Category Archives: Preventative Medicine

Hundreds of thousands of Australians are needlessly enduring days of agony because they dont know how to prevent migraines, researchers from The Australian National University (ANU) have found.

Once diagnosed migraines can be effectively managed. But the researchers say sufferers dont recognise the symptoms and so dont seek the right treatment.

Dr Stephanie Goodhew, from the Research School of Psychology, says the study highlights a need for a public health campaign to inform the community on the treatments and defining features of migraines.

Migraine is more than a headache. It is an incredibly disabling condition that is also incredibly common about 15 per cent of the population suffer from migraines, said Dr Goodhew.

What is unique about it is that among neurological conditions, migraines are one of the most underdiagnosed or misdiagnosed conditions. A lot of people have migraines and dont realise they have it.

Even when people see their GP it can be missed or undiagnosed.

People think having headaches is not big deal but having a migraine is not just a headache. It is a much more severe pain and can be debilitating.

The study found one-in-five people who suffered migraine did not know about preventative medications they can access which include Botox.

This research shows people suffering from migraines often have incomplete or insufficient information about their own condition, said Dr Goodhew.

If we can allow people to have greater knowledge about migraine they can advocate for the right level of care.

The study also showed one-in-five people who had migraine did not know about any of the dangers with acute medication treatments, which are often used to treat the condition.

In the short term acute medications can massively reduce the pain but there are other risks if those medications are overused, Dr Goodhew said.

They can create rebound headaches and they can create the problem that you are seeking to treat.

If you have migraines talk to your GP, arm yourself with knowledge and ask for a referral to a neurologist.

Dr Goodhew says she struggled to find a diagnosis and appropriate treatment for her own migraines.

I have had migraines my whole life, but I only received a diagnosis in my twenties, she said.

When I have one, looking at light induces a razor sharp pain and I was lucky enough to see a particularly savvy GP that realised I was light sensitive and referred me to a neurologist.

The researcher says the challenge for practitioners is that there is no single biological marker that indicates someone is suffering from a migraine and people experience different symptoms.

The source of the pain is often unilateral, on one side of the head whereas your standard headache is all over the head, she said.

Some people suffer from Aura visual disturbances, or sensitivity to light. Others might feel nausea or dizzy.

The study is published in Springer Nature Comprehensive Clinical Medicine.

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Migraine sufferers needlessly enduring agonising pain | ANU Science, Health & Medicine - ANU Science

Can a computer be used to explain why an environmental toxin might lead to neurodegenerative disease? According to Penn State College of Medicine researchers, a computer generated-simulation allowed them to see how a toxin produced by algal blooms in saltwater might cause Amyotrophic Lateral Sclerosis (ALS).

The researchers investigated an environmental toxin called -Methylamino-L-alanine (BMAA) that has been linked to significantly increased occurrence of sporadic ALS in populations with frequent dietary consumption of food sources containing high levels of BMAA including the Chamorro population of Guam where ALS incidence is approximately 100 times greater than other populations.

The toxin is produced by cyanobacteria, a blue-green algae, and can occur in marine ecosystems. According to the researchers, BMAA accumulates in sharks, shellfish and bottom feeders so populations relying mainly on these food sources may be at risk.

Elizabeth Proctor, assistant professor of neurosurgery, and Nikolay Dokholyan, professor of pharmacology, used a computer to investigate why exposure to the toxin may lead to the development of diseases like ALS.

According to the researchers, if BMAA becomes part of a protein called copper-zinc superoxide dismutase (SOD1), the protein may adopt a form that is toxic to neurons.

Proctor, who holds a doctorate in bioinformatics and computational biology, said the study may be a model for investigating non-genetic cases of ALS, which account for 90% of all diagnoses.

Our results suggest a need for further investigation of SOD1 modification patterns in ALS patients, Proctor said. If we can determine the molecular patterns of disease onset and progression, it may aid in the development of lifestyle and preventative interventions for sporadic ALS.

What eluded researchers was an explanation for why BMAA led to the development of ALS and other neurodegenerative diseases.

In their study, published in PLOS Computational Biology, Proctor and Dokholyan proposed that BMAA causes the protein SOD1 to fold into a form that is toxic to neurons.

Proteins are built using 20 amino acids according to specific recipes coded in DNA. Slight changes to the ingredients can result in proteins that arent able to function the way they are supposed to. Proctor said if enough BMAA is present in a motor neuron that is building SOD1, it may be mistaken for the amino acid L-serine, which has similar properties.

According to the researchers, who used computer modeling to see what the protein would look like with BMAA instead of serine, this substitution critically alters the structure and stability of the protein.

