The Johns Hopkins University
The Johns Hopkins University
News Article | May 9, 2017
CrowdReviews.com Partnered with Madridge Conferences to Announce International Conference on Immunology and Immunotechnology Immunology-2017 features highly enlightening and interactive sessions to encourage the exchange of ideas across a wide range of disciplines in the field of immunology. Immunology-2017 mainly showcases comprehensive approaches in immunology study and research. The field of Immunology is growing rapidly and its development is making tremendous impacts in medical sciences. Immunology-2017 invites the contributions related to immunology research. You can submit your work in these broad themes. Conference mainly focuses on: Clinical and cellular immunology Tumour and cancer immunology Neuro immunology Parasitology Autoimmunity and Therapathies Mucosal immunology Reproductive Immunology Immunobiology Infection & Inflammatory Disease Rheumatology Haematopoiesis Transplantation Immunology Virology Immunodermatology Molecular and Structural Immunology Veterinary Immunology and Immunopathology Allergology and Immunology All the abstracts should be submitted through Immunology-2017 Speakers: · Nadir Kadri, Karolinska Institute, Sweden · Pawel Gajdanowicz, Wroclaw Medical University, Poland · Joel Babdor, Stanford University School of Medicine, USA · Kwan Chow, Washington University, USA · Abdallah Badou, Cadi Ayyad University, Morocco Immunology-2017 Organizing Committee: · Carmen Fernández , Stockholm University, Sweden · Carl Borrebaeck, Lund University, Sweden · SY Seong, Seoul National University College of Medicine, South Korea · Shi, Guo-Ping, Brigham and Women's Hospital, USA · Gideon Berke, Weizmann Institute of Science, Isreal · Eyad Elkord, United Arab Emirates University, United ArabEmirates · Noah Isakov, Ben Gurion University of the Negev, Isreal · Joel Pomerantz, The Johns Hopkins University School of Medicine, USA · NanShan Chang, Institute of Molecular Medicine, Taiwan · Hisaya Akiba, Juntendo University School of Medicine, Japan · Ricardo Luiz Dantas Machado, Evandro Chagas Institute, Brazil Immunology-2017 is organizing an outstanding Scientific Exhibition/Program and anticipates the world’s leading specialists involved in Immunology Research. They welcome Sponsorship and Exhibitions from the Companies and Organizations who wish to showcase their products at this exciting event. Register for the conference and book your slots at: Contact person: Sumanjani email@example.com firstname.lastname@example.org Naples, FL, May 09, 2017 --( PR.com )-- International Conference Immunology and Immunotechnology is going to be held during November 1-3, 2017 in Barcelona, Spain.Immunology-2017 features highly enlightening and interactive sessions to encourage the exchange of ideas across a wide range of disciplines in the field of immunology. Immunology-2017 mainly showcases comprehensive approaches in immunology study and research. The field of Immunology is growing rapidly and its development is making tremendous impacts in medical sciences.Immunology-2017 invites the contributions related to immunology research. You can submit your work in these broad themes.Conference mainly focuses on:Clinical and cellular immunologyTumour and cancer immunologyNeuro immunologyParasitologyAutoimmunity and TherapathiesMucosal immunologyReproductive ImmunologyImmunobiologyInfection & Inflammatory DiseaseRheumatologyHaematopoiesisTransplantation ImmunologyVirologyImmunodermatologyMolecular and Structural ImmunologyVeterinary Immunology and ImmunopathologyAllergology and ImmunologyAll the abstracts should be submitted through online abstract submission or can be mailed at email@example.com Immunology-2017 Speakers:· Nadir Kadri, Karolinska Institute, Sweden· Pawel Gajdanowicz, Wroclaw Medical University, Poland· Joel Babdor, Stanford University School of Medicine, USA· Kwan Chow, Washington University, USA· Abdallah Badou, Cadi Ayyad University, MoroccoImmunology-2017 Organizing Committee:· Carmen Fernández , Stockholm University, Sweden· Carl Borrebaeck, Lund University, Sweden· SY Seong, Seoul National University College of Medicine, South Korea· Shi, Guo-Ping, Brigham and Women's Hospital, USA· Gideon