and pasta.
“I was able to get enough food,” he says, “but it was definitely difficult to maintain a healthy diet.” And with the expiration of the portion of the Obama stimulus devoted to SNAP, things like coffee were an unaffordable luxury.
In advance of continued congressional debate over whether to cut SNAP, about 15 MED students and deans took the SNAP challenge, sponsored by the school’s Student Nutrition Awareness & Action Council. The goal was to raise future doctors’ awareness of the nutritional challenges faced by poor patients.
Boy, was it raised.
“My body feels BAD,” one participant wrote on a blog set up for the experiment, after just two days on her regimen. “I’m not sure if the food has gone bad or was low-quality to begin with, but after my lunch of beans and meat yesterday around 3 p.m., I felt physically ill at school and had to come home to take a break and drink lots of water. I also notice that because my meals aren’t nutritious, no matter how much I eat, I don’t ever feel satisfied.” Another blogger reported that the experience prompted her to volunteer at a food bank.
Indeed, while few Americans starve—there’s an obesity epidemic, notes SNAP challenge taker Dan McGrail (MED’16)—shopping becomes stressful on a tight budget. “It is really difficult to walk through the store and pass up on items like bread because you think it will put you over budget,” McGrail says. “It is a challenge to obtain a healthy meal.” (A Harvard study corroborates the unhealthy aspects of eating under the constraints of SNAP, while also noting that it is possible to go hungry on the program: recipients may run out of food at month’s end, since benefits are paid at the start of each month.)
Before embarking on the challenge, Iris Trutzer (MED’21) confessed to feeling terror at a mere $30 budget, mitigated only by the fact that she knew she’d be able to eat normally again after seven days. “We all have to keep in mind that we’re not living like a person who lives on SNAP benefits,” she said. “We’ll be off this in a week, and we’re also living with a full kitchen in a house that has heating and no utilities insecurity, no housing insecurity. So we’re doing this very much in a vacuum.”
While student participants interviewed hoped to increase awareness of how paltry the SNAP food allotment is, their main goal was to show their aspiring-doctor peers that the condition of malnourished patients is not necessarily the patients’ fault. “Increasing the empathy of future health care providers—understanding where patients are coming from, the challenges they face—will hopefully help us be better providers of care,” McGrail says.
“For some of our kids in our clinic, SNAP can be a lifeline,” says Megan Sandel, a MED associate professor and a pediatrician at Boston Medical Center. Some of her patients have had problems ranging from inactivity to disruptive school behavior after their families’ food stamp benefits were cut, she adds.
Chang borrowed the one-week-on-SNAP idea from U.S. Senator Cory Booker (D-N.J.), who had done it while serving as mayor of Newark, N.J. It has been an education unlike that of medical school, teaching Chang the fine art of food budgeting: “The cheapest meat pieces are these chicken leg quarters that are like a dollar a pound.…If you budget those chicken quarters, you can get two meals out of them.” Frozen and in-season vegetables are also good buys, he discovered, but “fruits are a luxury.”
Canned beans, a good protein source, are more expensive than dried ones, but don’t need cooking, he notes. But he’s also learned that splurging to save a night’s cooking is a privilege denied those on SNAP.
“If you’re on that tight budget of $30, you have to cook every meal,” he says. “It gave me a level of understanding about people who may be at the poverty line who are struggling to make ends meet, and they might have two jobs—where do they find the time to cook all the food and plan?”
Read the Boston University SNAP Challenge blog.
This BU Today story was written by Rich Barlow. He can be reached at barlowr@bu.edu.
MED’s Joel Alpert Dies at 83
Pediatrician remembered as strong advocate of primary care
Joel Alpert was a vociferous advocate of universal health care long before it was politically in vogue. Photos by Boston University Photography
Joel Alpert loved the Yale Bulldogs, believed men should wear ties, hated smoking, and relished a good debate. But among his many passions, he most ardently supported the provision of quality primary care to the children and families he served as the one-time chief of pediatrics at Boston Medical Center (BMC).
