Dr. Michael Belzer given U of M’s 2015 Harold S. Diehl Award

DRBelzer #2Congratulations to Dr. Michael Belzer for being named the 2015 Harold S. Diehl Award recipient from the University of Minnesota Medical School. Established in 1962, this prestigious lifetime award is granted to individuals who have made outstanding professional contributions to the Medical School, the University, and the community.

The award was presented to Dr. Belzer at the Medical School Alumni Awards Banquet on Thursday, September 17 at the University’s McNamara Alumni Center.

Additionally, Dr. Belzer was the recipient of the University of Minnesota Medical School  Distinguished Alumni Award in 2004 and is the only individual to have won both Medical School awards since their initiation.

Since 1990, Dr. Belzer has been Medical Director/Chief Medical Officer of Hennepin County Medical Center.

Announcement of Vacancies on the Board of Directors of Hennepin Healthcare System, Inc.

Hennepin Healthcare System, Inc. (HHS), doing business as Hennepin County Medical Center, is a public corporation operated as a subsidiary of Hennepin County. Its purpose is to engage in the organization and delivery of health care and related services to the general public, including the indigent as defined by state and federal law as determined by the Hennepin County Board of Commissioners, and to conduct related programs of education and research.

A process is now under way to review and recommend candidates to fill up to four three-year terms on the HHS Board of Directors, beginning in January 2016.  Potential candidates will be considered by the Governance Committee of the HHS Board of Directors, whose recommendations will be considered by the full HHS Board. That Board will recommend a slate of candidates for these positions that will be forwarded to the Hennepin County Board of Commissioners for its consideration and vote to approve or reject the slate.

The statute creating HHS provides that members of the board shall possess a high degree of experience and knowledge in relevant fields and possess a high degree of interest in the corporation and support for its mission. Members shall be appointed based in part on the objective of ensuring that the corporation includes diverse and beneficial perspectives and experience including, but not limited to, those of medical or other health professionals, urban, cultural and ethnic perspectives of the population served by the corporation, business management, law, finance, health sector employees, public health, serving the uninsured, health professional training, and the patient or consumer perspective.

Interested persons should send a letter and their resume to the Executive Committee, c/o Craig Caldwell-Kirzan, S6, Hennepin Health care System, Inc., 701 Park Avenue, Minneapolis, MN 55415-1676, by Wednesday, October 7, 2015.

More information about the corporation can be found at www.hcmc.org.

HCMC receives message from space


Source: NASA

Today Dr. Kjell Lindgren, the astronaut who received his medical training at HCMC, took a photo of Minneapolis from the International Space Station and sent a hello to his friends and colleagues @hennepinmedical!

For more information about Dr. Lindgren what he and his colleagues are doing aboard the International Space Station, go to www.nasa.gov.

Summary of Expedition 45
Follow Dr. Kjell Lindgren to the International Space Station
HCMC-trained astronaut MD Kjell Lindgren launches to International Space Station 

Positive Care Center gets top scores in MN Survey

The Positive Care Center at Hennepin County Medical Center was recently 104787781recognized for providing an exceptional patient experience in the 2015 Patient Experience of Care Survey.

Conducted by the Minnesota Department of Health and MN Community Measurement, the survey evaluated 765 primary care and specialty clinics using feedback from 200,500 patients. The Positive Care Center was one of the top 15 clinics for two out of four patient experience measures.

Dr. Nicholas Vogenthaler

Dr. Nicholas Vogenthaler

Dr. Nick Vogenthaler, the clinic’s medical director, was recently quoted in a Star Tribune article about the survey.

“A smile goes a long way,” he said. Read the entire article at http://www.startribune.com/ratings-reveal-minnesota-clinics-with-best-communication-access/323035851/

The Positive Care Center is staffed by a multi-disciplinary team committed to providing quality, comprehensive health and psychosocial services to those living with HIV. The program provides education, serves as a community and family resource, and contributes extensively to the advancement of HIV-related knowledge.

