Single cell dissection of plasma cell heterogeneity in symptomatic and asymptomatic myeloma

Multiple myeloma, a plasma cell malignancy, is the second most common blood cancer. Despite extensive research, disease heterogeneity is poorly characterized, hampering efforts for early diagnosis and improved treatments. Here, we apply single cell RNA sequencing to study the heterogeneity of 40 individuals along the multiple myeloma progression spectrum, including 11 healthy controls, demonstrating high interindividual variability that can be explained by expression of known multiple myeloma drivers and additional putative factors. We identify extensive subclonal structures for 10 of 29 individuals with multiple myeloma. In asymptomatic individuals with early disease and in those with minimal residual disease post-treatment, we detect rare tumor plasma cells with molecular characteristics similar to those of active myeloma, with possible implications for personalized therapies. Single cell analysis of rare circulating tumor cells allows for accurate liquid biopsy and detection of malignant plasma cells, which reflect bone marrow disease. Our work establishes single cell RNA sequencing for dissecting blood malignancies and devising detailed molecular characterization of tumor cells in symptomatic and asymptomatic patients

“Clean Air for Babies” App: A smoking cessation mobile app based on Cognitive Behavioral Therapy combined with personal counseling to help expectant mothers quit smoking.

Introduction Approximately 5%-10% of pregnant women smoke worldwide, placing their unborn babies under risk of complicated medical conditions. To date, common smoking cessation treatments have shown to be less adequate for smoking expectant mothers since the safety of anti-smoking medications during pregnancy has not yet been clearly proven, and current behavioral interventions available today fail to meet the intense emotional needs of this population. Our company, Mind Innovations, develops and integrates digital health solutions. Our aim is to reduce perinatal smoking by developing a clinical-based solution tailored specifically to the expectant mother that consists of three modules: (1) CBT-based mobile app, (2) 6-week personal counseling program, and (3) Patient Relationship Management (PRM) tool. We expect this will fill the gap where other solutions fall short by better addressing this population’s unique needs. Methods Mind Innovations collaborated with Meuhedet Health Provider, Israel to develop, implement, and recruit patients for this program. We created an 18-hour clinical training course designed to qualify experienced counselors for running a 6-week personal counseling program that prepares the perinatal smoker towards her quit date aided by our PRM. We developed a CBT-based app that provides motivation, knowledge, and training for preparing patients to succeed in meeting their quit date and preventing relapses Results We used questionnaires to evaluate our counselor training course. Results show satisfaction was very high (Mean=9.81/10 ;sd=0.48), and knowledge and skills increased from 5.93 to 8.86 (on a scale of 1-10, paired t-test ; p<0.001). The intervention program’s results will be published soon. Conclusions Counselor training has proved successful. Our mobile intervention program is undergoing research. Funding The project was funded by Global Bridges organization for Meuedet Health provider, Israel, and developed by Mind Innovations, a company specializing in developing digital health solutions

Clean air for babies: an integrated support system and app designed to increase perinatal smoking cessation

Aim and Objective Approximately 10% of pregnant Israeli women smoke. To date smoking cessation programs across Israel consist mainly of group interventions, but these have shown to be less effective during pregnancy due to the demand for intensive and immediate support. Smoking cessation during pregnancy is further complicated, as smoking while pregnant leads to feelings of guilt and shame. Such anxiety has been shown to lead to mood shifts and in some cases depression. Meuhedet is the third largest healthcare provider in Israel with over 1.2M members, many relatively young, with 30,000 births annually. One of our major concerns is perinatal smoking. We are currently developing an integrated support program consisting of two modules: a unique counsellor training program and a 6-week active intervention program, including use of a specialized app. We have already completed the counselor training program and are currently running the 6-week intervention program. We have partnered up with MindInnovations.co—a company focused on creating innovations in therapeutic care—in order to create the CBT-based app. The app provides motivation, knowledge, and skills by tracking progress, assigning tasks, and providing participants with a clear pathway towards their quit date. Methods Our counselor training program gave smoking cessation counselors practical clinical tools for delivering extensive emotional support to expectant mothers. This program integrated theoretical background with practical protocols to attend the patients’ intense emotional needs, based on current psychological theories (CBT, Narrative Therapy, Motivational Interviewing, Stages of Change and Mindset Theory). This was conducted over a 36-hour course to a group of experienced smoking cessation counselors. Our perinatal smoking intervention program is ongoing, and the app is in its final stages of development. Results Thirty-six smoking cessation counselors completed the training course. We used questionnaires to evaluate knowledge and skills pre-and post-intervention, and participant satisfaction. Satisfaction was very high (Mean=9.81/10 ;sd=0.48) with high correlation between all items. Most participants responded that the materials were new to them (2.21/4 on a scale of 1-4, with 1 being “highly agree”). Knowledge and skills increased from 5.93 to 8.86 (on a scale of 1-10, paired t-test; p<0.001). We are enthusiastic to report on the intervention program, as well as the app, in the coming months. Conclusions Our advanced training module for experienced counselors significantly increased their skills and met their expectations. Treatment commences at this period of time. Our presentation focuses on our consultation training module and our overall program, including our smoking cessation app. Funding The project is being funded by the Global Bridges organization