Arriving at BMC (then Boston City Hospital) in 1972, Alpert, a School of Medicine professor and chair emeritus of pediatrics, “came into a challenging situation and basically, at a time when everyone was moving to subspecialty care, put the limelight on primary care pediatrics,” says Robert Vinci, MED’s Joel and Barbara Alpert Professor of Pediatrics and department chair and chief of pediatrics at BMC. “He turned around this institution. He led with strength, with vision, and he became one of the national figures in academic pediatrics.”
Alpert, who was also a MED assistant dean for student affairs and a member of the Dean’s Advisory Board, died of leukemia on December 31, 2013, while in hospice care near his home in Palm Beach Gardens, Fla. He was 83.
During his four decades at MED and BMC, Alpert pioneered pediatric primary care training and the development of a curriculum that emphasized child development, advocacy, and community care. He held several leadership positions in major pediatric associations and earned numerous awards throughout his career. His writings, including The Education of Physicians for Primary Care in 1974, still define the practice today.
“Joel Alpert was a recognized leader in pediatric care and medical policy,” says Karen Antman, Medical Campus provost and MED dean. “He was an enormous influence on generations of medical students for whom he served as a role model and mentor and held himself, his department faculty, and students to the highest academic standards.”
Alpert was a vociferous advocate of universal health care long before it was politically in vogue. His position was likely rooted, colleagues say, in his Judaism, his focus on equity, and his experience serving as a doctor in London in 1958 and as an Army physician in Kansas in the early 1960s. He completed his residency at Boston Children’s Hospital and joined the Harvard faculty in 1961. A decade later, he arrived at BMC, MED’s primary teaching hospital, where patients largely come from the city’s underserved populations. In an American Academy of Pediatrics interview, he credited his mentor, Charles Alderson Janeway, then the physician in chief at Boston Children’s Hospital, for the advice that pushed him in that direction: “At Harvard, you will teach the people who teach,” Janeway told him. “At Boston University, you will teach the people who do.”
Alpert drilled the value of primary care and community-based pediatrics into the generations of doctors he trained. One of those doctors, Barry Zuckerman, the first Joel and Barbara Alpert Professor of Pediatrics, remembers how his mentor insisted that physicians show up at their clinics, continue to care for patients beyond their first appointments, and ensure that all patients’ needs were met—regardless of whether those needs were medical. “Back in 1972, that just wasn’t done,” says Zuckerman.
But he also recognized and nurtured the individual passions of his younger colleagues. As an intern in 1980, Vinci remembers Alpert encouraging his desire to start a branch of pediatric emergency medicine at BMC. Zuckerman says that Alpert supported him in setting up a division of developmental behavior pediatrics—one of the first in the country—despite Zuckerman’s being only one year out of his fellowship.
“He valued those things that I believed in,” Zuckerman says. Although they might not have been mainstream, “he cared about them and valued both me and my ideas.”
In 2000, Joel and Barbara Alpert established MED’s endowed chair in pediatrics and the Children of the City Fund at BMC, which supports studies on medical issues affecting inner-city youth.
Alpert campaigned tirelessly around issues of lead poisoning and gun control—even proudly pointing to his position on the National Rifle Association’s enemies list, according to the Boston Globe. And he despised smoking. Zuckerman remembers a conference Alpert hosted at his home in the early 1970s at which he insisted that anyone who wanted to smoke—including the woman who had helped endow the event—step outside the house, despite the rain. “You can’t fully appreciate how obnoxious he was” about smoking, Zuckerman says.
“When Joel believed in something, he went after it, and there was nothing that was going to stop him,” Vinci says. “I learned from Joel that no matter how challenging the situation, you just didn’t back down. If this was the right thing to do, you went after it.
“He really believed that pediatricians should be advocates, that our voices should be heard,” Vinci adds. “And in doing so, that we should be and become the voices of the children and families we served.”
Alpert’s “numerous contributions in the field of pediatrics improved the lives of countless children and their families and will continue to do so for many years to come,” says Kate Walsh, BMC president and CEO.