More than 150 mutations of SOD1 have been associated with ALS, but the structural changes from those mutations arent enough to affect the stability of the protein according to Nikolay Dokholyan, professor of pharmacology and co-author of the study.

SOD1 has a higher level of stability compared to most normal proteins, said Dokholyan, who has a doctorate in physics. Although many mutations in this protein are associated with ALS, the resulting changes to its structure are not strong enough to cause significant destabilization.

Serine, the amino acid that BMAA competes with, occurs ten times in the recipe for SOD1. The researchers tested their theory by substituting BMAA for serine in each of those ten occurrences using a computer program developed by Dokholyan. They observed that BMAA incorporation had detrimental effects to the structure and stability of the protein and caused it to fold, or adopt its shape, incorrectly.

According to the researchers, studying patterns of SOD1 modifications in patients may be useful in developing potential interventions for sporadic ALS. One example of a possible intervention is L-serine supplementation for people exposed to a high amount of BMAA.

Although the study suggestions a connection between two pieces of ALS evidence, Dokholyan says many molecular factors contribute to the presentation of symptoms that doctors see.

A variety of gene mutations and external factors, like BMAA exposure, are associated with ALS, Dokholyan said. If we can figure out one pattern out, it may give clues for how to unlock others.

Reference-Methylamino-L-alanine substitution of serine in SOD1 suggests a direct role in ALS etiology.Elizabeth A. Proctor, David D. Mowrey, Nikolay V. Dokholyan. PLOS Computational Biology, July 19, 2019, https://doi.org/10.1371/journal.pcbi.1007225.

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

Original post:
Model Shows How Algal Toxin May Cause ALS - Technology Networks

Genetic screening that can identify variants of the mucin-causing MUC5B gene the key risk factor that predisposes people foridiopathic pulmonary fibrosis (IPF) may hold the key to the development and administration oftargeted therapiesthat may prevent the disease before it can progress and cause harm.

The research behind this breakthrough the identification of the role of that MUC5B gene was led by David Schwartz, MD, professor of medicine and immunology, and chair of medicine at the University of Colorado (CU) Anschutz Medical Campus.

We should be able to diagnose the disease before it destroys the lung, and well be able to treat it and prevent the long-term complications of lung fibrosis and scarring, Schwartz said in a press release written by Cathy Beuten.

IPF is a progressive lung disease of unknown cause that is characterized by increased scarring in lung tissues, resulting in shortness of breath and dry cough. To date, no cure has been found, and most treatments have focused on reversing or slowing down the tissue scarring.

But that scarring oftentimes is already severe and may have become irreversible by the time IPF is diagnosed in many patients. The difficulty in diagnosing IPF is compounded by the fact that its often misidentified, given its clinical similarities to other chronic lung conditions, such as chronic obstructive pulmonary diseaseor frequent pneumonia.

Ideally, identifying the root causes of IPF before it scars the lungs would lead to preventative interventions, or treatments to halt progressive tissue damage.

In an effort to understand whether any genetic factors could contribute to the disease, Schwartz created an international IPF network of more than 60 researchers at more than 30 sites globally. The team collected and analyzed around 9,000 DNA samples from IPF patients who had close relatives who also had the disease.

The analysis revealed that the most important IPF risk factor was a single change in the DNA sequence of the MUC5B gene. That variation resultedin the increased production of the main gel-forming protein in mucous, calledmucin.

Mucous normally plays an important role in keeping the airways clear of dust particles and other potentially harmful agents. However, too much mucin can result in thicker mucous, and can interfere with the hair-like cilia that are in the airways to help in the process of mucous expulsion. Over the years, accumulation of mucous and airway contaminants can cause tissue scarring.

The newly identified MUC5B variant was found to occur in one of each five people of European descent (non-Hispanic). It is much more frequent in people of European ancestry compared with people from African or Asian descent. Schwartz speculates that this MUC5B gene variant may have given children in ancient European populations an advantage against respiratory illnesses during adulthood.

This hypothesis was reinforced by the discovery that pulmonary fibrosis associated with rheumatoid arthritis a disease that looks clinically similar to IPF is associated with the same MUC5B variant risk factor.

Based on these findings, the team believes that it is possible to develop personalized strategies to specifically treat people who carry the IPF-related MUC5B variant even before the disease onset.

Biological or therapeutic interventions can be applied, such inhaled medications, to reduced mucin production. That would prevent mucous build-up and subsequent lung tissue scarring. Such an approach may effectively block IPF in high-risk people before it begins.

