First Fully Complete Human Genome Has Been Published After 20 Years

By Jack Dunhill

31 MAR 2022, 19:00

The first fully complete human genome with no gaps is now available to view for scientists and the public, marking a huge moment for human genetics. Announced in a preprint in June 2021, six papers have now been published in the journal Science. They describe the painstaking work that goes into sequencing an over 6 billion base pair genome, with 200 million added in this new research. The new genome now adds 99 genes likely to code for proteins and 2,000 candidate genes that were previously unknown. 

Many will be asking: "wait, didn’t we already sequence the human genome?" In part, yes – in 2000, the Human Genome Sequencing Consortium published their first drafts of the human genome, results that subsequently paved the way for almost every facet of human genetics available today.

The most recent draft of the human genome has been used as a reference since 2013. But weighed down by impractical sequencing techniques, these drafts left out the most complex regions of our DNA, which make up around 8 percent of the total genome. This is because these sequences are highly repetitive and contain many duplicated regions – attempting to put them together in the right places is like trying to complete a jigsaw puzzle where all the pieces are the same shape and have no image on the front. Long gaps and underrepresentation of large, repeating sequences made it so that this genetic material has been excluded for the past 20 years. Scientists had to come up with more accurate methods of sequencing to illuminate the darkest corners of the genome. 

“These parts of the human genome that we haven’t been able to study for 20-plus years are important to our understanding of how the genome works, genetic diseases, and human diversity and evolution,” said Karen Miga, assistant professor of biomolecular engineering at UC Santa Cruz, in a statement. 

Much like the Human Genome Sequencing Consortium, the new reference genome (called T2T-CHM13) was produced by the Telomere-2-Telomere Consortium, a group of researchers dedicated to finally mapping each chromosome from one telomere to the other. T2T-CHM13 will now be available on UCSC Genome Browser for everyone to enjoy, complimenting the standard human reference genome, GRCh38. 

In case you don't believe it, this is the HGSC reference genome. Each number is a chromosome, and the font is size 4.5, which is almost illegible. Image Credit: widdowquinn/Flickr CC BY-NC-SA 2.0

 The new reference genome was created using two modern sequencing techniques, called Oxford Nanopore and PacBio HiFi ultra-long read sequencing, which massively increases the length of DNA that can be read while also improving the accuracy. Through this, they could sequence strings of DNA previously unreadable by more rudimentary techniques, alongside correcting some structural errors that existed in the previous reference genomes. 

Looking to the future, the consortium hopes to add even more reference genomes as part of the Human Pangenome Reference Consortium to improve diversity in human genetics, something sorely lacking at present. 

“We’re adding a second complete genome, and then there will be more,” said David Haussler, director of the UC Santa Cruz Genomics Institute, in a statement. 

“The next phase is to think about the reference for humanity’s genome as not being a single genome sequence. This is a profound transition, the harbinger of a new era in which we will eventually capture human diversity in an unbiased way.”

Source Link for Article

Investing in Preventative Healthcare and Public Health: An Ethical and Economical Choice

Ethics can sometimes seem at odds with decisions that are the most cost effective. However, it doesn't always have to be this way. What if there was a decision that was both ethical and economical? Here, we will explore the benefits of investing in public health, specifically in disease prevention. We will also consider how this could lead to lower healthcare costs (or at least more effective healthcare spending), and most importantly, a healthier country.

The United States spends more on healthcare than any other OECD nation, as a percentage of gross domestic product (GDP). 

Despite this investment in health, the U.S. falls short in many health metrics including life expectancy, avoidable mortality, and overweight/obesity compared to other OECD countries. This indicates that the U.S. healthcare system is inefficient. We are one of the wealthiest nations in the world, so it seems like a lack of resources is not the main issue. Though there could be many contributing factors for this discrepancy, one reason is the lack of investment in public health. Some researchers estimate that the U.S. spends as low as 1.5% of total health expenditures on population-level public health initiatives. This seems contradictory to evidence that suggests investing in public health can make more people healthier and reduce costs. After all, as Benjamin Franklin was known to say:

To consider why this may be the case, we must look at the view of health in the United States.

