Monthly Archives: December 2023

Emergency Medicine

Decision Fatigue in Emergency Medicine: An Exploration of Its Validity – Cureus

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Decision Fatigue in Emergency Medicine: An Exploration of Its Validity - Cureus

Emergency Medicine

New Year’s Eve safety tips, straight from emergency department doctors – Newsday

New Years Eve,thatbusy night of revelry,food and drink with friends and loved ones,also canbe a hectic time at hospital emergency departments when the fun goesawry.

Doctors say this is the time of year they see an increase in car crashes, intoxication cases and even accidents in the kitchen.

Newsday spoke with several emergency department doctors on Long Island about common holiday hazardsandhow people can celebrate and stay safe.

Injuries due to vehicle accidents increase every year around New Years Eve, said Dr. Neil K. Dasgupta, director of Emergency Critical Careat Nassau University Medical Center.

Its the holidays everyones stressed, everyone's busy, things are crowded, Dasgupta said. There are a lot of traffic accidents, whether they are related to alcohol or not. People are out trying to get places and they are not paying attention. There is a lot more traffic on the road.

The National Safety Council estimates that 375 people may die on U.S. roads during the New Years Day holiday period, which lasts from Friday through Monday. Alcohol consumption is a major contributing factor.

Doctors suggest designating a driver who will abstain from alcohol for the night, or using a ride share service. If possible, stay off the roads to avoid dangerous drivers.

Really, there is no safe amount [of alcohol]if you are driving, said Dr. Matthew Projansky, associate chair of emergency medicine for Plainview Hospital and Syosset Hospital.

There are a lot of alcohol-related cases that come into the emergency room every New Years Eve, Projansky said. A lot of teenand underage drinking takes place,he said. [Teens]are usually more susceptible to the effects of alcohol because they dont drink regularly.

Some patients require IV fluids to hydrate,and time, but others who are vomiting and aspirating may need more serious medical intervention, doctors said.

Excessive alcohol consumption also could lead to a condition known as holiday heart, said Dr. Robert Schwaner, medical director of the department of emergency medicine and chief of the division of toxicology at Stony Brook University Hospital.

Alcohol is a direct irritant to the heart, he said. If someone binges on alcohol over a week or two, its not uncommon to get atrial fibrillation," an irregular heart rate that impacts blood flow.

Projansky said he also sees more trips and falls, and twisted ankles, sometimes due to people wearing high-heeled shoes.

"Even if you aren't drunk, your balance might be a little off," he said.

Using knives and other sharp utensils to prepare meals;washing glasses;falling down stairs and even popping the cork can lead to injuries that land people in emergency rooms every New Years Eve.

A big one we see all the time is people trying to clean glasses who are intoxicated, Schwaner said. Then they break the wine glass and cut their hand.

And when you have 50 champagne corks going off in a room, it can definitely cause some injuries, Dasgupta said.

He said some people choose dangerous ways fireworks and even firearms to celebrate the holidays.

Make sure you are around people who you trust, Dasgupta said. Keep your phone charged and stay in touch with your friends and family.

Schwaner suggests everyone have a plan to keep an eye on each other, travel safely and dress appropriately for the weather. No one wants to be stranded, he said, especially since temperatures are expected to dip into the 30s on Sunday night.

Hypothermia is a real issue, he said.

Projansky pointed out that people who are drunk may not even realize they are hypothermic.

Whiskey going down feels warm, but alcohol doesnt raise your body temperature, he said. It actually lowers it.

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.

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New Year's Eve safety tips, straight from emergency department doctors - Newsday

Emergency Medicine

Emergency room doctor unveils the most dangerous toys this season – WTOP

Children's National Hospital emergency medicine physician and director of outreach Sarah Ash Combs shares what gifts parents should avoid this Christmas.

In less than 24 hours kids everywhere will begin tearing into toys from their wish list. But before that happens, one D.C.-area doctor suggested some ways to play it safe and avoid a Christmas trip to the emergency room.

Dr. Sarah Ash Combs, an emergency medicine physician and director of outreach for Childrens National Hospital, said there is an easy way for parents to make sure toys are safe. It begins with carefully checking the toys packaging and wrapping especially if you have children younger than three years old.