I think that were going to move from a palliative approach to this disease to a preventive approach to this disease, Schwartz said. We can now tell clinicians, relatives of patients are at risk for developing pulmonary fibrosis. And we can use genetic tests to diagnose it earlier before it scars the lungs irreversibly. And, were in the process of developing treatments that are focused on MUC5B, on the cause of pulmonary fibrosis.

Were trying to use what we have found for earlier diagnosis and gene-specific intervention, he concluded.

To listen to a podcast on this topic featuring David Schwartz, click here.

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Screening for Mucin Gene Mutation May Lead to Personalized IPF Prevention Therapy, Researcher Says - Pulmonary Fibrosis News

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In todays world, owning a smartphone is not so much a rite of passage as it is a standard for kids. A recent Pew Research Center survey found that 95% of teens have a smartphone or can readily access one, making them one of the most tech-savvy and well-connected generations. But such easy access to the internet and social media comes with its own host of issues, including an increased risk of online bullying, mental and emotional health problems, and an unhealthy attachment to screens all of which Gabb Wireless, the first company to provide phones and a network exclusively designed for kids, aims to combat.

Gabb, which announced its nationwide rollout for its phones and network this week, claims to be the premier safe network for young kids and teens. Gabbs phones stick to the basics, offering call and text options with a limited number of pre-installed apps, including a camera, a calculator, a calendar, and FM radio. And while neither of Gabbs phones or usage plans offers an internet browser or an app store, its products resemble popular smartphones on the market.

More from SheKnows

I wanted [the phones] to look and feel just like a smartphone because I dont know if you remember what its like to be 12, or 13, or 14, or 15, but these kids are mortified when their parents give them flip phones, Gabb founder and CEO Stephen Dalby told SheKnows.

Gabb currently offers two phone models: Gabb Z1, manufactured by ZTE; and Gabb S1, manufactured by Samsung and available on October 15. At $99, the Gabb Z1 is the more basic model, featuring a five-inch screen, a five-megapixel back camera, a two-megapixel front camera, and 32GB of expandable memory. Gabb S1 is a bit more sophisticated, with a nearly six-inch screen, an eight-megapixel front camera, a five-megapixel back camera, Bluetooth capabilities, and 512GB of expandable memory; it retails for $199.99. Both phones run on a leading 4G LTE provider.

The company also offers two usage plans, Gabb Basic and Gabb Plus. The Basic option, which is available now, comes with unlimited calls and text and costs $19.99 per month. As with the S1, the Plus plan offers a bit more, with unlimited calls and text, picture messaging, and group text capabilities; it costs $22.99 per month and will be available soon. Neither plan requires a contract.

It was critical to Dalby that both the phones and the plans were simple. As a parent of teens, Dalby said hed exhausted 30-40 hours of research looking for age-appropriate options that were safe as well as reasonably priced. Ultimately, none of the options on the market seemed worth it; even with parental controls, every phone allowed far too much access to the internet and social media apps. To top it all off, the phones and plans were exorbitantly priced. It was just a really painful experience, he said.

Keeping kids safe online is a growing concern for many parents, and rightly so. A recent study published in JAMA Psychiatry found that teens who spend more than three hours a day on social media were at a higher risk of mental and emotional health issues. These findings were consistent with a 2018 study published in Preventative Medicine Reports which found that kids ages 2-17 who spent more than an hour a day using screens had lower psychological well-being than those who didnt. The same study found that teens who had seven or more hours of screen time were twice as likely to have depression and anxiety. These findings are concerning, especially since 71% of teens reported that they use one or more social media platforms regularly, according to the Pew Research Center.

Additionally, the World Health Organization recommends reduced screen time including time spent on mobile devices, in front of gaming systems, and watching TV for kids of all ages, as it could cause developmental delays.

The evidence is clear, children who are consistently exposed to screens and excessive social media are suffering, Collin Kartchner, national social media activist and founder of Save the Kids, said in a Gabb Wireless press release. Whether its FOMO, anxiety, or exposure to predators, we owe it to our children to create safe ways for them to adopt mobile technology and content in ways that are better suited to their age and maturity levels.

Dalby says one of his objectives with Gabb is to teach kids about responsible technology use and to hold them accountable for the ways they interact via text messaging. He says parents can do this by first introducing kids to the Gabb Basic plan. Once kids have proven theyre more mature, Dalby suggests graduating to the Gabb Plus plan, where kids can enjoy group messaging and send photos. Ultimately, Dalby says he hopes that Gabb phones will prepare kids for their inevitable online usage.

So far, Dalby says both kids and parents have embraced Gabb phones.

The feedback were getting is really positive, he said. Its really positive from the kids because theyre excited to get the phone. Its really positive from the parents because they just dont need to worry about [kids accessing harmful apps or websites].

