Cureus People: Anne Liu, Stanford University

Anne Liu took 3rd Place in the Environmental Health category with her entry on Developing An Antibiotic Sensitivity Profile for Escherichia Coli in the Cur&#275us 2012 Fall Poster Competition.

Team Cur&#275us caught up with Miss Liu on the campus of Stanford University where she shared her passion about seeing hepatitis B eradicated in her lifetime.

In China, one in eight people are diagnosed as hepatitis B positive. Anne helped organize a mobile clinic called APA Health CARE that provides hepatitis B, blood pressure, glucose/cholesterol, and BMI screenings throughout LA and Orange County.

Anne used the opportunity of entering her research into the Cur&#275us 2012 Fall Poster Competition in order to showcase her work for a larger audience in hopes of motivating people to do research on hepatitis B screenings.

Anne Liu was born born in Changsha, China and came to Los Angeles at the age of 4.

 

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Cureus Medical Journal Featured in San Francisco Chronicle

John R. Adler M.D.

The San Francisco Chronicle interviewed John Adler, MD, Professor of Neurosurgery, Stanford University and Editor-in-Chief at Cur&#275us. They were interested in our revolutionary concept of using crowdsourcing to evaluate and publish medical papers.

John Adler points out that “Nowadays, you wouldn’t go to a restaurant without Yelping it first. You wouldn’t go see a movie without seeing what Rotten Tomatoes had to say about it.”

Still for some reason the world of medical journals is stuck in a 200 year old paradigm. He has spent the last three years changing the status quo.

The Cur&#275us model was created to expedite the process of medical publishing. An editorial board of experts will review submitted papers within days rather then months. But most of all, Cur&#275us is moving medical journals into the open from behind pay walls.

“The average Joe has little to no access to the medical literature today,” Adler said. “It’s not right. It should be a human right.”

Although the idea of crowdsourcing seems revolutionary, Dr. Adler’s vision has been stirring for some time.

He writes in A New Age Of Peer Reviewed Scientific Journals that he founded Cur&#275us “to address the challenges I have observed first-hand as an editor of numerous journals and an academic physician who has published and reviewed for years. We can do much better by authors, reviewers and certainly patients. This is the mission of Cur&#275us.”

Read the entire article at SF Gate.

Update: Fast Company picked this story up as well.

Cureus Editorial Board Feature: David I. Hoffman, M.D.

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The Cur&#275us team stopped in to meet with David I. Hoffman, M.D. a Reproductive Endocrinology and Infertility Specialist working alongside a team of infertility physicians at the IVF Florida Reproductive Associates since 1989.

A native of Pennsylvania, Dr. Hoffman completed his under graduate work at Trinity College in Hartford, Connecticut, before attending medical school at Temple University. He completed his residency in Obstetrics and Gynecology and his fellowship in Reproductive Endocrinology at the University of Southern California.

With over 25 years of experience in the diagnosis and treatment of infertility, Dr. Hoffman currently serves as a Voluntary Clinical Assistant Professor, Department of Obstetrics and Gynecology, Florida International University as well as a Voluntary Associate Professor, Department of Obstetrics and Gynecology, University of Miami, Miller School of Medicine.

Dr. Hoffman has published over 70 abstracts, articles, and book chapters and is a well-known presenter both nationally and internationally — he joined Cur&#275us as an Editorial Board member earlier this year.

Cureus People: Bowen Jiang, Stanford University

Bowen Jiang won the neurology category with his entry on 3-D Rotational Angiography in the Cur&#275us 2012 Fall Poster Competition. He’s currently working in a rehab center for veterans.

Team Cur&#275us stopped by the Stanford University campus to meet with Bowen who describes himself as an “aspiring neurosurgeon-scientist-innovator” in his profile.

Bowen is currently in is last year of medical school.

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Time Magazine Tackles Controversial Surgery for Addiction

Cur&#275us published a study from China on a controversial surgery for opiate addiction back in June — the scientific paper has just now begun to spark intense debate in the scientific community after drawing attention in a November English journal publication.

Time Magazine Neuroscience Journalist, Maia Szalavitz has written an insightful piece highlighting the study on Nucleus Accumbens Surgery for Addiction — pointing out the risks versus the push for innovation.

“The surgery is actually performed while patients are awake in order to minimize the chances of destroying regions necessary for sensation, consciousness or movement.  Surgeons use heat to kill cells in small sections of both sides of the brain’s nucleus accumbens.” Maia Szalavitz wrote for Time.

John Adler, MD, Professor of Neurosurgery, Stanford University and Editor-in-Chief at Cur&#275us spoke to Time Magazine about the controversy surrounding this risky surgery.

Even though Dr. Adler is not endorsing the procedure, he is convinced the surgery can “provide valuable information about how the nucleus accumbens works, and how best to attempt to manipulate it.”