Is it wrapped in shrink-wrap packaging? she said. Is it something that a young child can get their hands on and ingest and use to cover their mouths? Bear in mind what the toy is coming in.

Combs also suggested keeping toys with tiny magnets, loose buttons or coin batteries away from children. If those parts are swallowed, they could be deadly for kids.

Look at a toy critically, Combs said. Ask yourself, If this went into my childs mouth, could be sucked down into the back of their throat? If you are saying yes, I would just put those toys to one side.

Another toy that strikes fear in the hearts of emergency room physicians, especially with New Years Eve on the horizon, is balloons.

If ingested, Combs said, balloons can cut off a childs airway and cause suffocation.

We really like to veer away from too many balloons lying around, especially in a young childs house, she said.

For larger kids, Combs advised parents to avoid gifting trampolines and rocket launchers this holiday.

The risk with trampolines is that children can land wrong on their heads or necks, or fall and break a bone. And toys that propel objects can cause severe close-range injuries, Combs told WTOP.

She said strict parental supervision is key.

Bear in mind, were talking about a minority of toys to stay away from, with the idea that this will give you a joyful holiday, she said. So that youre not coming to visit me in the emergency department.

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Emergency room doctor unveils the most dangerous toys this season - WTOP

Emergency Medicine

Emergency physician jobs: Navigating tech’s impact on healthcare – Arizona Big Media

Step into the next future of healthcare transformation. A revolution that is reshaping emergency physician jobs and patient care.

Prepare to embark on a journey as we navigate the thrilling evolution. Uncovering the impacts of cutting-edge advancements.

Join us as we delve into this progressive landscape. Where healthcare tech revolutionizes the healthcare sector. It also redefines the scope and practice of emergency medicine. Brace yourself for an exploration of how innovation is shaping healthcare.

Lets dive in!

EHRs have transformed healthcare by replacing paper records. It can now be accessed with efficient and secure digital systems. It allows for quick access to medical information.

It will enable healthcare providers to make timely and accurate diagnoses. This further reduces errors and improves patient outcomes.

These apps have revolutionized emergency physician jobs. It offers advanced that include the following.

These apps empower individuals to enhance their health and well-being.

Telemedicine has sparked a radical transformation in the role of emergency healthcare. It uses video conferencing, remote monitoring, and secure messaging.

Doctors can now deliver consultations to patients from a distance. This improves access to healthcare services.

Telemedicine provides immediate support to paramedics. It also aids in triage operations during times of disaster. Websites like https://www.abstaffing.com/ offer the availability of travel nurses.

They also offer physician assistants and nurse practitioners to assist in emergencies. This tech influence expands the scope and reduces response times in critical situations.

Growth in diagnostic tools and imaging has improved emergency medicine. It provides real-time data at the bedside. These aid in quick diagnosis and decision-making, leading to better patient care.

These could include:

A technology impact is revolutionizing emergency medicine. It provides heart rate monitoring, fall detection, and even ECG capabilities. Devices like fitness trackers and smartwatches offer valuable data for emergency physicians.

This enables remote monitoring of high-risk individuals. This also gives valuable insights into patients health.

The future of healthcare lies in the USE of AI. This technology has already made significant strides in analyzing medical data. It also includes identifying patterns and predicting diagnoses.

In emergency medicine, AI is being utilized to assist in decision-making. This aids physicians in providing faster and more accurate care.

Growth in robotics has transformed emergency physician jobs. It helps aid in surgeries and provides remote support for patients.

Robots can also be utilized to transport medical supplies and perform tasks. This frees up physicians to focus on critical patient care.

VR technology is revolutionizing medical training and education for emergency physicians. Immersive simulations allow for hands-on learning. It also allows practicing high-risk procedures without putting patients at risk.

VR is also being used to manage pain and anxiety in patients. This further reduces the need for sedation and medication.

Groundbreaking advancements are transforming emergency physician jobs. This includes the likes of AI, telemedicine, and robotics. These innovations enhance diagnostics and patient engagement.

It also helps redefine the role of emergency physicians. The future of emergency medicine holds limitless potential driven by innovation.

Stay informed and explore the fascinating impact of technology on healthcare.