Born and raised in New Haven, Conn., Alpert graduated from Yale University in 1952. He earned a degree from Harvard Medical School four years later, but remained loyal to his undergraduate alma mater. He attended more than 50 Harvard vs. Yale football games over the years and always rooted for the Bulldogs, Vinci says.
While at BU, Alpert served as president of the American Academy of Pediatrics and of the Academic Pediatric Association, formerly Ambulatory Pediatrics. He was also elected a member of the Institute of Medicine and named an honorary fellow of the Royal College of Paediatrics and Child Health in London.
In 2000, Alpert and his wife, Barbara, established the Joel and Barbara Alpert Professorship in Pediatrics, which is held by the department chair. That same year, the couple established the Children of the City Fund at BMC to support early career pediatric researchers who study issues affecting inner-city children served by the hospital.
Despite his many career accomplishments, Alpert was first and foremost a family man. He is survived by his wife, three children, eight grandchildren, and his sister. Zuckerman recalls that whenever his boss got a call from his wife or children in the middle of a meeting, he would always take it.
“It was a clearly consistent message that family is what comes first for him,” he says.
Services for Joel Alpert were held on Monday, January 6, at Temple Isaiah and followed by a burial at Westview Cemetery, both in Lexington, Mass. In lieu of flowers, the family asks that contributions be made to the Joel and Barbara Alpert Children of the City Fund at Boston University School of Medicine, 850 Harrison Ave., fifth floor, Boston, MA 02118.
The School of Medicine plans to hold a memorial service in Alpert’s honor later this year.
This BU Today story was written by Leslie Friday.
BUSM, BMC Researchers Find Comparable Long-Term Outcomes between Diastolic and Systolic Heart Failure Patients
A new study by researchers at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) found comparable long-term outcomes between congestive heart failure patients with preserved ejection fraction commonly known as “diastolic heart failure” and congestive heart failure with reduced ejection fraction also known as “systolic heart failure.” The findings are published online in The American Journal of Cardiology.
Patients with normal percentage of blood leaving the heart each time it contracts and symptoms of heart failure are considered to have diastolic heart failure. Diastolic heart failure patients have not been as well studied as patients with systolic heart failure. Systolic heart failure patients have impaired blood ejection with each contraction of the heart, and do not derive long term benefit from the same medications.
According to the researchers, heart failure affects six million people in the U.S. alone and half of those admissions are patients with diastolic heart failure. However, there are not yet any treatments for this condition. In addition, the number of people who will develop diastolic heart failure is expected to rise as the population ages and the incidence of obesity and hypertension increases.
Dr. Flora Sam, senior author of this study
“An incredible amount of expensive and time-consuming resources are being spent on reducing readmissions at a national level, but have not translated into a reduction in heart failure mortality,” said senior author Flora Sam, MD, associate professor of cardiovascular medicine at the Whitaker Cardiovascular Institute at BUSM and attending physician of cardiovascular medicine and heart failure at BMC.
The researchers gathered patient data from all heart failure admissions over a two-year period at BMC. Using the American Heart Association’s Get-With-the-Guidelines quality improvement program, patients were reviewed for co-morbid conditions including kidney function, blood counts, and blood tests such as brain natriuretic peptide (BNP), a marker of heart failure.
The findings showed that in comparison to those with systolic heart failure, diastolic heart failure patients were older, more likely to be overweight, female and have hypertension. The one-year outcome of in-hospital morbidity and mortality was similar between diastolic and systolic heart failure patients. Though the early readmission rate in the 30 days after discharge was initially lower in patients with diastolic heart failure, this soon increased such that it was similar to those with systolic heart failure.
“This study shows the importance of refocusing our attention and resources on medication trials, which have historically reduced adverse long-term outcomes in chronic heart failure patients. Exploring medicinal treatment options for diastolic heart failure patients could potentially reduce readmissions, morbidity, mortality and long-term healthcare costs,” said Sam.
BUSM Professor Receives the Jerome Klein Award for Physician Excellence
Edward Alexander, MD, a professor of medicine and physiology at Boston University School of Medicine (BUSM) and a nephrologist at Boston Medical Center (BMC), has been named the 2013 recipient of the Jerome Klein Award for Physician Excellence. Selected by a senior committee of BMC and BUSM physicians, the award was presented at the Medical Executive Committee meeting on Dec. 13by Ravin Davidoff, MD, Chief Medical Officer of BMC.
