EM Newsletter Spring 2020

SPRING 2020 VOL. 1 THE FRONTLINE The Newsletter of Brigham Health's Department of Emergency Medicine IN THIS ISSUE IN THE NEWS IN THE NEWS Dr. VanRooyen named J. Stephen Bohan Professor IMPORTANT MILESTONE of Emergency Medicine at HMS IN HAITI SPOTLIGHT ON Left to right: Dr. Elizabeth Nabel, Dr. Michael VanRooyen, Dr. Stephen Bohan, Dr. Ron Walls, and Dean George Daley. AWARDS In March 2020, HMS conferred the title of the J. Stephen Bohan PROMOTIONS Professor of Emergency Medicine at Harvard Medical School to Michael VanRooyen, MD, MPH. Dr. VanRooyen was fêted at a COVID RESEARCH IN ceremony with the Deans of the medical school, his family and EMERGENCY MEDICINE close friends. COVID-19 GRANTS PUBLICATIONS THROWBACK: FACULTY RETREAT

Adaira Landry, MD, M.Ed Important Milestone Advisor and Associate Director in Haiti Walter Bradford Cannon Dr. Betsy Nabel announced in her February Society 2020 President’s Message the recently awarded institutional accreditation by the Adaira Landry, MD, M.Ed was named the Academic Society Accreditation Council for Graduate Medical Associate Director and Advisor for the Walter Bradford Cannon Education International of the five residency programs at Mirebalais University Hospital in Society at Harvard Medical School. The Cannon Society at Haiti, including the emergency medicine HMS is committed to the promotion and support of the residency program. Regan H. Marsh, MD, MPH and Shada A. Rouhani MD, MPH were academic and professional development of its students. The instrumental in developing and leading the Society encourages scholarship, personal growth and residency program at Mirebalais University Hospital though they weren’t specifically collegiality through a system of academic advising and a named in the President’s communication. We series of enrichment programs. The Society acts as a social would like to recognize the enormous effort center for Cannon students and encourages on-going contact that Drs. Marsh and Rouhani made in creating between students and faculty. Cannon Society faculty provide the first emergency medicine residency program in the country. The Accreditation students with personal and professional support and help Council for Graduate Medical Education guide students through their educational experience. International accredits medical residency and fellowship programs around the world. New Member of the Office of Faculty Affairs In April, the Chair named Stephanie R. Kayden, MD, MPH as Vice Chair of Faculty Affairs and Timothy B. Erickson, MD as the Vice Chair of Academic Affairs. Dr. Kayden will oversee such faculty administrative activities as the annual review process, FTE coverage, HR matters, onboarding and faculty development programs and assist with cross-cutting initiatives (i.e., Diversity/Inclusion, Wellness, Women’s Group). Dr. Erickson will continue to oversee faculty academic activities such as appointments and promotions, recruitment of BH faculty, awards and recognition, and strategic initiatives in the Department of Emergency Medicine. Vice Chair of Global Business Development Dr. Luis F. Lobón, MD, MS, was recently named Vice Chair of Global Business Development (GBS). In this role, Dr. Lobon will oversee all external business activities in the Department and coordinate all external consulting with BWH and the BWPO, including external partnerships, oversight of all contracting and coordination with IEDLI and other leadership development programs.

SPOTLIGHT ON Calvin A. Brown, III, MD in the news Calvin A. Brown, III, MD and David Preiss, MD, PhD, from Anesthesiology, were recently highlighted in the Boston Herald for their work developing the plastic hood used to intubate patients in the ED. The hood, made from plumbing material and a single-use plastic drape, is designed to protect medical staff from droplet contamination. ROBOT-DOC Peter R. Chai, MD, MMS was recently highlighted in the Boston Globe, the New York Times and The Washington Post for his work with Boston Dynamics’ robot dog, Spot. Spot is being used in the clinical testing tent at Brigham and Women’s Hospital, allowing hospital workers to speak to suspected COVID-19 patients from a distance via a tablet on Spot’s “face”. A RISING STAR... Onyekachi T. Otugo, MD, MPH is the senior Health Policy and Research Translation fellow in the Division of Health Policy and Public Health and is currently a Master of Public Administration degree candidate at the Harvard Kennedy School of Government. As a fellow, Dr. Otugo is studying racial and ethnic disparities and access to care issues. She received a competitive grant from MACEP to determine differences in language used in medical student letters of recommendation based on race and ethnicity. She is also beginning work to determine if there are differences in injection drug-related infections based on community access to addiction treatment services. Her previous experience included a fellowship at the FDA evaluating sex-related discrepancies in clinical trials, advocating with ACEP on the state and federal level, addressing the obesity epidemic in school-aged children in Chicago, and an MPH degree at Northwestern University. Dr. Otugo is a rising star in public health!