Positive Care Center Staff

Positive Care Center Staff

Eye Tracking Has High Sensitivity as a Biomarker for Concussion

Dr. Uzma Samadani

Dr. Uzma Samadani

Eye Tracking Detects Concussion with Sensitivity Comparable to that of Blood Tests for Heart Attack

New technology that tracks the eye movements of patients may be a more accurate measure of brain injury than any other diagnostic measurements currently in use, according to a study published in the journal Concussion. Dr. Uzma Samadani, who recently joined Hennepin County Medical Center, in collaboration with researchers at the Steven and Alexandra Cohen Veterans Center at NYU Langone Medical Center, developed the technology that can serve as a biomarker for concussion by tracking patients’ eye movements as they watch music videos.  

Eye tracker device demonstrated by subject

Subject participating in eye tracking study

The eye tracking technology works by having patients watch a music video for 220 seconds while eye movements are measured using a tracking camera.  Videos used in the study ranged from Disney’s Puss in Boots to Wavin Flag by K’Naan.  Multiple measures of each eye’s movement, followed by comparisons of their positions over time are used to distinguish between normal subjects and those with concussion.

In the work, led by Uzma Samadani, MD PhD, Charles Marmar, MD, and Eugene Laska PhD, the investigators built a classifier based on 34 emergency room patients with brain injury and 34 uninjured healthy control subjects of similar age. A classifier is a mathematical model that converts a patient’s eye movement measures into a prediction of the concussive status of the individual. They then tested the models on a dataset of 255 subjects, of whom 8 had concussions, and found that the eye tracking test had an optimal sensitivity of 88% and specificity of 87%.

Typically, a classifier produces a score and a subject is classified as having a concussion if the score exceeds a predefined threshold value. The accuracy of a biomarker is measured by plotting the probability of a true versus false positivity at each possible threshold value and the Area Under the Curve (AUC) is computed. A perfect biomarker has an AUC of 1.00, while a worthless marker – no better than the chance toss of a coin – has an AUC of 0.50.  Most tests used clinically have AUC’s greater than 0.80.  For example, serum troponin, the most commonly performed blood test for heart attacks has an AUC ranging in various studies from 0.76 to 0.96.  In this study, the eye tracking based classifier had an AUC of 0.88, and a cross-validated AUC of 0.85.

According to Dr. Samadani, the major challenge for any technology proposed as a biomarker for concussion is first defining concussion.  “When doctors look for a biomarker for heart attack, it is relatively easy to check the accuracy of a potential candidate because they can perform a cardiac catheterization and confirm that the heart vessel is blocked and an attack has occurred.  There is no analogous capability with brain injury – there is no gold standard diagnostic, no blood test, and no imaging study for definitively concluding that a patient has experienced a concussion.  We use symptom severity scales and standardized cognitive examination assessments but the imperfect nature of these may result in incorrect subject classification. Potentially, eye tracking may be more accurate than it appears, because of its objective appraisal of a complicated process of coordination that may be impaired.”

The investigators defined concussion as (1) trauma to the head with a normal CT (computed tomography) scan of the brain, (2) symptom severity score of 40 or greater on SCAT3 testing and (3) standardized assessment of concussion (SAC) score less than 24.  The symptom severity score measures the self-reported severity of 22 concussion symptoms ranging from headache to dizziness and irritability.  The SAC measures orientation, memory, and concentration – capabilities which have some variability even among uninjured healthy control subjects.

In an accompanying editorial that also appears in the journal, Dr. Samadani proposes that eye tracking will help diagnose and classify brain injury and concussion, particularly in patients with elevated pressure inside their skulls and disruption of pathways in the brain that control eye movements.