Healthcare can be generally divided into primary, secondary, and tertiary care:

• Primary care is where public health has the most influence. When successful, public health initiatives will promote health at a population and community-level and prevent people from getting sick in the first place. 
• Secondary care describes more specific screening measures, seeing primary care physicians, and getting short-term treatments to prevent health issues from growing e.g., responsible use of antibiotics in response to bacterial infections. 
• Tertiary care is where a disease has already been established and specialists work to manage long-term care to prevent the disease from worsening. This would include controlling diabetes, treating cancer, or managing COPD. 

Common sense tells us that investing the most in primary prevention strategies would be the most effective. These population based initiatives impact the most people and prevent disease from even occurring. However, the U.S. seems to have this "healthcare pyramid" flipped upside down, focusing primarily on tertiary care.

This needs to change if we want to be serious about not only making healthcare spending more efficient but also creating healthier communities. Neglecting public health can lead to dire consequences, and one of the most relevant examples can be found in the current pandemic. To be fair, health emergencies are difficult to plan for because there are many unknowns. However, ten plus years worth of underfunding U.S. public health is one of the reasons many states did not feel prepared for COVID-19.

Lately, public health, and medicine in general, have received a lot of attention from the general public and government leaders. Some hope that this could lead to a renewed effort to build up public health infrastructure. However, many fear that this will be the same cycle of neglect, panic, and repeat. When there is no current public health crisis (at least not on the surface), it is relatively easy to turn to other issues. A crisis such as the pandemic or ebola outbreaks, stirs the public and lawmakers enough to start making large investments. Then, the crisis goes away, and the cycle starts over. 

One of the reasons for this cycle is that when public health is working well, it is often invisible. It is like electricity, you don't think about it until it gets dark and the power goes out. 

With all this being said, it is important to note that a few studies have found that some prevention strategies could be extremely costly and might exceed the savings from preventing illness. However, objecting to public health initiatives based on these findings is problematic on multiple fronts: 

• For one thing, some of these studies made generalities, expecting programs to be implemented across the board regardless of matching interventions with specific populations. A relatively new concept called "Precision Public Health," could be a solution to this issue. It utilizes technology and large datasets to help make public health policies and initiatives more targeted and effective. 

• Another issue with this objection is related to ethics. Even if such prevention interventions were more costly than treating the disease itself, don't we have an ethical obligation to prevent disease when we have the power to do so? I am not talking about changing genomes of embryos or anything like that (I will leave that topic up to others). I am talking about having a clear intervention known to work and not using it solely due to financial considerations.

In addition to neglecting public health, a Harvard Study indicated that other areas have led to the high cost of U.S. healthcare, including administrative costs, expensive pharmaceuticals, and high physician and nurse salaries. This can be a complex situation to fix. Though looking at these issues more closely reveals that investment in the public health system could ultimately reduce the need for as many healthcare professionals and medication.

While it is clear that there is not a simple solution (there rarely is one), it would be extremely detrimental to forget about the need for public health. As citizens of this nation and the world, it should be our hope that all people get to live healthy and fulfilling lives. The fact that investing in public health could lower healthcare costs is a bonus but should not be the sole incentive. By utilizing precision public health techniques, we could increase health equity, prevent diseases, and promote a more community-centered approach to healthcare.

Discussion questions

1. What could the United States do better in terms of preventative care?
2. How can we make the accomplishments of public health more visible to the public on a everyday basis? 
3. Do you think we have an ethical obligation to invest in our public health system?
4. Do you think that focusing on primary prevention could make healthcare spending more efficient? Or do you think that this could be too narrowminded and not account for the complexities of the system?
5. What do you see as stepping stone to the larger issue of U.S. healthcare and public health reform?

Exam Question: The U.S. spends as low as what percentage of total health expenditures on population-level public health initiatives? 

Answer: 1.5%

Ethics Through the Lens of Insurance

 Hello everyone, 

This is my final presentation for Bioethics, where I will be discussing Insurance from a dual perspective. 

I hope you enjoy my presentation, and that you come away from it with a bit more knowledge about why insurance is structured the way it is. 

Enjoy! 

Let's start with a question: What do you know about insurance? What do you think its goals are? 