“I am very honored to receive this award,” said Alexander. “I have been blessed to work at an institution I cherish and with colleagues, residents and students who have continually challenged me and demanded my best,” he added.
Edward Alexander, MD, (right) receives the Jerome Klein Award for Physician Excellence from Dr. Ravin Davidoff, Chief Medical Officer (left) at BMC.
The Jerome Klein Award was established in 2010 to commemorate Klein’s 50 years of service to BMC/BUSM and is presented annually to a physician who shares his attributes. Alexander, who has served the BMC/BUSM community for more than 40 years, received this recognition for his clinical and research excellence, leadership and dedicated commitment to education and mentoring.
“Ed is a wonderful role model. He deserves this award, not only for longevity, but for his unfailing commitment to excellence and his selfless devotion to the former Boston City Hospital, BMC and BUSM,” said David Salant, MD, Chief of Nephrology at BMC and Professor of Medicine at BUSM.
Serving as chief of nephrology for 25 years at the former Boston City Hospital, now BMC, Alexander is a member of the American Society of Nephrology, the International Society of Nephrology, the American Society of Clinical Investigation and is a fellow of the American College of Physicians. He is the recipient of an Outstanding Teaching Award and the Evans Outstanding Clinician Award from BUSM’s Department of Medicine.
He has authored several book chapters in clinical nephrology and published extensively in several areas of research including renal acidification mechanisms, electrolyte excretion, the relation of the adrenal and the kidney to hypertension and the effects of aging and of pregnancy on renal function.
Alexander earned his bachelor’s degree in biological sciences from Rutgers University and his medical degree from Northwestern University Medical School. He completed his internship and junior residency at Kings County Hospital in Brooklyn and then served as Captain in the U.S. Army Medical Corps. His senior residency was at Boston City Hospital followed by a nephrology fellowship at BMC and a physiology fellowship at Yale Medical School.
Boston University Researchers Explore Possible Link between Cognitive Depressive Symptoms and Antiretroviral Therapy Uptake
Researchers from Boston University’s School of Medicine (BUSM) and College of Arts and Sciences (CAS) found that among HIV-infected Russian drinkers, depressive symptom severity alone was not significantly associated with lower rates of antiretroviral therapy (ART) initiation. However, when examining cognitive symptoms of depression, results showed that high levels of depressive symptoms may be associated with delayed ART initiation. The findings are published online in the journal AIDS and Behavior.
Jeffrey Samet, MD
While depressive symptoms impact on adherence to ART is widely studied, there are few studies that have investigated the impact of these symptoms on initiating ART. According to the researchers, understanding factors associated with ART initiation may be particularly useful in locations where it is not as commonly prescribed, such as Russia, which has experienced a dramatic increase in HIV infection rates during the past decade.
Led by Jeffrey Samet, MD, chief and professor of internal medicine at BMC and BUSM and principal investigator of the study, the researchers enrolled participants from the HIV’s Evolution in Russia – Mitigating Infection Transmission and Alcoholism in a Growing Epidemic (HERMITAGE) study. The 133 eligible participants had their depressive symptom severity measured at the six- and 12-month marks.
Although the results did not provide evidence that depressive symptom severity alone had a statistically significant effect on ART initiation, findings suggested a potential role of cognitive depressive symptoms in decisions to initiate ART. According to the researchers, cognitive symptoms of depression are often considered to be an index of depression that is less influenced by HIV symptoms. Further, the study demonstrated findings consistent with existing studies that show participants with co-morbid heavy drinking and injection drug use appeared to have delayed ART initiation.
“Depressive symptoms have been shown to influence progression of HIV and have been associated with poor virologic response to treatment and increased immunologic failure,” said Tracie Goodness, a doctoral student in clinical psychology at CAS and corresponding author of the study. “Timely ART initiation has been associated with multiple positive health effects, such as lower mortality, increased immune functioning and lower rates of HIV transmission,” she added.
