By Kevin Griffin

Patient Navigation May Aid in Breast Cancer Treatment in High-Risk Populations

August 4th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

FOR IMMEDIATE RELEASE, August 4, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org 

(Boston)–Patient navigation, or the linking of a newly diagnosed cancer patient with a professional trained in assisting patients though the complex journey of cancer diagnosis and treatment, may lead to better breast cancer care in high risk and minority women. The findings, recently published in the Journal of Clinical Oncology, is the first national study to show a relationship between navigators and the initiation of certain recommended treatments in breast cancer.

Using data from a previously published, multi-center study funded by the National Cancer Institute, researchers aimed to identify the possible benefits of assigning patient navigators to women recently diagnosed with breast cancer. According to the results, women were more likely to start recommended treatment when assisted by one of these trained specialists. For example, they were more likely to start hormonal therapy, which is considered the gold standard in treatment for certain types of breast cancer.

Naomi Ko, MD, MPH, instructor of medicine in the Section of Hematology Oncology at Boston University School of Medicine and a practicing breast oncologist at Boston Medical Center, stresses the need for further investigation. “This study gave us a glimpse of the potential benefit of patient navigation but there’s a lot more research to be done. At this point we still need to understand how or why patient navigation works. Understanding where patient navigation is most beneficial in cancer care, in order to help the neediest patients, is a rich topic for future research,” said Ko.

Navigators are experts in helping patients overcome the numerous obstacles they face, including monetary difficulties, transportation issues, educational and even language barriers, and have become an integral part of the cancer care model. It has been known that minority and high risk patients, or those who may benefit most from these navigators, often have worse outcomes after diagnosed with cancer.

Researchers Identify Potential Biomarker for AD

July 28th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine, Uncategorized 0 comments

 FOR IMMEDIATE RELEASE, July 28, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston)– Researchers from Boston University School of Medicine (BUSM) report variants in a new gene, PLXNA4, which may increase the risk of developing Alzheimer’s disease (AD). The discovery of this novel genetic association may lead to new drug treatment options that target PLXNA4 specifically. These findings appear in the Annals of Neurology.

AD is the most frequent age-related dementia affecting 5.4 million Americans including 13 percent of people age 65 and older, and more than 40 percent of people age 85 and older. Genetic factors account for much of the risk for developing AD with heritability estimates between 60 percent and 80 percent. However much of the genetic basis for the disease is unexplained. Less than 50 percent of the genetic contribution to AD is supported by known common genetic variations.

Using data from the Framingham Heart Study, the researchers obtained strong evidence of an association with several single nucleotide polymorphism in PLXNA4, a gene which had not been previously linked to AD. They then confirmed this finding in a larger dataset from the Alzheimer’s Disease Genetics Consortium and other datasets. Next, they performed a series of experiments in models that pinpointed the mechanism by which this gene affects AD risk. “Importantly, this is one of few single studies which go from gene finding to mechanism,” explained corresponding author Lindsay Farrer, PhD, Chief of Biomedical Genetics and professor of medicine, neurology, ophthalmology, epidemiology and biostatistics at BUSM.

According to the researchers a form of the protein encoded by this gene promotes formation of neurofibrillary tangles consisting of decomposed tau protein, one of the two pathological hallmarks of the disease. “We showed that PLXNA4 affects the processing of tau as it relates to neurofibrillary tangles, the primary marker of AD.  Most drugs that have been developed or that are in development for treating AD are intended to reduce the toxic form of beta-amyloid, a sticky substance that accumulates in the brain of persons with AD, and none have been very effective. Only a few drugs have targeted the tau pathway,” added Farrer.

This study was supported by grants from the National Institute on Aging (R01-AG025259, P30-AG13846, R01-AG0001, U24-AG021886, U24-AG26395, R01-AG041797 and P50-AG005138), the Alzheimer Association, the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (#A110742), and the Evans Center for Interdisciplinary Biomedical Research (ECIBR) ARC on “Protein Trafficking and Neurodegenerative Disease” at Boston University.

