Vera Kimbrell views the results of a brain scan from the 7 Tesla MRI.

When the first test images from a brain scan performed by the Brigham’s new 7.0 Tesla (7T) MRI machine appeared on the monitor, the texture and details reminded Srinivasan Mukundan, MD, PhD, of the awe he felt in medical school looking at slices of brain tissue.

“Every time we have one of those quantum leaps in technology, it’s like seeing these images for the first time again,” said Mukundan, a neuroradiologist and medical director of Magnetic Resonance Imaging. “A lot of us went into this field because we love anatomy, and the image quality from the 7T makes it seem as though you’re looking directly at the brain.”

An MRI scan performed by the 7T depicting the brain’s circulatory system

Delivered to the Building for Transformative Medicine (BTM) in May, the 7T is among the world’s most advanced MRI scanners. The device was granted approval for clinical use by the U.S. Food and Drug Administration in early October; state regulatory approval for clinical use is still pending. For now, the device can only be used for research purposes, such as clinical trials. If approved, the Brigham’s 7T will be the first in New England to be used in a clinical setting.

One of several advanced imaging devices in the BTM, the 7T joins a diverse fleet of MRI scanners across Brigham Health. It is highly specialized, currently equipped to perform only brain and knee scans. The BTM is home to the Neurosciences Center and the Orthopaedic and Arthritis Center, making the 7T’s location especially beneficial if the device is approved for clinical use.

Getting the 7T ready for primetime is no simple affair. Given the strength of its magnet – producing a magnetic field thousands of times greater than the Earth’s – the device took nearly two months to fully power up and calibrate, explained Steven Seltzer, MD, chair emeritus in the Department of Radiology.

The device’s initial images have come from a group of healthy volunteers – comprising mostly BWHers – who participated in brain and knee scans. Part of a finetuning process known as applications training, and approved by the Institutional Review Board of Partners HealthCare, these test scans have helped Brigham physicists and technologists to become familiar with the 7T and optimize its performance.

This training period has set the stage for the first research projects using the 7T, which are expected to launch in the coming weeks, Seltzer said.

“We were delighted that the first day of applications training that we saw pictures of the brain and knee that – right out of the box – met or exceeded our hopes for the kind of fidelity we could get out of this device,” Seltzer said. “The images it has produced were just beautiful, and it will only get better.”

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Emergency physician Scott Weiner, MD, MPH, describes a chilling scene: You’re walking down the street and see someone unconscious on the ground. The person isn’t breathing, and nearby drug paraphernalia suggests that’s due to an overdose.

Although a 911 call triggers an emergency response, the chances of survival drop with every minute that ticks by until first responders arrive. But anyone can take actions that may save this person’s life, Weiner said.

Weiner described this scenario – and call to action – during “Empowering Bystanders to Become Heroes: Rescue an Opioid Overdose Victim,” one of five interactive sessions at the Brigham  on Oct. 11 as part of HUBweek, a weeklong festival celebrating discovery and creativity across Greater Boston.

This is the first year BWH has participated in the event, adopting an inaugural theme of “Inside the Brigham: Innovation in Action.” Other HUBweek activities at BWH showcased the simulated spacecraft medical bay at the Neil and Elise Wallace STRATUS Center for Medical Simulation, “Stop the Bleed” training with experts from the Gillian Reny Stepping Strong Center for Trauma Innovation, mobile app development with the Brigham Digital Innovation Hub (iHub) and a live pitch session with the Brigham Research Institute’s 2017 BRIght Futures Prize finalists.

Traditional lectures were in short supply. Interactive and immersive, the event invited 115 attendees to be not only observers but also active participants as they learned about breakthrough research and cutting-edge technologies at the Brigham.

“HUBweek showcases the best of Boston’s innovation culture, and our first year participating was a success by all measures,” said Adam Landman, MD, chief information officer at Brigham Health. “Attendees left not only knowing more about Brigham research and initiatives, but the content of several sessions also helped them feel knowledgeable and empowered in the face of crisis.”

Novel Research, Programs Inspire

During the opioid session, Weiner and his colleague Scott Goldberg, MD, discussed a study done in partnership with the city of Cambridge. The study assessed bystanders’ ability to administer naxolone, a fast-acting treatment that can reverse an opioid-related overdose, to a simulation manikin with help from a mock 911 operator. HUBweek attendees had the opportunity to participate in the same exercise at the STRATUS Center.

Nyryan Nolido, MA, a research project manager in the Division of Internal Medicine and Primary Care, attended the opioid session and stopped by the iHub pop-up studio to submit ideas for a BWH app in development. She described both sessions as inspiring and empowering.

“The event reminded me that we can all be active stakeholders in innovation at BWH as patients, family members, providers and researchers,” Nolido said. “It’s exciting to see a mammoth like Brigham Health working nimbly in the area of innovation.”

Difei Tong, a local college student, was among those who donned a NASA spacesuit at the STRATUS Center and learned how to pack a wound and apply a tourniquet during the Stop the Bleed session.

“The Brigham does a lot to educate the community,” she said. “It was really cool to come in and ask doctors and researchers about their work.”

Fellow attendee Umit Sami, MBA, a systems engineer in Scientific Computing at Partners HealthCare, said his favorite part of the day was the BRIght Futures pitch session.

“An event like this goes well beyond scientific presentations, and it is especially compelling because they’re doing it right in the hospital,” Sami said. “I see BWH as a central hub for medical innovation, and I’m really inspired by these creative, visionary projects.”

On Sept. 26, the Brigham Health Scientific Advisory Board (SAB) convened to provide strategic guidance and recommendations to help advance Brigham research. Three new members of the board were in attendance: James (Jay) Bradner, MD, president of Novartis Institutes for Biomedical Research, Susan Hockfield, PhD, president emerita and professor of Neuroscience at Massachusetts Institute of Technology, and Sue Siegel, MS, CEO of GE Ventures and Healthymagination at GE Healthcare.

SAB members engaged in a closed-door review session of finalists for the Brigham Research Institute Director’s Transformative Award, making a recommendation on the project most suitable for funding. During the second half of their meeting, the SAB held an open discussion with several leaders from BWH and Partners HealthCare about major trends in biomedicine and opportunities and challenges for academic medical centers over the next five years.

From left: Geoff Smith, JD, managing partner at Digital Ventures; Betsy Nabel, MD, Brigham Health president; Sue Siegel, MS, CEO of GE Ventures; Jay Bradner, MD, president of the Novartis Institutes for BioMedical Research (NIBR); Terry McGuire, MS, MBA, co-founder and general partner at Polaris; Michael Rosenblatt, MD, chief medical officer at Flagship Ventures; Susan Hockfield, PhD, professor of Neuroscience and president emerita at the Massachusetts Institute of Technology; and Jeff Leiden, MD, PhD, CEO, director and president of Vertex Pharmaceuticals.