As you initially read through this(though I hope you do wait till the presentation, so it doesn't spoil too much), I want you to think through all you know about the insurance world and let your mindscape expand to show a full picture by the end of the post. 

History Lesson (No punny satirical videos this time, sorry!) 

Insurance, in its most modern sense, can be traced to the past 120 years, but pieces of its principles can be found all throughout the pages of history. I won't bore you with too many details, but if curiosity strikes you, do take a gander here: 

http://wsrinsurance.com/how-insurance-began-3000-years-of-history/

The basic thought process of Insurance comes from the lack of true individuality. More or less, a problem you have is likely to also plague someone else, and some problems span the whole of society or even a huge part of it. And because the world runs on currency, most problems require funds to solve. If our society as a whole all have these issues that cost money (perhaps even more money than one individual can easily pay), then would it not make sense to pool funds to pay for those who are currently having that issue?

From this perspective, society can chip in equal amounts to begin and all of society is covered so long as the problems happen sporadically amongst them. Now, as in fairness, those who pull from the pool more often, end up needing to pay a bit more since they pull from it more than the average individual does. 

Does this make sense? I sure hope so!

Now, we talk about the modern issues that declare insurance to be unethical. AKA Profitability

Our country runs off of markets, businesses in the markets must remain solvent and be able to expand if necessary, so they get stuck between a rock and a hard place. They want to insure you based on the original principle, they have all this historical data to use, and they also have a market to fit into. They must charge high enough to keep the company going, but charge low enough that customers aren't deterred by the price and go find insurance elsewhere. This is where ethics come in. Some argue that any company that is meant to serve society but is influenced by the whims of capitalism and profitability cannot and will never be considered ethical.

One can also argue that we don't need insurance, we should just save and pay for our bills. BUT here's the problem with that logic. 

So insurance companies cannot be ethical if they're in the market. So they leave the market. Suddenly, you get injured, the hospital hits you with a bill for $10,000  plus another $4000 for the ambulance. Do any of you have 14,000 in savings to shell out for these bills? No? Okay, so you take out a loan to pay it, that works, but then there's interest and collections, oh look! Your credit score is now going down because of the loan.  This is an exaggeration, but not by much. 

You can't just get rid of one element of the market, but keep the others. Sure, you can argue that they're all greedy and take more than they should from the common citizen, and many would agree with you, but simply removing insurance from the market won't solve the issue. It's too ingrained.  

I mainly discuss this point to jab at a coworker, he didn't like this approach, but he also couldn't deny it either, so I think I win this round. 

Let's switch to the consumer side. 

Many of the issues I hear about people having has to do with the amount they are paying for their policies, or they argue the case of someone who is very sick and needs insurance but cannot pay the amount the company decides.  

Let's stop for a moment and ponder this: What are your own personal feelings regarding insurance and this scenario? 

Do you feel you pay too much? 

Do you think these issues would be different if we had a different type of economy?

Honestly, I sit in the middle ground between the consumer and the insurance world because of my studies, and even I find difficulty finding an easy solution to the disconnect between insurers and insurees. The business side makes it purely logical, numerical. If one is a greater risk, if they pull from the pool more than others, they should pay more. But from the consumer perspective, they might not have the funds to pay more hence why they have insurance in the first place. It is quite the dilemma, and I intend to further my own research on this topic because insurance as a whole has quite the grasp on our economy (cue 2008), and I want to know where the equilibrium is. 

Questions for Test:

How long has modern insurance been in practice?

Why is modern insurance considered unethical? 

Looking forward to the 7th!

Increasing Life Expectancy?

 "Since 1840, life expectancy at birth has risen about three months per year. Thus, every year a newborn lives three months longer than those born the previous year. Sweden, which keeps excellent demographic records, documents female life expectancy at 45 years of age in 1840 and 83 today. Experts even believe that with recent breakthroughs in science and medicine coupled with lifestyle changes, this number could reach far beyond 100 years. Tons of ethical and philosophical questions appear with that possibility.

What would longevity bring for the individual and for society? Does a longer life also go hand in hand with a physically and cognitively stable older age? Do we even want to live longer if we cannot keep our bodies fit for the task? And what about our societies? How would governments, institutions, communities and even our ideas about life itself cope with the changes?"

