On Oct. 15, Dr. Graham Nichol, 91Ě˝»¨professor of medicine and director of the UW-Harborview Center for Prehospital Emergency Care, launched MyHeartMap Seattle. This was a month-long, city-wide scavenger hunt to discover all of Seattle’s automated external defibrillators, or AEDs. The winner or winning team would be awarded $10,000 provided to Nichol’s research efforts by the Food and Drug Administration and several AED companies. Thirty-two teams signed up to participate. The AED sightings started rolling in.

On Twitter, teams posted selfies with AEDs, asked for hints, and celebrated when they found “golden AEDs,” which were worth $50 extra. The contest was extremely close.

One month later, Nichol announced the winning team: Team HeartMarket, a group of six 20-somethings with a serious love for scavenger hunts, had found 800 AEDs.

Rebecca Bridge heard about the contest through a Google alert for the phrase “scavenger hunt.” She described the four frantic weeks her team spent searching: “Health clubs, dentist offices, hotels, office buildings. Sometimes they were locked up somewhere.”

The contest required some sleuthing.Ěý One evening, while having dinner on Capitol Hill, Rebecca and her teammate Mike Pantoliano walked by Seattle Academy’s open house for parents. They just looked at other and proceeded inside to what turned out to be a gold mine of defibrillators.

Fellow HeartMarket teammates were Ben Estes, Lara Petersburg, Megan Singley, Miranda Rensch, and Aaron Wheeler. Mike said that often the folks he encountered at the front desk of a business didn’t know what an AED was, or were immediately suspicious.

“They thought we were there to ticket or fine them for not having one,” he said.

In some cases, employees would direct Team HeartMarket to an area of the building where they might have an AED. The searchers would find a fire extinguisher instead.

“We developed an irrational hatred of fire extinguishers,” joked Mike.

Although there is currently no legal penalty associated with not having an AED, keeping one on hand in areas frequented by many people is a good idea.Ěý These medical devices are extremely important in saving lives. When combined with CPR, the use of an AED improves survival rates for sudden cardiac arrest by almost half. Before the contest began, Nichol and his team knew of roughly 250 registered AEDs in various public locations like schools and public buildings. Now his team is sorting through over 2,000 reportings. After eliminating duplicates, they expect a potential database of at least 1,500.

MyHeartMapSeattle was the second of two AED hunts in the United States. The first, in Philadelphia, was orchestrated by Dr. Raina Merchant, assistant professor of emergency medicine at the University of Pennsylvania. Both contests arose from the need to map and monitor defibrillators. The FDA has publicly stated a desire to monitor these devices to see how often they are used and how they affect the survival rate of sudden cardiac arrest. So, rather than sending one person or even a team of hourly-paid individuals to search each city building by building, researchers decided to hold a contest to capitalize on the recent success of crowdsourcing. Eventually, the FDA hopes to place unique labels (QR codes) on each defibrillator.

The inspiration for the HeartMap project was the DARPA Red Balloon Challenge, Ěýa 2009 contest/experiment that offered $40,000 to the person or team that was able to submit the exact locations of 10 large red, weather balloons hidden in plain sight all around the United States. The winning team located all 10 balloons in just under 9 hours. Armed with this knowledge, researchers were able to secure funding from the FDA and several AED companies to offer the $10,000 reward.

Of course, the other purpose for tracking and mapping AEDs is that they are designed for public use. Any person can follow the directions correctly and deliver the electrical current that could correct an irregular heartbeat and save a person’s life. CPR can sustain a victim’s life, but without an AED the survivor could still suffer brain damage or death. Having a map of AEDs will allow 911 operators to pinpoint a location and relay that information to a bystander before a first-responder can make it to the scene. With modern technology, it’s possible that each city could have a comprehensive location-based smartphone app that would allow a bystander to find the nearest AED with the swipe of a finger.

For now, Nichol and Merchant and their teams have inspired other cities to hold their own scavenger hunts, and they’re taking the show on the road. There’s no word yet as to exactly where the next HeartMapChallenge will be, but we can bet $10,000 it will be a fruitful endeavor.

Oh, and Seattle, if you’re wondering… ĚýAfter downtown, HeartMarket’s guess is that Capitol Hill is the next best heart-friendly neighborhood.

In June 2011 Dr. Alisa Hideg was a 42-year-old mother and family physician in the prime of her career practicing at Group Health in Spokane when she was diagnosed with estrogen and progesterone receptor negative/HER 2 positive breast cancer.