Incomplete HPV Vaccination May Offer Some Protection

July 28th, 2014 in 2014, News Releases, School of Medicine 0 comments

FOR IMMEDIATE RELEASE, July 24, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston)–Minority women who received the Human Papillomavirus Vaccination (HPV) even after becoming sexually active had lower rates of abnormal Pap test results than those who were never vaccinated. These findings appear in the journal Sexually Transmitted Diseases.

Researchers from Boston University School of Public Health and School of Medicine conducted a cross-sectional study of 235 women age 21 to 30 undergoing routine cervical cytology testing. HPV status and demographic and behavioral characteristics were self-reported and verified with electronic medical records.

“Although data clearly indicate better immune responses and vaccine efficacy against both genital warts and cervical dysplasia when vaccination occurs before age 14, this study suggests that HPV vaccination may be effective in reducing abnormal Pap test results even after sexual debut,” explained co-author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at Boston University School of Medicine and a gynecologist at Boston Medical Center.

At the time of the study, 41 percent had received at least one HPV vaccination; 97 percent of women were vaccinated after sexual debut. Ten percent of women had an abnormal cervical cytology result. The prevalence of abnormal cytology was 65 percent lower in women who received at least one HPV vaccination as compared to unvaccinated women.

According to the researchers continued surveillance of HPV vaccination is necessary to identify clinical benefits, particularly given the low rate of vaccine uptake and completion and vaccination of many young women after sexual debut. “Studies should continue to compare vaccine effectiveness before and after sexual debut and by vaccine doses received and to explore the role of herd immunity,” added Perkins.

Funding for this study was provided by the American Cancer Society.

BU Researchers Discover that Klotho is Neuroprotective Against Alzheimer’s Disease Toxic Amyloid

July 28th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

Contact: Gina DiGravio, (617)-638-8480, gina.digravio@bmc.org

(Boston)—Boston University School of Medicine researchers may have found a way to delay or even prevent Alzheimer’s disease (AD). They discovered that pre-treatment of neurons with the anti-aging protein Klotho can prevent neuron death in the presence of the toxic amyloid protein and glutamate. These findings currently appear in the Journal of Biological Chemistry.

Alzheimer’s disease is the most frequent age-related dementia affecting 5.4 million Americans including 13 percent of people age 65 and older and more than 40 percent of people over the age of 85. In AD the cognitive decline and dementia result from the death of nerve cells that are involved in learning and memory. The amyloid protein and the excess of the neurotransmitter, glutamate are partially responsible for the neuronal demise.

Nerve cells were grown in petri dishes and treated with or without Klotho for four hours. Amyloid or glutamate then were added to the dish for 24 hours. In the dishes where Klotho was added, a much higher percentage of neurons survived than in the dishes without Klotho.

“Finding a neuroprotective agent that will protect nerve cells from amyloid that accumulates as a function of age in the brain is novel and of major importance,” explained corresponding author

Carmela R. Abraham, PhD, professor of biochemistry and pharmacology at BUSM. “We now have evidence that if more Klotho is present in the brain, it will protect the neurons from the oxidative stress induced by amyloid and glutamate.

According to the researchers, Klotho is a large protein that cannot penetrate the blood brain barrier so it can’t be administered by mouth or injection. However in a separate study the researchers have identified small molecules that can enter the brain and increase the levels of Klotho. “We believe that increasing Klotho levels with such compounds would improve the outcome for Alzheimer’s patients, and if started early enough would prevent further deterioration. This potential treatment has implications for other neurodegenerative diseases such as Parkinson’s, Huntington’s, ALS and brain trauma, as well,” added Abraham.

Funding for this study was provided by the Alzheimer’s Drug Discovery Foundation.

Researchers Discover New Way to Determine Cancer Risk of Chemicals

July 28th, 2014 in 2014, School of Medicine 0 comments

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston)–A new study has shown that it is possible to predict long-term cancer risk from a chemical exposure by measuring the short-term effects of that same exposure. The findings, which currently appear in the journal PLOS ONE, will make it possible to develop simpler and cheaper tests to screen chemicals for their potential cancer causing risk.

