‘Genetic doppelgangers:’ Emory research provides insight into two neurological puzzles

An international team led by Emory scientists has gained insight into the pathological mechanisms behind two devastating neurodegenerative diseases. The scientists compared the most common inherited form of amyotrophic lateral sclerosis and frontotemporal dementia (ALS/FTD) with a rarer disease called spinocerebellar ataxia type 36 (SCA 36). Both of the diseases are caused by abnormally expanded and strikingly similar DNA repeats. However, ALS progresses quickly, typically killing patients within a year or two, while the disease Read more

Emory launches study on COVID-19 immune responses

Emory University researchers are taking part in a multi-site study across the United States to track the immune responses of people hospitalized with COVID-19 that will help inform how the disease progresses and potentially identify new ways to treat it.  The study is funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. The study – called Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) – launched Friday. Read more

Marcus Lab researchers make key cancer discovery

A new discovery by Emory researchers in certain lung cancer patients could help improve patient outcomes before the cancer metastasizes. The researchers in the renowned Marcus Laboratory identified that highly invasive leader cells have a specific cluster of mutations that are also found in non-small cell lung cancer patients. Leader cells play a dominant role in tumor progression, and the researchers discovered that patients with the mutations experienced poorer survival rates. The findings mark the first Read more

Shamim Nemati

Predict the future of critical care in #STATMadness

Emory is participating in STAT Madness, a “March Madness” style bracket competition featuring biomedical research advances instead of basketball teams. Universities or research institutes nominate their champions, research papers that were published the previous year. It’s like “Battle of the Bands.” Whoever gets the loudest — or most numerous — cheers wins.

Please check out all 64 entries, follow the 2019 STAT Madness bracket and vote here:

Emory’s entry for 2019:
It’s like the “precogs” who predict crime in the movie Minority Report, but for sepsis, the deadly response to infection. Shamim Nemati and colleagues have been exploring ways to analyze vital signs in ICU patients and predict sepsis, hours before clinical staff might otherwise notice.

As landmark clinical studies have documented, every hour of delay in giving someone with sepsis antibiotics increases their risk of mortality. So detecting sepsis as early as possible could save thousands of lives. Many hospitals have developed “sniffer” systems that monitor patients for sepsis, but this algorithm tries to spot problems way before they become apparent.

As published in 2018 in Critical Care Medicine, the algorithm can predict sepsis onset—with some false alarms—four, eight, even 12 hours ahead of time. No algorithm is going to be perfect, but it was better than any other previous sepsis predictor. The technology is headed for additional testing and evaluation at several medical centers, as part of a project supported by the federal Biomedical Advanced Research and Development Authority (BARDA).

You can fill out a whole bracket or you can just vote for Emory. The contest will last several rounds. The first round began on Monday, March 4, and lasts until the end of the week. Before 10 am Eastern time Monday morning, there were already more than 5,000 brackets entered!

If Emory advances, then people will be able to continue voting for us starting on Friday. Emory’s first opponent is a regional rival, Vanderbilt University School of Medicine. We are on the upper left side of the bracket.

STAT News is a Boston-based news organization covering biomedical research, pharma and biotech. If you feel like it, please share on social media using the hashtag #statmadness.

Posted on by Quinn Eastman in Uncategorized Leave a comment

Life-saving predictions from the ICU

It’s similar to the “precogs” who predict crime in the movie Minority Report, but for sepsis, the deadly response to infection. That’s how Tim Buchman, director of the Emory Critical Care Center, described an emerging effort to detect and ward off sepsis in ICU patients hours before it starts to make their vital signs go haywire.

As landmark clinical studies have documented, every hour of delay in giving someone with sepsis antibiotics increases their risk of mortality. So detecting sepsis as early as possible could save lives. Many hospitals have developed “sniffer” systems that monitor patients for sepsis risk. See our 2016 feature in Emory Medicine for more details.

What Shamim Nemati and his colleagues, including bioinformatics chair Gari Clifford, have been exploring is more sophisticated. A vastly simplified way to summarize it is: if someone has a disorderly heart rate and blood pressure, those changes can be an early indicator of sepsis.* It requires continuous monitoring – not just once an hour. But in the ICU, this can be done. The algorithm uses 65 indicators, such as respiration, temperature, and oxygen levels — not only heart rate and blood pressure. See below.

Example patient graph. Green = SOFA score. Purple = Artificial Intelligence Sepsis Expert (AISE) score. Red = official definition of sepsis. Blue = antibiotics. Black + red = cultures.    Around 4 pm on December 20, roughly 8 hr prior to any change in the SOFA score, the AISE score starts to increase. The top contributing factors were slight changes in heart rate, respiration, and temperature, given that the patient had surgery in the past 12hr with a contaminated wound and was on a mechanical ventilator. Close to midnight on December 21, other factors show abnormal changes. Five hours later, the patient met the Sepsis-3 definition of sepsis.

As recently published in the journal Critical Care Medicine, Nemati’s algorithm can predict sepsis onset – with some false alarms – 4, 8 even 12 hours ahead of time. No predictor is going to be perfect, Nemati says. The paper lays out specificity, sensitivity and accuracy under various timelines. They get to an AUROC (area under receiving operating characteristic) performance of 0.83 to 0.85, which this explainer web site rates as good (B), and is better than any other previous sepsis predictor. Read more

Posted on by Quinn Eastman in Heart, Immunology Leave a comment