Berke, Weizmann Institute of Science, Isreal· Eyad Elkord, United Arab Emirates University, United ArabEmirates· Noah Isakov, Ben Gurion University of the Negev, Isreal· Joel Pomerantz, The Johns Hopkins University School of Medicine, USA· NanShan Chang, Institute of Molecular Medicine, Taiwan· Hisaya Akiba, Juntendo University School of Medicine, Japan· Ricardo Luiz Dantas Machado, Evandro Chagas Institute, BrazilImmunology-2017 is organizing an outstanding Scientific Exhibition/Program and anticipates the world’s leading specialists involved in Immunology Research. They welcome Sponsorship and Exhibitions from the Companies and Organizations who wish to showcase their products at this exciting event.Register for the conference and book your slots at: http://immunology.madridge.com/register.php Contact person:Sumanjani
News Article | May 22, 2017
GREENWICH, Conn.--(BUSINESS WIRE)--Berkley Insurance Company, a Berkley company, today announced the appointments of each of Naomi B. Kinderman and Beth Zaro Green as vice president – claims senior counsel. The appointments are effective immediately. Ms. Kinderman joined Berkley in 2011 and has over 20 years of legal experience. Prior to joining the Company, she directed extra-contractual and coverage litigation for a leading multi-line U.S. insurer. Both an insurance professional and an attorney, Ms. Kinderman was in the private practice of law in Connecticut for 7 years prior to her insurance career, handling general commercial litigation. She earned a Bachelor of Arts degree in English and Psychology from Washington University in St. Louis and a Juris Doctorate from Boston University School of Law. Ms. Green joined Berkley in 2014 and has over 25 years of experience in claims litigation management in the insurance industry. Prior to joining Berkley, she served as senior vice president and managing attorney of a multinational insurer’s centralized defense of global professional liability errors and omissions, other extra contractual claims and coverage. Previously she worked as a trial lawyer admitted in New York and New Jersey. She is a graduate of The Johns Hopkins University and earned her Juris Doctorate from Boston College Law School. Berkley Insurance Company is the lead insurance company subsidiary of W. R. Berkley Corporation, which is among the largest commercial lines writers in the United States and operates worldwide in two segments of the property casualty insurance business: Insurance and Reinsurance. For further information, please visit www.wrberkley.com.
News Article | May 17, 2017
Over three decades of research suggest that depression increases the odds of death. However, a new research paper throws doubt on this presumed link after finding no evidence of a direct association between depression and all-cause mortality. The paper, authored by a research team from The Johns Hopkins University, Federation University Australia and the University of Amsterdam (UvA), involved the largest ever analysis on the topic and is published in the latest edition of World Psychiatry. Since the 1980s, numerous studies have appeared which suggest a high risk of mortality among people suffering from depression. This has generally been taken as evidence that depression directly causes death. As part of their study, researchers Beyon Miloyan and Eiko Fried re-evaluated this supposed link by reassessing 293 studies derived from 15 systematic reviews. The studies in question comprised over 3.6 million participants and 400,000 deaths. Despite the widespread suggestion that depression leads to more death, at least 95% of the studies the researchers investigated were found to be of insufficient quality. Using quantitative and qualitative methods, the researchers identified a pronounced publication bias. Specifically, studies that identified the largest associations between depression and mortality featured small samples, a low number of deaths, and short follow-up periods. Moreover, the researchers discovered that only about 5% of the 293 studies adjusted their statistical models for other mental health conditions like anxiety or substance use problems, which are very common among depressed patients: comorbidity rates exceed 50%. The researchers also found