Although more research is needed, these results provide initial evidence of the role of depressive symptoms and may contribute to the understanding of ART initiation in HIV-infected populations
The study was supported by the National Institute on Alcohol Abuse and Alcoholism: R01AA016059, U24AA020778, U24AA020779, and K24AA15674.
MED Physicians Among Boston’s Top Docs
Boston magazine’s annual list includes 68 faculty
- Boston magazine’s “Top Docs 2013” list includes 68 from the BU School of Medicine and Boston Medical Center.
Among the 650 physicians named to Boston magazine’s recently released “Top Docs 2013” list are 68 from Boston Medical Center (BMC) and the BU School of Medicine. The list, which provides consumers with information on the Hub’s top doctors across 50 specialties, commended BMC physicians from 30 different disciplines, such as cardiovascular disease, surgery, and pathology, and profiled another—Jeffrey Kalish, a MED assistant professor of surgery and of radiology and BMC director of endovascular surgery—for heroic work during the April 15 Boston Marathon bombings. The list appears in the magazine’s December issue.
“We are delighted that these outstanding faculty are being recognized by their colleagues for providing the highest quality of compassionate care,” says Karen Antman, MED dean and provost of the Medical Campus.
Alik Farber, a MED associate professor of surgery and of radiology and chief of the BMC division of vascular and endovascular surgery, has been included on the list in the vascular surgery category each year since 2010.
“To be nominated in a city that is the center for medicine for the United States and possibly the world is a humbling experience,” Farber says. Having 67 of his colleagues on the list, he adds, is “an important accolade for Boston Medical Center.”
Francis A. Farraye, a MED professor of medicine and codirector of BMC’s Center for Digestive Disorders, has held a spot as a top gastroenterologist on the list each year since 2010. Farraye is especially proud of the gastroenterology department’s recognition, in light of the fact that it is smaller than those at many of the other teaching facilities in Boston. Four gastroenterologists were named to the list this year, which he says is “a testament to the breadth of the clinical faculty.”
The profile of Kalish, titled “Six Heroic Saves,” focused on his work treating Adrianne Haslet-Davis, a professional ballroom dancer whose foot Kalish amputated. The two became close during her stay at BMC. Nearly eight months later, Haslet-Davis is dancing—albeit differently—and her doctor promises to watch her perform again someday.
Kalish says that “when members of the health care system get together across disciplines, we provide more effective and better care for all of our patients.” In the aftermath of the bombings, he recalls, professionals from all specialties and ranks worked in sync to determine the best course of action for the patients. “Forming bonds with these patients through this tragedy reinvigorated for many of us why we actually went into health care,” he says. “It reminds us why we do this.
“I’m just one person that was part of an enormity of people that did amazing work, he says. “While I have this unique bond with Adrianne, there are plenty of others who have done the same.”
Kalish says the medical community learned “amazing lessons” this year. Boston’s December issue should reinforce Bostonians’ confidence in their medical community as it proves “the variety and strength of physicians and the ability of the city’s medical community to address any problem that might arise,” he says.
To be included in Boston magazine’s Top Doc list, physicians undergo a rigorous screening process by national medical research firm Castle Connolly. The firm gathers nominations online from other licensed physicians, conducts phone interviews with medical professionals to corroborate nominations, and checks the professional qualifications of all nominees, among them education, experience, and disciplinary history. The nominees complete a professional biography form, and the information is cross-referenced and confirmed.
“We have an incredible medical community here in Boston, and that was on full display in the wake of the Marathon bombings,” says Boston magazine senior editor Janelle Nanos. Nanos says she relished the opportunity this year “to celebrate the work that they did and acknowledge how lucky we are as citizens of Boston to be surrounded by such amazing medical professionals.”
A full list of 2013’s “Top Docs” and those from Boston Medical Center is here.
This BU Today story was written by Emily Truax.