AWARDS Edward W. Boyer, MD, PhD Leadership Development Physicians and Scientists Edward W. Boyer, MD, PhD was selected for the Leadership Development for Physicians and Scientists at Harvard Medical School/Harvard School of Dental Medicine. Alice K. Bukhman, MD, MPH AWAEM \"Catalyst\" Award Dr. Bukhman was awarded the AWAEM \"Catalyst\" Award recognizing female faculty who have made outstanding contributions through clinical work, teaching, mentorship, role modeling, or administration with great local or regional impact. The spirit of this award is designed to recognize those who contribute significantly to their department or the field of EM but who may have escaped national recognition. P. Gregg Greenough, MD, MPH Academic Achievement Award (GEMA) Dr. Greenough was awarded the Academic Achievement Award in recognition to his significant contributions to the subspecialty of Global Emergency Medicine through investigative research and/or educational endeavors. This award is given to an individual whose research has helped to move the field of Emergency Medicine forward and also recognize an individual whose educational endeavors have served to prepare many future leaders in Global Health and Emergency Medicine, as evidenced by publications. Dana Im, MD AWAEM Resident Award and SAEM Travel Scholarship Dr. Im was awarded the AWAEM Resident Award and SAEM Travel Scholarship. This scholarship honors female EM residents who have shown promise for significant career achievements in emergency medicine through research, education, service, advocacy, or administration. Adaira I. Landry, MD, M.Ed. & Eric Goralnick, MD, MS Young Mentor Award Adaira I. Landry, MD, M.Ed., and Eric Goralnick, MD, MS were each selected for the Young Mentor Award at Harvard Medical School. This award recognizes faculty with less than 10 years who devote significant time to providing mentorship to others.

Megan M. Rybarczyk, MD, MPH Global Emergency Medicine Education Award (GEMA) Megan M. Rybarczyk, MD, MPH was part of the team that was awarded the Global Emergency Medicine Education Award by SAEM’s Global Emergency Medicine Academy (GEMA) in recognition of their work creating sustainable education solutions, educational curriculum and projects encouraging the growth and development of emergency physicians internationally. Eric J. Nilles, MD, M.Sc. Humanitarian Service Award (GEMA) Eric J. Nilles, MD, M.Sc. was awarded the Humanitarian Service Award from SAEM’s Global Emergency Medicine Academy (GEMA) in recognition of his dedication and expertise in providing humanitarian assistance to distressed populations in a disaster situation and creating access to sustainable care Yeu-Shin Cindy “CJ” Chang MD, MPH AWAEM Early Career Research Award Yeu-Shin Cindy “CJ” Chang MD, MPH was awarded the AWAEM Early Career Research Award that honors an early career female faculty who has shown promise for significant career achievements in emergency medicine through research and who has worked to promote the role of women in academic emergency medicine. Charlotte Goldfine, MD MACEP Fellow of the year Charlotte Goldfine, MD, our newest faculty member was awarded the 2020 MACEP fellow of the year for her excellent work as a toxicologist to be, teacher and researcher! Desiree Azizoddin, PsyD, MS Kornfeld Scholars Program Award Dr. Azizoddin was selected for the 2020 National Palliative Care Research (NPCRC) Award’s Kornfeld Scholars Program for her project on Harnessing Mobile Technology to Deliver Tailored, Brief Pain-CBT for Advanced Cancer Patients on Opioids for Pain. She will join our Division of Medical Toxicology in July.