Breast cancer in young, premenopausal women is usually aggressive. So even after chemotherapy, a double mastectomy, and radiation, with her cancer in remission, Hideg wasn’t ready to take it easy. Both the type of breast cancer and the fact that it happened at a young age made her chances of relapse higher. This knowledge led her to experimental trials, and to the UW’s Tumor Vaccine Group.

Hideg found the 91Ě˝»¨Tumor Vaccine Group on the National Institutes of Health clinical trials website, ClinicalTrials.gov. She had heard about a trial at the University of Pennsylvania’s Perelmen School of Medicine, where the use of gene-transfer therapy converted the patients’ own immune cells into weapons aimed at cancerous tumors. All 12 patients had advanced stage leukemia; nine of the 12 responded positively to the treatment, and two of the first three patients treated have been in remission for two full years. ĚýThe Perlelmen results encouraged her to seek out a 91Ě˝»¨study to see if she qualified.

The 91Ě˝»¨Tumor Vaccine Group currently offers clinical trials for patients with breast, ovarian or colon cancer. Hideg is in a very desirable , and being approved to participate wasn’t easy. The goal of the clinical trial is to allow the patient to make and keep enough antibodies to quash any future HER-2 expressing breast cancer.

Dr. Nora Disis, 91Ě˝»¨professor of medicine and principal investigator of the study, explains how the vaccine may work.

“The vaccine is designed to stimulate a particular cell of the immune system, the T cell, to recognize the HER2 protein (that causes cancer),” Disis said. “If effective immunity is generated, the T cell activated by the vaccine should be able to hunt out tumor cells wherever they may be and destroy them.Ěý This particular study is testing the use of an immune stimulator, ampligen, which may be able to activate the T cells more effectively than other agents we have used before.“

Last month, Hideg received a vaccine dose at 91Ě˝»¨Medical Center. The process is gentle — a series of four small injections that make a little grid of dots on the upper arm — but the body’s response can be angry. Hideg experienced flu-like symptoms after the first visit. The reaction Ěýmay actually be a promising sign that her body is responding to the vaccine.

She’s positive and funny in the face of serious medicine. She tweets pictures of her experience to a network of fans and writes about her cancer in Spokane’s daily newspaper, the Spokesman-Review. In addition to being a doctor, patient and full-time mother, Hideg recently went through a series of intense interviews to add “teacher” to her resume. She has become a clinical faculty member to teach second-year 91Ě˝»¨medical students at the Spokane WWAMI site. ĚýWWAMI is a regionalized medical education program that covers Washington, Wyoming, Alaska, Montana and Idaho.

“Teaching has always been a part of my clinical practice,” Hideg said. “I have taught medical students, residents and others in my clinic since I finished my own training. This experience has reminded me how important teaching can be and how much I enjoy passing on what I have learned as a physician, a parent, and as a patient. Whether the vaccine is effective for me or not, I am grateful for the opportunity to participate in the trial and help move the science forward. I believe in the potential of vaccine therapy for cancer and perhaps for other diseases also and I want a future with more options for my daughter and for others.”

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For 25 years, folks have traveled from all over the Pacific Northwest to meet for their pulmonary fibrosis support group at 91Ě˝»¨ Medical Center. This week, as they celebrated the support group’s quarter-century anniversary, the room buzzed with laughter, greetings, and smiles. Some members wore oxygen tanks, necessary after the disease began hardening and scarring their lung tissue and made breathing difficult.

Pulmonary fibrosis is a life-threatening disease in which excess fibrous tissue develops in the lungs. People with pulmonary fibrosis experience a hacking cough and shortness of breath that causes fatigue, weight loss, and weakness. No single cause of pulmonary fibrosis has been identified; it is often classified as a secondary effect of other interstitial lung diseases. The term “interstitial lung disease” refers to a large group of disorders involving both lungs, most of which cause progressive scarring of lung tissue (pulmonary fibrosis). There is no cure for pulmonary fibrosis, and almost no treatment. One can only hope to be a good candidate for a successful lung transplant.

A number support group members had already received lung transplants from 91Ě˝»¨Medical Center’s transplant services. One gentleman received news one month ago to the day, as he was walking out of the support group, that he was to have his transplant.

Dave Sherry, the group leader, beamed as he described the bond between fellow members. Each month, he and the team organize a speaker from 91Ě˝»¨Medical Center or an outside medical organization to give a talk about the disease. Members also spend time voicing their fears and successes with each other.

“We have a shared destiny that ties us together,” said Sherry. In fact, this support group has been so strong throughout the years that it became a model for other support groups. One prominent Italian surgeon was so impressed that he implemented a similar system of support groups in Europe.