My proudest moment at BWH was receiving the Linda Morgante Hope Award: Best Work to Inspire Hope in MS at the Multiple Sclerosis Consortium with my colleagues in June 2016.

Audrey Cecil, MSW, LICSW, Clinical Social Worker, Partners MS Center, Department of Neurology

JoAnn Manson

Hormone therapy is known to be effective for treating menopausal symptoms like hot flashes and decreasing risks of bone fractures and diabetes, but it has also been linked to risks such as venous blood clots, stroke and certain cancers. A recent BWH study suggests that the net effect of these therapies on mortality rates over 18 years is neutral – providing reassuring news for women considering or receiving hormone therapy.

The research, published in the Journal of the American Medical Association (JAMA) on Sept. 12, is the first to examine the long-term rates of death reported in the two hormone therapy trials from the Women’s Health Initiative (WHI), a long-term study of postmenopausal women in the U.S., funded by the National Institutes of Health. The WHI hormone therapy trials tested the most common forms of menopausal hormone therapy – estrogen or a combination of estrogen plus progestin – to assess the benefits and risks of treatment.

Upon analysis of the WHI data, BWH researchers found no increase or decrease in overall mortality or deaths from cardiovascular disease, cancer or other major illnesses among women age 50 to 79. In fact, among younger women (age 50 to 59), those who received hormone therapy had death rates about 30 percent lower than women of the same age who received placebo. Over 18 years of cumulative follow-up, however, differences by age group were no longer statistically significant.

“These findings provide support for clinical guidelines endorsing the use of hormone therapy for recently menopausal women to manage bothersome hot flashes and other menopausal symptoms. However, they do not support the pendulum swinging back to widespread use of hormone therapy for the prevention of cardiovascular disease or other chronic diseases of aging,” said JoAnn Manson, MD, DrPH, chief of the Division of Preventive Medicine and lead author of the study.

She added: “In clinical decision-making, considerations about risks must be weighed against benefits for the individual patient, taking into account the patient’s personal health profile and indications for treatment.”

Unpacking the Data

Researchers used data from the WHI trials to explore the effect of treatment over a five- to seven-year period, with 18 years of follow-up, among 27,000 women. The mortality rates they uncovered account for all causes of death among women, as well as their rates of death from specific illnesses.

“All-cause mortality provides a critically important summary measure for an intervention such as hormone therapy that has a complex matrix of benefits and risks,” Manson said. “Mortality rates are the ultimate ‘bottom line’ when assessing the net effect of a medication on serious and life-threatening health outcomes.”

The WHI hormone therapy trials addressed the benefits and risks of the most common formulations of hormone therapy used at the time the study began. BWH researchers noted that clinical practices have evolved since then – including the use of lower doses and novel administration methods – and that additional research on the long-term benefits and risks of these newer treatments is needed.

Leslie Farland

A study by BWH investigators finds that women who breastfed for longer periods of time had significantly lower risk of being diagnosed with endometriosis – a chronic and incurable gynecologic disorder. These findings offer new insights into a condition that, up until now, has had very few known, modifiable risk factors. The findings were published in The BMJ.

Affecting approximately 10 percent of women in the U.S., endometriosis symptoms can be debilitating and include chronic pelvic pain, painful periods and discomfort during intercourse.

“We found that women who breastfed for a greater duration were less likely to be diagnosed with endometriosis,” said Leslie Farland, ScD, a research scientist at the Center for Infertility and Reproductive Surgery. “Given the chronic nature of endometriosis and that very few modifiable risk factors are currently known, breastfeeding may be an important modifiable behavior to reduce the risk of endometriosis among women after pregnancy.”

The team used data from the Nurses’ Health Study II (NHSII), which began in 1989. In the current analysis, they followed thousands of women for more than 20 years. During that time, more than 3,000 women in the study were surgically diagnosed with endometriosis after their first pregnancy. The research team examined how long each woman breastfed, exclusively breastfed (breastfed without the introduction of solid food or formula) and how much time passed before their first postpartum period.

A Closer Look at the Findings

The team found that for every three additional months that mothers breastfed per pregnancy, women experienced an 8 percent drop in risk of endometriosis. This drop was even higher for mothers who exclusively breastfed: Risk of endometriosis dropped 14 percent for every three additional months of exclusive breastfeeding per pregnancy.

Researchers also looked at the effect of breastfeeding across reproductive lifetime – that is, breastfeeding more than one child. Women who breastfed exclusively for 18 months or more across their reproductive lifetime had a nearly 30 percent lower risk.

The authors note that although they find a robust association between breastfeeding and lower risk of endometriosis, they cannot disentangle whether women who breastfeed are less likely to develop the disorder itself or whether women who breastfeed are less likely to experience pain symptoms severe enough to lead to a surgical evaluation.

The study did not include women who had been diagnosed with endometriosis prior to their first pregnancy, but the researchers are interested in investigating whether breastfeeding could help ease the symptoms of endometriosis for women already diagnosed.

“Our findings lend support to the body of public health and policy literature that advocates for the promotion of breastfeeding,” said Farland. “Our work has important implications for advising women who are looking to lower their risk of endometriosis. We hope that future research will illuminate whether breastfeeding could help lessen the symptoms of endometriosis among women who have already been diagnosed.”

Khalid Shah

Brigham researchers have found an unlikely ally in the fight against brain cancer: viruses.

It can be challenging to treat more than one tumor in the body, and cancers that spread to the brain are especially difficult to treat. That’s because the same membrane preventing substances in the blood from entering the brain also prevents many therapies, such as chemotherapy, from breaching what’s known as the blood-brain barrier.

In a new study published in PNAS, researchers from BWH and the Harvard Stem Cell Institute identified a potential solution for how to kill cancer cells that have metastasized – that is, spread – to the brain. Their strategy? Delivering cancer-killing viruses that can selectively target, infect and replicate within cancer cells. The team tested this treatment using skin cancer cells in a preclinical model that closely mimics what is seen in advanced melanoma patients.

When injected on their own, these cancer-killing viruses are unable to locate cancerous brain tissue. To overcome this limitation, the research team packaged the “anti-tumor viruses” inside stem cells and delivered them via the carotid arteries (major blood vessels in the neck that supply blood to the brain, neck and face) in a preclinical tumor model.

The stem cells track tumor deposits and act as a cellular vehicle to deliver the viruses directly to tumor cells. The population of stem cells used in this study were derived from human bone-marrow and loaded with oncolytic herpes simplex virus (oHSV), which specifically kills dividing cancer cells while sparing normal cells.

Like hunting dogs following a scent, these stem cells loaded with oHSV sniffed out the tumor cells and began destroying them as intended. Researchers reported that this treatment led to significant decreases in the number of metastatic cancer cells and prolonged survival in these preclinical models.

Khalid Shah, MS, PhD, director for the Center for Stem Cell Therapeutics and Imaging in the Department of Neurosurgery, who led the study, says that metastatic brain tumors – often from lung, breast or skin cancers – are the most commonly observed tumors within the brain and account for 40 percent of advanced melanoma metastases.