Gabbs goals are ambitious, and its mission to reduce the number of hours kids spend online will be hard-fought. But its a challenge Dalby and his team are happy to take on, starting in their own homes.

The same phones that were selling at Gabb Wireless are the same phones that my children are using, Dalby said. Theres never going to be a phone on this network thats not safe for kids.

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The First Phone Network Exclusively for Kids Aims to Curb Screen Time Addiction - Yahoo Lifestyle

Oak Knoll School of the Holy Child will host "ACL: The Physical and Mental Prevention and Recovery," a panel discussion, on Monday, September 23, 2019, from 6:30-8 p.m. on the school's 11-acre campus in Summit, New Jersey.

The event is free and open to the public. Pre-registration suggested.

The school's panel of doctors will discuss both prevention and recovery of the ACL injury. Physical and mental aspects will be discussed and how proper training is vital to both the prevention and recovery of such a prevalence injury. The conversation will focus on preventative techniques and then transition into what happens after injury. We will then focus the conversation on both the physical and mental aspects of rehabilitation and coming back from what once was thought to be a career ending injury.

Our Panel:

Andrew A. Willis, M.D.: A sports medicine surgeon specializing in athletic injuries and disorders of the shoulder, knee, elbow, wrist, and hand at the Sports Medicine Center and the Hand & Upper Extremity Center at Tri-County Orthopedics.

Lonnie Sarnell, Psy.D.: A a licensed psychologist who provides clinical and sport psychology services for children, adolescents and adults, at her private practice in Millburn, NJ.

Brianne O'Connor, PT, DPT: Graduated with honors from Columbia University with a Doctorate in Physical Therapy.

Jeff Boucher: Owner of Parisi Speed School in Morristown

More:
Oak Knoll to Host ACL Prevention and Recovery Panel - Patch.com

HERSHEY, Pa. Can a computer be used to explain why an environmental toxin might lead to neurodegenerative disease? According to Penn State College of Medicine researchers, a computer generated-simulation allowed them to see how a toxin produced by algal blooms in saltwater might cause Amyotrophic Lateral Sclerosis (ALS).

The researchers investigated an environmental toxin called -Methylamino-L-alanine (BMAA) that has been linked to significantly increased occurrence of sporadic ALS in populations with frequent dietary consumption of food sources containing high levels of BMAA including the Chamorro population of Guam where ALS incidence is approximately 100 times greater than other populations.

The toxin is produced by cyanobacteria, a blue-green algae, and can occur in marine ecosystems. According to the researchers, BMAA accumulates in sharks, shellfish and bottom feeders so populations relying mainly on these food sources may be at risk.

Elizabeth Proctor, assistant professor of neurosurgery, and Nikolay Dokholyan, professor of pharmacology, used a computer to investigate why exposure to the toxin may lead to the development of diseases like ALS.

According to the researchers, if BMAA becomes part of a protein called copper-zinc superoxide dismutase (SOD1), the protein may adopt a form that is toxic to neurons.

Proctor, who holds a doctorate in bioinformatics and computational biology, said the study may be a model for investigating non-genetic cases of ALS, which account for 90% of all diagnoses.

Our results suggest a need for further investigation of SOD1 modification patterns in ALS patients, Proctor said. If we can determine the molecular patterns of disease onset and progression, it may aid in the development of lifestyle and preventative interventions for sporadic ALS.

What eluded researchers was an explanation for why BMAA led to the development of ALS and other neurodegenerative diseases.

In their study, published in PLOS Computational Biology, Proctor and Dokholyan proposed that BMAA causes the protein SOD1 to fold into a form that is toxic to neurons.

Proteins are built using 20 amino acids according to specific recipes coded in DNA. Slight changes to the ingredients can result in proteins that arent able to function the way they are supposed to. Proctor said if enough BMAA is present in a motor neuron that is building SOD1, it may be mistaken for the amino acid L-serine, which has similar properties.

According to the researchers, who used computer modeling to see what the protein would look like with BMAA instead of serine, this substitution critically alters the structure and stability of the protein.

More than 150 mutations of SOD1 have been associated with ALS, but the structural changes from those mutations arent enough to affect the stability of the protein according to Nikolay Dokholyan, professor of pharmacology and co-author of the study.

SOD1 has a higher level of stability compared to most normal proteins, said Dokholyan, who has a doctorate in physics. Although many mutations in this protein are associated with ALS, the resulting changes to its structure are not strong enough to cause significant destabilization.

Serine, the amino acid that BMAA competes with, occurs ten times in the recipe for SOD1. The researchers tested their theory by substituting BMAA for serine in each of those ten occurrences using a computer program developed by Dokholyan. They observed that BMAA incorporation had detrimental effects to the structure and stability of the protein and caused it to fold, or adopt its shape, incorrectly.