Betancourt v. Trinitas Hospital

Betancourt v. Trinitas Hospital is a New Jersey legal case concerning whether a hospital may unilaterally refuse care to a patient on the grounds that it is futile to prolong the person's life because there is little chance that the condition will improve. It has become the focal point of the ongoing debate surrounding denial of care among professional bioethicists. 

"Rueben Betancourt underwent surgery at defendant Trinitas Hospital to remove a malignant tumor. While Rueben was recovering in the post-operative intensive-care unit, the ventilation tube that was supplying him with oxygen became dislodged. As a result, he developed anoxic encephalopathy, a condition that left him in a persistent vegetative state. Ultimately, he required dialysis three times per week, was maintained on a ventilator, developed decubitus ulcers that had developed into osteomyelitis and was fed with a feeding tube. After various unsuccessful attempts to resolve the issue of continued treatment with Rueben’s family, defendant and various doctors, claiming that continued treatment would be futile and violated the standard of care, placed a Do Not Resuscitate (DNR) order in Rueben’s chart. In addition, defendant declined to provide further dialysis treatment.

Plaintiff Jacqueline Betancourt, Rueben’s daughter, filed an action to enjoin defendant from implementing such an order. After appointing plaintiff as Rueben’s guardian and following a hearing, Judge Malone, in the Chancery Division, restrained defendant from withholding treatment. This appeal followed, but within three months of the judge’s order requiring reinstatement of treatment, Rueben died. Plaintiff moved to dismiss the appeal as moot."

POLST (Physician Orders for Life Sustaining Treatment), now required by law in New Jersey, is a written medical form given by a physician, nurse practitioner or physician assistant that helps give people with serious illnesses more control over their illness and life by asking them for specific instructions to follow during certain medical emergencies. An example of this could be an ill patient stating that they do not wish to be resuscitated or they do not want to receive nutrients through way of tube.

I read that Mr. Betancourt's prolonging of life cost the hospital in total 1.6 million dollars. 

What are your thoughts? 

The value of philosophy

That was a crowded, exceptional, enlightening day.

Picked up the first of our two visiting faculty candidates at the airport, in from Portland ME, and proceeded to crawl the first half of the way to campus in what I honestly assured him was an atypically-congested commute on I-24. Honestly atypical, I mean, in that direction at that hour. I don't know how drivers coming into the city and out again tolerate that volume of traffic, morning after morning and night after night... (continues)

Case Study: Obey Law on Criminal Reporting for a Pregnant Mother Addicted to Heroin?

Case Description: 

You are the obstetrician of a 27-year old single woman referred to you late in her first trimester after positive pregnancy test. She admits to a history of heroin addiction, with several unsuccessful attempts “get off it” in community-based programs, as well as to current using. Although buying and using heroin is illegal, she has no criminal record. The heroin use poses developmental risks to the fetus as well as the risk of fetal addiction.

She claims she will “do anything now to help my baby.” She says she previously believed she was infertile and considers the pregnancy a gift from God. She insists that “all I want in life is to be a good Mom.”

You live in a state that defines drug abuse while pregnant as criminal child endangerment with mandatory reporting and mandatory treatment. As you interpret the law, your patient clearly falls under its purview. You know if you follow the law on mandated reporting, she will be prioritized for immediate access to an inpatient drug treatment program that provides medically-supported heroin withdrawal for mother and fetus. But she may also get a criminal record. Or she may be flagged to child protective services in advance of treatment, treatment outcome, or pregnancy outcome—increasing the risk that after birth her baby will be taken from her regardless of treatment outcome.

You believe she is strongly motivated to try to become drug-free for the sake of her fetus, and with proper medical and social support, could be successful without coercion.

What should you do?

See full discussion of case here

Can Moving the Body Heal the Mind?

Like Einstein said (and as I keep telling students who say they're anxious and that they don't exercise), keep moving...

Can Moving the Body Heal the Mind?

In her new book, Jennifer Heisz blends personal experience and the latest science about how exercise can improve your mental well-being.