PROMOTIONS Elke Platz, MD, MS Eric Goralnick, MD, MS AssociateElke Platz, MD, MS was promoted to AssociateEric Goralnick, MD, MS was promoted to Professor of Emergency Medicine on 1/1/2020. Elke Professor of Emergency Medicine on 4/1/2020. As served as Research Director in the Division of Emergency the Medical Director for Emergency Preparedness at Brigham Health, Eric leads the institutional and regional Ultrasound where her work focused on research efforts to prepare for, mitigate, respond to and recover from a wide array of crises that require multidisciplinary investigations in the sonographic assessment of approaches to complex problems such as mass casualty events and institutional disasters, such as information breathless patients using lung ultrasound (LUS) and system downtimes, medication shortages and adverse weather events. He is a nationally recognized leader in echocardiography, and translating the knowledge into emergency preparedness and the creator of resilient health system. He has led many initiatives to improve practice. She led an observational study that safety for patients, family and staff during a variety of crises and has been dedicated to layperson demonstrated that lung ultrasound clip length rather empowerment to treat life threatening hemorrhage. Dr. Goralnick has volunteered time with various veteran than type of ultrasound machine impacted the number group to assist in their transition to civilian life and established and leads the Harvard Medical School of B-lines. Her observational study funded by the Civilian Military Collaborative. He was awarded the Boston Celtics “Heroes Among Us” award for his American Heart Association investigated the prognostic “overwhelming impact on the lives of others”. importance of lung ultrasound-detected pulmonary congestion in the cardiology outpatient clinic at BWH. This was one of the first to discover that heart failure patients with the highest number of ‘B-lines’ had a four- fold higher risk of heart failure hospitalization or death over the following 6 months. Dr. Platz served as the leading authority on the lung ultrasound component of a national and international expert consensus statement on the use of both echocardiography and lung ultrasonography in patients with acute heart failure. More recently, Dr. Platz initiated and led an international group of physicians with expertise in lung ultrasound research, heart failure, epidemiology and clinical trials in the development of a reporting checklist for quantification of pulmonary congestion by lung ultrasound in heart failure. Another study identifying the optimal needle length for pediatric epinephrine autoinjectors led to the FDA approval of a new epinephrine autoinjector specifically for infants and toddlers with allergic reactions. Dr. Platz recently transferred her research activities to the Division of Cardiology in the Department of Medicine at Brigham Health but retains a secondary appointment in Emergency Medicine.

Matthew J. Brochu, PA, MPH Eleanor Graber, PA Matthew J. Brochu, MPH, was recently promoted to PA Eleanor Graber was recently promoted to PA II in III/ Senior PA in recognition of his strong work and recognition of her work with substance use disorder collaboration as the Quality and Safety PA Lead and patients. She received the 2019 PA Foundation’s his participation on peer review for PA cases, in National Institute on Drug Abuse Mentored Outreach addition to his support for PAs in the M&M process and Award that funded a year-long project filming the contributions to the PRC team. stories of substance use disorder patients to share with medical professionals in an effort to (1) improve Michelle L. Greer, PA communication between providers and SUD patients, (2) expand treatment for patients by encouraging Michelle L. Greer was recently promoted to PA III/ providers to obtain a Suboxone waiver, and (3) to Senior PA in recognition of her long-standing improve opioid prescribing habits. She also created dedication to EM PA Education. She consistently the website www.EveryUserHasAStory.org as part of coordinates quality lectures and hands on training in this project which was featured in an AAPA article order to provide the EM PA team with the most up to highlighting the work. https://www.aapa.org/news- date and relevant education, in order to help the EM central/2019/10/every-user-has-a-story-pa-aims-to- PA team provide the best patient care. humanize -patients-with-sud. One of her videos was also featured at the American Public Health Kelly K. Long, PA Association’s annual conference in Philadelphia, PA in 2019. Kelly K. Long was recently promoted to PA III/ Senior PA in recognition of her leadership in establishing the Kelly K. Long, PA PA Chart Review Program, which includes the top ten pitfalls and improvements in charting. She created an Bethany S. Snow was recently promoted to PA III/ organized approach to evaluate and standardize the review of EM PA charts both in terms of billing and Senior PA in recognition of her initiative and oversight quality metrics. This has quickly has become one of the most impactful programs to the entire PA team of the entire emergency department’s Microbiology lab and has optimized billing and ensured quality charting. result process. She provides ongoing up to date training, ongoing education, Q&A, hospital communication and overall oversight of the microbiology lab process in order provide a safety net for providers and patient care.