“Current therapeutic options for such patients are limited, particularly when there are many metastases,” Shah said. “Our results are the first to provide insight into ways of targeting multiple brain metastatic deposits with stem-cell-loaded oncolytic viruses that specifically kill dividing tumor cells.”

Brian Bateman

Opioids, most commonly oxycodone, are the standard pain medications prescribed to women following cesarean delivery (C-section), but the number of pills prescribed often varies between providers and institutions. In a new study, BWH researchers found that patients are prescribed twice as many pills as they want or ultimately take.

By more precisely determining how much pain medication is required and finding ways to cut down on unnecessary prescribing, providers can help reduce the number of unused opioid pills in medicine cabinets at home, said Brian Bateman, MD, chief of Obstetric Anesthesia, researcher in the Division of Pharmacoepidemiology and Pharmacoeconomics and corresponding author of the two papers contained in the study.

“We know that leftover medications are fueling our current opioid epidemic,” Bateman said.

The findings, published in Obstetrics & Gynecology, outline how many pills are typically prescribed after a C-section and what happened when patients used a shared decision-making tool to select how much pain medication they would be prescribed.

After surveying 720 women from six U.S. academic medical centers, researchers found there was variation in how opioids were prescribed following a C-section; the median was 40 pills. They also discovered that this was in excess of what patients actually used.

Typically, women took about half the number of pills they were prescribed and had 15 pills leftover. Two weeks after discharge, 95 percent of patients had not disposed of their excess medication.

In addition, women who were prescribed a higher number of pills ended up taking more medication and were more likely to suffer from the side effects of opioids.

“This was especially interesting to us, because it suggests that we are setting patient expectations based on the number of pills that we prescribe,” Bateman said.

Engaging Patients in Opioid Prescribing

Another part of the study tested the use of a decision-making tool with 50 women who delivered babies by C-section at Massachusetts General Hospital. With help from a clinician, patients reviewed information on a tablet about their recovery, including anticipated patterns of pain in the first two weeks after C-section, as well as the risks and benefits of various pain medications. Then, women chose the number of pills they would be prescribed at discharge, with a potential maximum of 40 pills, which is the usual number prescribed at that institution.

Use of the tool was associated with a 50 percent decrease in the number of opioid pills prescribed at discharge. Additionally, researchers found that the refill rate was low, regardless of the number of pills that were prescribed, and the vast majority of women were satisfied with their pain control.

“With cesarean delivery, we have the opportunity to tailor pain medication prescriptions to an individual’s needs and preferences, while also limiting the number of unused pain medications that have the potential to be misused. If we can scale this concept to be widely adopted, then we can make significant improvements in both patient care and public health,” Bateman said.

Anecdotal evidence of food allergies is everywhere, but exactly how common are these allergies and intolerances? In a new study, investigators from BWH analyzed data from medical records of more than 2.7 million patients across Partners HealthCare, identifying more than 97,000 with at least one documented food allergy or intolerance. Their findings were recently published in the Journal of Allergy and Clinical Immunology.

“Recent reports suggest that food allergies are on the rise, with more food-allergy related hospitalizations in the U.S. over the last decade. However, many studies have been based on telephone surveys or have focused on a specific food allergen or allergen group,” said Li Zhou, MD, PhD, of the Division of General Medicine Primary Care. “We recognized that the electronic health record system could offer a treasure trove of information about allergies to better understand which populations may be most affected and just how common food allergies and intolerances are in the U.S.”

The team looked at a variety of food allergens, finding that almost 13,000 patients (3.6 percent) had a reported allergy or intolerance to peanuts. Within that group, more than 7,000 (56.5 percent) had experienced hives, anaphylaxis or other reactions.

From left: Jonathan Hoggatt, Anna Greka, Marc Sabatine, Robert C. Green, Florence Lai and Eve Valera

The challenge was simple: How well could five researchers from the Brigham and Massachusetts General Hospital (MGH) communicate their work to the general public in just four minutes? On April 20, members of the local community gathered at the Cambridge Public Library for a friendly competition, known as the Research Rumble, to find out.

Hosted by the Brigham Research Institute and Mass General Research Institute as part of the annual Cambridge Science Festival, the event brought together researchers with different areas of expertise to pitch their science to the audience and a panel of judges.

MGH scientist Jonathan Hoggatt, PhD, of the Mass General Cancer Center/Center for Transplantation Sciences, was crowned the Research Rumble’s inaugural winner, but BWHers who competed in the event earned praise from the judges for their use of audience interaction and understandable language.

Competing on behalf of BWH was Anna Greka, MD, PhD, a physician-scientist in the Renal Division in the Department of Medicine, who shared her strategy for unearthing new therapies for kidney diseases. One in three Americans is at risk for a kidney disease. One in nine has been diagnosed with a kidney disease, yet there have been no new therapies for any kidney disease in more than 30 years. Greka asked how this can be.

The lack of therapeutic discoveries for kidney diseases may be impeded by the scientific community’s desire to find a universal cure for kidney disease as if it were a single entity, she explained. Greka proposed an alternative approach: a concept she calls “one-to-more-to-all,” which she defined as a focus on patients with rare, molecularly defined kidney diseases and developing targeted therapies for them first.

Greka also shared the story of a patient who developed nephrotic syndrome, a rare kidney disease, and eventually became the first in the world to receive a targeted treatment as a result of Greka’s work.

“The patient’s before-treatment and after-treatment pictures were worth more than a 1,000 words,” Greka said. “In the context of ‘one-to-more-to-all,’ this patient was the ‘one.’”

Other patients in Greka’s ongoing clinical trial for this targeted therapy represent the “more.” Once positive outcomes are achieved over and over again, the findings can be used to develop the combination of molecularly targeted therapies that can cure “all.”

Fellow BWH Research Rumble competitor Robert C. Green, MD, MPH, a medical geneticist and physician-scientist in the Division of Genetics, opened his four-minute presentation on the BabySeq Project by talking about technology.

Holding up his smartphone, Green asked the audience, “How many of you remember a time before cell phones?” Most raised their hands. “Now, how many can imagine a life without them?” This time, most of the audience shook their heads.

“We’re approaching an explosive revolution in life sciences – greater than technology or these cell phones,” said Green, who is co-leading the BabySeq Project, an innovative project exploring translational genomics and health outcomes in newborns at BWH and Boston Children’s Hospital.

The project has two aims: One is to evaluate the risks and benefits of genome sequencing in healthy and sick infants, with the goal of developing evidence to support guidelines for use of this technology in newborn screening or care. The second objective is to study parents’ thoughts and feelings about genetic testing, as well as how those might change over time.

While Green did not ultimately sway the judges for the evening’s top honor, he captured the popular vote of the night. An app measured the audience’s applause level for each storyteller; Green scored the highest.

Robert Green, of the Division of Genetics, displays a sign at the March for Science rally.