that two-thirds of the studies comprised respondents who were pre-selected on the basis of medical conditions. Many symptoms of depression like insomnia and fatigue are shared with various physical conditions or may arise as side effects of medications used to treat existing disorders. This, say Miloyan and Fried, could lead to the conclusion that depression is the cause of death, even though death may be better attributed to preexisting illnesses. To eliminate this confound, one solution is to properly control for comorbid psychological and physiological conditions, another to specifically study depressed patients without pre-existing physical illnesses. 'The studies we looked at have over the years led many people to place too easily, and perhaps mistakenly, a lot of confidence in the notion that depression is directly to blame for the high mortality', says Miloyan, a researcher at The Johns Hopkins University and faculty member at Federation University Australia. 'In fact, when we look more closely at the data from the few studies that are of acceptable quality, we do not find convincing evidence that depression is directly associated with all-cause mortality.' Instead, the results suggest that other variables, more specifically health behaviours and comorbidity, might be related to the higher rate of mortality among depressed individuals. 'For example, it is known that depression goes hand in hand with unhealthy lifestyle behaviours such as smoking, drinking and physical inactivity', says Fried, a psychologist and postdoctoral researcher at the UvA. 'Smoking in particular is associated with an increased risk of developing depression and with many causes of death. Such complex interactions among variables associated with depression and death, which have been largely ignored in the literature, imply that it is premature to draw strong causal conclusions.' Miloyan and Fried hope their findings encourage other researchers to investigate this question more carefully before designing and implementing programmes and policies aimed at curbing depression in order to substantially reduce deaths. Miloyan: 'This isn't to suggest that depression shouldn't be treated, of course, but rather that as far as the cause of overall mortality is concerned, the key factors probably lie somewhere else and warrant more rigorous future research.'
News Article | May 23, 2017
Johns Hopkins Genomics at The Johns Hopkins University, Georgia Cancer Center at Augusta University, CID Research, Progenity, Inc., DarwinHealth, Inc., and Channing Division of Network Medicine at Brigham and Women's Hospital Among New Qumulo Customers; Qumulo Reports More Than 2X Growth in Petabytes Shipped to Life Sciences and Medical Research Customers in 12 Months SEATTLE, WA--(Marketwired - May 23, 2017) - Qumulo, the leader in modern scale-out storage, today announced that leading life sciences and medical research institutions are choosing Qumulo to accelerate their data-intensive workflows, including cancer and infectious disease research, genomics, bioinformatics, proteomics, microscopy and big data. Johns Hopkins Genomics (including the NIH CIDR Program at The Johns Hopkins University), the Center for Infectious Disease Research, Georgia Cancer Center at Augusta University, Channing Division of Network Medicine at Brigham and Women's Hospital, Progenity, Inc., and DarwinHealth, Inc. have joined the rapidly growing number of customers turning to Qumulo to speed discovery of new medical breakthroughs. "Workflows in life sciences are characterized by massive volumes of machine-generated file data pipelined into downstream processes for analysis," said Peter Godman, co-founder and CTO of Qumulo. "The rapid growth of file-based storage and processing requirements compounded by limited IT resources has created a scalability crisis for life sciences and medical research organizations. Efficient, high-performance processing of file-based data is at the heart of innovation and discovery in life sciences -- something legacy file storage cannot provide. Qumulo has become the clear answer for data-intensive life sciences workflows." Qumulo accelerates data-intensive workflows in life science and medical research including cancer and infectious