Despite an overall decrease in incidence of and mortality from cancer, about 40 percent of Americans will be diagnosed with the disease in their lifetime, and around 20 percent will die of it. Currently fewer than two percent of the chemicals on the market have been tested for their ability to induce cancer.

Using an experimental model, researchers from Boston University School of Medicine (BUSM), Boston University School of Public Health, the BU Bioinformatics Program and the National Toxicology Program at the National Institute of Environmental Health measured the effects on healthy tissue from few days of exposure to a given chemical and assessed the effects on the gene expression response in the liver. “By comparing the responses to known chemical carcinogens and non-carcinogens, we were able to extract a “signature” and an associated predictive model capable of discriminating with high accuracy between the two,” explained corresponding author Stefano Monti, PhD, associate professor of medicine at BUSM and a member of the BU Superfund Research Program. “Furthermore, by inspection of the coordinated set of genes driving the response to chemical exposure, we were able to zoom in to the potential mechanisms driving cancer induction,” he added.

According to the researchers there is growing recognition that the role played by environmental pollutants in human cancer is under-studied and that more formal approaches to the analysis of the biological consequences of prolonged exposure to pollutants are needed. “This work has confirmed that it is possible to predict the long-term cancer risk by measuring the short term effects,” said Monti. “As a result of our findings we expect that accurate and cost-effective screening for evaluating the carcinogenic potential of the more than the 80,000 chemicals currently in commercial use soon will be a reality.”

This work was partially supported by the NIH-funded Boston University Superfund Research Program, the Evans Center for Interdisciplinary Biomedical Research ARC on “Computational Genomic Models of Environmental Chemical Carcinogenicity” at Boston University (http://www.bumc.bu.edu/evanscenteribr/), the National Center for Advancing Translational Sciences, National Institutes of Health, through BU-CTSI Grant Number UL1 TR000157, and the Art BeCAUSE Breast Cancer Foundation.

BUSM’s Michael F. Holick Receives American Society for Bone and Mineral Research Award

July 11th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

FOR IMMEDIATE RELEASE: July 11, 2014

Contact: Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

Boston—The American Society for Bone and Mineral Research awarded Michael F. Holick, PhD, MD, of Boston University School of Medicine (BUSM), with the 2014 Louis V. Avioli Award. Holick, a professor of medicine, physiology and biophysics at BUSM, is internationally known for revolutionizing the understanding of vitamin D and its role in disease prevention.

The award honors a member of the American Society for Bone and Mineral Research (ASBMR) for fundamental contributions to bone and mineral basic research. It is named for ASBMR’s first president and founding member, Louis Avioli, MD, who was one of the world’s leading medical authorities on osteoporosis and calcium metabolism. Holick will be recognized at the ASBMR Annual Meeting in September by the society’s president, Roberto Civitelli, MD.

“I am honored to receive this award named for my very close friend and trusted colleague,” said Holick. “I collaborated with Louis on multiple occasions, and he provided samples of blood from his patients that I used to identify, for the first time, 25-hydroxyvitamin D3 in human blood. This discovery led me to receiving a masters’ degree in biochemistry.”

Holick has revolutionized the field of vitamin D research with the identification of 1,25-dihydroxyvitamin D3, for which he received his PhD degree, which led to therapies for metabolic bone diseases, hypocalcemic disorders and psoriasis. His work raised awareness of the vitamin D deficiency epidemic and its role in causing metabolic bone disease and osteoporosis and increasing the risk of autoimmune diseases, type 2 diabetes, infectious diseases, heart disease and common deadly cancers.  He has helped develop guidelines for the prevention and treatment of vitamin D deficiency with vitamin D supplementation and sensible sun exposure.

The author of more than 500 publications, Holick received his doctorate in biochemistry and attended medical school at the University of Wisconsin before completing a residency in medicine at Massachusetts General Hospital.

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About the American Society for Bone and Mineral Research:  The American Society for Bone and Mineral Research (ASBMR) is a professional, scientific and medical society established to bring together clinical and experimental scientists who are involved in the study of bone and mineral metabolism.