BWH leadership, clinicians, researchers, graduate students and other supporters gathered on the Harvard Medical School Quad before participating in the March for Science Boston on April 22, one of more than 600 events held worldwide that day to celebrate scientific discovery and education.

Before marching together to Boston Common, Thomas Michel, MD, PhD, of the Division of Cardiovascular Medicine, welcomed the crowd and led them in singing an anthem titled “Stand Up for Science,” performed to the tune of “This Land is Your Land.” Michel, who wrote the song’s lyrics, provided an accompaniment on the accordion.

“How wonderful to hear voices joined in solidarity for science,” said Michel. “This is a march for science, not a march by scientists. It doesn’t matter whether you are a surgeon or a soprano, a chemist or a carpenter, a student or a senior citizen. We march together.”

Michel introduced a lineup of speakers that included patients, clinicians, researchers and the dean of Harvard Medical School, George Q. Daley, MD, PhD. Among the speakers was Katherine Helming Walsh, PhD, who has been both a researcher and a patient.

“I went from being a researcher in one of the laboratories to being a very sick patient in one of the hospital rooms,” said Helming Walsh. “I would not be here today if it were not for the persistence, the creativity and the courage of the many scientists who came before us.”

Fidencio Saldana, MD, of the Division of Cardiovascular Medicine, greeted the crowd with remarks in both English and Spanish.

“Science is for all of us. Science affects all of us. La ciencia es para todos. La ciencia afecta a todos,” Saldana said. “I stand before you as the child of immigrant parents who came to this country from Mexico with little more than a fourth-grade education, in search of a better life. Science has allowed me to give back to people like my parents, as a cardiologist to both Spanish- and English-speaking patients in Boston.”

Julie Losman, MD, PhD, a hematologist at BWH and Dana-Farber Cancer Institute, and Elizabeth Henske, MD, director of BWH’s Center for LAM Research and Clinical Care and director of the Brigham Research Institute, both shared examples illustrating that it is impossible to predict what research will lead to medical breakthroughs.

“Improving human health requires a broad vision that’s shared by Harvard Medical School, the Harvard hospitals and the NIH,” said Henske, who studies a rare lung disease known as LAM. “For LAM, we needed scientists studying fruit fly eyes and soil samples. Who knows what’s needed for the next breakthrough in asthma, diabetes or leukemia?”

Following the rally, the crowd joined thousands at Boston Common to hear remarks from students, physicians, researchers and others. Among the speakers on the Common was Altaf Saadi, MD, of the Department of Neurology, who spoke about being both a physician and an American Muslim woman. Saadi reminded the crowd that issues of sexism, racism and anti-Muslim discrimination are real.

“As scientists, we must fight these problems from within and take these issues just as seriously as we do federal budget cuts and other policies that threaten scientific research,” said Saadi. “Standing up for science means standing up for all scientists.”

Xiang (Vicky) Bai speaks with Jeffrey Golden, chair of the Department of Pathology, about her research during the poster session.

On April 7, the Department of Pathology hosted its 11th annual research celebration, which recognizes trainees and junior faculty for their basic, clinical and translational research.

Dozens of people gathered in the Building for Transformative Medicine to view the more than 30 research posters on display. The event continued with presentations by junior faculty and a reception and awards ceremony. Kelly Lohr, PhD, Inga-Marie Schaefer, MD, and Vignesh Shanmugam, MD, received Posters of Distinction Awards for their work.

From left: Shannon Coy, Michael Wu, Jeffrey Golden, Thomas Gill III, Sandro Santagata and Simon Simonian

Distinguished guests Thomas J. Gill III, MD, and Simon J. Simonian, MD, ScD, were in attendance to present the Thomas J. Gill III, MD, and Simon J. Simonian, MD, ScD, Prize for Research Excellence, which was awarded to resident Shannon Coy, MD, and his mentor Sandro Santagata, MD, PhD.

In addition, Michael Pei-hong Wu, a student in the Harvard-MIT Division of Health Sciences and Technology, who worked with Coy and Santagata, was also recognized.

Marc Sabatine

A new class of medications has been shown to dramatically reduce LDL cholesterol levels when added to a statin therapy. Recent studies led by BWH investigators explore whether these drugs also reduce the risk of cardiovascular events, such as heart attacks and strokes.

Statins are already recommended for most patients who are trying to lower their levels of LDL cholesterol – informally known as “bad” cholesterol – but not all patients on statin therapy have achieved adequate control of their LDL levels.

Recent studies led by Marc Sabatine, MD, MPH, chairman of the TIMI Study Group, and Paul Ridker, MD, director of the Center for Cardiovascular Disease Prevention, offer insights from two large clinical trials that tested the effectiveness of using statins in concert with cholesterol-lowering drugs known as PCSK9 inhibitors.

The FOURIER trial (Further Cardiovascular OUtcomes Research with PCSK9 Inhibition in subjects with Elevated Risk), led by Sabatine, was designed to determine whether a PCSK9 inhibitor called evolocumab would reduce adverse cardiovascular events when added to statin therapy.

Patients in the FOURIER trial who received evolocumab had a 20 percent reduction in the risk of major cardiovascular events. This protection improved over time and was seen even in patients whose level of LDL cholesterol started in the low 70s. Researchers found evolocumab was safe and well-tolerated.

“These data show that lowering LDL cholesterol beyond current treatment targets confers significant benefits for our patients with cardiovascular disease who are at a high risk of cardiovascular events,” said Sabatine. “Given these findings, patients with cardiovascular disease should review their LDL cholesterol with their physicians and discuss whether it should be lowered beyond what they have achieved with diet, lifestyle modifications and statin therapy.”

Paul Ridker

The SPIRE (Studies of PCSK9 Inhibition and the Reduction of Vascular Events) clinical trials program, led by Ridker, sought to determine the effect of a different PCSK9 inhibitor, known as bococizumab, on LDL cholesterol among high-risk patients taking statins.

Bococizumab had short-term benefits on lowering cholesterol levels, and it significantly reduced the risk of cardiovascular events by 21 percent among patients whose baseline LDL cholesterol level was greater than 100 mg/dL. However, the drug did not reduce such rates among those patients with LDL levels below that threshold.

The SPIRE trial was ended last fall after initial results indicated that some participants developed an immunologic response to bococizumab. Among those patients who developed this response, 15 percent also saw a reduction in the effectiveness of the drug.

“Our findings are limited by the shortened follow-up time, which in most cases was less than one year. Despite that, our data are quite encouraging for this class of drugs, particularly because those who were treated for the longest and achieved the largest cholesterol reductions were the very patients who benefitted the most,” said Ridker.

Neil Bhattacharyya

Loud noise exposure is a common environmental hazard in the U.S. that can lead to hearing loss and other conditions, such as cardiovascular disease and diabetes.

In a study published last month in The Laryngoscope, BWH researchers found that substantial noise exposures commonly occur in occupational and recreational settings, and only a small percentage of those exposed are consistently wearing recommended hearing protection.