disease research and microscopy. Analysis of tissue and cancer tumor studies generates millions to billions of small files, and the expanding bio-repository file data requirements are outgrowing the capacity of legacy storage. Qumulo's modern scale-out storage provides researchers with faster analysis times and IT staff with real-time visibility and control at scale. The high performing, cost-effective storage platform allows for a single file system to be shared across groups to prevent long wait times previously associated with sharing large data sets among groups. Qumulo is the modern replacement for legacy scale-out storage architectures that cannot keep up with modern data requirements. Ron Hood, director of IT at the Center for Infectious Disease Research said, "Qumulo Core's modern architecture is built for the future and that's what closed the deal for us. We didn't want to spend our budget on legacy scale-out storage systems that are obsolete or will be in two to three years. Qumulo supports our needs today and well into the future, so that we can achieve faster times to analysis for our most critical research." Microscopy systems often generate image data sets as large as 1TB per experiment. Those images are stored and accessed for processing and analysis from client computers running operating systems such as Windows, macOS and Linux. The sequencing data is a widely varied collection of files ranging in size from a few kilobytes, often numbering in the millions to billions, up to large image files that can be 50 GB each. Qumulo is the ideal solution for this workload, providing high scalability, high performance, fast access to files across the entire range for processing and analysis, storage of billions of files and support for mixed file workloads. Qumulo Core was designed from the ground up for the new era of multi-petabyte data scale on premises and in the cloud. Qumulo Core stores tens of billions of files with scalable throughput and is the only product that provides real-time visibility and control for file systems at petabyte scale. Storage administrators and life sciences researchers can instantly see usage, activity and throughput at any level of the unified directory structure, no matter how many files in the file system, allowing them to pinpoint problems and effectively manage how storage is used by analysis pipelines. In addition, a Qumulo Core storage cluster can be installed and deployed in minutes without specialized IT expertise. Qumulo's publicly announced life sciences customers include: Carnegie Institution for Science, CID Research, Channing Division of Network Medicine at Brigham and Women's Hospital, DarwinHealth, Inc., Georgia Cancer Center at Augusta University, Institute for Health Metrics and Evaluation (IHME) at University of Washington, Johns Hopkins Genomics at The Johns Hopkins University, Progenity, Inc., UConn Health, University of Utah Scientific Computing and Imaging (SCI) Institute. Connect with Qumulo at Bio-IT World Qumulo will be featured in booth #333 at Bio-IT World, taking place May 23-25 in Boston. The company will sponsor, exhibit, and demonstrate the power of Qumulo Core for life sciences workflows. In addition, Peter Godman, the company's co-founder and CTO, will present on Kickstarting Breakthroughs in Life Sciences with Intelligent, Next-Generation Scale-Out Storage on Thursday, May 25 at 11:40am ET. To schedule one-on-one meetings with Qumulo representatives at Bio-IT World, send an email to firstname.lastname@example.org or schedule online here. Suggested Tweet: Life Sciences and Medical Research Turning to @Qumulo For Modern Scale-Out File #Storage http://qumulo.com/4061 About Qumulo Qumulo enables enterprises to manage and store billions of digital assets with real-time visibility and control built directly into the file system. Going past the design limitations of legacy NAS, Qumulo Core is modern scale-out storage for the new era of multi-petabyte data footprints on premises and in the cloud. It is used by the leaders of data-intensive industries. Founded in 2012 by the inventors of scale-out NAS, Qumulo has attracted a world-class team of innovators, investors and partners. For more information, visit www.qumulo.com.