Representatives from the Chicago-based Pulmonary Fibrosis Foundation, including CEO Dr. Daniel M. Rose, traveled to Seattle for the support group’s 25^th anniversary. Rose presented a short and fascinating lecture that compared the history of cystic fibrosis with pulmonary fibrosis. He emphasized the need for research and clinical trials, and showed how the Cystic Fibrosis Foundation’s aggressive approach to finding treatment for the disease ultimately improved the estimated lifespan of patients by more than 25 years. His goal is to approach pulmonary fibrosis with the same commitment to finding treatment and finding a cure.

Indeed, this month’s support group was particularly celebratory. In addition to the 25-year anniversary, this past week 91Ě˝»¨Medicine announced the formation of the Center for Interstitial Lung Disease. The Center’s founding director is , 91Ě˝»¨professor of medicine in the Division of Pulmonary and Critical Care Medicine and co-director of 91Ě˝»¨Medical Center’s scleroderma clinic. Raghu is also the prescient doctor who had the foresight to start the long-running support group—the first of its kind in the world.

Said Raghu, ”The establishment of the Center for Interstitial Lung Diseases is an essential expansion of a long standing interstitial lung disease /sarcoidosis/pulmonary fibrosis program at 91Ě˝»¨Medical Center. The initiative will result in more accurate diagnosesĚýand better outcomes for patients confronted with the challenges of interstitial lung diseases. This is the beginning of a new and exciting era ofĚýsubstantial progress for our patients, who will now receive care tailored to the individual patient’s preference and choice based on current and new evidence. It is my most sincere privilege and honor to serve our patients and to work with everyone at 91Ě˝»¨Medical Center. It is a superb clinical and researchĚýenvironment, committed to maintaining and restoring health for those in need.”

For 91Ě˝»¨Medicine, establishing the Center for Interstitial Lung Disease means more opportunities for research, collaboration, training, and technology. For these incredible patients, who have supported each other for so long, the Center could mean a new lease on life.

A blow to the head can result in aĚý concussion, a condition in which the brain fails to function normally.

The researchers sought to identify risk factors for prolonged concussion symptoms by examining a large national database of high school athletes’ injuries. Previous concussion studies were limited in scope, focusing only on male football players. The information from this study applies to male and female athletes from a number of different sports.

Researchers found that athletes who have four or more symptoms at initial injury were more likely to have persistent concussive symptoms. Drowsiness, concentration difficulties, nausea and sensitivity to light and noise were also associated with longer-lasting concussive symptoms. Because concussions tend to be a common occurrence in football, researchers compared data from football players to other sports, and found that risk factors were different for football and non-football-related concussion.

The results of this study could change how long high school athletes are kept from returning to play after a concussion. Previously, athletes who lost consciousness were held out from playing longer than those who did not lose consciousness, but the study found little correlation between loss of consciousness and persistent symptoms.

Dr. Sara P. D. Chrisman, an adolescent medicine fellow in the 91Ě˝»¨ Department of Pediatrics, headed the study. She said, “The medical community is becoming more aware that concussions may not be a minor injury and may result in prolonged symptoms. This is a step towards developing evidence-based return to play guidelines.”

The study was carried out with the help of the Harborview Injury Prevention and Research Center and published by Brain Injury. The study was supported by the Ruth L. Kirchstein National Research Service Award.

In related news, several 91Ě˝»¨Medicine sports injury experts were among the co-authors of a on sports concussions released this week from the American Society of Sports Medicine. They are Drs. Kimberly Harmon, Jonathan Drezner, and Stan Herring.

The statement offers evidence-based best practices to assist physicians in evaluating athletes for possible sports concussions, and summarizes knowledge gaps and areas requiring additional research.

A number of factors seemed to underlie athletes’ reluctance to report concussive symptoms. Most athletes wanted to play, and knew that reporting symptoms might cause them to be pulled from the game. Athletes also expressed hesitation to report symptoms if they didn’t cause significant pain or prevent them from being able to play.

Concussive symptoms are nonspecific and athletes might attribute them another cause, such as viral illness. Athletes didn’t want to be wrong about being injured and then look weak or be misjudged by their teammates or coach. Athletes took the lead from their coach. If their coach had encouraged athletes to report concussive symptoms, athletes were more likely to report.

New laws in many states require athletes to be taught about concussion, but education alone is ineffective if it does not translate into concussive reporting behavior.