Comfort Level of Emergency Responders Trained in Active Shootings Scenario Increases Following Instruction

July 11th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

For Immediate Release, July 10, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston) – Emergency Medical Service (EMS) responders felt better prepared to respond to an active shooter incident after receiving focused tactical training according to a new study in the journal Prehospital and Disaster Medicine. This is the first study to specifically examine the EMS provider comfort level with respect to entering a scene where a shooter has not yet been neutralized or working with law enforcement personnel during that response.

Incidents such as the Columbine High School shooting, the Virginia Tech campus shooting, the 2009 Fort Hood shooting, the movie theater shooting in Aurora, Colorado, and more recently, the Sandy Hook elementary school shooting remind us of the relative frequency of these events compared to most other mass casualty incidents for which EMS trains and prepares.

For this study, EMS providers responded to an anonymous survey both before and after a four-hour training session on joint EMS/police active shooter rescue team response. Survey questions focused on individual provider comfort level when responding to active shooter incidents compared to conventional HAZMAT incidents; comfort with providing medical care in an active shooter environment; perception of EMS provider role in an active shooter incident; and the appropriate timing of EMS response at the scene.

The survey results showed that more participants felt adequately trained to respond to an active shooter incident after focused training (87 percent) compared to before the training (36 percent) regardless of a providers prior tactical experience. Additionally, more EMS providers felt more comfortable working jointly on rescue operations with law enforcement personnel in response to an active shooter incident after training participation (93 percent) compared to before the training (61 percent).

According to the researchers, despite rapid deployment of law enforcement to neutralize an active shooter, it is not uncommon for a significant amount of time to pass before law enforcement has rendered the scene “safe.” “Unfortunately this unintentionally prolongs the time before victims can receive life-saving care on the scene, as well as at a definitive care facility,” explained lead author Jerrilyn Jones, MD, a clinical instructor of emergency medicine at Boston University School of Medicine and EMS Fellow at Boston EMS. “Our study showed that after receiving appropriate training, EMS providers felt better equipped to work on joint rescue operations even if an active shooter was still present,” added Jones, who also is an emergency room physician at Boston Medical Center.

The researchers recommend further studies be undertaken to determine the significance of such training as well as the mortality impact on patient outcomes.

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BU Researchers Relate Arrests with HIV Risk Environment

July 9th, 2014 in 2014, Health & Medicine, School of Medicine, School of Public Health 0 comments

FOR IMMEDIATE RELEASE: July 9, 2014

Contact: Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

Boston—Practices used in policing injection drug users in Russia might contribute to HIV transmission and overdose mortality.

A study, conducted by researchers from Boston University Schools of Medicine and Public Health, in collaboration with St. Petersburg Pavlov State University, sought to discover the effect police arrests had on the health outcomes of a cohort of HIV-positive people with lifetime of injection drug use.

Those who were arrested by police were more likely to share needles—increasing HIV transmission—and to overdose, according to the study published in the Journal of the International AIDS Society. Their research also found no indication that police arrests reduce drug use.

“We already know that addressing individual risk behaviors is important in reducing HIV transmission among people who use drugs, who are most at risk for HIV infection,” said lead author Karsten Lunze, MD, MPH, DrPH, a BUSM assistant professor of medicine. “Our study adds that drug laws and policies, and the way they are enforced, are also important to prevent the spread of HIV.”

By linking the impact of police tactics with health outcomes of injection drug users, the researchers identified the need to create prevention programs for modifying individual behaviors and to address policing practices as part of the HIV risk environment.

“Instead of arresting people who use drugs, there should be more of a focus on facilitating access to treatment,” said Jeffrey Samet, MD, MA, MPH, a professor of medicine and community health sciences at BUSM and BUSPH who also led the study. “Public health and public safety working together can help address the increasing problem of HIV among people who use drugs.”

Further research needs to relate these findings to the operational environment of law enforcement and to understand how police interventions among injection drug users can improve, rather than worsen, the HIV risk environment, the researchers said.