COVID RESEARCH IN EMERGENCY MEDICINE Eric Nilles, MD, MSc Dr. Nilles is leading a team of emergency medicine and infectious disease researchers, including Christopher Bennett, MD and Peter R. Chai, MD, MMS, to better understand SARS-CoV-2 infections in healthcare workers. Over the next several weeks the team will enroll 1000 ESAs, nurses, doctors, administration staff and others working at BWH and MGH and follow them for the next year. By testing their blood for antibodies to SARS-CoV-2 (at 0, 1, 2, 3, 6, 12, months) and monitoring for symptoms and risk exposures, the team will be able to understand both the proportion of healthcare workers that develop symptomatic infection (ie get sick) and the proportion that get infected but don’t get sick (asymptomatic infections). Ongoing data analysis will be performed to better understand the risk to different types of healthcare workers during the pandemic, with the goal of informing and improving local, national and international policies on healthcare workers risks and risk reduction. Tim Erickson, MD and Peter Chai, MD, MMS Dr. Erickson and Dr. Chai are studying robotic enabled wastewater analysis to detect SARS-nCoV-2 in wastewater catchement areas in Boston. They are working with Biobot Analytics to measure the presence of SARS-nCoV-2 and quantify the prevalence of virus in Boston. They are conducting an additional study to help develop a quantification per individual of the amount of virus shed in stool by symptomatic individuals. Edward W. Boyer, MD, PhD, Peter Chai, MD, MMS and Farah Dadabhoy, MD Dr. Boyer, Dr. Chai and Dr. Dadabhoy are working on the robotic assessment of individuals with suspected COVID- 19. This collaboration with Boston Dynamics deploys robots with enabled telemedicine platforms and infrared cameras to assess individuals with suspected COVID-19 disease in the emergency department. Phuong Pham, PhD, MPH, Patrick Vinck, PhD, MS, Peter Chai, MD, MMS, and Farah Dadabhoy, MD Phuong Pham, PhD, MPH, Patrick Vinck, PhD, MS, Peter Chai, MD, MMS, and Farah Dadabhoy, MD are surveying PPE use and safety patterns among EM physicians in the US. This study deploys a national survey to measure perceptions of safety among U.S. emergency medicine physicians treating COVID-19 patients. Peter Chai, MD, MMS Peter Chai, MD MMS is working with a team investigating breath testing for COVID-19. They have submitted a DoD proposal to develop a breath point of care test for COVID-19 disease using a smart straw that detect volatile organic compounds. Patterns of respiration and quantification of VOCs may correlate with a signature consistent with COVID-19 disease. This project is in response to a DoD urgent need to develop diagnostics for the military. Peter Chai, MD, MMS Dr. Chai  is working with a team studying injection molded N95 masks. They are developing an understanding of polymers that can be used to create injection molded, reusable N95 masks. This project also assesses various techniques to sterilize existing N95 fabric and other 3-D printed N95 style masks.

COVID-19 GRANTS Peter R. Chai, MD, MMS’s proposal, CTA: Assessment of Display Screens for Emergency Department Patient Satisfaction and Coordination, was awarded $185K from E Ink Corporation. Roger Dias, MD, PhD, MBA’s proposal: Using Digital Biomarkers to Measure Burnout among EM Physicians was selected for a recent Brigham Health Department of Emergency Medicine’s Esther B. Kahn Research Award. Timothy B. Erickson, MD’s Proposal:  Wastewater-based epidemiology to rapidly diagnose and map the Co-COVID-19 pandemic. Massachusetts Consortium on Pathogen Readiness (MassCPR) Lead PI: TB Erickson; PIs Chai PR, Alm EJ (MIT), Matus MG (Biobot Analytical). $375,000. Goals of Project: To measure the presence of SARS-CoV-2 within the City of Boston. To map the concentration and penetrance of SARS-CoV-2 within the greater Boston community. This award was recelty highlighted in the Harvard Gazette. Guruprasad Jambaulikar, MBBS, MPH’s proposal, CTA: cobas Influenza A/B & RSV v2 Nucleic Acid Test for use on the cobas Liat System: Clinical Performance Evaluation, was awarded the $199K Roche Molecular Systems, Inc grant. Jocelyn T. D. Kelly, MS, PhD’s proposal: Empowering Congolese Women in Mining Communities, was awarded $33K from SSG Advisors, LLC d/b/a Resonance. Kei Ouchi, MD, MPH’s proposal: A Nurse-led Behavioral Intervention to Empower Seriously Ill Older Adults to Formulate Their Goals for Medical Care in the Emergency Department, was selected for the Cambia Health Foundation $90K grant. Scott G. Weiner, MD, MPH’s proposal: Prescribing of Opioids at Hospital Discharge and Associated Adverse Patient Outcomes, was selected for the $45K President and Fellows of Harvard College Grant.