Using data from the 2014 National Health Interview Series hearing survey, researchers reported that almost 22 percent of those surveyed were exposed to very loud sounds at work for at least four hours a day, several days a week, and 38 percent of people who were exposed never used hearing protection.

Additionally, the team found only 58 percent of the 34.7 million people who shot firearms in the last year used hearing protection consistently, while 20 percent of those who shot more than 10,000 rounds of ammunition in the last year never used protection.

“This degree of noise exposure has the potential to cause long-term hearing consequences with our aging population,” said Neil Bhattacharyya, MD, senior author and associate chief of the Division of Otolaryngology.

The researchers noted that employers and health care providers need to increase their efforts to identify dangerous noise exposures both at home and work and that noise related to firearms use deserves further attention.

Research team members, from left: Manoj Kumar Kanakasabapathy, Charles Bormann, Hadi Shafiee, John Petrozza and Prudhvi Thirumalaraju

Walk down the family planning aisle in any drugstore and one observation becomes immediately clear: Most at-home fertility tests on the shelf are catered to women.

Hadi Shafiee, PhD, of the Division of Engineering in Medicine and Renal Division of Medicine, set out to change that.

More than 45 million couples worldwide grapple with infertility, but current standard methods for diagnosing male infertility can be expensive, labor-intensive and require testing in a clinical setting. Men contribute to infertility in more than 40 percent of cases, but across many cultures, women are often presumed to bear sole responsibility when a couple struggles to conceive. In addition, social and cultural stigma, and lack of access in resource-limited countries, may prevent men from being tested.

Joined by researchers from BWH and MGH, Shafiee developed a diagnostic test to measure semen quality that men could conduct in the privacy of the own home, using a smartphone-based device. Their latest findings indicate that the analyzer can identify abnormal semen samples – measuring sperm concentration and motility – with approximately 98 percent accuracy. The results were published online this month in Science Translational Medicine.

“We wanted to come up with a solution to make male infertility testing as simple and affordable as home pregnancy tests,” Shafiee said. “Men have to provide semen samples in these rooms at a hospital, a situation in which they often experience stress, embarrassment, pessimism and disappointment. Current clinical tests are lab-based, time-consuming and subjective. This test is low-cost, quantitative, highly accurate and can analyze a video of an undiluted, unwashed semen sample in less than five seconds.”

The analyzer consists of an attachment, similar to a phone case, that connects to a smartphone and turns it into a small microscope. A semen sample is placed on a disposable kit that is inserted into an opening in the attachment for analysis. The team also designed an app to guide users through each step and a miniaturized weight scale that wirelessly connects to the smartphone to measure total sperm count and total motile sperm.

The analyzer is currently in a prototyping stage. The team plans to perform more tests and file for FDA approval.

In addition to the hard work of his lab team, Shafiee credits the Brigham Innovation Hub for helping turn an idea into device by connecting him with experts and providing pilot funding.

Shafiee’s team, which focuses on developing new technologies using microfluidics – the science of using fluids in microliter-sized amounts – sees many applications for the technology. One other possible use for the device could be for men who have had a vasectomy and want to verify the procedure was successful. Usually, men must visit a urologist for several months after the surgery; the new test may allow them to be monitored at home.

“My job is to try to understand some of the problems patients and physicians face in the clinic and to help develop new solutions. We are always thinking about what’s next and how to develop something new,” said Shafiee.

Researchers at the Brigham have developed a user-friendly counseling tool that estimates the number of eggs a woman should freeze based on her age and the number of children she wants to have in the future.

It is the first model to consider maternal age by individual year, versus age range, and to include how likely an embryo created with those eggs will have the correct number of chromosomes.

Janis Fox

“We wanted to create a tool that is evidence-based in order to provide the best possible guidance for our patients, who are making big decisions about their lives, their families and their finances,” said Janis Fox, MD, attending reproductive endocrinologist in the Center for Infertility and Reproductive Surgery and senior author of the paper describing this new model, which was published in Human Reproduction this month.

The American Society for Reproductive Medicine lifted the experimental status for egg freezing in October 2012. Since then, the popularity of the procedure has increased.

Developing Data-Driven Guidance

Although primarily intended for women whose fertility may be in jeopardy due to treatment for cancer or other illnesses, egg freezing has become an attractive option for women who are electively delaying childbearing. But, because this option is relatively new, and the majority of women who have frozen their eggs have not yet returned to use them, the likelihood of a frozen egg resulting in a healthy baby is largely unknown.

The procedure is also expensive. The majority of women who elect to have their eggs frozen face out-of-pocket costs of up to $6,000, excluding the cost of medications. That typically covers one egg-freezing cycle that, depending on individual circumstances, results in a variable number of eggs suitable for freezing.

Randi Goldman

It’s also not known how many frozen eggs are necessary to have a child in the future and what happens when a woman wants to have more than one child. These questions often leave a woman unsure of whether she should repeat a cycle in order to store more eggs and potentially increase her future chances of having a baby.

To address these issues, Fox and her colleagues looked at data from 520 healthy, fertile women undergoing in vitro fertilization. Researchers studied survival rates of thawed eggs, the percent of fertilized eggs that developed into healthy embryos and the number of healthy embryos needed to result in a live birth.

Their model found that a 35-year-old woman who freezes 10 eggs following her first cycle had a 69 percent chance of one live birth. If she undergoes a second cycle and now has 20 frozen eggs, the chances jump to 90 percent for one live birth. With 30 eggs, the likelihood of success rises to 97 percent.

Catherine Racowsky

“Rather than explicitly telling women how many eggs they should freeze or how many cycles they should undergo, we believe that our model will help women make informed choices based on the data that is available and on their family-building goals,” said Randi Goldman, MD, a Reproductive Endocrinology fellow in the Center for Infertility and Reproductive Surgery and first author of the paper. Catherine Racowsky, PhD, HCLP, director of BWH’s IVF Laboratory, also contributed to the study.

Researchers are developing a digital version of the tool that they hope to make available in the near future. They caution that the assumptions used to create the model, while data-driven, were based on outcomes from BWH and may vary by fertility center.

Lauren Tanz

Investigators at the Brigham have found that women who deliver a baby prematurely are at a significantly increased risk of developing cardiovascular disease later in life.

The study, published in Circulation on Feb. 2, in the American Heart Association’s “Go Red for Women” issue, found that women who delivered before 37 weeks were 40 percent more likely to develop cardiovascular disease, and their risk doubled if they delivered before 32 weeks.

Researchers also found that risks were higher among women who delivered more than one preterm infant. This was true after adjusting for age, race, parental education, pre-pregnancy lifestyle and cardiovascular disease risk factors.

Janet Rich-Edwards

“Delivering a preterm infant may be an early warning signal of high risk for cardiovascular disease,” said Lauren Tanz, MSPH, a programmer and data analyst in the Department of Medicine and the study’s first author. “Since cardiovascular risk develops over a lifetime, it’s not too early for these women to adopt a heart-healthy lifestyle.”

