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News and Notes

With everyone in PHU-land pretty busy now, we wanted to post some snippets of the latest news along with some brief (and we mean brief) analysis and direct you where to go to learn more.

NIH has released details of the federal budget sequester impact, and it isn’t pretty. The overall budget has been cut by 5%, and almost 1,400 awarded grants are being canceled, 700 of which would have funded completely new research. Additionally, continuing grants may be cut up to 10%, and will no longer be increased annually to keep pace with inflation.

The novel coronavirus (nCoV) that emerged last year is back in the news just as the H7N9 outbreak in China seems to be waning. Although it has caused many fewer cases than H7N9, nCoV has killed 50% of patients (20/40) and seems more transmissible between people. The latest cases include two healthcare workers who became sick after treating a patient confirmed to have nCoV. Transmission to healthcare workers is always a concern with emerging disease outbreaks, as it demonstrates transmissibility and opens the door to possible hospital-associated amplification of the outbreak. The CDC has extensive information on this outbreak and on the virus behind it. (Update-proposed official name: Middle Eastern Respiratory Syndrome coronavirus—MERS-CoV)

Angelina Jolie’s double mastectomy made headlines this week, as she made a brave, and increasingly common decision to undergo this major preventive procedure after finding out she was genetically predisposed to developing breast cancer. On the scientific side, this represents a fantastic collaboration of genetics and clinical medicine. The bigger question is should all women have this option? Testing for the gene mutations Angelina Jolie carries costs $4,000, and is only covered by insurance in “high risk” women, those over 45 and with multiple breast cancer cases in their families. This will only become a bigger issue as we associate more and more disease with particular genetic mutations.

Also in the news is that suicides by active members of the military and veterans are at record levels. The timeline of this increase coincides with increased incidence of concussion and other traumatic brain injury due to the wars in Iraq and Afghanistan. However, the suicide rate also highlights the lack of access to mental healthcare for many Americans, both veterans and not.

Finally, and likely of interest to many of you, new research also identified a link between prescription painkiller use and erectile dysfunction. If you needed one more reason to only take narcotics as closely directed by a doctor, there it is.

-Steve

Coming soon!

Check back at the end of the week for 4 new podcasts:

1) Interview with Dr. Al Sommer (Get a taste of his bio here http://magazine.jhsph.edu/2005/Fall/Prologues/default.cfm)
2) Interview with Nobel Laureate Peter Agre (Check out an old interview of Peter on The Colbert Report: http://www.colbertnation.com/the-colbert-report-videos/76990/october-19-2006/peter-agre)
3) Interview with Christine Santos
4) News Analysis #2 with Nick, Nina, & guest Christine Santos

To Speak Or Not To Speak: When Political BS Gets In The Way of Communication by Nina Martin

Communication is at the core of any successful relationship. However, when you are not secure in your position, be it at a corporation, school, or other hierarchical organization, there are constraints on what you can and cannot say. How often do you keep your mouth shut because vocalizing a complaint or suggestion could possibly damage your standing or reputation? Hierarchies are the backbone of many careers and learning to navigate these political networks is often key to achieving success and advancing your career. Have you ever considered how these political relationships are, in fact, damaging the overall success of the organization and in certain cases, impeding progress of an entire field?

In science, we have these same communication dilemmas and our careers are ruled by hierarchies. Let’s take a typical lab hierarchy in order of least to most power: High School Student, Undergrad Student, Masters Student, PhD Student, Post-doc, Senior Scientist, Principle Investigator (PI), and Department Chair. All are at different levels of training and expertise and require different amounts of guidance. At the very top of this hierarchy—or we could possibly place it at the core of this system—is funding sources. Our livelihoods—all of us in the hierarchy from the high school student up to the PI—depend on the PI’s ability to procure funding through public and private donors.