PUBLICATIONS Boyer EW, Chai PR.Lai, JT, Chapman BP, Carreiro SP, Babu KM, Understanding Naloxone Uptake from and Emergency Department Distribution Program Using a Low-Energy Bluetooth Real-Time Location System. J Med Tox. Accepted 24 March 2020. www.doi.org/10.1007/s13181=020-00774-8./pm/pnaa070. Chai PR Jambaulikar GD Boyer EW, Gale JY, Patton ME, Schartz E, , Taylor SW, Edwards RR, , Schreiber KL. The Impact of Music on Nociceptive Processing. Pain Medicine. 0 (0), 2020, 1-8. doi: 10-1093 Goralnick, E.Franklin, B**, Vakili, S, Huckman, R, Hosein, S, Falk, N, Cheng, K, Murray, M, Harris, S, Morris, C, The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding. Ann Emerg Med. 2020 Jan 23. Goralnick, EFranklin, B**, Vakili, S, Huckman, R, Hosein, S, Falk, N, Cheng, K, Murray, M, Harris, S, Morris, C, . The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding. Ann Emerg Med. 2020 Jan 23. Stoklosa H Erickson TB, Kunzler N, Zheng BM, Martinez de Vedia G, : Pesticide Exposure and Heat Exhaustion in a Migrant Agriculture Worker: A Case of Labor Trafficking. Accepted by Annals Emergency Medicine 2020, in print. Erickson TBPatel S, Zvinchuk O, : The Conflict in East Ukraine: A growing need for addiction research and substance use intervention for vulnerable populations. Forensic and Addiction Research (FASR) Jan 2020; 5(3): 406-408. dio: 10.31031/FSAR.2020.05.000616 Erickson TB, Chai PR:Endo N, Ghaeli N, Duvallet C, Foppe K, Rapid assessment of opioid exposure and Matus M, treatment in cities through robotic collection and chemical analysis of wastewater. J Med Toxicol 2020, Jan 9, doi: 10.1007/s13181-019-00756-5 Erickson TB, Chai PR, Boyer EW: Chloroquine, hydroxychloroquine and COVID-19. Toxicology Communications. 2020, April 4:1, 40-42. doi: 10.1080/24734306.2020.1757967 Dobiesz V Erickson TB,, Fricke A, Safi R, Radhakrishnan, Pham P: Political Identity and Access to Health Higher Education in Syria. Accepted by Oxford Middle East Review 2020, in print. Faust. J.  Comparing COVID-19 Deaths to Flu Deaths Is like Comparing Apples to Oranges. Published online Scientific American, April 28, 2020. URL: https://blogs.scientificamerican.com/observations/comparing-covid-19-deaths-to-flu- deaths-is-like-comparing-apples-to-oranges/ Faust. J. Medication Shortages Are the Next Crisis. Published online, April 28,2020. URL: https://www.theatlantic.com/ideas/archive/2020/04/medication-shortages-are-next-crisis/610798/ Hou PCMansoori JN, Linde-Zwirble W, , Havranek EP, Douglas IS. Variability in usual care fluid resuscitation and risk- adjusted outcomes for mechanically ventilated patients in shock. Crit Care. 2020 Jan 28;24(1):25. doi: 10.1186/s13054- 020-2734-9. PubMed PMID: 31992351; PubMed Central PMCID: PMC6986034. Hou, PC. Article: Multi-Tiered Screening and Diagnosis Strategy for COVID-19: A Model for Sustainable Testing Capacity in Response to Pandemic Journal: Annals of Medicine (IANN) Article ID: IANN 1763449