“I do think it’s worth learning from,” he says. “As far as I’m concerned, ablation of the nucleus accumbens makes no sense for anyone. There’s a very high complication rate. [But] reporting it doesn’t mean endorsing it. While we should have legitimate ethical concerns about anything like this, it is a bigger travesty to put our heads in the sand and not be willing to publish it,” Dr. Adler told Maia Szalavitz.

It’s important to note that Dr. Adler collaborated with Chinese researchers on their publication and he is listed as a co-author. When the study was originally published in the free Cur&#275us journal library back in June, Dr. Adler spoke to the value of the research for neurosurgeons.

“Although this procedure has been used in 1000s of patients in China yet never reported in English until now, other scientific journals and their reviewing processes made it exceedingly difficult to publish in a traditional peer reviewed journal.” Dr. Adler wrote.

“I expect many physicians, especially neurosurgeons, involved in treating behavioral diseases or addiction, to be CURIOUS about the findings contained within this paper!” he added.

In a passionate post entitled “Forbidden Science – Addressing Behavior With Surgery”, Dr. Adler called out the ongoing challenge of publishing such “taboo clinical studies” in peer reviewed medical journals.

“The team of Chinese researchers who conducted this study have personally reported to me that despite the truly ground breaking and novel nature of the experience they report, their work has more than once been rejected by major English medical journals in the past.” Dr. Adler wrote.

You can read the entire Time Magazine article yourself and then jump headlong into the controversy surrounding this not so new bit of “forbidden science”.

 

Altered Immune Cells Help Young Girl Beat Leukemia

Emma Whitehead, with her mother, Kari last spring — Photo credit Jeff Swensen for The New York Times

 

After relapsing twice when chemotherapy treatment failed, 6-year-old Emma Whitehead was near death from acute lymphoblastic leukemia she had battled with since the age of 5.

With no viable cure in sight, her parents turned to an experimental treatment at Children’s Hospital of Philadelphia in a desperate attempt to save Emma’s life. The treatment had never before been used on anyone with the type of leukemia Emma had and it had certainly not been tried in a child.

“The experiment, in April, used a disabled form of the virus that causes AIDS to reprogram Emma’s immune system genetically to kill cancer cells.” the New York Times reported.

Although the experimental treatment nearly killed the 6-year-old — she was ultimately found to be cancer-free and Emma still remains in complete remission seven months later. Emma’s own immune system was given the lasting ability to fight cancer.

As many as three adults treated at the University of Pennsylvania who also battled with chronic leukemia have been reported to have complete remissions after the treatment, with no further signs of the disease. According to Dr. David Porter, two of the patients have been well for more than two years now.

“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. Dr. June hopes that one day the new treatment will eventually replace bone-marrow transplantation.

Cancer experts not connected with the research see tremendous promise since the early testing has worked so well in treating seemingly hopeless cases.

“I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.

Drugmaker Novartis Pharmaceuticals, has already committed $20 million to the Pennsylvania team to build a research center on the university’s campus with hopes of eventually bringing the treatment to market.

Read the entire NYT post

Stanford Hospital Residents Pull Smart Devices Into Patient Care

This week Cur&#275us highlighted the work of Olufisayo Ositelu — an MD/MBA joint degree candidate at the Stanford University School of Medicine and Stanford Graduate School of Business.

In his study researching the use of smart devices, Olufisayo surveyed Stanford Hospital resident physicians in Anesthesia, Medicine, Surgery, Emergency medicine, Pediatrics, Psychiatry, and Neurology — nearly 97% percent of respondents owned a smartphone and 53% percent owned a tablet.

While the use of smartphones and tablets are high among healthcare professionals, Olufisayo realized that little detail is actually known about the specific tasks related to patient care performed by physicians using mobile technology.

Olufisayo Ositelu

His study revealed the two most common uses for smart devices with 60% percent of responding physicians were communication exchanging patient care-related text messages and obtaining pharmacy or medication-related information. Some 45% percent of residents cited using their devices “as a medical reference, textbook, or as a patient care related study aid.”

It became obvious that residents who own smart devices are likely to leverage their handheld technology to deliver better patient care. But the power of these devices for physicians relies on intuitive apps that make mission critical medical information easier to access.

“A systematic review of 57 smartphone apps found that disease diagnosis, drug reference, and medical calculator applications were deemed to be most useful by healthcare professionals and medical or nursing students,” Olufisayo wrote in his paper.

In many ways, the proliferation of gadgets, apps and Web-based information is rapidly redefining medicine, opening up a new frontier of possibilities for young physicians. But some professionals are focused on the next generation of device-happy doctors becoming more caring clinicians in the era of digital technology.

“Just adding an app won’t necessarily make people better doctors or more caring clinicians,” said Dr. Paul C. Tang, chief innovation and technology officer at Palo Alto Medical Foundation in Palo Alto, Calif. “What we need to learn is how to use technology to be better, more humane professionals.”  – Source NYT

Read Olufisayo Ositelu’s entire study

Duke University Professor Offers 10 Tips For Better Writing

 

Michael C. Munger, Duke University

Professor Michael C. Munger of Duke University, writing in the Chronicle of Higher Education, offers “10 Tips on How to Write Less Badly,” something every graduate student should read.