Browse our blog for more interesting reads.

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Emergency physician jobs: Navigating tech's impact on healthcare - Arizona Big Media

Cardiology

7 New Year’s Resolutions for Heart Health From Cardiologists – Livestrong

If you're over 40, make an appointment this year to get your heart checked.

Image Credit: andreswd/E+/GettyImages

February is American Heart Month, but you don't have to wait until then to show your heart some love.

Heart disease is still the leading cause of death in the U.S., per the Centers for Disease Control and Prevention (CDC), so it's important to stay on top of your heart health in any way you can.

We asked cardiologists what resolutions they'd like patients to make in regards to their hearts year. Here's what they said:

As with most New Year's resolutions, we start out super motivated in January with diet and exercise goals, then lose momentum as the days go by.

This year, try to be more realistic about your resolutions. This can set you up for consistent, long-term changes in your health, which will ultimately protect your heart in the long term, too.

Case in point: "Diets [and exercise] that begin in colder months fail more than those that begin in the spring," says Allan Stewart, MD, a cardiac surgeon in Miami, Florida. "A great New Year's resolution is to set modest, realistic goals from January to March, and then as you succeed, ramp up those goals in the spring."

For example, maybe a 10,000-step-per-day goal is unrealistic in the wintertime, so start with 5,000 per day and increase as the weather gets warmer.

Only 1 in 10 Americans eat the recommended amount of produce per day, according to the CDC.

But eating enough fruits and veggies reduces your risk of having (and dying from) heart disease and a stroke by up to 27 percent, per an October 2020 meta-analysis in the Journal of the American Heart Association.

One doable way to eat more produce? "Add a piece of fresh fruit to your breakfast and a side of veggies to lunch and dinner," says Karishma Patwa, MD, a cardiologist with Manhattan Cardiology in NYC and contributor to LabFindDieter.

Another bonus: Eating more produce aligns with the Mediterranean diet, which has been shown to be beneficial for your heart, per the Mayo Clinic.

"The five major risk factors for heart disease high cholesterol, high blood pressure, high blood sugar, overweight and poor diet are often food-related," says Elizabeth Klodas, MD, FACC, a preventive cardiologist in Edina, Minnesota, and creator of Step One Foods.

"Changing your diet is especially powerful, but I'm not asking anyone to turn their life upside down," Dr. Klodas says.

Instead, plan to add one nutritious food and remove one not-so-nutritious food from your diet each day.

This could look like eating an apple a day and removing a can of soda each day (or whatever is applicable to your diet). While one day of change won't do much, sticking with this habit over the course of a year is very beneficial.

Dr. Klodas also mentions this two-per-day approach has helped people significantly reduce their "bad" LDL cholesterol within 30 days. This method was also supported by February 2020 research in The Journal of Nutrition.

The Physical Activity Guidelines for Americans recommend getting 150 minutes of moderate-intensity exercise every week for optimal health, per the CDC, which equals about 30 minutes of activity five days per week.

"If this amount feels daunting, you can try to break it into shorter bursts of exercise," Dr. Patwa says.

She recommends taking small, two- to three-minute walks every hour. If you spend eight hours of the day sitting at a desk, for example, that's about 24 minutes of walking a day almost at the goal. Plus, you'll be giving your body a much-needed break from sitting still.

Alcohol in any amount is associated with a higher risk of heart disease, according to a March 2022 study in JAMA Network Open.

If you've tried to commit to a "dry" January (where you don't drink alcohol for the month) and have missed the mark, know that this is the ideal year to do it, Dr. Stewart says. That's because "New Year's Day is a Monday," he says.

Many people see Monday as the day to start fresh and kick off healthier habits. In contrast, Dr. Stewart says when the day falls on a Friday or Saturday, it's more difficult to start dry January, especially because the New Year parties can keep going through the weekend.

If you feel you've overindulged in alcohol over the holidays (as many of us do), dry January can give you a break. Plus, it gives you a chance to reevaluate your relationship with alcohol.

Keep in mind: This means you may have to change up how you socialize with friends, so planning is key, Dr. Stewart says. And try to avoid counting down the days until February 1, he adds.