According to the researchers, studying patterns of SOD1 modifications in patients may be useful in developing potential interventions for sporadic ALS. One example of a possible intervention is L-serine supplementation for people exposed to a high amount of BMAA.

Although the study suggestions a connection between two pieces of ALS evidence, Dokholyan says many molecular factors contribute to the presentation of symptoms that doctors see.

A variety of gene mutations and external factors, like BMAA exposure, are associated with ALS, Dokholyan said. If we can figure out one pattern out, it may give clues for how to unlock others.

David Mowrey, of the University of North Carolina at Chapel Hill also contributed to this study.

This work was supported by the National Institutes of Health Grants R01GM080742 and R01GM114015.

The authors declare no conflict of interest.

View original post here:
Research suggests how environmental toxin produced by algae may lead to ALS - Penn State News

Yale professor Michael Murray and a team of scientists want to collect over 100,000 samples of DNA in the coming years.

They want yours, too.

Since its recent launch in September, a new DNA sequencing project called Generations has been collecting blood samples from willing patients across the Yale New Haven Health System. Researchers plan on sequencing the protein-making parts of the genetic material in the blood to better understand, prevent and treat diseases and cancers.

The project may sound like 23andMe, the for-profit DNA testing company that is famous for predicting ones ancestral makeup. But Murray, a professor of genetics at the School of Medicine, said Generations is much more complex.

What theyre doing is not to be dismissed, but it only covers a small amount of risk, he said. Well be looking at more genes and more conditions, and well be looking at them in a more detailed way.

The process is free and fairly simple. Once a patient reads and signs a consent form, they can do a blood test. A few weeks later, he said, if the samples test positive for a gene variant that could lead to certain diseases, the patient is notified.

In the best case, you could do it all in a half hour, he said.

Murrays team collects the DNA from blood tests instead of cheek swabs because it is more reliable. And unlike blood donations, which can turn potential donors away for their medicine use or sexual orientation, Generations wants as many samples as possible, with the goal of collecting over 100,000 individuals DNA.

All one needs is a medical record number, he said, and that can be generated on the spot for Yale students.

Theres no age or health status inclusions or exclusions. Anybody thats interested can sign up, he added.

The DNA sequences will then be stored in a biobank, or a data repository, for researchers to access and analyze in conjunction with patients medical records. With such a large amount of data, Chair of the Department of Laboratory Medicine Brian Smith said that Generations can look for trends that would not be as apparent in smaller study groups.

And because the New Haven area mimics locally what the entire United States looks like in terms of ethnic origin, Smith said the data will be especially helpful in making connections between diseases and genes.

The fact that there are so many people from a wide spectrum of genetic backgrounds, combined with the information from the electronic medical record, really gives us the ability to understand that a gene is clearly associated with a medical problem, he said.

Privacy is a big concern for the project. Since Murray and his team are working within the health system, which legally requires strict confidentiality measures for patient data, the genetic data they collect will be kept safe, Murray said.

But he is well-prepared for the task. In fact, that is what Yale hired him to do.

The researcher came from Geisinger Health in Pennsylvania last year, where he helped to create a biobank with over 50,000 patients genetic data.

Now at Yale, Murray plans on replicating that project, but at roughly twice the size. However, much of the testing his team will do will happen later on, as they work out any kinks in the system, he added.

For example, once it becomes available, Generations will also use samples to predict patients responses to certain medicines. Armed with such information, Murray said, doctors could know if a patient may need more or less of a medication to reach the desired outcome, compared to the average person.

You dont start everything at once, he said. Every sample they receive will be tested in the future once more features roll out.

To chair of the genetics department Antonio Giraldez, who participated in Generations himself, the project is also a way to prevent costly diseases that can pop up later in life. If a babys genetic data reveals that they have a high chance of developing cancer, he said, preventative measures could be taken to make sure cancer does not arise saving thousands of dollars.

I hope that many people in greater Connecticut [participate], he said.

Partial genome sequencing costs hundreds of dollars, according to Smith.

Matt Kristoffersen | matt.kristoffersen@yale.edu

Original post:
Have DNA? These Yale geneticists want it - Yale Daily News

A documentary featuring world class athletes speaking about the pros of a plant-based diet claims eating meat could kill you.

The Game Changers focuses on the truth in nutrition and features the likes of Arnold Schwarzenneger talking about the benefits of veganism in sports training.

It also aims to debunk the theory that people need to consume meat to build muscle and claims eating meat can cause cancer and cardiovascular disease.

On the documentarys website, it claims, citing a Harvard study, avoiding animal products can reduce the risk for coronary heart disease by 55 per cent.