News Article | April 28, 2017
In an analysis of Medicare billing data submitted by more than 2,300 United States physicians, researchers have calculated the average number of surgical slices, or cuts, made during Mohs micrographic surgery (MMS), a procedure that progressively removes thin layers of cancerous skin tissue in a way that minimizes damage to healthy skin and the risks of leaving cancerous tissue behind. The study, the researchers say, serves as a first step towards identifying best practices for MMS, as well as identifying and informing physicians who may need re-training because their practice patterns deviate far from their peers. A report of the study, published in the journal JAMA Dermatology April 28, suggests that identifying and informing high outlier physicians of their extreme practice patterns can enable targeted re-training, potentially sparing patients from substandard care. The analysis is part of a medical quality improvement project called "Improving Wisely," funded by the Robert Wood Johnson Foundation and based at The Johns Hopkins University. The initiative focuses on developing and using individual physician-level measures to collect data and improve performance. The U.S. Centers for Medicare and Medicaid Services provided broad access to their records for the study. "The project aims to work by consensus, encouraging outliers to seek educational and re-training tools offered by their professional society," says Martin Makary, M.D., M.P.H., professor of surgery at the Johns Hopkins University School of Medicine and the paper's co-senior author. "That's the spirit of medicine's heritage of learning from the experience of other physicians." He estimates that the initiative could result in Medicare savings of millions of dollars. Ideally, says Makary, those who perform MMS make as few cuts or slices as possible to preserve as much normal tissue as possible while ensuring complete removal of cancers. As each layer of skin is removed, it is examined under a microscope for the presence of cancer cells. However, there can be wide variation in the average number of cuts made by a physician. Measuring a surgeon's average number of cuts was recently endorsed by the American College of Mohs Surgery (ACMS) as a clinical quality metric used to assess its members. "Outlier practice patterns in health care, and specifically Mohs surgery, can represent a burden on patients and the medical system," says John Albertini, M.D., immediate past president of the American College of Mohs Surgery and the paper's other senior author. "By studying the issue of variation in practice patterns, the Mohs College hopes to improve the quality and value of care we provide our patients." Taking their cue from that support, Makary and his research team analyzed Medicare Part B claims data from January 2012 to December 2014 for all physicians who received Medicare payments for MMS procedures on the head, neck, genitalia, hands and feet. These regions of the body account for more than 85 percent of all MMS procedures reimbursed by Medicare during those years. A total of 2,305 physicians who performed MMS were included in the analysis. The researchers also gathered the following data for each physician: sex, years in practice, whether the physician worked in a solo or group practice, whether the physician was a member of ACMS, whether the physician practiced at an Accreditation Council for Graduate Medical Education site for MMS, volume of MMS operations, and whether the physician practiced in an urban or rural setting. Physicians had to perform at least 10 MMS procedures each year to be included in the analysis. The researchers found that the average number of cuts among all physicians was 1.74. The median was 1.69 and the range was 1.09 to 4.11 average cuts per case. Of the 2,305 physicians who performed MMS during each of the three years studied, 137 were considered extremely high outliers during at least one of those years. An extremely high outlier was defined as having a personal average of greater than two standard deviations, or 2.41 cuts per case, above all physicians in the study. Forty-nine physicians were persistently high outliers during all three years. Physicians in solo practice were 2.35 times more likely to be a persistent high outlier than those in a group practice; 4.5 percent of solo practitioners were persistent high outliers compared to 2.1 percent of high outlier physicians who performed MMS in a group practice. Volume of cases per year, practice experience and geographic location were not associated with being a high outlier. Low extreme outliers, defined as having an average per case in the bottom 2.5 percent of the group distribution, also were identified. Of all physicians in the study, 92 were low outliers in at least one year and 20 were persistently low during all three years. Potential explanations for high outliers include financial incentive, because the current payment model for MMS pays physicians who do more cuts more money, Makary says. These charges are ultimately passed on to Medicare Part B patients, who are expected to pay 20 percent of their health care bill. Low outliers may be explained by incorrect coding, overly aggressive initial cuts, or choice of tumors for which MMS is not necessary, he says. Although the study was limited by lack of information about each patient's medical history, or the diameter or depth of each cut, Makary says it's a meaningful step toward identifying and mitigating physician outliers. "Developing standards based on physicians' actual experience and practices is the home-grown approach needed now to improve health care and lower costs of care," says Makary. Other authors on this paper include Aravind Krishnan, Tim Xu, Susan Hutfless and Angela Park of the Johns Hopkins University School of Medicine; Thomas Stasko of the University of Oklahoma; Allison T. Vidimos of the Cleveland Clinic; Barry Leshin of The Skin Surgery Center; Brett M. Coldiron of the University of Cincinnati Hospital; Richard G. Bennett of Bennett Surgery Center in Santa Monica, California; and Victor J. Marks and Rebecca Brandt of the American College of Mohs Surgery. Funding for this study was provided by a grant from the Robert Wood Johnson Foundation (grant No. 73417) and the American College of Mohs Surgery.