"It's important not to count down the days until January 31, as it somewhat defeats the purpose of the potential joy you could feel in the process, or the potential to stay sober [beyond January 31]," he says.

If the hectic holiday season left you even more sleep-deprived than you already were, let January be the time you get into a good sleep schedule.

When we're low on sleep, we tend to reach for "quick pick-me-ups like caffeine and sugar," Dr. Klodas says, which can lead to heart palpitations and other issues.

The American Heart Association suggests getting seven to nine hours of sleep per night, as well as getting treated for sleep disorders, such as insomnia, restless leg syndrome or sleep apnea.

To that end: "Non-restorative sleep, especially when due to sleep apnea, can be a major contributor to high blood pressure," Dr. Klodas says, which is a risk factor for heart disease, heart attack and other serious health conditions.

If you, your bed partner or someone in your household suspects you have a sleep disorder (because you snore, talk in your sleep or stop breathing during sleep), this may be the year to finally get a sleep study done and treat the problem.

Are you over 40? If so, Dr. Patwa recommends going to the cardiologist for a preventive screening.

This can help ensure your heart's working properly.

If your doctor has any concerns about your heart, they may run tests such as an electrocardiogram, echocardiogram or stress test, which are the best ways to pick up on heart disease, Dr. Patwa says.

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7 New Year's Resolutions for Heart Health From Cardiologists - Livestrong

Cardiology

Creatinine and Cystatin C-based GFR Estimation in HF Mortality – Physician’s Weekly

The following is a summary of Prognostic Value of Creatinine versus Cystatin C-Based Estimation of Glomerular Filtration Rate for Mortality in Heart Failure, published in the November 2023 issue of Cardiology by Roehm et al.

Researchers conducted a retrospective study to examine heart failure with reduced ejection fraction (HFrEF) data, comparing the prognostic power of creatinine and cystatin C-based estimated glomerular filtration rate (eGFR), alone and combined, to pinpoint the most accurate predictor of mortality.

They examined data from 310 participants in the Registry Evaluation of Vital Information for Ventricular Assist Devices in Ambulatory Life with baseline serum creatinine and cystatin C. The primary outcome was all-cause mortality. Cox models were adjusted for age, gender, race, diabetes mellitus, and NYHA class.

The results showed median eGFR by cr, cys, and cr-cys were 60, 58, and 60 ml/min/1.73m2, respectively. In the 2-year follow-up, 45 participants died, with eGFRcr and eGFRcys differing by -49 to 50 ml/min/1.73m2 within each patient. Worse survival was observed for estimates with baseline eGFR <60 ml/min/1.73m2. Lower baseline eGFRcr [HR 0.97, 95% CI (0.96-0.99), P =0.008, C 0.67], eGFRcys [HR 0.98 (0.97-0.99), P= 0.006, C= 0.68], and eGFRcr-cys [HR 0.98 (0.96-0.99), P= 0.004, C= 0.68] correlated with higher mortality. C-statistic comparisons revealed no significant difference in predictive ability: eGFRcr vs. eGFRcys, P=0.7; eGFRcr vs. eGFRcr-cys, P=0.9; eGFRcys vs. eGFRcr-cys, P=0.3).

They concluded that eGFR was linked to HFrEF death, but creatinine and cystatin C flunked as accurate predictors.

Source: ahajournals.org/doi/10.1161/circ.148.suppl_1.17090

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Creatinine and Cystatin C-based GFR Estimation in HF Mortality - Physician's Weekly

Cardiology

Smidt Heart Institute at Cedars-Sinai opens Aortic Surveillance Clinic for patients with enlarged aortas – News-Medical.Net

The Smidt Heart Institute at Cedars-Sinai has opened an Aortic Surveillance Clinic for the evaluation and long-term monitoring of patients with enlarged aortas, or aortic aneurysms, for whom surgery may not be necessary.

The clinic is the newest offering from the heart institute's dedicated Aortic Program, an interdisciplinary team of highly specialized cardiologists, cardiac and vascular surgeons, radiologists, genetic counselors, and nurses treating the full spectrum of aortic disorders.