Researchers reviewed data on more than 70,000 women in the Nurses’ Health Study 2, examining the association between premature delivery and cardiovascular disease. The Nurses’ Health Studies are among the largest prospective investigations into the risk factors for major chronic diseases in women, following the health of female nurses around the country, including some at the Brigham.

“On average, 31 percent of female mortality in the U.S. is due to cardiovascular disease,” Tanz said. “If the risk that we saw among the relatively young nurses persists with age, we expect that 36 percent of women who give birth three to seven weeks early and 60 percent of women who deliver eight or more weeks before term will die from cardiovascular disease.”

Researchers are hopeful that this finding will help identify women who should be especially concerned about developing cardiovascular disease down the road.

“Very little of the risk associated with preterm delivery was explained by traditional cardiovascular risk factors like weight and hypertension,” said Janet Rich-Edwards, ScD, director of Developmental Epidemiology in the Connors Center for Women’s Health and Gender Biology and senior author of the research study. “We need more research to understand why women who deliver preterm are at higher risk and what we can do to help them lower it.”

A study led by BWH researchers in partnership with colleagues at Boston Children’s Hospital to explore the use of genome sequencing in newborns may give parents greater insight into their infants’ health.

Genome sequencing maps out the order in which the building blocks of our genes – known as nucleotides – appear in an individual’s DNA. The BWH/BCH study, known as the BabySeq Project, has two objectives. One is to evaluate the risks and benefits of genome sequencing in healthy and sick babies, with the goal of developing evidence to support guidelines for use of this technology in newborn screening or care. The second objective is to study parents’ thoughts and feelings about genetic testing, as well as how those might change over time.

The study, co-led by Robert Green, MD, MPH, of the Division of Genetics, is the first randomized controlled trial of genome sequencing in both healthy and sick newborns. The BWH/BCH project is part of a consortium of four institutions conducting related research as part of a federally funded initiative called Newborn Sequencing In Genomic medicine and public HealTh (NSIGHT). Scientists from the NSIGHT institutions published a paper in the journal Pediatrics last week laying out the consortium’s objectives.

Newborn screening is mandatory in most states, unless parents refuse for religious purposes or other reasons. Screening is performed for about 30 conditions where measures are available to save the baby’s life or mitigate the harms of the condition, if found early enough.

“Genomic sequencing has the potential to allow for significantly more extensive screening of disorders that newborns could be at risk for developing during childhood,” Green said. “Earlier diagnosis of these conditions could in turn lead to specific screening, surveillance and treatment options, allowing for more personalized and preventative health care.”

In the BabySeq Project, researchers hope to enroll 240 healthy babies from BWH’s Well Baby Nursery and 240 sick infants from the NICUs at the Brigham and Boston Children’s Hospital by August 2018. All families enrolled in the study receive state-mandated conventional newborn screening and a family history report, while babies in the sequencing arm also receive a genomic sequencing report. The latter report contains information about mutations that are associated with childhood-onset diseases. Researchers also sometimes identify genetic changes that could affect how a baby responds to certain medications.

Babies in the sequencing arm who have or develop health conditions that may have an underlying genetic cause may also receive another analysis, with a specific focus on genes associated with the health condition. BabySeq Project researchers have already identified genetic mutations associated with increased risk of specific diseases in about 10 percent of sequenced infants.

One surprising early finding has been the low rate of enrollment to date, said Shawn Fayer, a genetic counselor and project manager working on the study. Before the study launched, researchers surveyed parents to gauge their interest in participating in the trial. A vast majority – 83 percent – were at least somewhat, very or extremely interested in newborn genetic testing. However, only 8 percent of families approached so far have enrolled. Most decline due to logistical reasons, with about one in five families saying they are simply overwhelmed after having a baby. Other reasons for declining include concerns about insurance discrimination or privacy. Of those families who agree to meet with a genetic counselor, 70 percent enroll in the study, Fayer said.

Early-stage funding from the Brigham Research Institute (BRI) has enabled 21 projects to flourish, according to recent feedback from award recipients.

For the past five years, the BRI and the BWH Health & Technology Subcommittee, which comprises BWH donors, have supported basic, clinical and translational research that is too early in its development to receive other types of funding.

Formerly called Research Day seed grants, the BRI’s Health & Technology Innovation Awards are $50,000 grants that have funded projects exploring everything from new therapies for heart failure and chronic kidney disease to a rapid breath test for community-acquired pneumonia.

“We recently circled back to the 21 awardees to check on their progress, and the results are remarkable,” said Jacqueline Slavik, PhD, BRI executive director. “The BRI has awarded $1 million over the grant program’s five-year history. Awardees report collectively receiving an additional $82.4 million in total funding for research based on the seed grants.”

Additionally, nearly 60 percent of awardees established research collaborations, resulting in 19 new partnerships, and 47 percent of awardees hired new personnel, resulting in 21 jobs.

“A BWH seed grant was vital in propelling forward our work using stem cells to investigate mechanisms of Alzheimer’s disease,” said Tracy Young-Pearse, PhD, of the Department of Neurology. “This seed funding allowed us to acquire data that was essential for getting additional funding from the NIH.”

Letters of intent for the next round of applications are due Tuesday, Jan. 17. To learn more or apply, click here.

Earth and space may be vastly different settings, but they share a common need: clinically trained staff who can skillfully respond to medical emergencies. A multidisciplinary team of BWHers is working outside of their usual orbit and developing a tool that can help astronaut crews respond to medical events in deep space.

The project has its roots in a program that Steven Yule, PhD, director of Education and Research at BWH’s Neil and Elise Wallace STRATUS Center for Medical Simulation, developed with his colleagues a decade ago while he was at the University of Aberdeen in Scotland. The Non-Technical Skills for Surgeons (NOTSS) behavior rating tool was created to assess and improve surgeons’ nontechnical skills, such as situation awareness, decision-making, communication, teamwork and leadership.

Yule and an interdisciplinary team of researchers from the STRATUS Center and BWH’s Center for Surgery and Public Health, as well as experts from other institutions, are now developing and assessing a nontechnical skills training program for astronauts on human-exploration missions to Mars, near-Earth asteroids or the moon.

“The only thing the simulated bay will not have that the real medical bay does have is zero gravity.”
-Steven Yule

The team – which recently received a $400,000 grant from NASA’s National Space Biomedical Research Institute to fund the project – consists of experts in training and simulation, human factors, emergency medicine and surgery.

The first part of the project involves identifying and assessing which skills are essential for astronaut crews for responding to in-flight medical emergencies effectively, with the goals of enhancing proficiency, reducing errors and improving patient outcomes.

“These are skills like leadership, communication, teamwork and situational awareness – the kind of skills that are really important for team function and dynamic in high-risk situations, but aren’t formally taught to medical teams, nor are they being assessed,” said Yule, the project’s principal investigator.