National Academy of Inventors Announces Fellows
Two Boston University School of Medicine (BUSM) faculty members, David Center, MD, and William W. Cruikshank, PhD, have been named Fellows of the National Academy of Inventors (NAI). Election to NAI Fellow status is a high professional distinction accorded to academic inventors who have demonstrated a prolific spirit of innovation in creating or facilitating outstanding inventions that have made a tangible impact on quality of life, economic development and the welfare of society.
David Center, MD
Center and Cruikshank join 141 peer innovators who represent 94 universities and government and non-profit research institutes. Together, they hold more than 5,600 U.S. patents. Included in the 2013 class are 26 presidents and senior leadership of research universities and non-profit research institutes, 69 members of the National Academies (IOM, NAS, NAE), five inductees of the National Inventors Hall of Fame, six recipients of the U.S. National Medal of Technology and Innovation, two recipients of the U.S. National Medal of Science and nine Nobel Laureates, among other major awards and distinctions.
Center is chief of pulmonary, allergy and critical care medicine at BMC and the Gordon and Ruth Snider Professor of Pulmonary Medicine at BUSM. In addition, he is associate provost for Translational Clinical Research at Boston University, where he oversees efforts to facilitate translational research and leads initiatives that identify new areas for development as well as directs the Clinical and Translational Research Institute, funded by the National Institutes of Health. His research interests include asthma pathology, mechanisms of inflammation and immune-based lung disease.
William W. Cruikshank, PhD
Cruikshank, director of immunology and a professor of medicine at BUSM, has been conducting basic science and translational research for the past 34 years and has authored more than 160 publications in peer reviewed journals. His research addresses the development of asthma as well as mechanistic steps involved in the onset of cutaneous T cell lymphomas. Serving as director of the Summer Undergraduate Research Program at BUSM, Cruikshank is focused on increasing diversity within the graduate programs and is providing summer research opportunities for under-represented minorities.
Center and Cruikshank were nominated by the NAI Fellows Selection Committee that comprises 13 Members including NAI Charter Fellows, recipients of U.S. National Medals, National Inventors Hall of Fame inductees, members of the National Academies and senior officials from the United States Patent and Trademark Office, the American Association for the Advancement of Science, the Association of University Technology Managers, and the National Inventors Hall of Fame.
Transgender Medical Research and Provider Education Lacking
As a result of the limited transgender medical training offered at medical schools, very few physicians possess the knowledge needed to treat transgendered patients. This circumstance is the topic of a paper in this month’s issue Current Opinion in Endocrinology, Diabetes and Obesity.
Joshua Safer
Joshua Safer, MD, FACP, associate professor of medicine at Boston University School of Medicine (BUSM) and Director of the Endocrinology Fellowship Training Program at Boston Medical Center, is the senior author of the piece which includes guidelines for transgender treatment and also references the impact of recently piloted teaching on the topic at BUSM.
There are approximately 900,000 transgender persons living in the U.S. These individuals have a unique set of medical needs because their gender identities do not correlate with their biological sex. Medical interventions such as hormone therapy are required to appropriately and safely address the health of transgender patients.
According to Safer while many of the treatment regimens for transgender patients are fairly straightforward, very few physicians have the knowledge needed to treat these individuals. In fact, many physicians share the misconception that transgender treatment is a psychological issue and that gender identity can be reversed—an assumption that has been discredited.
“Because medically appropriate high-quality care for transgender individuals is not taught in most medical curricula, too few physicians have the requisite knowledge and comfort level for treatment of transgender individuals,” explained Safer.
Safer has recently piloted a transgender medicine component to the pathophysiology curriculum for medical school students at BUSM. According to pre- and post-course surveys published this summer in the journal Endocrine Practice, there was a 67 percent improvement among students enrolled in his course regarding their confidence with transgender medicine.
Safer is working to develop comprehensive transgender medicine training curricula for medical students, physician trainees, teaching physicians and other health care professionals. to address the specific biological distinctions of the patient group and evidence-based treatment paradigms derived from that biology. This training program would increase access to safe care for transgender patients.
MED Prof Wins Gates Foundation Condom Challenge
$100,000 grant for radiologist’s next-generation design
- Building a better condom: MED Professor Ducksoo Kim has won a $100,000 grant from the Bill and Melinda Gates Foundation to develop a self-lubricating “next-generation” condom. Photo by Flickr contributor Kerry J.