Dr. Sara P. D. Chrisman, an adolescent medicine fellow in the 91Ě˝»¨ Department of Pediatrics, led the study. She said, “Our research suggests coaches have a larger role to play in concussive safety than they realize. They set the tone for concussive symptom reporting, and if they send a message that athletes should tell them when they have concussive symptoms, athletes might actually tell them. Coaches are central to concussion management.”

The study was published in the Journal of Adolescent Medicine and funded by a 91Ě˝»¨ Graduate Medical Education grant and the Harborview Injury Prevention and Research Center.

No health care professional is an island. On October 30, nearly 450 91Ě˝»¨Health Sciences students from four schools convened as teams to apply their diverse skills in a medical scenario. Groups consisted of first-year physician assistant students, second-year pharmacy and medical students, and senior nursing students. Interprofessional education had earlier covered simulated urgent care situations and medical errors, but today’s situation forced the teams to reconsider their treatment plan for a hospitalized patient. In this case, an actress portrayed a fictionalized patient, Doris.

The student teams started by discussing diagnoses for Doris’s condition. Thirty professionals from all areas of the health sciences offered assistance when students were stuck. Teams created and submitted an initial plan of care, keeping in mind elements like medications, patient safety, comfort, follow-up, and psychosocial needs. Then, teams watched a video of Doris. She was telling them that she refused their recommendations. The student teams then brainstormed on the ethical, clinical and personal issued they were going through in figuring out what to do now in caring for Doris.

During the second half of the training event, videos of medical professionals who had cared for patients in similar situations applied their experiences to the complex case at hand. A physician explained efforts made to educate the patient about heart medications. A nurse talked about wanting to support the patient’s autonomy, yet being frustrated with the decisions the patient was making. The social worker addressed safety issues in the community. The pharmacist talked about trying to explain prescribed medications in a difficult situation. The occupational therapist shared concerns for the patient’s well-being.

In the end, student teams developed a care plan that met Doris’s preferences and she was discharged to her home. Students were disappointed at this outcome. They recognized that it is easier when patients do what the team wants, but that occurrences like this one require teams to communicate well and coordinate their care expertly.

As the training sessions came to a close, students rolled out buzzing with energy. Amy Tung, a pharmacy student, said she felt that “events like this prepare us to work in a team and remind us that we aren’t alone in making tough decisions.”

Other students were overheard praising their teammates and expressing respect for the breadth of knowledge and interest. Faculty member Sarah Shannon offers her perspective on the importance of these collaborative training events: “As new health care professionals, we are educated in silos, but expected to practice in teams. During my own nursing education, I had no experiences learning with other members of the care team. An experience like this or the other IPE [interprofessional education] events that our 91Ě˝»¨students have the opportunity to engage in would have better prepared me for the real world of patient care.”

Coordinators were Karen McDonough, associate professor of medicine; Sarah Shannon and Mayumi Willgerodt, both associate professors of nursing; Jennifer Danielson, clinical assistant professor of pharmacy, and Linda Vorvick, senior lecturer in the MEDEX physician assistant program. The Josiah Macy Jr. Foundation provided funding that helped to build this faculty teaching team. The 91Ě˝»¨Center for Health Science Interprofessional Education, Research, and Practice hosts and designs other events like this and is dedicated to teaching collaboration among health professionals.

For more information about the Center visit .

His most recent study, published in the Proceedings of the National Academy of Sciences has touched a nerve in the scientific community and beyond.

A 2011 report in Nature identified how many scientific papers had been retracted that year, but not necessarily the reason (because of errors or plagiarism, for example). In the new research, Fang and Dr. Arturo Casadevall of the Albert Einstein College of Medicine in New York found that among 2,047 papers retracted since 1977, misconduct—blatantly falsified data or data manipulation— was the cause in 41 percent of the cases.

Casadevall and R. Grant Steen of MediCC! Medical Communications Consultants in Chapel Hill, N.C., are Fang’s coauthors on the PNAS paper.

The research was spurred by Fang’s own experience. A couple of years ago, in his capacity as editor in chief of the journal Infection and Immunity, he was contacted by a medical school dean who told him that a reviewer noticed something suspicious in a paper submitted to another journal. The same author had previously published a number of articles in Infection and Immunity. After an investigation by the author’s institution, the author was forced to retract more than 30 papers, including the ones in Fang’s journal. The idea that this misinformation might have remained in the literature was unconscionable, Fang said.

He noted previous research by Dr. Donald Kornfeld, a Columbia University psychiatrist, that referred to those who commit such fraud as perfectionists, “ethically-challenged” and even “sociopathic.” Trainees who commit fraud are afraid of failure, while faculty members who do so display “a conviction that they could avoid detection,” said Kornfeld.

