At the moment, it would appear the bacteria are winning. Antibiotic resistance is on the rise globally (in part because much of the public may not really understand how antibiotics work), threatening doctors’ ability to treat bacterial infections and potentially making surgery, chemotherapy and other medical procedures whose safety depends on antibiotic prophylaxis more risky.
Mapping antibiotic resistance — which bacteria are resistant to which drugs, and where — can help clinicians and public health officials decide how best to focus their control efforts. The challenge to date has been compiling resistance data in geographically useful ways.
“The data about antibiotic resistance are fragmented across laboratories and hospitals globally,” says Derek MacFadden, MD, a doctoral student at the Harvard T.H. Chan School of Public Health who is working with the HealthMap team in Boston Children’s Computational Health Informatics Program. “Most of the data that are available are very high level, so you can’t get an understanding of regional-level antibiotic resistance.”
This is where ResistanceOpen could come in handy. This new tool, launched by HealthMap team this week during the World Health Organization’s World Antibiotic Awareness Week, provides a window into regional and local antibiotic resistance patterns across the globe.
We’ve all heard the George Santayana quote, “Those who cannot remember the past are condemned to repeat it.” But there’s another way of thinking about the lessons that the past holds for the future: Those who do remember the past can recapture and harness earlier feelings of energy, urgency and possibility to overcome new problems, now and in the future.
In taking the audience on a tour through the last 60 years of advances in cancer biology, genomics and treatment, Mukherjee highlighted the central role pediatrics played as the starting point for the cancer successes we see today. How, he asked, did children come to play such a central role? What can we learn from the successes in the 1950s and ’60s, when pediatric cancer started to evolve from a death sentence to a treatable, even curable disease?
And how, he asked, can we recapture and harness the energy and urgency of that time today?
With SCNT, researchers take an egg cell and replace its nucleus with that of an adult cell (such as a skin cell) from another individual. The donated nucleus basically reboots an embryonic state, creating a clone of the original cell.
It’s a hot topic in both agriculture and regenerative medicine. SCNT-generated cells can be used to clone an animal (remember Dolly the sheep?) or produce embryonic stem (ES) cell lines for research. But it’s an inefficient process, producing very few animal clones or ES lines for the effort and material it takes.
Zhang’s team reported last year that they could boost SCNT’s efficiency significantly by removing an epigenetic roadblock that kept embryonic genes in the donated nucleus from activating in cloned cells. Now, in a new paper in Cell Stem Cell, Zhang and his collaborators report that they’ve extended their work to improve the efficiency of SCNT in human cells.
Part of the problem may be that, until now, the right tools haven’t been available to exploit GWAS data. But a few recent studies—including two out of Dana-Farber/Boston Children’s Cancer and Blood Disorders Center—have used GWAS data to identify therapeutically promising targets, and then manipulated those targets using the growing arsenal of gene editing methods.
“The main problems with measuring patient experience by survey are the small numbers of people who respond to surveys and the lag time,” says Jared Hawkins, MMSc, PhD, of Boston Children’s Hospital’s Computational Health Informatics Program (CHIP). “It can take up to two years before survey data are released to the public. Given that social media data are close to real time, we wanted to see if we could capture this discussion and if the content is useful.”
Hawkins, with Boston Children’s chief innovation officer, John Brownstein, PhD, and their colleagues collected more than 400,000 public tweets directed at the Twitter handles of nearly 2,400 U.S. hospitals between 2012 and 2013. Using machine learning, natural language processing and manual curation, they tagged 34,735 patient experience tweets directed at 1,726 hospital-owned Twitter accounts.
“It’s all about the patients,” says Katherine Janeway, MD, when asked about the motivations behind her efforts to bring precision medicine to pediatric oncology. But it’s more than that; the drive to combine science and care is in her blood. A solid tumor specialist and cancer genomics researcher at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Janeway is the sixth generation of her family to choose a scientific or medical path—not just as a career, but also as a form of service.
Although treatments for childhood cancer patients are improving, cancer remains the leading cause of death by disease in children. Doctors and researchers are also focused on decreasing the toxicity of these treatments, which can have side effects years after a child finishes treatment.
“What you can do in an environment where you have chemists, biologists, and clinicians adjacent and working collaboratively is very powerful,” says Stegmaier. “That’s why I’m here today—we need to cure 100 percent of kids, and we can’t do this alone.”
“Emir is the star of the trial,” Sung-Yun Pai, MD—a Dana-Farber/Boston Children’s gene therapy and immunodeficiency transplant specialist and lead (along with David Williams, MD, and Luigi Notarangelo, MD) of the U.S. arm of the trial—tells our sister blog, Thriving. “He has the highest platelet count of all of the children who have gone through gene therapy with this vector so far. His immune function is excellent, and we have no worries whatsoever from a bleeding standpoint. He’s perfectly safe to play like a normal child.”
Boston Children’s Hospital’s new chief innovation officer, John Brownstein, PhD, is an epidemiologist by training and a founding father of the growing field of digital epidemiology—the use of digital (especially social and mobile) data from a variety of sources to detect and track disease and promote health. As co-founder of HealthMap and director of the Computational Epidemiology Group in the hospital’s Computational Health Informatics Program, he infuses his work into many aspects of his life—along with a healthy helping of hot sauce.
Hover over the icons in the photo below to learn about the things in Brownstein’s phone, office and life that keep him going.