News Article | April 17, 2017
On April 18 and 19, the Levy Economics Institute of Bard College will gather top policymakers, economists, and analysts at the 26th Annual Hyman P. Minsky Conference on the State of the U.S. and World Economies to discuss, among many issues, the implications of the new administration’s “America First” policies, focusing on the outlook for trade, taxation, fiscal, and financial regulation measures to generate domestic investments capable of moving the growth rate beyond the “new normal” established in the aftermath of the Great Recession, without jeopardizing financial stability. The conference, “‘America First’ and Financial Stability,” is being organized by the Levy Institute and will take place Tuesday and Wednesday, April 18–19, at the Levy Economics Institute of Bard College in Annandale-on-Hudson, New York. Participants include Esther L. George, president and chief executive officer, Federal Reserve Bank of Kansas City; Eric S. Rosengren, president and chief executive officer, Federal Reserve Bank of Boston; Thomas M. Hoenig, vice chairman, Federal Deposit Insurance Corporation; Peter Praet, chief economist and executive board member, European Central Bank; Michael E. Feroli, chief U.S. economist, JPMorgan Chase & Co.; Arturo O’Connell, formerly, member of the board of governors, Central Bank of Argentina; Lakshman Achuthan, cofounder and chief operations officer, Economic Cycle Research Institute; Rana Foroohar, global business columnist, Financial Times, and global economic analyst, CNN; Michael S. Derby, special writer, The Wall Street Journal; Christian Plumb, Latin America business editor, Reuters; and Yalman Onaran, senior writer, Bloomberg News. The 2017 Minsky Conference will assess, among other issues, the impact of different financing schemes on both infrastructure investment and the return of central bank monetary policies to more neutral interest rates. Since these new policy proposals will have a global impact, the conference will focus on their implication for the performance of European and Latin American economies. The conference will include presentations by Jan Kregel, director of research, Levy Institute; Robert J. Barbera, codirector, Center for Financial Economics, The Johns Hopkins University; Fernando J. Cardim de Carvalho, senior scholar, Levy Institute, and emeritus professor of economics, Federal University of Rio de Janeiro; Scott Fullwiler, professor of economics, University of Missouri–Kansas City; Arturo Huerta González, professor of economics, Universidad Nacional Autónoma de México; Stephanie A. Kelton, research associate, Levy Institute, and professor of economics, University of Missouri–Kansas City; Paolo Savona, formerly, Italian minister of industry and president, Banco di Roma and the Fondo Interbancario di Tutela dei Depositi; Edwin M. Truman, nonresident senior fellow, Peterson Institute for International Economics; Michalis Nikiforos, research scholar, Levy Institute; and L. Randall Wray, senior scholar, Levy Institute, and professor of economics, Bard College. The Levy Economics Institute of Bard College, founded in 1986 through the generous support of the late Bard College trustee Leon Levy, is a nonprofit, nonpartisan, public policy research organization. The Institute is independent of any political or other affiliation, and encourages diversity of opinion in the examination of economic policy issues while striving to transform ideological arguments into informed debate. Press registrations should be made by calling Mark Primoff at 845-758-7412 or by sending an e-mail to primoff(at)bard.edu.