"When patients hear that they have an aortic aneurysm, they often think they are ticking time bombs, but that is not always the case," said Robbin Cohen, MD, professor of Cardiac Surgery and director of the Cardiac Surgery Program at Huntington Health, a Cedars-Sinai affiliate. "Most of the patients that we see-;many with genetic conditions affecting the heart-;have aortas that are not large enough or serious enough to need surgery, but they do require ongoing monitoring.

"Through the Aortic Surveillance Clinic, we offer reassurance that they are being carefully and closely monitored and that proper therapy, including surgery, will be offered if needed."

Smidt Heart Institute patients benefit from access to a multidisciplinary team including cardiac and vascular surgeons skilled in treating a range of aortic conditions.

We take pride in our collaborative approach, which benefits patients with various complex aortic diseases. Our team is versed in innovative, minimally invasive procedures, in which cardiac surgeons and vascular surgeons are thorough and thoughtful in how best to manage each individual patient's needs."

Ali Azizzadeh, MD, vascular surgeon, professor and director of Vascular Surgery, associate director of the Smidt Heart Institute at Cedars-Sinai and an aortic aneurysm expert

Cohen has more than 25 years of experience monitoring and treating patients with aortic aneurysm.

"Aortic surgeons know that over time, they will accumulate hundreds of patients with aneurysms that they are following and not operating on," Cohen said. "This requires expertise in aortic imaging, the natural history of aortic disease, and the guidelines and criteria for surgery-;areas in which the Smidt Heart Institute team is highly skilled."

The aorta is the largest and most important artery. It carries blood away from the heart into the rest of the body. Careful monitoring of a significantly enlarged aorta, or aortic aneurysm, can help prevent the possibility of a life-threatening condition, such as aortic dissection-;a tear that develops along the inner layer of the aorta.

The Aortic Surveillance Clinic also provides expert care for patients with certain genetic syndromes, such as connective tissue disorders like Marfan syndrome and Loeys-Dietz syndrome, as well as other genetic disorders affecting the aorta and aortic valve, such as Turner syndrome. These patients are at high risk of developing an enlarged aorta and subsequently, a tear or dissection in the aorta due to abnormalities in the heart and blood vessels. Because these disorders also can affect other areas of the body, the Aortic Surveillance Clinic goes a step further and addresses these issues by connecting patients with genetic counselors, ophthalmologists, orthopedists, psychologists, reproductive endocrinologists and other specialists, as needed.

"We are pleased to have the ability to focus on a subset of patients when they don't need surgery-;and educate them on how to prevent acute aortic events, which can be fatal," said Joanna Chikwe, MD, chair of the Department of Cardiac Surgery and the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai. "And if these patients do need surgery-;which can be complex and challenging-;the Smidt Heart Institute has the expertise of a comprehensive, multidisciplinary team to take care of them, with superb results."

The Aortic Surveillance Clinic is located at 127 San Vicente Blvd., in Los Angeles and is open for patient evaluation the second Friday of each month. Patients can call 310-423-3851 for more information.

Cedars-Sinai once again has been recognized by U.S. News & World Report, this year as the #2 program in the nation for Cardiology, Heart & Vascular Surgery. The Smidt Heart Institute is also #1 for Cardiology, Heart & Vascular Surgery in California and Los Angeles (highest U.S. News ranking in the region).

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Smidt Heart Institute at Cedars-Sinai opens Aortic Surveillance Clinic for patients with enlarged aortas - News-Medical.Net

Cardiology

Pulse Biosciences Announces First-in-Human Procedures with its Novel CellFX Nanosecond Pulsed Field Ablation … – Diagnostic and Interventional…

December 26, 2023 Pulse Biosciences, Inc., a company primarily focused on leveraging its novel and proprietary CellFX Nanosecond Pulsed Field Ablation (nsPFA) technology for the treatment of atrial fibrillation, announced the completion of the first five procedures in its first-in-human feasibility study with its novel CellFX nsPFA cardiac catheter. All patients were successfully discharged by treating physicians. Patients will continue to be monitored and evaluated over the coming months to assess safety and effectiveness with the primary safety endpoint at 30 days.