This framework has become a crutch in the science community and remains one of the major reasons why there is a rift between researchers and the public. We are so concerned with offending people—bosses, funders, public—that we are too afraid to speak our minds in the correct forums (meaning, perhaps we feel comfortable speaking our mind around the water cooler, but in places where our voices should be heard, they are absent). ‘Balancing’ this out, of course, are those who are secure in their jobs and power and can say anything they want—and in any way that they want, which includes unprofessional behavior. While they are allowed to act however they want, we are left quietly fuming. If you are not allowed to communicate, these negative feelings will build up over time and propagate a negative cycle of dysfunctional communication. This is a shame because it oppresses the younger generations that come into a field with such excitement and passion and new ideas.

There are many negative impacts of this system, but the one most relevant to my career is its impact on the student-teacher relationship (or in our case, the student-advisor/PI relationship). While PIs are fighting for grants and focused on creating stories to get published—the students are often left to navigate these hierarchies with no guidance. This is not just because PI’s are busy with their own careers, but because there is some attitude that students should be independent and figure things out for themselves. Being a good mentor is not about coddling the student and telling them what they should be doing step by step. Mentoring is about taking an interest in the student’s goals and career development. We are here to learn how to be excellent scientists: which means we want to learn how to ask the right questions and how to effectively design experiments. I have had 8 years of technical experience; I know how to follow orders and protocols. What I have not been trained to do, and what I hope to learn here, is how to lead my future lab.

I’ve observed, and I can’t talk specifics because I am taking a risk in even just bringing up these issues in a public forum, that at many levels for Masters & PhD students, and also post-docs, there is a general lack of interest in teaching in the lab. PIs don’t have time for it and want to focus on grant and article writing (that is, after all, what is keeping the lab going, paying for all of our salaries, and bringing in the fame and glory). Students don’t have time for it. In fact, I’ve observed that students are often the most impatient with newer students…something which I find incredible since it wasn’t so long ago that we didn’t know where the pipets were kept or how to set up a Western Blot. New students should be encouraged to ask many questions—and ask them more than once. A person starting in a new lab (or any new job) is already going to feel like an idiot. If the person teaching them also has an impatient attitude (sighs, rolling of the eyes), the situation becomes worse. The new student doesn’t want ‘to bother’ anyone and ceases asking questions, ceases learning and growing. Related, I have observed that sometimes a (student) mentor will not answer a new student’s questions (and act impatient or say “Oh that’s not important to know”) because they don’t actually know the answer. Instead of admitting ignorance and looking it up, they save their reputation and make the new person feel stupid. Again, halting the progress of learning. It’s ok to admit that you don’t know something. Educate yourself!

I remember exactly how hard it is to navigate a new place and a new field; and in turn I always take care of new students and try to pass off my knowledge and, more importantly, my passion for science. I’ve been in charge of both high school and college students in the lab who, at first, didn’t even know how to set up a dilution. I understood that my attitude toward them was going to shape their attitudes about science and lab work. I wanted them to love it and to understand why we were doing things. Anyone can be given a recipe to follow; excellent scientists know why they are doing things and understand the background of their experiments. A new student can’t be expected to know all this and if we accept a student into our lab, we have an obligation to teach and mentor them.

Part of why I value mentoring is because I have been extraordinarily lucky to have excellent mentors: people who have taken the time out of their extremely busy schedules to get to know me and personally take an interest in my career and general well-being. We have a relationship, not just a business arrangement. We care about each other and show loyalty and respect. Like in any relationship, there are ups and downs. But in the end, we know that we support each other.  

What incentive do PIs (and students) have to be good mentors? To me, it seems self-evident that the better the students are, the more successful the lab will be. Moreover, if students go on to lead excellent careers, this only reflects well on the PI. However, these are nebulous, long-term incentives. In reality, PIs don’t receive monetary bonuses or formal awards for being a great mentor; it is a thankless job that could be seen as taking time away from the more important cycle of grant and article writing.

An improved and positive communication cycle can start with us. Even as a student or post-doc, lead by setting excellent examples. Realize that we are only as strong as the individuals in our institute, so it should follow that by helping our teammates to achieve their goals, we will all benefit and receive more prestige in the end. Ask yourself, are you a good mentor? Do you teach those under you with patience and take time to teach them the background (Do you know yourself these things? Do you know why you add reagent A to reagent B?). We may not be able to change the system today, but we can initiate change by improving our own teamwork and communication.