The second part of the project is to create a simulated spacecraft medical bay in the STRATUS Center and run a series of filmed simulation scenarios to fine-tune the assessment tool and gauge its accuracy in measuring improvement.

“We want to recreate what the medical situation is really like in that environment so we can start to run training courses and evaluate competence of performance in simulation,” explained Yule. “The only thing the simulated bay will not have that the real medical bay does have is zero gravity. It will be using a lot of the same equipment, sensors and technology.”

Clemens Scherzer

BWH researchers have found that a genetic mutation known to be a risk factor for Parkinson’s disease is also closely linked to memory loss in people with Parkinson’s.

This knowledge may lead to more precise clinical trials that “match the right therapies with the right patients,” said Clemens Scherzer, MD, of the Department of Neurology, who led the study and heads up the Neurogenomics Lab and Parkinson Personalized Medicine Initiative of BWH and Harvard Medical School.

“I believe this is the dawn of personalized medicine for Parkinson’s disease,” said Scherzer.

Although the hallmark symptoms of Parkinson’s disease – such as involuntary shaking, slow movement and muscle rigidity – are related to movement, recent evidence has suggested that memory impairment plays an exceptional role in diminished quality of life and the burden placed on caregivers.

More than 15 previous clinical trials for medications designed to slow or halt Parkinson’s have been inconclusive or failed, perhaps in part, Scherzer notes, due to cumbersome and inefficient trial designs. Scherzer and his colleagues hope that their findings will lead to better trial design and increased interest from pharmaceutical companies to tackle Parkinson’s.

The study was led by researchers in BWH’s Ann Romney Center for Neurological Diseases and published in the November edition of Annals of Neurology. It identified that mutations in the gene for the enzyme glucocerebrosidase (GBA) are present in 10 percent of patients with Parkinson’s and have a powerful influence on the development of cognitive decline.

Two copies of the GBA gene with severe defects are known to cause Gaucher disease, a disorder that causes neurologic complications and typically emerges in childhood.

Scherzer and colleagues from an international consortium followed 2,304 patients with Parkinson’s for nearly 13 years. The study is one of the largest longitudinal assessments of patients with Parkinson’s.

Patients carrying one copy of the GBA gene with a severe gene defect were more likely to develop memory troubles. About half of these patients developed cognitive impairment within 10 years of diagnosis, compared to 20 percent of patients without the mutation.

General Electric CEO Jeffrey Immelt discusses the health care industry with Betsy Nabel at a luncheon kicking off Discover Brigham.

The Brigham Research Institute brought together industry leaders, BWH and Partners HealthCare leadership and faculty to kick off this year’s Discover Brigham at a luncheon held on Nov. 9.

The theme for Discover Brigham, “Collaborate, Accelerate, Translate,” and the luncheon’s setting in the new Building for Transformative Medicine (BTM) served as the backdrop for the event, which featured remarks from BWHC President Betsy Nabel, MD; Vertex Pharmaceuticals Chairman, President and CEO Jeff Leiden, MD, PhD; and General Electric Co. Chairman and CEO Jeff Immelt.

Opening the discussion, Nabel shared her vision for the BTM.

“It is our hope that this building will foster collaboration and creativity, and that the discoveries and innovations developed here will bring hope to our patients,” she said. “We are honored to have the best and brightest people train with us, and we take our role in training the next generation of physician-scientists seriously.”

Leiden, who completed his medical and research training at BWH, described the hospital as his “intellectual home,” tracing the route to many of his seminal discoveries – including the development of the first-ever monoclonal antibodies to treat immune diseases – back to pivotal moments in his time at the Brigham.

“BWH is where I learned to be both a physician and a scientist, and how to bring those two career paths together,” said Leiden, who chairs the BWH Scientific Advisory Board. “This building will be an important part of that training for the next generation.”

During the discussion, Immelt spoke highly of past collaborations with the late Ferenc Jolesz, MD, who had been a driving force behind the Advanced Multimodality Image-Guided Operating (AMIGO) suite at BWH. He also shared his perspective on industry-academic interactions and why GE recently chose Boston for its new headquarters. GE plans to employ 800 people at the new site, with the vast majority focused on research areas, including data analysis and the life sciences.

“We wanted to be in a sea of ideas,” said Immelt. “We’re an engineering company that respects technology and aspires to be at the interface of small companies, large research organizations, universities and startups.”

From left: Nurse-scientist Sasha DuBois discusses her research at Discover Brigham as Eileen O’Connell, nursing director, listens.

More than half a million dollars in research awards were presented at the second annual Discover Brigham, where winners of the BRIght Futures Prize and BRI Director’s $500K Transformative Award were revealed.

The Nov. 10 event, sponsored by the Brigham Research Institute (BRI), brought together clinicians, researchers and members of the public for a full day of panel discussions and presentations. The theme of Discover Brigham 2016 was “Collaborate, Accelerate, Translate,” reflecting the goals for the new Building for Transformative Medicine (BTM).

This year marked the debut of three simultaneous session tracks, covering a wide range of topics, including the opioid crisis, regenerative medicine, digital health and more.

“There was great energy at Discover Brigham this year. The scientific sessions were well-attended and really highlighted the breadth of the research,” said Jacqueline Slavik, PhD, executive director of the BRI. “This was the first year we featured only electronic posters, which looked fantastic and really allowed our junior investigators to present their work in a very engaging and interactive way.”

From left: David Levine, BRI Director Lisa Henske and Oliver Jonas

David Levine, MD, MA, a physician and researcher in the Division of General Internal Medicine and Primary Care, received the $100,000 BRIght Futures Prize to fund his project, “The Home Hospital.” The winner was determined by the public, with people from around the world casting their vote to fund one of three projects.

Patients selected for Levine’s randomized, controlled trial who come to the Brigham’s Emergency Department may receive care at home instead of being admitted to the hospital. Technology plays a key role in keeping the care team tuned into the patient’s status, including the use of a device that enables physicians and nurses to check vital signs via a skin patch. Patients use video conferencing to communicate with their providers and receive in-person visits at home from their physician and nurses.

The project is wrapping up a small pilot, with preliminary data showing that home hospital care lowers costs, improves patient experience and maintains quality and safety, Levine said. The BRIght Futures Prize will enable Levine to expand the pilot and study its outcomes.

“I am proud to be at an institution that supports innovation and outside-the-box thinking,” said Levine.

Going forward, Levine plans to incorporate community health workers, community paramedics and new technology into the program.

“It is our hope that, in the near future, home hospital care will be the standard not only at Brigham, but also nationwide,” Levine said.

Oliver Jonas, PhD, MA, a laboratory director in the Department of Radiology, received the BRI Director’s $500K Transformative Award – a two-year grant, the winner of which is selected by a scientific advisory board. Jonas’ proposal, “Lab in a Patient: Microdevices for Next-Generation Precision Medicine,” was selected from 21 submissions for its novel approach to improving cancer treatments.