Dr. Vivek Reddy, Director of Cardiac Arrhythmia Services at Mount Sinai Hospital, NY, and Dr. Petr Neuzil, Chief of Cardiology at Na Homolce Hospital, Prague, and colleagues used the Companys CellFX nsPFA 360 cardiac catheter integrated with 3D mapping and navigation technologies (iMap System, CardioNXT) to successfully treat five patients with atrial fibrillation (AF) at Na Homolce Hospital, a renowned research institution hospital in Prague, Czech Republic.

We have been collaborating with Pulse Biosciences to bring their novel nsPFA technology to the clinical realm, and are excited to report that our experience with these first five patients has validated our belief that this may represent the next generation of PFA technology for the treatment of AF, said Dr. Reddy. The results were consistent with our preclinical experience. Importantly, the speed and ease with which we were able to isolate the pulmonary veins with the nsPFA 360 catheter was impressive and all patients tolerated the procedure well. Now we look forward to completing enrollment in this study to fully assess the safety and durability of nsPFA treatment.

Pulse Biosciences CellFX nsPFA 360 cardiac catheter, which is still in the investigational stage, is uniquely designed to produce a nonthermal ablation, initially targeted for pulmonary vein isolation, using the Companys proprietary CellFX nsPFA energy in the treatment of atrial fibrillation. The catheter is designed to deliver a fast, transmural and fully circumferential ablation in a single energy delivery. The CellFX nsPFA cardiac catheter is integrated with 3D mapping and navigation to deliver a comprehensive visualization and precise ablation delivery solution.

Were honored to work with Dr. Reddy and his team and Prof. Petr Neuzil and his team at Na Homolce to bring our next generation nsPFA technology to the clinic. The unique value of nsPFA to deliver fast, precise, transmural and contiguous ablations in thick cardiac tissue is extremely exciting for the treatment of AF and we could not have found better partners, said Dr. Gan Dunnington, Chief Medical Officer, Cardiac Surgery of Pulse Biosciences. This initial clinical experience delivered as expected. We look forward to continuing our catheter clinical program and to starting our cardiac surgery clinical program with our surgical nsPFA clamp in 2024.

Kevin Danahy, President and CEO of Pulse Biosciences, having attended all patient cases, remarked on the recent milestone, As we embark on this new era of advancement in medical device technology, our mission is clear: to revolutionize healthcare with CellFX nsPFA, with the intention of significantly improving clinical outcomes for both patients and physicians. Through relentless innovation, unwavering dedication, and commitment to pushing the boundaries of what is possible in bioelectric energy, we are reshaping the future of the treatment for atrial fibrillation with our cardiac catheter in electrophysiology and with our cardiac clamp in cardiothoracic surgery. CellFX nsPFA will empower doctors, inspire patients to seek life-altering treatment, and create a world where CellFX nsPFA technology can become a catalyst for healing and hope.

The Company expects to enroll up to a total of 30 patients in the current feasibility study. Treated patients will be evaluated at regular intervals to further assess the safety and effectiveness of the treatments. The Company expects to provide additional updates on the first-in-human procedures with the CellFX system in the upcoming months. Pulse Biosciences will inform stakeholders promptly if results differ materially from the stated expectations addressing safety and efficacy. The observations to date have been positive but the broad set of risks associated with cardiac surgery remain. The Company anticipates initiating the regulatory process with the U.S. FDA and appropriate regulatory authorities worldwide including Europe in the coming quarters and expects additional studies will be required.

For more information: http://www.pulsebiosciences.com

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Pulse Biosciences Announces First-in-Human Procedures with its Novel CellFX Nanosecond Pulsed Field Ablation ... - Diagnostic and Interventional...

Immunology

Revolutionizing Vaccine Research: The Power of a New Algorithm – SciTechDaily

Immunology researchers have introduced a computational tool to improve pandemic preparedness by enabling the comparison of diverse experimental data. This algorithm uses machine learning to find patterns in datasets, enhancing the understanding of immune responses. It promises significant advances in vaccine design and immunology research, with broad potential in various biological contexts.

Computational biologists harness machine learning to make sense of immune system data.

Immune system researchers have designed a computational tool to boost pandemic preparedness. Scientists can use this new algorithm to compare data from vastly different experiments and better predict how individuals may respond to disease.