Arnold Schwarzenneger is one of many former and current athletes interviewed in The Game Changers. Source: The Game Changers

Dr Dean Ornish, founder of the Preventative Medicine Research Institute, is also cited in the trailer stating eating plants can reverse diabetes and heart disease.

The doco also features interviews with Formula 1 driver Lewis Hamilton, Australian Olympic sprinter Morgan Mitchell, and former NFL players Griff Whalen and Derrick Morgan.

While the documentary calls on a number of scientific studies, its been criticised by some experts.

Brian St Pierre, Director of Performance Nutrition at Precision Nutrition, told Mens Health while getting people to eat plants isnt bad the documentary shouldnt be telling people meat will kill them.

Some have criticised the documentary for claiming eating meat could kill people and cause many health problems. Source: Getty Images (file pic)

That is a false dichotomy, Mr St Pierre said.

Instead, teach them the benefits of adding more wholesome plant foods to their meat intake and then teach them to eat higher-quality meat options.

He added another alternative could be telling people to swap some meat for plant-based protein and find a happy middle ground.

UK mens news site Joe.co.uk also criticised the documentary with health writer Alex Roberts writing its a huge generalisation to claim all meat has the same risk.

High levels of saturated fat are linked to conditions such as atherosclerosis, true, Roberts wrote.

But a very lean cut of turkey is not as harmful as a fatty, rib eye steak, for instance.

Vegan mixed martial arts fighter James Wilks who was heavily involved in the documentary rebukes the criticism, saying the documentary never makes the claim that all meat carries the same risk.

Writing to Yahoo News Australia after publication he said the above criticism suggests that dietary fat is the only issue ... It's far more complicated than that, with meat containing other inflammatory mediators, concentrated pesticides, toxic heavy metals etc.

He also pointed to the raft of experts featured in the film, and claimed the documentary had been accredited by the American College of Lifestyle Medicine as well as the US Defense Health Agency.

The Game Changers premieres in Australian cinemas on Wednesday.

Do you have a story tip? Email: newsroomau@yahoonews.com.

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New documentary claims eating meat could kill you - Yahoo News Australia

Alex Gorelik, CTO & Founder of Waterline Data

According to IDC, all the data thats being created and captured in healthcare is projected to grow by 36 percent (CAGR)more than any other industry.

While managing growing volumes of data is a common challenge for many organizations across all sectors, healthcare is uniquely set apart by the sheer number of new data sources thats being made availablewith new sources being added all the time. This is driven in large part by advancements in telemedicine, personalized or precision medicine, as well as IoT-based medical and personal health devices. While this flood of real-time data and analytics adds to the opportunities for all kinds of data-driven benefits like more advanced and customized care as well as faster drug development, it also means healthcare organizations will have to manage increasingly large and varied data assets. This is creating some big challenges that these organizations will need to resolve, including how to ingest and organize the information, ensure it complies with HIPAA and other regulations, and make it valuable for all stakeholders.

The problem is compounded as healthcare focuses on population health management and becomes more preventative rather than merely reactive. This, of course, requires capturing and analyzing even more data that can be used to detect early indications of health risks. Meanwhile, there has been a shift toward more remote health monitoring and response. You may go to Kaiser and think your medical professionals are all on site, but its becoming more common for hospitals to tap the expertise of specialists who could live elsewhere on the globe. They connect via teleconference systems and trade data from different systems located in different countries, all with different regulatory requirements. Using data-driven collaboration to provide the best possible care for individuals or enable the most comprehensive research for global responses to disease outbreaks while meeting various compliance needs is no easy task.

To support these needs, IDC for its part recommends big investments in health IT, blockchain and analytics tools along with effective strategies for digital transformation. A big enabling part of this transformation requires using AI and machine learning technology thats taught to recognize patterns in unstructured data and automatically converting it into structured data that can be retrieved and analyzed. This is how you automate many of the time-, cost- and resource-intensive manual processes that often sink an organizations big data ambitions. These steps include:

1. System and Silo Consolidation:

The healthcare industry is constantly consolidating. This creates a challenge in integrating all the disparate systems and data silos that need to come together to provide a big data ecosystem that can draw from all the incoming streams of data and various data sources. This means everything from hospital monitoring machines to personal IoT-enabled medical devices. Together, they can paint a holistic picture of a patients health and medical needs, accelerate pharmaceutical drug development and so much more. Using AI and machine learning-driven technology to automate data classification and consolidation across systems, departments and organizations around the world in this way can dramatically cut the time, cost and required expertise of migrating disparate data into centralized data lakes.