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BU Researchers Receive NIH Funding for Genetic Research in Alzheimer’s Disease

July 9th, 2014 in 2014, News Releases, School of Medicine 0 comments

FOR IMMEDIATE RELEASE, July 8, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

(Boston) –Boston University School of Medicine (BUSM) received major funding from the National Institute on Aging (NIA) as part of a national effort to identify rare genetic variants that may protect against and contribute to Alzheimer’s disease risk.

The four-year, $3 million grant, “Identifying Risk and Protective Variants for AD Exploring their Significance and Biology” is led by Sudha Seshadri, MD, professor of neurology at BUSM and a Senior Investigator at the Framingham Heart Study and for the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium. This project is linked to CHARGE projects at two other universities which all together received grants totaling more than $10 million. Other BU investigators who are part of the CHARGE project are Anita DeStefano, PhD, Adrienne Cupples, PhD, and Josee Dupuis, PhD, who are professors of biostatistics, and Honghuang Lin, PhD, assistant professor of medicine.

“As a neurologist treating patients with Alzheimer’s disease, it is very exciting to see the increased recognition, at a national level, of the need to find more effective preventive and therapeutic measures,” said Seshadri.

Alzheimer’s disease, a progressive neurodegenerative disorder, has become an epidemic that currently affects 5.2 million people in the United States with economic costs that are higher than those of heart disease or cancer. Available drugs only marginally affect disease severity and progression. While there is no way to prevent this devastating disease, the discovery of genetic risk factors for Alzheimer’s is bringing researchers closer to learning how the genes work together and to identifying the most effective intervention for the disease.

Genetics is a cornerstone of identifying targets for Alzheimer’s disease therapies. This movement began in 2011, when President Barack Obama signed into law the National Alzheimer’s Project Act (NAPA), mandating support for Alzheimer’s research and health and long-term care services for affected individuals across all federal agencies. One of the first projects mandated by NAPA was the Alzheimer’s Disease Sequencing Project (ADSP). With this funding, CHARGE becomes a member of the National Institute of Aging-mandated Sequence Analysis Consortium, which also includes three National Human Genome Research Institute (NHGRI) Large-Scale Sequencing Centers.

CHARGE investigators will analyze whole exome and whole genome sequence data generated from 6,000 subjects with Alzheimer’s disease and 5,000 elderly individuals who do not have Alzheimer’s disease. They also will study data from approximately 100 large families, mostly of Caribbean and Hispanic descent, that include multiple individuals with Alzheimer’s disease to identify rare genetic variants that either protect against or cause Alzheimer’s disease. They will also be contributing additional CHARGE data from over 11,000 subjects with information on genetic sequence and AD-related traits.

“AD currently has no effective treatment thus prevention is the primary strategy to combat this disease,” said Boston University School of Medicine Dean Karen Antman, MD. “This is an exciting opportunity for our faculty to develop novel approaches that might ultimately delay or prevent AD.”

CHARGE is a collaboration of an international group of investigators. Eric Boerwinkle, PhD at the University of Texas, Houston and Baylor College of Medicine and Ellen Wijsman, PhD at the University of Washington will lead other funded CHARGE projects. Cornelia van Duijn, PhD who is a consultant on behalf of Erasmus University in the Netherlands.

This research at Boston University is supported by the National Institute on Aging grants U01-AG049505.

Boston University Researchers and Collaborators Receive $12.6 Million NIH Grant to Study Genetics of Alzheimer’s Disease

July 7th, 2014 in 2014, Health & Medicine, News Releases, School of Medicine 0 comments

For Immediate Release, July 7, 2014

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

Boston - Researchers from the Biomedical Genetics division of the Boston University School of Medicine (BUSM) are part of a five-university collaboration receiving a $12.6 million, four-year grant from the National Institute on Aging (NIA), part of the National Institutes of Health (NIH), to identify rare genetic variants that may either protect against, or contribute to Alzheimer’s disease risk.