Condoms are a cheap, universally accessible means of preventing unwanted pregnancy and reducing the spread of HIV and other sexually transmitted diseases. But condoms aren’t nearly as effective as they should be for one stark reason: most men don’t like using them. So as part of its ongoing Grand Challenges Explorations Programs, the Bill and Melinda Gates Foundation asked researchers to come up with a “next generation” of male condoms that would be easier to use and preserve or enhance sexual pleasure. The foundation awarded phase one grants to develop an improved condom to 11 researchers, one a Boston University School of Medicine radiologist whose team has received a $100,000 grant to pursue development of a self-lubricating condom that would not only be more durable and more resilient, but would make protected sex more pleasurable.
Ducksoo Kim, director of the vascular and interventional radiology fellowship at Boston Medical Center, will lead the project, along with Karen Buch, a BMC third-year radiology resident. They are working to create condoms with a coating of superhydrophilic nanoparticles—tiny particles that trap water. The result would be a condom that would allow more sensitivity and make the use of lubricants unnecessary, says Kim. Like the other winning proposals, which include a “reconstituted collagen” condom made from beef, a gradually tightening condom, and a condom constructed of the ultrathin crystalline carbon known as graphene, the self-lubricating design would be a significant change in a product that hasn’t evolved all that much in centuries of use.
BU Today asked Kim what drew him to the challenge and what it will take to perfect and produce a condom that lubricates itself.
BU Today: How did you become interested in developing a better condom?
Kim: As physicians, we have dedicated our careers to helping our patients through the diagnosis and treatment of disease. Our research efforts have a similar focus on providing better and safer medical devices that would allow for earlier disease detection or prevent disease transmission. This project was a natural fit for us given our research focus.
What does winning the Gates Foundation challenge mean to you and your colleagues?
We feel very honored and happy that our innovative idea was recognized by this prestigious grant. And we are looking to collaborate with other BU scientists, and we invite them to contact us at dukim@bu.edu. The $100,000 award is for phase one, and we can apply for a follow-up grant worth $1 million in order to further the project.
Is your interest in nanoparticles unusual for a radiologist? Can you explain how your field applies to this line of research?
Not unusual at all. Radiologists are performing almost every single procedure using hydrophilic devices, which facilitate the procedures and improve their technical success and clinical outcome.
What are the major problems with the current generation of condoms?
The polymer or latex materials used in the current generation do not have this hydrophilic coating and so create significant friction and shearing forces. The use of additional lubricants to coat current condoms is an added step with increased cost to users.
How would a nano-lubricated condom be an improvement?
The hydrophilic coating drastically alters the mechanical forces and decreases friction to improve its functionality. That minimizes trauma to body tissues and ultimately lowers rates of breakage. This feature would decrease the rates of infection transmission and decrease the rate of unwanted pregnancy.
How does the hydrophilic coating work?
The hydrophilic coating traps water so that it reduces friction between the condom and tissue.
What are some of the other applications of nanoparticle technology?
The use of nanoparticles in medicine and biological sciences is at an all-time high. This technology was initially discovered and refined in the engineering sector, and it has a growing influence in medical devices, pharmaceuticals and drug delivery, gene therapy, contrast agents, tissue engineering, nanoscale biopchips, and microsurgical technology.
Would the nanolubricated condom look different from ordinary condoms?
No. The hydrophilic coating would not change the overall look of a typical condom.
Would the condoms be more expensive to produce?
Not at all. The goal of this condom is to be of low cost to users to increase condom use.
Would these condoms eliminate the need for lubricants?
Yes, that will be one of the major benefits. It will be more convenient, handy and ready for use without the need for extra lubricants. It will avoid potential contamination of germs from manual application of those lubricants.
What are the obstacles to developing and mass-producing nano-lubricated condoms for everyday use?
The main obstacles are the refinement of materials and extra processing of the coating materials to be compatible with mass production techniques, and maintaining high quality.