“The ultimate goal for brain injury” said Dr. Samadani, “is to achieve the same level of diagnostic capability and care as currently exists for other medical conditions.  Right now when someone comes in to the emergency room with chest pain, doctors perform an EKG, blood test, imaging, and treatment.  With brain injury we need to be able to achieve the same level of care – to assess all aspects of the problem rigorously, classify, and treat accordingly.  We already know that there is much more to brain injury than what is seen on a CT scan.  Eye tracking tells us how well the brain is working regardless of how it looks, and represents the beginning of a solution to this problem.  It is non-invasive, inexpensive and extremely quick.  Testing does not require reading nor language skills which makes it useful for multiple patient populations.”

Commenting further on the study was Dr. David Cifu, the Herman J. Flax, M.D. Professor and Chair of Rehabilitation at Virginia Commonwealth University, Senior TBI Specialist with the U.S. Department of Veterans Affairs and Principal Investigator of the VA/Department of Defense Chronic Effects of NeuroTrauma Consortium.

“This innovative research by Samadani and colleagues highlights a novel approach to objectively and rapidly support the diagnosis of acute concussion using a novel technique of assessing eye tracking. This publication may represent the first step in the development of a more exacting method of diagnosing and monitoring recovery from traumatic brain injury. Computerized assessment of eye tracking may represent the first truly useful biomarker of TBI.”

Brain injury is the number one cause of death and disability in Americans under age 35, according to the U.S. Centers for Disease Control and Prevention. Every year, 1.4 million people suffer from a traumatic brain injury in the United States. Of those, 50,000 die and 235,000 require hospital admission.  Internationally it is a leading cause of death in India and China where access to radiographic diagnostics is also limited.

Dr. Samadani is the Rockswold Kaplan endowed chair for traumatic brain injury at Hennepin County Medical Center and an Associate Professor of Neurosurgery at the University of Minnesota.  Dr. Marmar is the Lucius N. Littauer Professor and Chair of the Department of Psychiatry at NYU Langone Medical Center and Director of its Cohen Veterans Center. Dr. Laska is a statistician at the Nathan Kline Institute for Psychiatric Research and a Research Professor of Psychiatry at the NYU School of Medicine.  Other co-authors of this study include Meng Li MA, Meng Qian PhD, Robert Ritlop M Eng, Radek Kolecki MS, Marleen Reyes BA, Lindsey Altomare BA, Je Yeong Sone, Aylin Adem, Paul Huang MD, Douglas Kondziolka MD, Stephen Wall MD, and Spiros Frangos MD. Technology described in this paper has been licensed to Oculogica Inc., a neurodiagnostic startup company in which NYU, Dr. Samadani and Robert Ritlop have an equity interest.

The work was supported in part by the Steven & Alexandra Cohen Veterans Center for the Study of Post-Traumatic Stress and Traumatic Brain Injury at NYU Langone.

Follow Dr. Kjell Lindgren to the International Space Center

Listen to Healthy Matters on WCCO Radio Sunday, August 2 at 7:30 AM when Dr. Brunette discusses his trip to Kazakhstan. 

Dr. Douglas Brunette was invited by his former student, astronaut Dr. Kjell Lindgren, to watch his launch to the International Space Center from the Cosmodrome in Kazakhstan on Wednesday, July 22. Here are some of the daily posts Dr. Brunette is sending from his trip.

We watched the docking with the ISS live, followed by the hatch opening. It was great. Kristi (Kjells wife) and their kids had a live video conversation that was great to witness.

6:03 PM  Launch was absolutely beautiful.

Not a cloud in the sky. The ISS passed directly overhead, and 30 seconds later the rocket lit up to go and chase it. Deafening sound, lit up the pitch black sky, physically rattled your chest.

launch 7/22

launch 7/22

We were able to track it all the way to loss of second stage rockets, which meant they were in space. Then we toasted Russian vodka…

We leave for Mission Control in a couple of hours to watch the docking with the ISS and then the hatch opening to greet Kjell aboard the ISS.

Per Kjells recommendation, I did not photo the launch. He told me to sit back and enjoy it, which is what I did. It will be available on NASA.gov.