News Article | May 8, 2017
In an analysis of medical records gathered from more than 300 hospitalized patients, a team of researchers reports that routine imaging scans used to help diagnose heart attacks generated "incidental findings" (IFs) in more than half of these patients. The investigators say only about 7 percent of these IFs were medically significant and urged imaging experts and hospitals to explore ways to safely reduce the added costly -- and potentially risky -- days in the hospital the IFs generate. "Incidental findings present clinical and financial challenges," says Venkat Gundareddy, M.D., M.P.H., a director of the Collaborative Inpatient Medicine Service at Johns Hopkins Bayview Medical Center in Baltimore. "In our new study, we saw an association between the presence of incidental findings and longer length of stay in the hospital, in some cases because of further tests to explore those findings." "Because this was an observational study, we can't conclusively attribute the added hospital days to one case, but we believe we have added to evidence that IFs are a factor," he adds. It's long been the case, Gundareddy notes, that people experiencing chest pain are usually admitted to a hospital and undergo CT or other forms of imaging. In their review, they discovered that findings unrelated to chest pain kept patients in the hospital an average of 26 percent longer than people without IFs. Results of the retrospective study appear in the May issue of the Journal of Hospital Medicine. The higher sensitivity and accuracy of X-rays, MRIs, ultrasound examinations, and especially CT scans, has led to more incidental findings such as kidney cysts, renal stones, thyroid nodules, enlarged lymph nodes, bone lesions, lung nodules and masses. Unexpected incidental findings are very common in patients hospitalized with chest paint thought to be cardiac related, the investigators say. Chest CT scans done to image the heart can end up showing lung or thyroid nodules or enlarged lymph nodes. Chest X-rays often show more than heart size, when bone lesions and arthritic changes are noted. The new study analyzed the medical records of 376 patients admitted to Johns Hopkins Bayview Medical Center, an urban academic medical center, over a two-year timeframe. Some 197 of them had unexpected incidental findings in diagnostic images, findings that were not related to their chest pain complaints. Fifty percent of the unexpected findings were deemed medically minor, 42 percent moderate and seven percent of major clinical significance. The unexpected findings are associated with a 26 percent increase in length of hospital stay. When unexpected findings such as nodules or bone lesions are discovered after diagnostic imaging, further tests are generally ordered. If the finding was of major clinical significance, often that workup takes place during the same hospitalization, increasing the length of stay, adding to provider workload, and increasing expenses for testing, imaging, surveillance, consults and labor. Clearly, the researchers say, such additional time and costs are needed for some patients, but nationwide efforts to reduce unnecessary costs could benefit from closer study of and attention to the best setting for dealing with incidental findings. "Choosing wisely what tests are needed for each patient, based on presenting complaints and pertinent history, would prevent unnecessary use of imaging and detection of incidental findings," notes Gundareddy. "Establishing a robust outpatient care pathway to further workup incidental findings, as needed, would also decrease inpatient length of stay," he adds. Gundareddy says radiologists' groups and associations already have some guidance related to follow up for certain incidental findings, such as the American College of Radiology's guidance on managing incidental findings from abdominal CT scans. However, no clear follow up guidelines exist for most incidental findings appearing in hospitalized patients. "It's important for patients and providers to understand that as imaging gets more sensitive, it will pick up more things that are unrelated to the main problem for which imaging is done," Gundareddy says. "These findings might or might not be clinically significant, and although they may need attention, they don't necessarily need inpatient hospital attention." Other authors on this paper include Nisa M. Maruthur, M.D., M.H.S. (co-first author), Abednego Chibungu, M.D., Regina Landis, M.S., and Shaker M. Eid, M.D., M.B.A., of The Johns Hopkins University; and Preetam Bollampally, M.D., of Saint Vincent Hospital.