As students make the shift from undergraduate studies to graduate school writing becomes crucial. According to Professor Munger, some talented people fail only because they write poorly.

“Many of the graduate students who were stars in the classroom during the first two years,” he writes, “suddenly aren’t so stellar anymore.”

Munger explains that some of the mediocre students go on to be published academics because they know how to write well.

Even though he offers a few obvious tips that encourage you to write a lot since “writing is an exercise” and “edit our work over and over,” there are some tips worth highlighting here.

“Everyone’s unwritten work is brilliant. And the more unwritten it is, the more brilliant it is.”

“Your most profound thoughts are often wrong. Or, at least, they are not completely correct. Precision in asking your question, or posing your puzzle, will not come easily if the question is hard.”

How well you write can make or break your career. Even though Munger doesn’t consider himself a good writer, “thinking about these tips, and trying to follow them myself,” he says he has “gotten to the point where I can make writing work for me and my career.”

Read the rest of the tips here.

Simple Breath Test Could Diagnose Colorectal Cancer

Researchers reported on Wednesday that an experimental breath test can diagnose colorectal cancer with over 75 percent accuracy according to the results of their new study published in the British Journal of Surgery (BJS).

Donato F. Altomare, MD, along with his colleagues from a hospital in Bari, southern Italy, conducted a small clinical trial using exhaled breath from some 37 patients with colorectal cancer and 41 healthy counterparts.

The study demonstrated for the first time that a simple breath analysis could be used for screening colorectal cancer.

The breath test-technology, processed offline, screens for colorectal cancer using “volatile organic compounds” (VOC), combinations of chemicals which can be found in small amounts in the breath.

Test results which analyzed 15 of 58 specific compounds in exhaled breath — revealed that patients with colorectal cancer have a different selective VOC pattern when compared with those of a healthy person.

“The technique of breath sampling is very easy and non-invasive, although the method is still in the early phase of development,” Dr. Altomare notes. “Our study’s findings provide further support for the value of breath testing as a screening tool.” – Source: Wiley

Although the death rate from colorectal cancer has been dropping in the past 20 years for men and woman — colorectal cancer ranks as the second leading cause of cancer-related deaths for both men and woman combined in the United States, according to the American Cancer Society.

Should the process of publishing a paper trump the power of scientific ideas within?

Henry Jacob Bigelow

Last week the New England Journal of Medicine announced that a survey of readers selected the 1842 publication of a paper by Henry Jacob Bigelow, reporting the first use of anesthesia, as the single most important paper in the 200 year old history of the journal.

Given the future implications of what was being reported in this paper, especially as we now look back over the medical landscape 150 years later, I cannot disagree with the selection. However, what I do find more than a little bit ironic is that such a paper, if submitted today, would stand almost no chance of being published in the NEJM, or virtually any so-called high impact journal.

As the Bigelow paper wended through the review process, this in-hindsight completely transformational paper, would be rightly criticized (and surely killed) as being little more than anecdote.

There is certainly no randomized blinded trial with rigorous statistical measures that ensures the quality of findings live up to the highest “scientific standards”. Moreover, lacking an IRB stamp of approval would certainly invalidate the paper for publication right out of the gate.

So I ask, have the standards of the NEJM and nearly all modern journals become so obtuse and elevated that the findings they now report are irrelevant to truly novel clinical innovation?

Also last week, I was advised by one of the journals for which I have long served as an editor, that future observational studies, if they are to even be considered for publication, must now assiduously adhere to STROBE guidelines.

Such STROBE guidelines represent the consensus of a 2004 big funded workshop, i.e. self appointed committee, composed of editors and sundry luminary academics who, presumably with the best of intentions, felt compelled to improve the reporting of observational studies.

But what started as well meaning “guidelines” have (perhaps not surprisingly) now morphed into a compulsory directive enforced by the editor in chief.  Will the quality of the journal articles now being published under the STROBE guidelines truly benefit from this new set of regulations?  Surely the editor in chief and politically-connected self-appointed STROBE experts would argue yes, but notably these sacrosanct “guidelines” have themselves never been subjected to any empirical test.

What I am quite confident about is that the journal in question has put up yet another barrier to authors reporting potentially interesting, and even ground breaking, clinical studies. As a result is it possible that that today’s equivalent to the good Dr. Bigelow’s reporting of anesthesia will go undiscovered because of the sheer hassle of publishing in the peer reviewed literature?

Is it possible that STROBE processes might drive some of today’s clinical innovators to just throw up his or her hands and say no thank you to reporting their findings? This leads to the bigger question, should the process of publishing a paper trump the power of scientific ideas within?

Readers of Cur&#275us are well aware of our Journal’s bias in this regard!