Launch was textbook with the exception of one solar array that did not deploy, which is a minor issue that can be dealt with after they dock.

Dr. Matt Herold, Dr. Douglas Brunette

Dr. Matt Herold, Dr. Douglas Brunette

Matt Herold is the person in the photo with me, an HCMC classmate of Kjell.

Dr. Lindgren saying goodbye to his children.

Dr. Lindgren saying goodbye to his children.

10:46 AM I have so much to write, but very little time. Attached are photos of the crew getting onto the bus that will be taking them to the launch site.

One of these photos is Kjell from inside the bus making his hands into a heart for his children, telling them he loves them.

One tradition is for each astronaut to plant a tree. There is impressive walkway of trees dating back to the first person in space, Yuri Gagarin. Kjells tree is obviously small and has a lot of growing to do!

7:46 AM Update since my recent last post. Typical Kjell…just hours from being hurled into space he sends me a very personal email the content of which I will mostly keep to myself.

However, he specifically stated he is extremely grateful for the support and interest that HCMC has demonstrated during these last few months, and considers himself humbled and privileged to have trained at HCMC, and thanks everyone for their support.

7:29 AM
Just a few hours left until launch!

It has been a clear, no clouds in the sky day, which should make for a beautiful launch. We will wave to Kjell when he exits the Cosmonaut Hotel, which is next to our hotel within the Cosmonaut Space Center.  We drive to Building 254 which is near the launch site (I think that’s the number), and again wave to Kjell when he exits wearing his full spacesuit en route to the launch pad.

At around midnight we apparently will be having a feast of a dinner meal before the 3am launch. Kjell will be spending close to 3 hours on his back in a fetal position, wearing his spacesuit, going through a very long pre-launch checklist.

We will be outside to watch the launch, approximately 0.7 miles from the launch pad. NASA shuttle launch viewing was from 3 miles, so this should be quite a show!

Post launch I think I will have some time to email photos before we go to Mission Control for watching the docking to the ISS and hatch opening.

Hope all is well. I have decided I would rather live on the frozen tundra (Minnesota) than the searing desert plains…

Low key day today. Toured space museum, lots of interesting fun facts, but hard to understand many exhibits as they were in Russian.

International press conference held tonight. There were several hundred reporters present. Astronauts behind glass in quarantine.

I am not sure when I will get to email you again. We leave for launch site tomorrow at 8pm our time (9am your time). Launch is at 3:00am our time (4 pm your time). After launch, we drive to Mission Control to watch the docking to the International Space Station at approximately 9am our time (10pm your time). We stay at Mission Control to watch the hatch opening and the astronauts board the International Space Station at approximately 10:30am(11:30pm your time).  Kjell will be able to communicate with us at Mission Control when he boards the ISS.  We then pack and go to the airport to travel back to Moscow.

So internet access will be a problem for me tomorrow. If I cant send anything, I will report in the day after the launch.


Dr. Lindgren, Oleg Kononenko, and Kimiya Yui

Great and fascinating day. Got up early to see the rocket roll out of the hangar. It was placed horizontally onto a train, and moved about 0.5 miles to the launch site. We were 10 yards away from the railroad tracks when it passed. Unbelievable sight.

Went to the launch site, and it was raised vertically into blast off position, where  we stood just a few yards away.

Then had a private meeting with Kjell. Just his family (mom, dad, sister, his kids, and Matt and myself) . Kjell was behind glass partition re: quarantine. We met with him for an hour. It was funny at times, very emotional at times for all in the room. It was a wonderful hour.

Low key day tomorrow. Visiting the Cosmonaut Museum, attending press conference.

The launch is 3 am Kazakhstan time on July 23rd, and we are 11 hours ahead of you. So launch for you will be 4 pm Wednesday, July 22nd.

We will be up for 30 straight hours or so on launch day. More on that later.

Day 3. Long day. Left hotel at 5am to airport for three hour flight into Baikonur, Kazakhstan. It is about 100F today. It is a desert, at least the part of the country that we are in. We are staying at the Sputik Hotel.