After a panel about regenerative medicine, attendees check out a salamander, which can regrow lost limbs, from Jessica Whited’s lab.

Jonas’ project centers on tiny devices, smaller than a grain of rice, that are implanted in a tumor. The devices can carry small doses of multiple anti-cancer therapies, directly depositing medication into different regions of the tumor to improve their effectiveness.

“The tissue is analyzed to measure the effect of each therapy on the tumor,” Jonas explained. “We hope that this can help us identify the optimal therapy for patients on a personalized basis.”

Jonas’ multidisciplinary research team, which includes staff from Radiology, Surgery and Surgical Oncology, is focusing on ovarian, lung and prostate cancers. Ultimately, he hopes the device can be used for many other types of cancer. The award will fund efforts to advance the technology and conduct clinical studies.

“There are clear synergies across the various clinical applications, and I feel very fortunate to bring all these amazing researchers and physicians together as one team,” Jonas said.

The BRI also awarded eight Research Excellence Awards, with a $1,000 prize going to each winner – selected from the pool of 80 poster presenters featured at Discover Brigham.

Jill Goldstein, PhD

Many women experience changes in memory as they get older, and according to a study conducted by BWH researchers, these changes are impacted by their menopausal status and not simply chronological age.

The study’s investigators found that women participating in the study who had lower levels of the sex hormone, estradiol – known to decline during the menopausal transition – performed more poorly on a verbal memory task than those who had higher levels regardless of age. Participants with lower estradiol levels also showed more changes in the brain circuitry that controls memory.

“Our findings underscore the incredible variability of the brain as we age and the critical importance and complexity of the impact of sex on aging, including the unique role of sex steroid hormones in memory function,” said senior author Jill Goldstein, PhD, director of Research at the Connors Center for Women’s Health and Gender Biology at BWH. “Maintaining intact memory function with age is one of the greatest public health challenges of our time, and applying a sex-dependent lens to the study of memory circuitry aging will help identify early antecedents of future memory decline and risk for Alzheimer’s disease.”

During the study, 200 male and female participants performed short- and long- term verbal memory tasks while lying in an MRI scanner to observe brain activity in memory circuitry regions. In addition, they collected blood to evaluate participants’ steroid hormone levels and women’s menopausal status, markers of immune function and genes.

“We set out to study cognitive aging from a women’s health perspective,” said lead author Emily Jacobs, PhD, formerly of the Division of Women’s Health and the Department of Psychiatry at BWH, and now of the University of California, Santa Barbara. “One of the most profound hormonal changes in a woman’s life is the transition to menopause. By shifting our focus to this early midlife period, we detected changes in memory circuitry that are evident decades before the age range traditionally targeted by cognitive neuroscience studies on aging.”

Betsy Nabel

Then a mid-career physician-scientist in the catheterization lab at the University of Michigan—and the only woman on the team—BWHC President Betsy Nabel, MD, was well-aware some of her colleagues felt women did not belong in science and medicine.

Even so, she was still astounded when a male faculty member at the university confronted her one day to insist he take her place as principal investigator (PI) in a high-profile study she was leading.

“He came into my office, shut the door and said, ‘Betsy, you’re no longer the PI for the trial. I’m going to be the PI,’” said Nabel, telling the story during a keynote at the Women in Medicine and Science Symposium in Bornstein Amphitheater on Sept. 26. “He was trying to intimidate and bully me, thinking that I would concede.”

His attempt to undermine her backfired. Nabel pushed back, alerting her department chair—with whom she had worked to develop a professional rapport—about the colleague’s inappropriate behavior. Within a year, the faculty member left the university. 

“I wasn’t going to give in. I learned a long time ago that you’ve got to stand up for yourself,” Nabel said. The story reflected more than the sexism women in medicine and science faced as recently as 20 years ago; it also illustrated the importance of building and maintaining professional networks, something Nabel noted is especially vital for women in the field.

The keynote, “Reflections on a Life in Biomedicine: Making Change,” kicked off an afternoon of presentations in Bornstein by BWH physicians and scientists, followed by a poster session and reception in the 15 Francis St. rotunda. Celebrating its fifth year, the symposium was co-sponsored by the BWH Center for Faculty Development and Diversity (CFDD), the Brigham Research Institute, the Center for Clinical Investigation and the Connors Center for Women’s Health and Gender Biology.

“This event really aims to promote the accomplishments of women in many different domains of medicine and science,” said Kathryn Rexrode, MD, MPH, director of the Office for Women’s Careers in CFDD.

Elena Aikawa, MD, PhD, the event founder and co-chair, also noted the symposium provides an opportunity for clinicians and researchers from various disciplines—whose paths may not ordinarily cross—to learn about their colleagues’ work.

“It fosters cross-departmental collaborations and allows scientists and physicians to share their innovative discoveries with the entire Brigham community,” Aikawa said.

The featured presenters were Marta Fay, PhD, of Rheumatology, Immunology and Allergy; Nadine Palermo, DO, of Endocrinology, Diabetes and Hypertension; Maria Carmela Speranza, PhD, of Neurosurgery; and Viviany Taqueti, MD, MPH, of Cardiovascular Medicine.

Featured poster presenters were Agnieszka Bronisz, PhD, of Neurosurgery; Mandovi Chatterjee, PhD, of Genetics; Helen Christou, MD, of Pediatric Newborn Medicine; Kathryn Hall, PhD, MPH, of Preventive Medicine; Nina Paynter, PhD, of Preventive Medicine; and Jing Yan, PhD, of Rheumatology, Immunology and Allergy.

Jeremy Wolfe, PhD

In a new study, scientists at BWH, the University of York and Leeds in the UK and MD Andersen Cancer Center in Texas found that radiologists with an average of about 20 years’ experience could identify abnormal mammograms about 75 percent of the time after just a half-second glimpse.

The aim of the study was two-fold: confirm the radiologists really could distinguish between normal and abnormal patients at above-chance levels after such a brief look at the images, and to try to discover the signs in the mammograms that alerted the radiologists that an abnormality was present.

“Radiologists tell us that they frequently have ‘hunches’ after a first glance at a mammogram. We found that these hunches are based on something real in the images. It’s really striking that, in the blink of an eye, an expert can pick up on something about that mammogram that indicates abnormality,” said Jeremy Wolfe, PhD, senior author of the study and director of the BWH Visual Attention Laboratory. “We were particularly interested to discover that they can also detect something abnormal in the other breast, the breast that does not contain a lesion.”

Of course, no one would suggest that radiologists should take just a half second to read a mammogram in a clinical setting, Wolfe added. But the discovery of some ability to judge abnormality after a glimpse could be important if it identifies a signal that was previously unknown. In clinical practice, a radiologist may use computer-aided detection (CAD) systems to help detect cancer. A new ‘gist’ signal might be used by computer scientists to improve the accuracy of these systems.