Furthermore, to avoid complicating effortsits complex enough alreadydont try to build Rome in one day. Start with a few critical projects that require certain data that can be processed in order to form your projects bloodstream. Focus on a few key systems and get them cleaned up. Dont try to boil the ocean all at once. Settle on a few essential use cases to launch with. Apply your automation, curation, assessment of data quality, etc., and then use it in your AI and ML initiatives. Once youre able to demonstrate success, steadily build on those successes.

2. Data Lake Management:

After suffering some setbacks due to improper management, data lakes are regaining the luster they first captured in 2010 when organizations began using them to cost-effectively store their raw data. The problem? The data lake is great for storing data, but not so great when it comes to generating value. Organizations would often dump their data there with no proper management, leaving the data to rot ungoverned and unused. But the emergence of the cloud has combined with the development of new AI-driven cataloging techniques that help automate and simplify many management functions that keep data lakes healthy. Organizations can now use them to combine data from different systems in one place where the stored data can be rendered governable, searchable and accessible.

3. Packaging Data:

Storing all your data in one data lake doesnt automatically make it usable. All that data is still streaming in from all kinds of different sources, including medical records, patient surveys, cancer or cardiac registries, claims records, and so on. You need to be able to recognize and find data regardless of its source and then format and provision it for use according to what the use case requires. This is what will enable the self-service retrieval and analytics that todays medical practitioners want in order to provide better care. Sure, theyre more data-savvy now than ever, but you still need to package data in a way that makes sense to them.

4. Governance:

Healthcare generates oceans upon oceans of data, and all of it needs to be governed. This is an area that requires absolute automation to ensure every bit of data adheres to the rules governing that particular bit of data. All have to be maintained. Some data can be seen but not copied. Some data can be shared by one party with another party but only if anonymized. There are a lot of regulations and restrictions. Only granular governance will ensure youre deriving the most value from both restricted and unrestricted data without breaking any industry or governmental rulesor disobeying the patients stated data privacy and security preferences. For governance to work, you need to make sure all your data is properly identified so that the automated enforcement rules theyre bound by can be applied.

As advancements continue to be made in AI and machine learning to further enable data automation, the healthcare industry is poised for a dramatic transformation that will greatly improve the quality of care for humankind. But data automation cant be applied in one fell swoop. It requires deliberate implementation across many iterative stages. Making those modest moves to automate now will get you on track towards the giant leaps that data will undoubtedly make in the quality and effectiveness of healthcare.

About Alex Gorelik

Alex Gorelik, the author of the newly published book, The Enterprise Data Lake (published by OReilly Media), is CTO and founder of Waterline Data as well as three startups. He also served as GM of Informaticas Data Quality Business Unit. In addition, Alex was an IBM Distinguished Engineer and co-founder, CTO at Exeros and Acta Technology.

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4 Steps Healthcare Organizations Need to Take to Automate Their Data - - HIT Consultant

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Newswise New Brunswick, N.J., September 17, 2019 In what is believed to be the largest dataset study to date examining the role of race on survival outcome for pediatric patients with Hodgkin lymphoma, investigators at Rutgers Cancer Institute of New Jersey have found that black patients have significantly worse overall survival at five years than white patients when accounting for all available clinical variables. The work is being presented as part of a mini oral presentation at the Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Chicago this week.

The National Cancer Database, which captures oncology data from more than 1,500 facilities accredited by the Commission on Cancer, was utilized in the study. Identified and evaluated was a final sample of 9,285 eligible patients aged 21 and younger with a diagnosis of stage 1 to stage 4 Hodgkin lymphoma from 2004 to 2015.

Eighty-three percent of patients were white, 12 percent black and five percent other. Black patients were found to be younger (under age 15), at a lower stage of disease when diagnosed, less likely to have a sub-type of disease known as nodular-sclerosis, and more commonly to exhibit what are known as B symptoms (fever with no infection, night sweats, unexplained weight loss). This population also was found to be of lower income and lower education status, and more likely to be under/uninsured. Similar among the races were treatment interventions, including use of chemotherapy, radiation therapy, or combined modality therapy (chemotherapy followed by radiation). Clinical features and survival outcomes were evaluated using various statistical tests and models.

Black patients experienced a five-year overall survival of 91.5 percent compared to 95.9 percent experienced by their white counterparts. This difference was seen across all stages of disease. There were also differences in stratification of risk factors by race. Specifically, under age 15, stage 4 disease, presence of B symptoms, treatment with radiation, and income were prognostic factors for overall survival in white patients but not for black patients. Among the age groups 15 and younger, 16 to 18 years, and older than 18, poorer overall survival was associated for black patients compared to whites (95.4 percent versus 97.7 percent, 87.1 percent versus 96.1 percent, and 91.6 percent versus 94.6 percent respectively).