Kristi Lindgren and Kjell’s parents are going to see Kjell tonight. They will get to see him one more time about 5 hours before launch. None of the rest of us are allowed to see him.

We get up again early tomorrow, I think around 5am to go watch the rocket rollout of the hanger and head to the launch pad.

The airplane we flew in and a view of the terrain right before we landed:

We went to Star City today, which is where the astronauts and cosmonauts train. Fascinating. We also ate ISS freeze dried food – not so good…

We skyped with Kjell today — he is ready to go. We leave on 3-hour flight tomorrow morning to Kazakhstan.

Attached are some photos of the capsule that Kjell will be sitting on his back in during launch. Quite small a space. This is the training capsule, just like the real deal.

Arrived yesterday morning in Moscow after overnight flight.


St. Basil Basilica

Took a tour with our NASA astronaut guides of Red Square (see photo of St. Basil Basilica, built by Ivan the Terrible).

Went to dinner last night with Kjell’s parents and sister, and communicated with Kjell via email from the dinner table.

Kjell is in quarantine, so he does not get ill before launch. Everything is still a go. Kjell puts on his spacesuit today and climbs aboard the rocket capsule to get another feel of it.

We are traveling to Star City, Russia, about one hour outside of Moscow today. It is where NASA astronauts train in Russia.

Tomorrow we have an early chartered NASA flight, 3 hours, to Baikonur, Kazakhstan where the launch will take place at 3am local time on July 23rd.

HCMC-trained MD Astronaut Kjell Lindgren launches to International Space Station next week

official Expedition 44 crew portrait. Soyuz 42 (Gennady Padalka, Mikhail Kornienko, Scott Kelly) and Soyuz 43 (Oleg Kononenko, Kimiya Yui and Kjell Lindgren).

Official Expedition 44 crew portrait. Soyuz 42 (Gennady Padalka, Mikhail Kornienko, Scott Kelly) and Soyuz 43 (Oleg Kononenko, Kimiya Yui and Kjell Lindgren).

Excitement is building at Hennepin County Medical Center (HCMC) as they count down the days to NASA’s Expedition 44/45 launch on Wednesday, July 22. The Soyuz spacecraft will carry a crew to the International Space Station that includes astronaut Kjell Lindgren, MD who completed his medical residency in HCMC’s Emergency Department where he was also Chief Resident.

Dr. Lindgren (far left)  and crew.

Dr. Lindgren (far left) and crew.

Dr. Lindgren will serve as flight engineer for this mission, which was originally scheduled to launch on May 25, but was delayed after an unmanned Russian cargo spacecraft failed to reach the International Space Station (ISS) on April 30. An investigation into the malfunction had to take place before Expedition 44/45’s launch could be rescheduled.

Dr. Doug Brunette

Dr. Doug Brunette

“Of course we were concerned about Kjell’s mission after hearing about the Progress 59P problem,” explains Dr. Douglas Brunette, referring to the cargo spacecraft that eventually burned up after re-entering the Earth’s atmosphere. “But it’s better to be safe and wait until the cause of the problem was figured out, and we had every confidence that the launch would be rescheduled.”

Dr. Brunette supervised Dr. Lindgren’s medical training in the Emergency Department, and he was invited by Dr. Lindgren to be his guest in Kazakhstan to watch the launch from the Cosmodrome.

“I feel so honored that Kjell asked me to be there. Of course it’s a once in a lifetime opportunity for me, but to see my former resident – whom I now consider a friend and colleague – fulfill his dreams of being an astronaut, it’s just so exciting,” said Dr. Brunette, who leaves for Kazakhstan on July 16.

Hospital employees are counting down the days to the launch with posts on social media and even a Russian-themed menu in the cafeteria. For more information about NASA’s Expedition 44/45 as they prepare for their launch, go to: https://blogs.nasa.gov/spacestation/