When Jennifer Heisz was in graduate school, she borrowed a friend's aged, rusty road bike — and wound up redirecting her career. At the time, she was studying cognitive neuroscience but, dissatisfied with the direction of her work and her personal life, began experiencing what she now recognizes as "pretty severe anxiety," she told me recently. Her friend suggested biking as a reprieve. Not previously athletic, she took to the riding with enthusiasm, finding it "soothed my mind," she said.

That discovery convinced her to change the focus of her research. Now the director of the NeuroFit Lab at McMaster University in Hamilton, Ontario, she studies the interplay of physical and emotional health and how exercise helps stave off or treat depression, anxiety, stress and other mental health conditions.

"The effects of motion on the mind are just so pervasive and fascinating," said Dr. Heisz.

That idea animates her new book, "Move the Body, Heal the Mind," which details the latest science about exercise and mental health, as well as her own journey from inactivity and serial emotional slumps to triathlon training and increasing serenity... The Well

Questions MAR 31

Beyond 28-31; Lifelines 10-11

1. The greatest advances in health and longevity should go to what?

2. Why was BiDil removed from the market?

3. What broad consensus now obtains regarding health differences between and within groups?

4. Funding in 2014 was 50% greater for research areas including the word gene (etc.) than for those including the word _____.

5. Name an "unthinkable" medical experiment to which incarcerated individuals have been subjected.

6. Creating ethical standards for medical research is the flip-side of what "coin"?

7. Most viewers of The Constant Gardener would probably conclude what, mistakenly, about its fictional drug company?

8. Apart from being extraordinarily lucrative for the local doctors who procure test subjects in developing countries, what's another important reason why so much human research is conducted in Africa and other poor regions outside the U.S.?

9. Research in Nigeria for Pfizer was compromised by an apparently fraudulent claim involving a nonexistent what?

10. What two questions should be prerequisite to conducting research in the third world? What should precede human research anywhere in the world?

DQ

• Do you have a duty to be your best self? To whom?
• Is aging a "scourge worse that smallpox"? 265
• How can emergent biomedicine be suitably tailored to public (not just personal & profitable) health?
• COMMENT: "Health is determined by far more than health care." 269
• What forms of preventive medicine/health care do you think would have the greatest constructive impact on health in the U.S.?
• Is there any rationale for ever using human "guinea pigs" for research?
• Are adequate safeguards in place to prevent future research abuses targeting prison populations?
• What do you think of South Carolina's kidney proposal 278
• What's wrong with offering incentives to imprisoned women to donate their eggs?
• Have you read and/or seen The Constant Gardener? What's your review? (If you haven't, are you mad at Marcia Angell for her spoilers)?
• What do you think of CG's Hollywood ending (in the film)?

Lifelines

1. What were some of Senator Mikulski's memorable sayings?

2. What did Dr. Wen know she needed, but didn't think she had time for?

3. 3,500 babies with severe birth defects would cost the U.S. how much?

4. What are the typical metrics of public health, and what's problematic about them?

5. How many people suffer serious falls in the U.S. every year, with what consequences beyond serious physical injury?

6. What did Dr. Wen and her associates know about incremental progress?

DQ

• Why aren't men ever criticized for being "bossy"?
• How long will it take for our society to begin to accord female professionals the same show of respect males regularly receive?
• If you aspire to a career as a medical professional, do you worry about having enough time for reflection and personal wellness? How will you manage that?
• Have you had a strong mentor? Do you plan to be one? 
• How can public health acquire a "face"? 168
• Are you an incrementalist? (And what's another word for that? Starts with m...)

Ch 11 

1. What did the Eastern Center's staff do for the "Day of Service and Celebration"?

2. What training was the Baltimore city council the nation's first to mandate?

3. What Florida law did Dr. Wen see as an egregious intrusion into medical practice?

4. What was the premise of the "Safe Streets" program?

5. Why did Dr. Wen take issue with the "Defund the police" movement?

DQ

• Have you ever felt unappreciated for your service to an under-served community? Were you able to commiserate with the desperation of those who'd seemed unappreciative? 178
• "When you're a hammer, everything's a nail." How do we diversify our public health toolkit, so that not everything's a "hammer"?
• How do we break the generational cycle of violence and trauma?