Tell us about a great mentor you had? Do you have ideas for how we can improve this system? I would love to hear from you! -Nina

Can Federal Budget Cuts Make You Sick?

The answer is…they sort of might. The New York Times reported today that safety inspections of imported foodstuffs have declined markedly over the last several years. Both the USDA, which inspects meat and poultry, and the FDA, which inspects everything else, have been hit hard by budget cuts.

USDA inspections were spared in the recent budget sequester, but budget cuts in previous years have taken a toll, with an 18% decrease in funding for foreign inspections since 2010. In 2009 the USDA conducted inspections in 32 countries, and per today’s New York Times article, that number is now down to 10. Similarly, the FDA is able to inspect only 2.3% of the food shipped here from abroad every year.

Can this affect you? It very well might. According to this report, the CDC determined that foodborne disease outbreaks were more than twice as common between 2005 and 2010 compared to 1998 and 2004. Outbreaks of foreign origin figured prominently in these incidents. Just within the past two years a salmonella outbreak traced to Mexican cucumbers sickened 73, and Mexican papayas, Guatemalan cantaloupes, and Turkish pinenuts have also been implicated. Additionally, 2.5 million pounds of Canadian beef reached the U.S. market in 2012.

We at PHU have talked a lot about the importance of both basic and applied science research towards fighting disease, but funding programs like food safety are just as important, especially in the near term. Bird flu and novel coronaviruses can sound frightening, but we are all a lot more likely to get sick from our food, a risk that increases as safety inspections become more infrequent. As basic science researchers we are often inclined to focus on recent hits to the NIH or CDC budgets, but as our latest podcast should make clear, public health policy decisions can be just as impactful. No one should die because of something in his or her food; let’s hope Congress hears that message as well.

-Steve

Malaria, Safari Science, & Global Public Health Spending

 

Rhoel Dinglasan & Clive Shiff
Rhoel Dinglasan & Clive Shiff, Malaria Researchers at Johns Hopkins School of Public Health (1)

We are pleased to announce Expert Panel #2:
“Malaria, Safari Science, & Global Health Spending” recorded on  May 3, 2013. Guest experts Drs. Clive Shiff (JHMRI), Rhoel Dinglasan (JHMRI), & Jim Webb (Colby College) share diverse perspectives on why malaria is so hard to control.

To listen to the podcast, right click to download or click to stream. Also available on iTunes here.

Nina for one is new to the International & Global Health fields. If you are in the same boat, the following links will be helpful to understand the discussion. An article on vertical versus horizontal public health programs is also in the works.

Malaria and other global infectious diseases: why should we care? by Sean Murphy
Johns Hopkins Malaria Research Institute: Life Cycle of The Malaria Parasite & links to researchers at JHMRI
Dr. Rhoel Dinglasan’s Lab Website: http://www.dinglasanlab.org/
What is the Roll Back Malaria Partnership? http://www.rbm.who.int/rbmmandate.html
History of Public Health Timeline, Interactive Map by The North Carolina Institute for Public Health
“In pursuit of better global health, should we follow a horizontal or vertical approach?” by student blogger at NYU-Wagner/Global Health Policy class
Free Online Global Health Course: Module 4: Eradication Efforts: Malaria versus Smallpox
Dr. Jim Webb’s Book: Humanity’s Burden: A global history of malaria

Jim Webb pic

Jim Webb pic

(1) Photo courtesy of Johns Hopkins Magazine article featuring Clive & Rhoel.