Fang is wary of the current system of scientific research and publications, particularly the competitiveness that seems to prize quantity and journal reputation over quality.

91Ě˝»¨researchers can air suspicions about research fraud to the Office of Scholarly Integrity on campus, and are protected from retaliation by a Washington state “whistleblower” law.

Angela Gonzales, a researcher with the 91Ě˝»¨Center for Clinical and Epidemiological Research Partnerships for Native Health, will bike from Bellingham, Wash., to Ventura, Calif., this month to raise money on behalf of cancer patients at the Hopi Reservation. ĚýShe will start pedaling with a group of riders Sept. 25 and plans to complete the trip Oct.Ěý 25.

What started as a 50^th birthday vacation bike tour has become a way for Gonzales, who is Hopi, to help her fellow tribal members more directly. Her fundraising ride is a personal gesture that is in addition to the cancer research she has been conducting over the past three years.

Gonzales is one of the project leads for the multi-university, National Cancer Institute-funded program called the Collaborative to Improve Native Cancer Outcomes. She is is also an assistant professorĚý of sociology at Cornell University.

Gonzalez and her research partner, Rachel Winer, 91Ě˝»¨assistant professor of public health, study human papillomavirus, also known as HPV, in American Indian populations. Their work could shed light on how American Indians on reservations understand HPV and how providers can help prevent and screen for the disease. Some forms of HPV are linked to cancer of the cervix and other less common but serious types of cancer

The goal of the collaborative is to approach cancer disparities as “systemic disorders of society,” and focuses on cultural attitudes toward smoking, cancer screenings, and surgical disparities in a number of different cancers.

“I’ve seen a lot of tribal members die of cancer. Almost all of my family is diabetic,” Gonzales said in a recent interview.

Her goal is to raise $10,000 for the Hopi Cancer Assistance Fund, which helps tribal members with cancer attend off-reservation treatment services. The services are most often in the Phoenix area, which can be over 500 miles roundtrip from the Hopi Reservation.

Gonzales will ride with a group from WomanTours, an all-female cycling tour group.

“I’m not necessarily an athlete, but I think cycling is an equal-opportunity exercise. It doesn’t matter about your age or weight,” she said.

Gonzales, who holds two Masters degrees and a doctorate from Harvard University, feels fortunate and thankful for her education and career, and added Ěýthat her tribal leaders were very pro-education.

“We had a lot of programs that supported education, and the idea is that you’ll come back [to the reservation]. But it’s hard—and I want people to understand that there are a lot of ways to give back without having to go back.” To follow Gonzales on her journey and support her efforts, visit her , Angela Bikes 4 Hopi.

91Ě˝»¨medical researchers are launching a study to help determine which of the two most common blood product combinations provide the best outcomes for trauma patients who require massive blood transfusions. Dr. Eileen Bulger, 91Ě˝»¨professor of surgery and chief of trauma at Harborview Medical Center, is the principal investigator for the clinical study.

The study will be conducted at 12 Level I trauma centers across the United States, including 91Ě˝»¨Medicine’s Harborview Medical Center. Bulger and her team will look at the results to determine which of the two blood product combinations prove better at preventing certain complications fromĚý traumatic injuries.This information will likely help determine how patients who are severely bleeding are transfused.

Trauma physicians will use such data as blood pressure, pulse, injury type, and ultrasound test results to predict whether emergency patients will require a significant amount of blood products.

The Harborview Blood Center will provide randomized combinations for eligible patients: one that provides more plasma and platelets, and one that gives less. All other treatments will be the same. Patients whoĚý chose not to participate in this study will receive the amount and type of blood product determined by their trauma physician.

All blood products used for the study will be the standard FDA licensed blood products patients would normally receive for transfusions. ĚýBecause this study is being conducted on patients who have suffered severe trauma and are unlikely to be conscious, informed consent will most likely be impossible to obtain. Because of this, the 91Ě˝»¨Institutional Review Board (IRB) that oversees all clinical studies has granted the study a waiver of consent. ĚýStudy leaders will be conducting community consultation meetings to provide the general public with more information about the study.

ĚýAnyone who does not wish to be involved in this study can contact the study nurse at 206-744-7724 and ask for a red silicone wristband with “PROPPR” indicated. The band will ensure that the wearer will not be screened or enrolled into this studyĚý if he or she arrives unconscious at a trauma center.

If you would like to schedule a community consultation meeting or would like more information, please contact the study nurse at 206-744-7724 or email