UC Berkeley loses CRISPR gene editing patent case

UC Berkeley scientist Jennifer Doudna earned a Nobel Prize for her work on CRISPR-Cas9, a revolutionary method to edit DNA.

But her lab now has lost enormously lucrative patent rights to the tool.

Ending — for now — a long, vitriolic and expensive fight over commercial application of a pioneering tool that is transforming biological research, a board of the U.S. Patent and Trademark Office ruled on Monday that the patent for use of the genome-editing technology in humans belongs to the Broad Institute of Harvard and MIT, not UC Berkeley.

UC’s claims “are unpatentable,” according to the decision.

Article: link

As mentioned in our Beyond Bioethics reading, the University of California Berkeley's case for CRISPR has been halted.

The most striking portions of the paragraph to me are 

" The gene-editing tool gives scientists near godlike power, allowing them to rewrite the code of life by moving genes from one living creature to another. Doctors are now testing it as a cure for genetic disorders such as sickle cell disease, cancer and hereditary blindness."

The articles continues with

"Monday’s ruling throws a monkey wrench into the business model of several up-and-coming biotech companies, such as Caribou Biosciences of Berkeley and Boston’s Intellia Therapeutics and CRISPR Therapeutics, which aim to create treatments using CRISPR"

and ends with

"The litigation has been extremely expensive for both UC and Broad. Some experts have long urged the two universities to agree to a truce and share through what’s known as a cross-license agreement, the CRISPR spoils.

“Given the time to commercialization for medical therapies,” said Greely, “the eventual patent-owners seem, to me, unlikely to make profits nearly worth what they’ve spent in litigation.”"

This article raises questions on who has the rights to the sequenced information.

Who, if anyone, should have the rights to CRISPR? 

Would a free market allow monetary compensation to the appropriate geneticists?

Women Are Calling Out ‘Medical Gaslighting’

Studies show female patients and people of color are more likely to have their symptoms dismissed by medical providers. Experts say: Keep asking questions.

...Research suggests that diagnostic errors occur in up to one out of every seven encounters between a doctor and patient, and that most of these mistakes are driven by the physician's lack of knowledge. Women are more likely to be misdiagnosed than men in a variety of situations.

Patients who have felt that their symptoms were inappropriately dismissed as minor or primarily psychological by doctors are using the term "medical gaslighting" to describe their experiences and sharing their stories on sites like Instagram. The term derives from a play called "Gaslight" about a husband's attempt to drive his wife insane. And many patients, particularly women and people of color, describe the search for accurate diagnosis and treatment as maddening.

"We know that women, and especially women of color, are often diagnosed and treated differently by doctors than men are, even when they have the same health conditions," said Karen Lutfey Spencer, a researcher who studies medical decision-making at the University of Colorado, Denver.

Studies have shown that compared with men, women face longer waits to be diagnosed with cancer and heart disease, are treated less aggressively for traumatic brain injury, and are less likely to be offered pain medications. People of color often receive poorer quality care, too; and doctors are more likely to describe Black patients as uncooperative or non-compliant, which research suggests can affect treatment quality... nyt

What Was Liberal Education?

From our upcoming Lyceum speaker Richard Eldridge:

"IN OUR CURRENT historical moment, STEM disciplines, with their experimental-mathematical methods and measurable results, are central in educational practices, and humanistic education is in decline. At my own elite liberal arts college, Swarthmore, only 15 percent of the students now major in the Humanities or the Arts, and 75 percent major in Computer Science, Engineering, Biology, Economics, or Political Science. To some extent, this is natural. After all, in a difficult world like ours, why should anything as vague and unmeasurable as cultivation be taken seriously? Why should one learn Greek or art history or music composition, unless one just happens to enjoy such things? And why should the public or parents pay for these private enjoyments that seemingly lack significant public effect and value for the conduct of life?Yet education is a historically evolved and evolving ensemble of practices, and it is also possible to wonder whether we might have lost our collective way. Do we really know what we're doing in turning so strikingly toward STEM and away from the humanities? And are there good reasons for this turn?" (continues)

Infectious Omicron BA.2 now dominant in U.S., with coronavirus spring rise likely