How do you plan to test the condoms’ strength and durability?
There are industrial standards that require electrical current testing for the existence of any porous defects (holes or tears) and a test that involves inflation and deflation of the condom hundreds or thousands of times to test its strength and durability.
This BU Today story was written by Susan Seligson. She can be reached at sueselig@bu.edu.
$30 Million from AHA Bolsters Framingham Heart Study
Sponsors collaboration between BU, University of Mississippi
Philip Wolf, a MED professor and principal investigator of the Framingham Heart Study, says AHA’s support will allow further exploration of the genetics underlying cardiovascular disease. Photo by Cydney Scott
Thanks to a $30 million commitment from the American Heart Association (AHA), researchers from Boston University and the University of Mississippi will collaborate for at least five years on a shared mission to find better preventive measures and treatments for heart disease—the leading cause of death in the world, according to the World Health Organization.
The Framingham Heart Study (FHS), with more than 15,000 participants and 65 years of data, is the nation’s longest running heart study. It has been supported almost since its 1948 beginning by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, and run by Boston University since 1971. The study was the first large-scale investigation to link risk factors—such as smoking, high blood pressure, and high cholesterol—to cardiovascular disease. In 2000, the University of Mississippi Medical Center, along with its partners at Jackson State University and Tougaloo College, replicated the FHS model in creating the Jackson Heart Study (JHS), with a focus on the genetic factors related to cardiovascular disease in African-Americans. With 5,000 participants, it is the largest study in history to focus on this population.
Researchers from both studies have collaborated over the years, but the new renewable funding from the AHA will facilitate a closer working relationship through what the organization has coined Heart Studies v2.0.
AHA CEO Nancy Brown told the Wall Street Journal that the organization sees this project as critical to its goal of achieving a 20 percent improvement in cardiovascular health in the United States while reducing deaths from heart disease and stroke by 20 percent for the decade ending in 2020.
The collaboration “gives us the opportunity to extend what we’ve been doing into the newest avenues of research,” particularly in genetics, says FHS principal investigator Philip Wolf, a School of Medicine professor. Vasan Ramachandran, a MED professor and chief of preventive medicine and epidemiology, will take over from Wolf as principal investigator in January.
Combining the Framingham and Jackson studies’ findings could reveal “differences in the causes of heart disease in the two populations,” says Karen Antman, MED dean and provost of the Medical Campus. African-Americans suffer disproportionately from cardiovascular disease, with annual death rates up to 64 percent higher for black males.
Scientific and oversight committees are still being formed, so details on how the collaboration will play out in coming months and years are not yet available, according to Wolf and Antman.
This $30 million in funding is very good news for the Framingham Heart Study, which was notified over the summer that its budget would be cut by $4 million, or about 40 percent of the money it receives through its core contract with the NHLBI. Those cuts forced the elimination of participants’ biennial exams, which Wolf describes as “the lifeblood of the study,” because they engender participant loyalty and include blood pressure readings, MRIs, and CT scans.
The exams are also important because they provide an opportunity for technicians to collect blood, urine, and cell samples, which are eventually frozen in biobanks. The FHS already has more than one million samples, while Jackson holds 40,000. Wolf considers the biobanks genetic gold mines, in that they may enable the development of tests that link certain genes to cardiovascular disease. Researchers could search for the frozen white blood cells or plasma of participants known to have suffered a heart attack or a stroke, analyze the DNA, and confirm a new test’s efficacy for predicting health risks.
Wolf believes the technique will open doors to more personalized health care. For example, he says, people living with hypertension get better results from one drug over another, but the more effective drug is apparent only after weeks of trial and error with a cocktail of medications that could have uncomfortable—or life-threatening—side effects. He and his colleagues think they will someday be able to analyze participants’ genomes and categorize them according to who would benefit the most from a given medication. Wolf hopes Heart Studies v2.0 will allow for the collection of more real-time data, such as daily miles walked or calories consumed by participants, to provide greater context for genetic analyses.
This BU Today story was written by Leslie Friday. She can be reached at lfriday@bu.edu; follow her on Twitter at @lesliefriday.