The race-based disparity demonstrated through this work transcends that of differences in socioeconomic status, notes the works senior investigator, Rutgers Cancer Institute radiation oncologist Rahul Parikh, MD, who is the director of the Laurie Proton Therapy Center at Robert Wood Johnson University Hospital, an RWJBarnabas Health facility. Future research should focus on understanding the biological causes of this disparity and identifying ways to alleviate it, adds Dr. Parikh, who is also an associate professor of radiation oncology at Rutgers Robert Wood Johnson Medical School.

Along with Parikh, other investigators on the work are Karishma Khullar, MD, Rutgers Cancer Institute and Rutgers Robert Wood Johnson Medical School; Zorimar Rivera-Nunez, PhD, Rutgers Cancer Institute and Rutgers School of Public Health; Sachin R. Jhawar, MD, Rutgers Cancer Institute and Rutgers Robert Wood Johnson Medical School; Richard Drachtman, MD and Peter D. Cole, MD, both Rutgers Cancer Institute and Rutgers Robert Wood Johnson Medical School; and Bradford S. Hoppe, MD, MPH, University of Florida, Gainesville.

Related work published earlier this year by Parikh and colleagues believed to be the largest study to date involving this same population showed improved overall survival in those who received combined modality treatment versus chemotherapy alone in early stage patients (JAMA Oncology, doi: 10.1001/jamaoncol.2018.5911).

Other data set exploration by Rutgers Cancer Institute investigators includes that of radiation oncologist Nisha Ohri, MD and colleagues. She is the senior author on work presented during a poster presentation this past Sunday at ASTRO that evaluated the change in volume of a lumpectomy cavity during hypofractionated breast radiation therapy and assessed the benefits of adaptive planning for lumpectomy boost delivery.

A retrospective review of Rutgers Cancer Institute data identified 37 eligible patients who were treated with hypofractionated radiation therapy followed by a lumpectomy boost from October 2017 to December 2018. Two separate CT scans were obtained. The first was utilized to plan whole breast irradiation and the second to plan the lumpectomy cavity boost. Patient and tumor variables were examined for correlation with change in lumpectomy cavity volume between CT scans.

The mean reduction in lumpectomy cavity volume with adaptive boost planning was 18.8 percent. Adaptive planning allowed for significant reductions in mean heart and lung doses. In comparing the 18 patients (47.4 percent) who had a significant reduction in lumpectomy cavity volume (defined as 20 percent or greater) to those who did not, no significant differences were found in age, body mass index, breast volume, tumor size, history of re-excision, or presence of an implantable marker. Length of time from surgery to initial CT scan was significantly associated with a reduction in lumpectomy cavity volume, and patients who had a large initial lumpectomy cavity volume often demonstrated significant volume reduction with adaptive boost planning. With these findings, investigators note that adaptive lumpectomy cavity boost planning can be considered for select patients to reduce normal tissue exposure, although longer follow-up is needed to assess the clinical benefits.

Along with Dr. Ohri, other investigators on the work include Mutlay Sayan, MD; Zeinab Abou Yehia, MD; Irina Vergalasova, PhD; Marc Reviello, CMD; Shicha Kumar, MD, and Bruce Haffty, MD, all Rutgers Cancer Institute and Rutgers Robert Wood Johnson Medical School.

Rutgers Cancer Institute faculty members are also collaborators on a number of other on-site presentations and abstracts/posters published in conjunction with the ASTRO annual meeting that are not listed here.

About Rutgers Cancer Institute of New Jersey

As New Jerseys only National Cancer Institute-designated Comprehensive Cancer Center, Rutgers Cancer Institute, along with its partner RWJBarnabas Health, offers the most advanced cancer treatment options including bone marrow transplantation, proton therapy, CAR T-cell therapy and complex robotic surgery. Along with clinical trials and novel therapeutics such as precision medicine and immunotherapy many of which are not widely available patients have access to these cutting-edge therapies at Rutgers Cancer Institute of New Jersey in New Brunswick, Rutgers Cancer Institute of New Jersey at University Hospital in Newark, as well as through RWJBarnabas Health facilities.

Along with world-class treatment, which is often fueled by on-site research conducted in Rutgers Cancer Institute laboratories, patients and their families also can seek cancer preventative services and education resources throughout the Rutgers Cancer Institute and RWJBarnabas Health footprint statewide. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 848-932-8013 or visit http://www.cinj.org/giving.

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Read more:
Racial Disparities in Survival Outcomes Shown in Pediatric Hodgkin Lymphoma Patients - Newswise