The highly infectious BA.2 Omicron subvariant is now the dominant version of the coronavirus circulating in the United States, according to federal estimates, a development that is triggering fresh concerns of a potential springtime wave.
How big that potential upswing might prove to be remains the subject of much debate. Some officials and experts believe California is well-armored against another significant surge — largely because the vast majority of residents have either been vaccinated or likely have some natural immunity left over from a recent infection.
But BA.2 has fueled substantial increases in other countries, demonstrating how readily the super-contagious subvariant can still spread.
"We will have a wave. The only question is how big it will be," tweeted Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla…

https://www.latimes.com/california/story/2022-03-29/spring-omicron-ba-2-wave-is-likely-but-how-big-will-it-be

A Plan to Reduce Mammal Use in Drug Development

 "Mount Desert Island Biological Laboratory, a non-profit research institute in Maine, is funding a new initiative to increase the use of non-mammalian models in early drug development. The initiative, dubbed MDI Bioscience, aims to turn to species like zebrafish (Danio rerio), C. elegans, axolotls (Ambystoma mexicanum), and African turquoise killifish (Nothobranchius furzeri) to evaluate potential therapeutic compounds at scale before they’re tested in mammals or enter human clinical trials, potentially hastening and honing the decision-making process in early drug discovery and reducing the reliance on mammals such as mice. MDI Bioscience hopes to evaluate drugs before money is spent on costly mammal research, to speed the drug development process, and reduce the number of mammals, and animals in general, used in scientific research. Jim Strickland, the director of MDI Bioscience, says that these goals are aligned the general research practice to reduce, replace, and refine (three R’s) animals in research. The three R’s seek to address the potential ethical issues involved in animal research, which become heightened in higher order animals like rodents and primates."

Thoughts? 

Also- if you need a mood boost, please google axolotls. I promise you will not be disappointed. 

 

Wanted to give you all (and myself) some Monday inspiration. I also think that this quote is relevant to some of the issues we have been discussing. In many cases, like climate change and public health infrastructure, there is a sense that we should have made major changes years ago. Of course, doing this would have helped us be further along than we are now. However, it is important to not get stuck in a "it's too late to fix it" mentality. I suppose I am also a melliorist (though I didn't know that term before this class) because I believe that we can improve many of the problems that face us. But we have to actively work toward it. So, whether it's a paper you're procrastinating on or a world issue you want to tackle, the first step is to start.  

Image Credit

Questions MAR 29

Beyond 23-27, Lifelines 8-9 

Time to select final report topics, presentations to follow same order as midterm reports. Try to relate your topic to the texts we're reading now, even if you're expanding on your midterm presentation theme. 

Remember, the accompanying final blog post is due April 29 but you can post earlier drafts if you want potentially-helpful constructive feedback. I'll send author invitations out soon, to those who need them.

1. In this touted Age of Genomics, what frequently follows the hopeful hype about gene therapy?

2. Steve Jones says we know what of genetics?

3. What was Francis Collins' prediction in 2000? In 2014?

4. What's the best way to engineer a tall person, and what does that tell us about the effects of "Many Assorted Genes..."?

5. "Anonymous" tissue samples can be what?

6. What is Jessica Cussins' practical objection to the results of DTC genetic tests?

7. What more than doubled in illustration of the "Angelina Jolie effect"?

8. There aren't enough what to support population-wide screening for the BRCA genes?

9. The UC-Berkeley DNA project was intended to introduce students to what?

10. How should leading geneticists have responded to loose talk in the early '90s (and still) about "the gay gene," "the violence gene," etc.?

DQ

• Who's responsible for over-hyping the promise of gene therapy?
• Why is the history of genomics so full of unfulfilled promise?
• If short people are discriminated against, is the solution to engineer tall people? Or to oppose discrimination more aggressively?
• Do you agree that we should divert billions from genomic research to behavioral modification? 249
• Why do patients who support genomic research nonetheless "want to be informed..."? 251
• Is there any reason in principle why 23andMe's algorithm could not be corrected to detect and distinguish gene mutations that are and are not life-threatening? 253
• Is there anything ethically wrong with women electing for prophylactic mastectomies?
• Do the risks of universal screening for the BRCA genes outweigh the benefits? 
• If there were enough genetic counselors to support population-wide screening, would you support it?
• Should patients be informed of mutations that are not found to correlate with increased cancer risk? 257
• Is it in fact "common knowledge" that there isn't a gene for homosexuality, etc.?