At BUSM, the Consortium for Alzheimer’s Sequence Analysis (CASA) is led by Lindsay A. Farrer, PhD, Chief of Biomedical Genetics and professor of medicine, neurology, ophthalmology, epidemiology, and biostatistics, who is the principal investigator. Other Boston University investigators include Kathryn Lunetta, PhD, professor of biostatistics; Gyungah Jun, PhD, assistant professor of medicine, ophthalmology and biostatistics; and Richard Sherva, PhD, research assistant professor of medicine.

CASA investigators will analyze whole exome and whole genome sequence data generated during the first phase of the NIH Alzheimer’s Disease Sequencing Program, an innovative collaboration that began in 2012 between NIA and the National Human Genome Research Institute (NHGRI), also part of NIH. They will analyze data from 6,000 volunteers with Alzheimer’s disease and 5,000 older individuals who do not have the disease. In addition, they will study genomic data from 111 large families with multiple members who have Alzheimer’s disease, mostly of Caucasian and Caribbean Hispanic descent to identify rare genetic variants.

“This is an exciting opportunity to apply new genomic technologies and computational methods to improve our understanding of the biological pathways underlying this disease,” said Farrer. “The genes and pathways we identify as integral to the Alzheimer process may become novel therapeutic targets,” he added.

Alzheimer’s disease, a progressive neurodegenerative disorder, has become an epidemic that currently affects as many as five million people age 65 and older in the United States, with economic costs that are comparable to, if not greater than, caring for those of heart disease or cancer. Available drugs only marginally affect disease severity and progression. While there is no way to prevent this disease, the discovery of genetic risk factors for Alzheimer’s is bringing researchers closer to learning how the genes work together and may help identify the most effective interventions.

This effort is critical to accomplishing the genetic research goals outlined in the National Plan to Address Alzheimer’s Disease, first announced by the U.S. Department of Health and Human Services in May 2012 and updated annually. Developed under the National Alzheimer’s Project Act, the plan provides a framework for a coordinated and concentrated effort in research, care, and services for Alzheimer’s and related dementias. Its primary research goal is to prevent and effectively treat Alzheimer’s disease by 2025.

With the current award, CASA joins the NHGRI Large-Scale Sequencing and Analysis Centers program, an NIH-supported consortium that provides large-scale sequence datasets and analysis to the biomedical community. CASA researchers will facilitate the analyses of all Alzheimer’s Disease Sequencing Project (ADSP) and additional non-ADSP sequence data to detect protective and risk variants for Alzheimer’s disease.

“We are delighted to support the important research being accomplished under this broad-based, collaborative effort. A team effort is vital to advancing a deeper understanding of the genetic variants involved in this complex and devastating disease and to the shared goal of finding targets for effective interventions,” said NIH Director Francis Collins, MD, PhD.

“Alzheimer’s disease research is appropriately one of our highest priorities,” said BUSM Dean Karen Antman, MD “We need more to better understand the genetic and environmental mechanisms that will come in part from CASA to develop more effective treatments or even better, to prevent the disease,” she added.

CASA is a collaboration of Boston University School of Medicine and four other American universities. Jonathan Haines, PhD, will lead the project at Case Western Reserve University; Richard Mayeux, MD, at Columbia University; Margaret Pericak-Vance, PhD, at the University of Miami; Gerard D. Schellenberg, PhD, at the University of Pennsylvania; and Lindsay Farrar, PhD, at Boston University.

This research is supported by the NIA grant UF1-AG047133.

Originally established in 1848 as the New England Female Medical College, and incorporated into Boston University in 1873, Boston University School of Medicine today is a leading academic medical center with an enrollment of more than 700 medical students and more than 800 masters and PhD students.  Its 1,246 full and part-time faculty members generated more than $335 million in funding in the 2009-2010 academic year for research in amyloidosis, arthritis, cardiovascular disease, cancer, infectious disease, pulmonary disease and dermatology among others. The School is affiliated with Boston Medical Center, its principal teaching hospital, the Boston and Bedford Veterans Administration Medical Centers and 16 other regional hospitals as well as the Boston HealthNet.