Were trying to understand how individuals fight off different viruses, but the beauty of our method is you can apply it generally in other biological settings, such as comparisons of different drugs or different cancer cell lines, says Tal Einav, Ph.D., Assistant Professor at La Jolla Institute for Immunology (LJI) and co-leader of the new study in Cell Reports Methods.

This work addresses a major challenge in medical research. Laboratories that study infectious diseaseeven laboratories focused on the same virusescollect wildly different kinds of data. Each dataset becomes its own independent island, says Einav.

Some researchers might study animal models, others might study human patients. Some labs focus on children, others collect samples from immunocompromised senior citizens. Location matters too. Cells collected from patients in Australia might react differently to a virus compared with cells collected from a patient group in Germany, just based on past viral exposures in those regions.

Theres an added level of complexity in biology. Viruses are always evolving, and that changes the data too, says Einav. And even if two labs looked at the same patients in the same year, they might have run slightly different tests.

La Jolla Institute for Immunology (LJI) Assistant Professor Tal Einav, Ph.D. Credit: Matthew Ellenbogen, La Jolla Institute for Immunology

Working closely with Rong Ma, Ph.D., a postdoctoral scholar at Stanford University, Einav set out to develop an algorithm to help compare large datasets. His inspiration came from his background in physics, a discipline whereno matter how innovative an experiment isscientists can be confident that the data will fit within the known laws of physics. E will always equal mc2.

What I like to do as a physicist is collect everything together and figure out the unifying principles, says Einav.

The new computational method doesnt need to know precisely where or how each dataset was acquired. Instead, Einav and Ma harnessed machine learning to determine which datasets follow the same underlying patterns.

You dont have to tell me that some data came from children or adults or teenagers. We just ask the machine how similar are the data to each other, and then we combine the similar datasets into a superset that trains even better algorithms, says Einav. Over time, these comparisons could reveal consistent principles in immune responsespatterns that are hard to detect across the many scattered datasets that abound in immunology.

For example, researchers could design better vaccines by figuring out exactly how human antibodies target viral proteins. This is where biology gets really complicated again. The problem is that humans can make around one quintillion unique antibodies. Meanwhile, a single viral protein can have more variations than there are atoms in the universe.

Thats why people are collecting bigger and bigger data sets to try and explore biologys nearly infinite playground, says Einav.

But scientists dont have infinite time, so they need ways to predict the vast reaches of data they cant realistically collect. Already, Einav and Ma have shown that their new computational method can help scientists fill in these gaps. They demonstrate that their method to compare large datasets can reveal myriad new rules of immunology, and these rules can then be applied to other datasets to predict what missing data should look like.

The new method is also thorough enough to provide scientists with confidence behind their predictions. In statistics, a confidence interval is a way to quantify how certain a scientist is of a prediction.

These predictions work a bit like the Netflix algorithm that predicts which movies you might like to watch, says Einav. The Netflix algorithm looks for patterns in movies youve selected in the past. The more movies (or data) you add to these prediction tools, the more accurate those predictions will get.

We can never gather all the data, but we can do a lot with just a few measurements, says Einav. And not only do we estimate the confidence in predictions, but we can also tell you what further experiments would maximally increase this confidence. For me, true victory has always been to gain a deep understanding of a biological system, and this framework aims to do precisely that.

Einav recently joined the LJI faculty after completing his postdoctoral training in the laboratory of Jesse Bloom, Ph.D., at the Fred Hutch Cancer Center. As he continues his work at LJI, he plans to focus on the use of computational tools to learn more about human immune responses to many viruses, beginning with influenza. Hes looking forward to collaborating with leading immunologists and data scientists at LJI, including Professor Bjoern Peters, Ph.D., also a trained physicist.

You get beautiful synergy when you have people coming from these different backgrounds, says Einav. With the right team, solving these big, open problems finally becomes possible.

Reference: Using interpretable machine learning to extend heterogeneous antibody-virus datasets by Tal Einav and Rong Ma, 25 July 2023, Cell Reports Methods. DOI: 10.1016/j.crmeth.2023.100540

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Revolutionizing Vaccine Research: The Power of a New Algorithm - SciTechDaily