Lifelines
1. What was Leana's simple question? How did nurses and social workers respond?

2. What's Leana's motto? What was an example (besides waiting for the "high-tech dashboard") of its violation?

3. What was Leana's "singular dream"?

4. Which hospitals make the most progress?

5. What did the new mayor say about patients seeking treatment for addiction?

6. What luxury can those of the front lines of public health not afford?

7. What three things was Leana unwilling to do?

8. What does Leana see as the cause(s) of drug addiction?

9. What did health clinics (like libraries, schools, and senior centers) represent to a community under siege?

10. What's a PIO?

11. What is public health's moral imperative?

12. Leana's philosphy is what?

DQ

• Do you agree with the policy of making naloxone readily available to drug abusers, educating them about the dangers of drug abuse, asking that they not use drugs alone, etc.? 128
• Aren't "work-arounds" like getting people in the field to share emergency information promptly just common sense? Why must common-sense solutions so often be improvised in an administrative system, rather than integrated with its structure?
• Is it a good idea to collaborate and engage with the private sector, to promote public health? 129
• Is it a mistake to launch programs like "Bad Batch" without evidence that they work? Is failure a "necessary part of progress" in the deployment of such programs? 130
• Would you have confronted the new mayor or tried to work with and educate her as Leana did?
• What do you think accounts for the change of attitude regarding drug treatment, between 2014 and 2018?141
• Why is public health "often overlooked" in a crisis? 144
• 
  

Health news... Weekly health quiz... WHQ 3/8... WHQ 3/3...  Treating Alzheimer's... Her son died. And then anti-vaxers attacked her

 Madeleine Albright published this opinion piece a month before her death.  What a remarkable woman?  Towering intellect and amazing leadership abilities.  She made history and then helped other women make history.  She immigrated with her family to the United States in 1948 from Czechoslovakia. Her father, diplomat Josef Korbel, settled the family in Denver, Colorado, and she became a U.S. citizen in 1957. I loved her broach diplomacy...

Putin Is Making a Historic Mistake 

Feb. 23, 2022

Putin's Moves on Ukraine Will Be a Historic Mistake - The New York Times

 

A Comic's View on the Topic:  

American Healthcare Is Racist

The Amber Ruffin Show     March 18, 2022

Healthcare is Racist

 

PILL FOR MEN Male contraceptive pill ‘99% effective in preventing pregnancy’ – with human trials set for later this year

 A PILL for men could be closer — offering hope of new birth control options.

A non-hormonal drug was 99 per cent effective in preventing pregnancy in lab tests on mice.

Human trials may start by the end of the year, with the possibility of coming to market in five years or less.

Most such drugs undergoing trials target the male sex hormone testosterone. But this has shown side effects of obesity and depression.

Lead author Abdullah Al Noman, of Minnesota University, US, said: “We wanted to develop a non-hormonal contraceptive to avoid these side-effects.”

It targets a gene that produces retinoic acid, a form of vitamin A that fuels sperm development.

Lab experiments have shown that mice without this gene are sterile.

The researchers created a chemical that blocked the gene, and when given to mice, it significantly reduced sperm counts.

After four weeks, it was able to prevent pregnancy in mice.

But promisingly, the mice were able to conceive six weeks after being taken off the drug.

No clear side effects were found. However, mice cannot report side effects like headaches or mood changes.

At present, there are only two forms of contraception for men — condoms and vasectomies.

Condoms can only be used once and are not guaranteed to prevent impregnation.

Vasectomies are a form of surgical sterilisation that is expensive to reverse and is not always successful.

It has left the women with the responsibility, for the most part, to use birth control methods such as the Pill, the coil, and the implant.

The female pill also carries side effects, including blood-clotting risks.

But since women face becoming pregnant without contraception, the risk calculation differs.

Other scientific teams globally have been working towards a male contraceptive, incuding in the form of pills, injections and gels that are rubbed into the skin.

Even though I posted the full article here is the link

Is this the future for contraceptives? 

Would this be a step away from a patriarchal society?