Seethala R, Keller SP. ECMO Resource Planning in the Setting of Pandemic Respiratory Illness [published online ahead of print, 2020 Apr 15]. Ann Am Thorac Soc. 2020;10.1513/AnnalsATS.202003-233PS. doi:10.1513/AnnalsATS.202003- 233PS. https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202003-233PS Baugh CWMoore AB, Su E, Weiss RE, Yagapen AN, Malveau SE, Adler DA, Bastani A, , Caterino JM, Clark CL, Diercks DB, Hollander JE, Nicks BA, Nishijima DK, Shah MN, Stiffler KA, Storrow AB, Wilber ST, Sun BC. Frequency of Abnormal and Critical Lab Results in Older Patients Presenting to the Emergency Department with Syncope. Academic Emergency Medicine (in press). Baugh CW.Eichelberger C, Patel A, Ding Z, Pericone CD, Lin JH, Emergency Department Visits and Subsequent Hospital Admission Trends for Patients with Chest Pain and a History of Coronary Artery Disease. Cardiology and Therapy (in press). Baugh CWChang AM, Hollander JE, Su E, Weiss RE, Yagapen AN, Malveau SE, Adler DH, Bastani A, , Caterino JM, Clark CL, Diercks DB, Nicks BA, Nishijima DK, Shah MN, Stiffler KA, Storrow AB, Wilber ST, Sun BC. The Accuracy of InterQual Criteria in Determining the Observation Versus Inpatient Status in Older Adults with Syncope. Journal of Emergency Medicine (in press). Baugh CBaymon D, . Patients with Atrial Fibrillation in the Emergency Department: Strategies to Achieve Best Outcomes. EP Lab Digest. Jan 2020;20(1). Valerie DobieszStacey Chamberlain, MD, MPH; Nicole Gonzalez, MPH; , MD, MPH; Marcia Edison, PhD, MBA; Ja:e t Lin, MD, MPH, MBA; Stevan Weine: A Global Health Capstone: An Innovative Educational Approach in a Competency-Based Curriculum for Medical Students. MD BMC Medical Education (in press). Dobiesz V, Wittels K.Gaw G, Wilcox S, A Rare Case of Oral Bleeding. Journal of Emergency Medicine (in press). Dobiesz, ValerieMadsen, Tracy; ; Das, Devjani; Sethuraman, Kinjal; Agrawal, Pooja; Zeidan, Amy; Goldberg, Elizabeth; Safdar, Basmah; Lall, Michelle: \"The Pursuit of Academic Emergency Medicine during the COVID-19 Pandemic: The Gender Perspective\". Submitted online for Academic Emergency Medicine. Erickson TB:Patel S, Grace R, Prodanchuk M, Chellew P, Romaniuk O, Skrebets Y, Ryzhenko S, Emerging Technologies, Countermeasures to CBRN agents: Advanced Training Response to Conflict & Security Challenges in East Ukraine. Accepted to Conflict & Health April 2020 In print: DOI: 10.1186/s13031-020-00279-9 Erickson TB, Chai PR,Duvallet C, Hayes DB, Matus M: Public health and pharmacy collection: Mapping community opioid exposure through wastewater-based epidemiology as a means to engage pharmacies in harm reduction efforts. Prev Chronic Dis. Accepted, in print April, 2020 Faust JS, Del Rio C: Assessment of Deaths From COVID-19 and From Seasonal Influenza. JAMA Intern Med. Published online May 14, 2020. DOI:10.1001/jamainternmed.2020.230

THROWBACK: FACULTY RETREAT In January, we hosted a Faculty Retreat designed specifically for the Emergency Medicine faculty. This event was held at South Boston’s Artists for Humanity Epicenter and offered beautiful surroundings and great food. Throughout the day, we leveraged the framework of Appreciative Inquiry to explore the themes and qualities of “Organizations that Bring out the Best in People.” One of the goals of the retreat was to give faculty a space to connect in a meaningful way, and that goal was accomplished through a series of exercises including one-on one interviews and fun group activities. Additionally, the group identified some of the key themes that are present in organization that bring out the best in people, including more recognition. This concept was the genesis of this newsletter! We also learned the power of Appreciative Inquiry as a positive way to move our organization forward in the direction of our aspirations. To learn more about Appreciative Inquiry, click here: Distributed by The Office of Faculty Affairs Department of Emergency Medicine Brigham Health For Inquiries or submissions please contact [email protected] or [email protected]