Historical Epidemiology of Malaria Control

What can current malaria and other public health researchers learn from past eradication attempts? This is the subject of last week’s Friday Malaria Seminar at the Johns Hopkins Malaria Research Institute given by guest speaker Dr. James L.A. Webb Jr., PhD, MA, Professor, Colby College, Department of History. His talk, “The Historical Epidemiology of African Malaria 1945 – 1965,” gives us a sneak peak at his newest book coming out next year. Introduced by renowned malariologist, Dr. Clive Shiff. NB: Dr. Webb is Nina’s former undergraduate adviser, mentor, and friend and is also featured on this month’s Expert Panel #2 podcast along with Drs. Shiff & Rhoel Dinglasan.

Click here to listen or right click to download. Available on iTunes here.

Here’s Dr. Webb’s page at Colby College and here’s his website with links to his book Humanity’s Burden: A Global History of Malaria.

Jim Webb pic

Are we close to curing AIDS?

This week the New York Times published an excellent article putting in context many of the recently reported breakthroughs on HIV/AIDs research. The article details three exciting developments in HIV research that have occurred over the last few years.

One of these is the famed Berlin patient, actually a 46 year-old American named Timothy Ray Brown. Mr. Brown was already HIV+ when he was diagnosed with leukemia and received in a bone marrow transplant in Berlin in 2008. Mr. Brown’s bone marrow donor happened to have a rare genetic mutation that makes his cells resistant to infection by HIV. Mr. Brown, following the transplant, has reaped this benefit, and is HIV and symptom-free five years later, and with no anti-retroviral treatment.

The second development detailed was the “functionally cured” baby described in a PHU post by Nick last month. This baby was born HIV+ but immediately given anti-retroviral therapy. Almost a year later without continued treatment, the baby remains virus-free. The third development came out of France last year when 14 individuals were identified as HIV-free two years or more after stopping treatment. All of these reports demonstrate that the outcome of interaction between HIV (or any virus) and the host is always defined by the unique genetics of each individual, as well as by the virus.

Current anti-retroviral treatment can target many stages of the HIV lifecycle, but the goal is to prevent replication of the virus. We still don’t know how to train the immune system to kill infected cells that constitute the reservoir of HIV in a host. Understanding how the immune systems of these individuals not only prevented HIV replication but actually cleared the virus may allow us to adapt these strategies for use in the vast majority of HIV+ individuals who will require lifelong anti-retroviral therapy. Funding this kind of basic research and applying its findings to the clinic may, one day, save millions of lives.

-Steve

What Is Cancer? An explanation for the non-scientist of the biology behind cancer

Curious about what cancer really is? Here is the first of a series of articles explaining the science behind cancer.  This is by no means an exhaustive background, but we hope this will help you understand the cancer research presented in the news and perhaps help you spot misinformation.

Please let us know if you have more questions or want something clarified. We are also working on a glossary–let us know if you have terms you want included!

Public Health and Diseases of Food

For those of you that took our advice and have been looking at ProMED-mail for a good source of science/disease outbreak news (or for those who were already doing so), you may be noticing a lot of outbreaks for animal and plant diseases.

One Health, which Stephanie Porter brought to our attention in the first News Analysis episode, figures prominently into this. Many of the diseases that infect humans are zoonoses (disease transmitted from animals to humans or from humans to animals). Wild and domestic animals provide a possible source for new human diseases (think SARS and avian influenza), and to be truly healthy as people, we have to be mindful not to harm the health of animals.

A more important impact that animal and plant diseases have is their role in agriculture. Most food we consume is produced in monoculture (the growing or raising of a single crop or animal species in agriculture). For example, the corn we consume is made up of a few different strains of genetically identical organisms. This means that they susceptible to the same infectious diseases. A single germ can potentially wipeout a large area of corn monoculture.

For example, there was a recent ProMED-mail post about Schmallenberg virus and its recent reemergence in parts of Europe. The virus is a disease of ruminants, including cows, sheep, and goats, and it is relatively mild in nature except that it causes congenital defects in animals born to infected mothers. This can have devastating consequences on future food reserves.

So while human diseases and outbreaks are undoubtedly important to our health, animals and plant infections that may either spread to humans as zoonoses or wipeout our food sources are also important to the health and wellbeing of humans.

-Nick Wohlgemuth

Saving Lives With Better Science Communication