News Article | April 26, 2017
In a preclinical study in mice and human cells, researchers report that selectively removing old or 'senescent' cells from joints could stop and even reverse the progression of osteoarthritis. The findings, published April 24 in Nature Medicine, support growing evidence that senescent cells contribute to age-related diseases and demonstrate that using drug therapies to remove them from the joint not only reduces the development of post-traumatic osteoarthritis, but creates an environment for new cartilage to grow and repair joints. Senescent cells accumulate in tissues as we age and are a normal part of wound healing and injury repair. They secrete important signals that call immune cells and other cell types into damaged tissue so they can clean up and rebuild. However, in articular joints such as the knee, and cartilage tissue in particular, these senescent cells often are not cleared from the area after injury. Their prolonged presence causes a cascade of events, which starts the development of osteoarthritis. "Combine age-related increases in senescent cells, plus trauma, and it's a double whammy," says Jennifer Elisseeff, Ph.D., director of the translational tissue engineering center and Morton Goldberg Professor of Ophthalmology at the Johns Hopkins Wilmer Eye Institute. The researchers took young mice and performed surgery on them, cutting their anterior cruciate ligaments (ACL) to mimic injury. The researchers then administered injections of an experimental drug named UBX0101, which was recently identified to kill senescent cells in laboratory studies. Researchers injected UBX0101 into the mice's joints 14 days after trauma, when degradation was already starting, and observed that the presence of senescent cells was reduced by roughly 50 percent. In addition, the researchers monitored gene expression in treated mice and found that genes associated with reparative cartilage growth were activated in the joint after treatment. Similar experiments were conducted in older mice, which showed some key differences from the treatment in younger mice. The older mice had thinner cartilage in the joint and increased pain levels before the experiment. After treatment with UBX0101 injections, the older mice exhibited reduced pain like their more youthful counterparts, but did not exhibit signs of cartilage regeneration. To gauge the potential for UBX0101 to be translated to a human treatment, researchers tested the drug in cultures of human cartilage cells taken from donors with clinically severe osteoarthritis (i.e. patients who had undergone a total knee replacement surgery due to damage from osteoarthritis). Elisseeff's group then grew these cartilage cells into 3D structures in the lab. The 3D structures mimic how cartilage tissues grow in the body, Elisseeff explains. They then exposed these cells to UBX0101 for four days. The researchers observed that not only were the number of senescent cells dramatically reduced, but the tissue derived from these patients began forming new cartilage after the elimination of senescent cells. "What was most striking about the results in human tissue is the fact that removal of senescent cells had a profound effect on tissue from very advanced osteoarthritis patients, suggesting that even patients with advanced disease could benefit," says Elisseeff. Although the treatment appears promising, Elisseeff says one limitation in the current study is the short time that UBX101 remains in the joint. However, Unity Biotechnology, who co-developed UBX0101, is working on single-injection formulations. The researchers are hopeful that with further development, UBX0101 may one day offer a one-dose treatment for osteoarthritis. Elisseeff explains, "Because the drug targets and kills the senescent cells directly, once they are eliminated, patients will not need to return for frequent treatments." Prior to this study, Johns Hopkins Technology Ventures (JHTV), the commercialization arm of The Johns Hopkins University, licensed intellectual property around the senescent cell technology to Unity Biotechnology Inc., a company aiming to develop therapeutics that address age-related diseases; both jointly own the patent. "The promising results from this collaboration between Johns Hopkins and Unity showcase how industry and academia can work together to develop innovative therapies," says Neil Veloso, JHTV's executive director of technology transfer. "We are excited that the results from this collaboration may develop into a product that will positively impact people around the world." Other researchers involved in this study include: Ok Hee Jeon, Sona Rathod, Jae Wook Chung and Do Hun Kim from the Johns Hopkins University School of Medicine; Alain P. Vasserot, Yan Poon and Nathaniel David of Unity Biotechnology; Darren J. Baker and Jan M. Van Deursen of the Mayo Clinic College of Medicine; Judith Campisi of the Buck Institute for Research on Aging; Chaekyu Kim of the Johns Hopkins University School of Medicine and the Ulsan National Institute of Science and Technology; Remi-Martin Laberge of the Buck Institute for Research on Aging and Unity Biotechnology; and Marco Demaria of the Buck Institute for Research on Aging and the University Medical Center Groningen. This research was supported by Unity Biotechnology, the Morton Goldberg professorship, the National Cancer Institute (R01CA96985, the Paul F. Glenn Foundation, a Fulbright scholarship from the Institute of International Education, and the Bloomberg-Kimmel Institute for Cancer Immunotherapy. Jennifer Elisseeff owns equity in Unity Biotechnology. Johns Hopkins University and Unity Biotechnology own intellectual property related to the research. Ok Hee Jeon, Chaekyu Kim and Jennifer Elisseeff are inventors of JHU intellectual property licensed to Unity. This arrangement has been reviewed and approved by The Johns Hopkins University in accordance with its conflict of interest policies.